Importance of proinflammatory cytokines in synovial fluid from 121 joints with temporomandibular disorders

The concentrations of cytokines were measured by an ELISA in the synovial fluid from 117 patients with temporomandibular disorders (TMD) and correlated with degenerative changes of the condyle and clinical symptoms.Fifty-seven patients had degenerative changes of the condyle. The fluid from seven healthy volunteers was used as controls. The concentrations of interleukin-1beta (IL-1beta), tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and interleukin-8 (IL-8) were significantly higher in the synovial fluid of patients than controls (P<0.05). The concentration of IL-6 was significantly higher in the patients with degenerative changes than in other patients (P<0.05). The detection of IL-8 correlated with the concentrations of IL-6 and TNF-alpha. However, there was no correlation between the concentrations of any cytokines and symptoms. In conclusion, the cytokines in the synovial fluid may participate in the pathogenesis of TMD. In particular, IL-6 is important and may be associated with the development of osteoarthritis.

Expression and localization of the cysteinyl leukotriene 1 receptor in human nasal mucosa

BACKGROUND

The cysteinyl leukotrienes (CysLT) are lipid mediators that have been implicated in the pathogenesis of allergic diseases. Pharmacological studies using CysLTs indicate that two classes of receptors, named CysLT1 and CysLT2 receptor, exist. The former is sensitive to the CysLT1 antagonist currently used to treat asthma and allergic rhinitis. Recently, the cDNA for human CysLT1 and CysLT2 receptor have been cloned, making it now possible to study the gene expression of CysLTs receptors.

OBJECTIVE

We have used reverse transcription and polymerase chain reaction (RT-PCR) to study the gene expression of CysLT1 and CysLT2 receptor and in situ hybridization to determine the distribution of CysLT1 receptor mRNA in human nasal mucosa. In addition, the distribution of the CysLT1 receptor protein was studied by immunohistochemistry.

METHODS

Human turbinates were obtained after turbinectomy from six patients with nasal obstruction refractory to medical therapy. Total RNA was isolated from human nasal mucosa and both CysLT1 and CysLT2 receptor mRNA was detected in these tissues by using RT-PCR. For in situ hybridization study of human nasal mucosa, we used biotin-labelled oligonucleotides probes encoding human CysLT1 receptor cDNA. To identify the cells expressing the CysLT1 receptor protein, double immunostaining was performed by using anti-CysLT1 receptor antibody and monoclonal antileucocyte antibodies.

RESULTS

RT-PCR analysis of total nasal RNA demonstrated the expression of both CysLT1 receptor and CysLT2 receptor mRNA. In situ hybridization indicated high levels of CysLT1 receptor hybridization in blood vessels and the interstitial cells, but a sparse signal in airway epithelium and submucosal glands. The immunohistochemical studies revealed that anti-CysLT1 receptor antibody labelled eosinophils, mast cells, macrophages, neutrophils and vascular endothelial cells in the nasal mucosa.

CONCLUSION

The results may have an important clinical implication and also promote further investigation of the regulation of CysLT1 receptor in health and disease.

Discrepancies in dietary intakes and plasma concentrations of fatty acids according to age among Japanese female dietitians

OBJECTIVE

To clarify the influences of age on dietary intakes and plasma concentrations of fatty acids (FAs) in Japanese female dietitians.

SUBJECTS AND METHODS

In autumn 1996, we estimated dietary FA intakes based on 7 day weighed diet records and analyzed plasma FA concentrations in 79 healthy Japanese female dietitians, and investigated their relationships with age, dividing into three age groups (young (32-42 y), middle-aged (43-50 y) and elderly (51-66 y)).

RESULTS

Dietary intakes of total FA, saturated FAs, monounsaturated FAs, n-3 polyunsaturated FAs (PUFAs) and alpha-linolenic acid (18:3n-3) were significantly highest in the middle-aged group, and lowest in the elderly. Similar trends were observed for dietary intakes of n-6 PUFAs and linoleic acid (18:2n-6), but there were no differences with regard to eicosapentaenoic acid (EPA; 20:5n-3), docosahexaenoic acid (DHA; 22:6n-3) and n-3 highly unsaturated FAs (HUFAs=EPA+22:5n-3+DHA). On the other hand, plasma concentrations of all FAs except for arachidonic acid (20:4n-6) demonstrated positive correlations with age. Moreover, plasma concentrations of EPA in all age groups, DHA in the elderly and n-3 HUFAs in the middle-aged and the elderly were all positively correlated with dietary intakes.

CONCLUSIONS

We should take into account the influence of age on dietary habit and lipid metabolism when interpreting associations between dietary FA intakes and plasma FA concentrations.

Gouty tophus of the patella evaluated by PET imaging

We report a case of gouty tophus of the patella, a rare lesion, which was evaluated using positron emission tomography (PET). This modality, which uses a combination of an amino-acid analog emitter, L-[3-(18)F]-alpha-methyl tyrosine (FMT), which neglects malignancies, and a glucose analog emitter, (18)F-fluoro-2-deoxy-D-glucose (FDG), which neglects benign lesions, simulating the radiographic findings, may be useful for the preoperative evaluation of gouty tophus occurring in patella partita, including detection, differentiation from malignant tumors, and possible pathogenetic diagnosis.

Importance of the changes in joint effusion shown by magnetic resonance imaging before and after arthroscopic lysis and lavage of the temporomandibular joint

We investigated the changes in the amount of joint effusion estimated from T2-weighted magnetic resonance imaging (MRI) before and after arthroscopic lysis and lavage of the temporomandibular joint (TMJ). We studied 29 consecutive patients, each with internal derangement and osteoarthritis in one TMJ. Before operation, the MRI showed joint effusions in 22 of the patients (76%). After operation, the amount of the effusion decreased in 16 and increased in 2 patients. Effusions developed postoperatively in four of the seven patients who had no effusion before operation. In four of the six patients in whom the effusion increased, the symptoms had almost resolved by the time the MRI was taken. There was no significant correlation between changes in the amount of joint effusion and the clinical condition of the patients before and after the operation. In conclusion, changes in the amount of joint effusion in the TMJ are not related to the patient's clinical condition.

B2 receptor-mediated enhanced bradykinin sensitivity of rat cutaneous C-fiber nociceptors during persistent inflammation

Bradykinin (BK), which has potent algesic and sensitizing effect on nociceptors, is of current interest in understanding the mechanisms of chronic pain. BK response is mediated by B2 receptor in normal conditions; however, findings that B1 receptor blockade alleviated hyperalgesia in inflammation have been highlighting the role of B1 receptor in pathological conditions. It has not yet been clear whether nociceptor activities are modified by B1 receptor agonists or antagonists during inflammation. In addition, previous studies reported the change in BK sensitivity of nociceptors during short-lasting inflammation, and data in persistent inflammation are lacking. Therefore we investigated whether an experimentally induced persistent inflammatory state modulates the BK sensitivity of nociceptors and which receptor subtype plays a more important role in this condition. Complete Freund's adjuvant was injected into the rat-tail and after 2-3 wk, persistent inflammation developed, which was prominent in the ankle joint. Using an in vitro skin-saphenous nerve preparation, single-fiber recordings were made from mechano-heat sensitive C-fiber nociceptors innervating rat hairy hindpaw skin, and their responses were compared with those obtained from C-fibers tested similarly in normal animals. BK at 10(-8) M excited none of the 10 C-fibers in normal animals while it excited 5 of 11 (45%) C-fibers of inflamed animals, and at 10(-6) M BK excited all of the 11 inflamed C-fibers (or 94% of 36 tested C-fibers) but only 4 of 10 (or 45% of 58 tested C-fibers) in normal animals. Thus the concentration-response curves based on the incidence of BK induced excitation, and the total number of impulses evoked in response to BK were significantly shifted to the left. Moreover, an increased percentage of the inflamed C-fibers responded to 10(-6) M BK with bursting or high-frequency discharges. Thirty-percent of inflamed C-fibers had spontaneous activity, and these fibers showed comparatively less tachyphylaxis to consecutive second and third 10(-6) M BK stimulation. A B2 receptor antagonist (D-Arg-[Hyp3, Thi5,8,D-phe7]-BK) completely eliminated BK responses in inflamed rats, while B1 receptor antagonists (B 9958 and Des-Arg9-[Leu8]-BK) had no effect. Selective B1 receptor agonist (Des-Arg10-Kallidin) excited 46% (n = 13) of inflamed C-fibers at 10(-5) M concentration, which is 1,000 times higher than that of BK needed to excite the same percentage of inflamed C-fibers. We conclude that in chronically inflamed tissue, sensitivity of C-fiber nociceptors to BK, which is B2 receptor mediated, is strongly increased and that B1 receptor may not be important to a persistent inflammatory state, at least at the primary afferent level.

Sevoflurane and nitrous oxide anaesthesia suppresses heart rate variabilities during deliberate hypotension

BACKGROUND AND OBJECTIVE

Despite the fact that both general anaesthetics and hypotensive drugs influence autonomic nervous activity, no study has yet examined the heart rate variability during deliberate hypotension and general anaesthesia. The aim of this was to clarify the heart rate variability changes during deliberate hypotension under sevoflurane-nitrous oxide anaesthesia.

METHODS

Autonomic nervous system activity in patients (n=45) subjected to deliberate hypotension during sevoflurane in nitrous oxide and oxygen anaesthesia was investigated by a heart rate variability measurement. Three different types of hypotensive drugs, a calcium channel antagonist (nicardipine), a nitric oxide donor (nitroglycerin) and a vasodilatory prostaglandin (alprostadil), were used to induce hypotension.

RESULTS

In all groups, low frequency power (sympathetic and parasympathetic indicator) and the ratio of low frequency to high frequency power (the LF/HF ratio, sympathetic indicator) were suppressed by induction of anaesthesia. In the control group, preanaesthesia low frequency power was 195 +/- 139 ms(2), the LF/HF ratio 10.3 +/- 5.7, during anaesthesia 5 +/- 9 ms(2), 0.6 +/- 0.8, respectively, P=0.0093, 0.0034, whereas high frequency power (parasympathetic indicator) was not significantly changed. In those patients receiving nicardipine or nitroglycerin during anaesthesia, these variables did not differ significantly from those in the control group. During prostaglandin E1 infusion, high frequency power was higher compared with the values in the other groups (17 +/- 12 ms(2) in the prostaglandin group, 7 +/- 6 ms(2) in the nicardipine group, 6 +/- 5 ms(2) in the nitroglycerin group and 6 +/- 4 ms(2) in the control group, respectively, P=0.0326, 0.0251, 0.0197).

CONCLUSIONS

Sevoflurane in nitrous oxide and oxygen anaesthesia reduces sympathetic autonomic activity considerably, and the expected increases caused by hypotensive agents that occur in awake volunteers were not seen.

[The problem of post-marketing surveillance planning on drugs for infectious disease]

In principle, a new drug is approved via the assessments of safety and efficacy by the Ministry of Health, Labor and Welfare (MHLW). After approval, conduct of post-marketing surveillance is requested by law in order to assess the safety and efficacy of the drug in a large number of patients. Before initiating a surveillance, submission to MHLW of a document on the plan of survey is necessary in the purpose of inspection if it includes any ethical or regulatory problem or not. Through the inspections of the plans submitted during the period of April 1998 and March 2000, many problems have been pointed out. In this report, the author introduces some of the concrete problems noted in the plans on drugs for infectious diseases and shows some of the guidance made by the authority how to improve them. It is expected that such practical analyses of cases may be useful for future planning of post-marketing surveillance on drugs for infectious diseases.

Effects of minor surgery and endotracheal intubation on postoperative breathing patterns in patients anaesthetized with isoflurane or sevoflurane

We studied the effects of minor surgery and endotracheal intubation on postoperative breathing patterns. We measured breathing patterns and laryngeal resistance during the periods immediately before intubation (preoperative) and immediately after extubation following minor surgery (postoperative) in eight patients anaesthetized with sevoflurane and eight patients anaesthetized with isoflurane, breathing spontaneously through a laryngeal mask airway at a constant end-tidal anaesthetic concentration (1.0 MAC). In both sevoflurane-anaesthetized and isoflurane-anaesthetized patients, expiratory time was reduced and inspiratory and expiratory laryngeal resistance increased after surgery. In sevoflurane-anaesthetized patients, occlusion pressure (P0.1) increased without changes in inspiratory time (T(I)). Occlusion pressure did not change and T(I) was greater in isoflurane-anaesthetized patients after surgery. Minor surgery may have a small but significant influence on breathing and increased laryngeal resistance following endotracheal intubation may modulate these changes. The difference in breathing pattern between sevoflurane and isoflurane may be a result of different responses of the central nervous system to different anaesthetics in the presence of increased laryngeal resistance.

Modification by exercise training of activity and enzyme expression of hepatic branched-chain alpha-ketoacid dehydrogenase complex in streptozotocin-induced diabetic rats

The branched-chain alpha-ketoacid dehydrogenase (BCKDH) complex is the rate-limiting enzyme in the catabolism of branched-chain amino acids. In the present study, we examined the effects of exercise training on the activity and enzyme expression of the hepatic BCKDH complex in diabetic rats. The rats were prepared by intravenous injections of streptozotocin (50 mg/kg BW), and exercise training was accomplished by treadmill running for 45 min/d for 4 wk. The total and actual activities of hepatic BCKDH complex were significantly increased to approximately 160% by 4 wk of diabetes. On the other hand, diabetic rats in the trained group had the same level of activities as those in the normal rats, indicating that exercise training inhibited the diabetes-induced increase in the enzyme activities. The activity state (% active form) of the enzyme complex was about 100% in all groups and was not affected by diabetes or training. The protein amounts of the enzyme subunits (E1alpha and E2) and the abundance of mRNA for the E2 subunit, but not for the other subunits, in the liver had the same trend as the activities. These results suggest that the capacity for branched-chain amino acid catabolism in streptozotocin-induced diabetic rats is reduced by exercise training and that this modification is associated with the suppression of diabetes-induced BCKDH complex expression in the liver.

Does joint effusion on T2 magnetic resonance images reflect synovitis? Comparison of arthroscopic findings in internal derangements of the temporomandibular joint

OBJECTIVE

The purpose of this study was to clarify the characteristics of joint effusion (JE) in the temporomandibular joint by comparing T2-weighted magnetic resonance (MR) images with arthroscopic findings.

STUDY DESIGN

MR images of 47 symptomatic temporomandibular joints (47 patients) with internal derangement associated with painful hypomobility were taken to evaluate the degree of JE on a scale of 0 to 3. Within 2 months after MR images, arthroscopic findings with respect to the severity of synovitis, adhesion, and degenerative change in the superior compartment were each quantitatively assessed on a scale of 0 to 10. The arthroscopic scores were compared among the 4 JE grades, as well as between 2 groups, effusion-present (grades 2 and 3) and effusion-absent (grades 0 and 1), by using the Spearman correlation coefficient and the Mann-Whitney U test.

RESULTS

The distribution of JE was as follows: 10 joints had grade 0, 5 joints had grade 1, 19 joints had grade 2, and 13 joints had grade 3. The synovitis score had a significant relationship to the degree of effusion (P =.0012) and was higher in the effusion-present group (6.4 +/- 2.0) than in the effusion-absent group (4.2 +/- 1.6) (P =.0005) On the other hand, there was no statistically significant correlation between either adhesion or degenerative change and effusion.

CONCLUSIONS

JE may reflect synovitis; however, the nature of JE itself needs to be further elucidated by additional studies.

Relative validity of a semi-quantitative food frequency questionnaire versus 28 day weighed diet records in Japanese female dietitians

OBJECTIVE

To assess the relative validity of a semi-quantitative food frequency questionnaire (SQFFQ) against 28 day weighed diet records (WDRs).

SUBJECTS AND METHODS

The SQFFQ was administered to 106 (21 male and 85 female) Japanese dietitians in Aichi Prefecture in autumn, 1996 and four-season consecutive 7 day WDRs were carried out during 1996-1997. We evaluated validity of intakes of 15 foods and 31 macro- and micro-nutrients based on the SQFFQ against those according to 28 day WDRs among 79 Japanese female dietitians.

RESULTS

Mean daily intakes of selected foods and nutrients determined by the SQFFQ were generally equivalent to those measured by 28 day WDRs. Pearson's de-attenuated correlation coefficients (CCs) with log-transformation and energy-adjustment between intakes of selected foods and nutrients quantified by the SQFFQ and 28 day WDRs (minimum-median-maximum) ranged from 0.17 (beverages)-0.52 to 0.74 (rice), and Spearman's rank CCs with energy-adjustment ranged from 0.28 (confectionery)-0.42 to 0.68 (rice). Respective Pearson's CCs for intakes of nutrients were 0.28 (PUFAs)-0.51 to 0.73 (magnesium), and Spearman's rank CCs ranged from 0.23 (n-3 PUFAs)-0.45 to 0.71 (magnesium). Favorably higher agreement for intakes of foods/nutrients was achieved along with lower disagreement.

CONCLUSIONS

Satisfactorily higher relative validity was attained in Japanese female dietitians with the SQFFQ. This calibrated questionnaire seems therefore appropriate for administration to Japanese dietitians to clarify associations between diet and health/disease.

SPONSORSHIP

A grant-in-aid from the Ministry of Education, Science, Sports and Culture (06454242).

Comparison of the effects of three sulfonylureas on in vivo insulin action

To clarify the diversity in hypoglycemic actions of sulfonylureas, chronic effects of three sulfonylureas were compared on in vivo insulin-induced glucose uptake in peripheral tissues. After oral administration of glimepiride (CAS 93479-97-1), glibenclamide (CAS 10238-21-8), gliclazide (CAS 21187-98-4), or saline as control, two-step euglycemic clamp procedures were performed. During physiological hyperinsulinemia induced by 6 mU/kg/min insulin infusion, metabolic clearance rates (MCR) of glucose of the glimepiride-administered group (GP) significantly (p < 0.01) increased to 153% of the saline-administered group (SA). There was no significant statistical difference between the glibenclamide-administered group (GC), gliclazide-administered group (GZ) and SA. During 30 mU/kg/min clamps that lead to maximal insulin action, MCR of either GP or GC were significantly higher than those of SA (128% and 141%, p < 0.05 and p < 0.01, respectively). MCR of GZ were lower than those of GC (80%, p < 0.05), and showed no significant difference from those of SA. These data indicate that glimepiride activates insulin binding levels to a greater degree than the other two sulfonylureas, and that glibenclamide and glimepiride activate post-receptor binding mechanisms in peripheral tissues much more than gliclazide. These results suggest that hypoglycemic actions of sulfonylureas at the extra pancreatic levels vary with the nature of each reagent.

Parasympathetic schwannoma of the submandibular gland

Schwannomas of the submandibular gland have only been documented sporadically throughout the medical literature. We describe a case of schwannoma of the submandibular gland originating from the submandibular branch of the lingual nerve, which carries the preganglionic parasympathetic nerve fibers. The clinical aspect of this tumor is discussed, followed by a brief literature review.

Differences in the dynamic cerebrovascular response between stepwise up tilt and down tilt in humans

We studied dynamic cerebrovascular responses in eight healthy humans during repetitive stepwise upward tilt (SUT) and stepwise downward tilt (SDT) maneuvers between supine and 70 degrees standing at intervals of 60 s. Mean cerebral blood flow velocity (FV(MCA)) was measured at the middle cerebral artery (MCA) with transcranial Doppler ultrasonography. Mean arterial blood pressure (ABP) was measured via the radial artery and adjusted at the level of the MCA (ABP(MCA)). Cerebral critical closing pressure (P(CC)) was estimated from the systolic-diastolic relationship between FV(MCA) and ABP(MCA). ABP(MCA) minus P(CC) was considered the cerebral perfusion pressure (CPP). The tilt maneuvers produced stepwise changes in both CPP and FV(MCA). The FV(MCA) response to SUT was well characterized by a linear second-order model. However, that to SDT presented a biphasic behavior that was described significantly better (P < 0.05) by the addition of a slowly responding component to the second-order model. This difference may reflect both different cardiovascular responses to SUT or SDT and different cerebrovascular autoregulatory behaviors in response to decreases or increases in CPP.

Effect of dexamethasone palmitate-low density lipoprotein complex on cholesterol ester accumulation in aorta of atherogenic model mice

In order to confirm the efficacy of dexamethasone palmitate (DP)-low density lipoprotein (LDL) complex on experimental atherosclerosis in vivo, we examined whether DP-LDL complex could be effective for cholesterol ester accumulation in the aorta of atherogenic mice. Nonatherogenic and atherogenic mice were fed with normal and atherogenic diet for 14 weeks, respectively. Dexamethasone (DEX), lipid emulsion containing DP (DP-LE), or DP-LDL complex was intravenously injected once a week from 8 to 14 weeks. Cholesterol levels in serum and aorta in the atherogenic mice were significantly higher than those of nonatherogenic mice. Injection of DP-LDL complex significantly reduced cholesterol ester (CE) accumulation in the aorta of atherogenic mice. The reduction of CE accumulation in aorta treated with DP-LDL complexes was 10 and 100 times more potent than that with DP-LE and DEX, respectively. The radioactivity in the aorta of atherogenic mice treated with 3H-DP-LDL complex was significantly higher than that with 3H-DP-LE and 3H-DEX at 24 h after injection. Even 7 d after injection, a significant amount of radioactivity was present only in the aorta of atherogenic mice treated with DP-LDL complex. This result suggests that DP-LDL complex is selectively delivered to the atherogenic lesions in the aorta of atherogenic mice, and then DP released from the complex inhibits CE accumulation in the aortic intima. Therefore, DP-LDL complex may be a good drug-carrier in drug delivery system for atherosclerosis.

Scintigraphic evaluation of pamidronate and corticosteroid therapy in a patient with progressive diaphyseal dysplasia (Camurati-Engelmann disease)

A 27-year-old woman with progressive diaphyseal dysplasia (Camurati-Engelmann disease) received pamidronate and corticosteroid therapy for bone pain. During therapy, disease activity was assessed serially using bone scintigraphy with Tc-99m HMDP. With pamidronate administration, the bone pain became worse and diaphyseal uptake of Tc-99m HMDP increased, whereas corticosteroid administration improved the bone pain and reduced the diaphyseal uptake. In this case, pamidronate and corticosteroid produced different effects. Bone scintigraphy allowed an objective assessment of the response to these treatments, accurately reflecting clinical symptoms.

The combination of a fiberoptic stylet and a McCoy laryngoscope facilitates tracheal intubation in difficult airway cases

PURPOSE

Fiberoptic stylets are considered useful for difficult airway management. In the present study, we assessed the usefulness of a fiberoptic stylet when the stylet was used with a Macintosh or a McCoy laryngoscope.

METHODS

Twenty-four patients, whose airways were graded as Cormack grade III, were studied. We compared the times required for tracheal intubation when the fiberoptic stylet was used with a Macintosh direct laryngoscope and when it was used with a McCoy laryngoscope. Cormack grade III was subdivided into IIIa (with distance between the epiglottis and the posterior wall of the pharynx) and IIIb (with no distance between the epiglottis and the posterior wall of the pharynx), according to the view of the vocal cords by the laryngoscope.

RESULTS

The intubation time in grade IIIb patients, who were intubated by the concurrent use of the fiberoptic stylet and the McCoy laryngoscope (28 +/- 4 s), was not significantly different from that in grade IIIa patients (28 +/- 10 s). The intubation time in grade IIIb patients, who were intubated by the concurrent use of the fiberoptic stylet and the Macintosh laryngoscope (52 +/- 8 s), was significantly longer than that in grades IIIa (28 +/- 10 s; P < 0.01) or IIIb with the McCoy laryngoscope (28 +/- 4 s; P < 0.01).

CONCLUSION

The combination of a new handy fiberoptic stylet and a McCoy laryngoscope facilitated tracheal intubation of patients whose airway had no distance between the epiglottis and the posterior wall of the pharynx in laryngoscopic vocal cord view.

Gene transfer of manganese superoxide dismutase reverses vascular dysfunction in the absence but not in the presence of atherosclerotic plaque

Impaired endothelium-dependent vasorelaxation (EDVR) is observed in hypercholesterolemia both in the presence and absence of morphological abnormalities and may be due to superoxide anions. Our aim was to assess the effect of gene transfer of manganese superoxide dismutase (MnSOD) to blood vessels from hypercholesterolemic animals with and without atherosclerotic plaque and to compare the effects of endothelial nitric oxide synthase (eNOS) and MnSOD over-expression on vascular dysfunction in the setting of atherosclerosis. Rabbits received a high-cholesterol diet for 10 weeks, resulting in abnormal EDVR in the absence of plaque in the carotids and the presence of plaque in the aorta. In Group 1, adenoviral vectors encoding MnSOD (AdMnSOD) or beta-galactosidase (Ad(beta)gal) were delivered to the carotid arteries in vivo. Four days later, transgene expression and vascular reactivity were assessed. In Group 2, segments of the aorta were transduced ex vivo with AdMnSOD, AdeNOS or both. Transgene expression and vascular reactivity were assessed 24 hr later. In Group 1, MnSOD expression was detected in AdMnSOD-ransduced vessels and impaired EDVR was reversed in the absence of atherosclerotic plaque. In Group 2 (with atherosclerotic plaque present), MnSOD and eNOS expression were detected by western analysis, and eNOS, but not MnSOD over-expression, improved EDVR whereas simultaneous over-expression of eNOS and MnSOD was no better than eNOS alone. Adenovirus-mediated gene transfer of MnSOD to nonatherosclerotic carotid arteries, but not atherosclerotic aorta, normalizes EDVR. eNOS gene transfer improves EDVR, even in the presence of plaque.

Comparison of cardiac sympathetic nervous function with left ventricular function and perfusion in cardiomyopathies by (123)I-MIBG SPECT and (99m)Tc-tetrofosmin electrocardiographically gated SPECT

The objective of this study was to clarify the relationship between cardiac sympathetic nervous function (CSNF) and left ventricular (LV) function and perfusion in hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM).

METHODS

Thirty-eight cases (32 males, 6 females; mean age, 56 +/- 15 y), consisting of 5 healthy control subjects, 15 patients with DCM, and 18 patients with HCM, were studied with (123)I-metaiodobenzylguanidine (MIBG) and (99m)Tc-tetrofosmin SPECT. CSNF was evaluated from cardiac uptake and washout of MIBG, whereas LV perfusion and function were evaluated from tetrofosmin uptake and wall thickening on electrocardiographically gated SPECT. As quantitative parameters of global cardiac MIBG uptake and washout, the heart-to-mediastinum ratio (H/M) and percentage washout were calculated from early and delayed planar images. As quantitative regional parameters, the regional uptake and percentage washout of MIBG were calculated from SPECT images dividing the left ventricle into 12 segments. In the tetrofosmin study, the H/M and LV ejection fraction were calculated as the parameters of global LV perfusion and function. As quantitative regional parameters, the regional uptake and wall thickening were also calculated for the 12 myocardial segments using the quantitative gated SPECT software. Multiple linear regression analysis was performed to investigate the correlations between the parameters from the 2 studies.

RESULTS

In DCM and HCM, multiple linear regression analysis of the regional parameters showed significant correlations between LV function and CSNF (P < 0.0001) and between LV perfusion and CSNF (P < 0.0001). According to the partial correlation coefficients, washout and early uptake of MIBG were the most significant factors for predicting LV function and LV perfusion, respectively.

CONCLUSION

In cardiomyopathies, CSNF was closely related to LV function. The quantitative parameters of MIBG washout could reflect cardiac functional impairment. Early MIBG uptake might be determined by myocardial perfusion in cardiomyopathies.

Histopathological and immunohistological analyses in IgA deficient lymphoplasia (aly/aly) mouse

The aly/aly mouse has a severe immunodeficiency, because it lacks peripheral lymph nodes as well as IgA and IgG immunoglobulin synthesis. In the present study, we performed histopathological and immunohistological examinations to clarify histological disorders of various immune organs in these mice. Carbon CH40 injections into the apex of the tongue confirmed the absence of submandibular lymph nodes in aly/aly mice. The thymus had a poorly constructed cortex and medulla, and the number of lymphoid follicles was clearly decreased in the spleen. No IgG- or IgA- producing cells were found in any immune organs, including the mucosal immune sites, though several IgM -producing cells were identified. Other characteristic findings included perivascular lymphocytes accumulation in the salivary glands, lungs, liver and pancreas, which caused tissues damage. These results demonstrated that the various lymphoid tissues disorders and organ-specific lymphocyte infiltration cause immuno-deficiency in the aly/aly mouse.

Gene transfer of superoxide dismutase isoforms reverses endothelial dysfunction in diabetic rabbit aorta

Increased production of oxygen free radicals is an important mechanism of endothelial dysfunction in diabetes mellitus. Our goal was to test whether adenovirus (Ad)-mediated gene transfer of copper/zinc (CuZn) or manganese superoxide dismutase (Mn SOD) improves relaxation of diabetic vessels. The aortas from 9 alloxan-induced diabetic mellitus (DM) and 16 control rabbits were used. Control and DM rings were transduced ex vivo with Ad vectors encoding Mn SOD (AdMn SOD), CuZn SOD (AdCuZn SOD), β-galactosidase (Adβgal), or diluents. In the absence of gene transfer, SOD activity was significantly increased in DM aortas. Transgene expression in DM AdCuZn SOD and DM AdMn SOD-transduced vessels was confirmed by Western blot analysis and by increased SOD activity (DM AdCuZn SOD, 76.2 ± 9.3; DM AdMn SOD, 65.2 ± 4.8; P < 0.05 vs. DM Adβgal; 50.9 ± 4.4 U/mg protein). Superoxide production was increased in DM Adβgal-transduced aorta and relaxations to acetylcholine were impaired in these vessels. Gene transfer of CuZn SOD and Mn SOD corrected both of these defects. Thus Ad-mediated gene transfer CuZn and Mn SOD to the diabetic aorta improves endothelium-dependent relaxation.

Accuracy of histologic grading of synovial inflammation in temporomandibular joints with internal derangement using Gynther's system

PURPOSE

The purpose of this study was to evaluate the accuracy of the system by Gynther et al (J Oral Maxillofac Surg 56:1281, 1998) for histologic grading of synovial inflammation in the temporomandibular joint (TMJ) in arthroscopically obtained synovial biopsy specimens.

PATIENT AND METHODS

Thirty-three human TMJ synovial biopsy specimens from patients with internal derangement of the TMJ were evaluated using the system of Gynther et al. The results were compared statistically with the intensity of synovitis seen arthroscopically using Spearman ranked correlation coefficient.

RESULTS

In 2 of the 3 parameters tested, a statistically significant correlation was found between the histologic findings by the system of Gynther et al and arthroscopic findings using the scale of Murakami et al (J Oral Maxillofac Surg 49:1159, 1991)

CONCLUSION

These results suggest that histologic grading of synovial inflammation by the system of Gynther et al has considerable accuracy. However, more investigations are necessary to confirm the results.

[A recurrent case of idiopathic interstitial pneumonia histologically diagnosed as nonspecific interstitial pneumonia group 1]

A 59-year-old man was admitted to our hospital because of dyspnea. Chest radiography showed infiltration and consolidation in both lung fields. He was clinically diagnosed as having idiopathic interstitial pneumonia (IIP), and histological examination of a thoracoscopic lung biopsy specimen showed nonspecific interstitial pneumonia (NSIP) group 1. Corticosteroid therapy had previously been effective, but about 1 year later the disease recurred. The patient's clinical condition was very similar to the first episode, and is improving in response to the same treatment again. Although it is generally accepted that patients with IIP diagnosed histologically as NSIP have a good prognosis, it should be remembered that recurrence is possible, even in patients with group 1.

Hydrogen peroxide-forming NADH oxidase belonging to the peroxiredoxin oxidoreductase family: existence and physiological role in bacteria

Amphibacillus xylanus and Sporolactobacillus inulinus NADH oxidases belonging to the peroxiredoxin oxidoreductase family show extremely high peroxide reductase activity for hydrogen peroxide and alkyl hydroperoxides in the presence of the small disulfide redox protein, AhpC (peroxiredoxin). In order to investigate the distribution of this enzyme system in bacteria, 15 bacterial strains were selected from typical aerobic, facultatively anaerobic, and anaerobic bacteria. AhpC-linked alkyl hydroperoxide reductase activities were detected in most of the tested strains, and especially high activities were shown in six bacterial species that grow well under aerobic conditions, including aerobic bacteria (Alcaligenes faecalis and Bacillus licheniformis) and facultatively anaerobic bacteria (Amphibacillus xylanus, Sporolactobacillus inulinus, Escherichia coli, and Salmonella enterica serovar Typhimurium). In the absence of AhpC, the purified enzymes from A. xylanus and S. inulinus catalyze the NADH-linked reduction of oxygen to hydrogen peroxide. Similar activities were observed in the cell extracts from each of these six strains. The cell extract of B. licheniformis revealed the highest AhpC-linked alkyl hydroperoxide reductase activity in the four strains, with V(max) values for hydrogen peroxide and alkyl hydroperoxides being similar to those for the enzymes from A. xylanus and S. inulinus. Southern blot analysis of the three strains probed with the A. xylanus peroxiredoxin reductase gene revealed single strong bands, which are presumably derived from the individual peroxiredoxin reductase genes. Single bands were also revealed in other strains which show high AhpC-linked reductase activities, suggesting that the NADH oxidases belonging to the peroxiredoxin oxidoreductase family are widely distributed and possibly play an important role both in the peroxide-scavenging systems and in an effective regeneration system for NAD in aerobically growing bacteria.

Migratory patterns of thoracic duct lymphocytes into bronchus-associated lymphoid tissue of immunized rats

Lymphocytes continuously circulate between the bloodstream and lymphoid organs, and their migration into lymphatic tissues presumably occurs through selective mechanisms. Although bronchus-associated lymphoid tissue (BALT) is known as an inductive tissue of the common mucosal immune system, little is known about how effectively the lymphocytes in the blood vessels migrate into the BALT, thereby enabling the BALT to act as an effector tissue in the immunologic responses of the lungs. To analyze whether or not thoracic duct lymphocytes (TDL) from immunized and nonimmunized rats possess different migratory patterns to the BALT, 5-(6)-carboxyfluorescein diacetate succinimidyl ester (CFSE)-labeled TDL were injected into rats with BALT hyperplasia that was produced by intratracheal administration of TNP-KLH, and then the number of labeled cells in the BALT were examined by immunohistochemical methods. We studied the following three groups at 12 h after the injection: group A, intraintestinally immunized donors and intratracheally immunized recipients; group B, nonimmunized donors and intratracheally immunized recipients; group C (control group), nonimmunized donors and nonimmunized recipients. Time course studies 0.5, 4, 12, and 24 h after the injection were done in groups A and C. In a cytokinetic study, larger numbers of CFSE-labeled lymphocytes were found at 12 h and 24 h in group A than in group C. At 12 h after the injection, the absolute number of CFSE-labeled lymphocytes per BALT was significantly higher in group A than in group B (p < 0.05), and was lowest in group C. Histologically, there was a marked proliferation of high endothelial venules (HEV), with findings of adhesion and influx of lymphocytes inside the HEV in group A. These observations indicate that the immunized BALT actively recruits immunized TDL through a specific mechanism of lymphocyte-endothelium recognition in HEV, which partially explains the process of BALT development as an effector tissue for local immunity.

Effects of lifestyle factors on ultrasonographically determined bone health in Japanese women

The objective of this study was to determine by ultrasonographic measurements, an inexpensive and radiation-free technique, the association between bone health and lifestyle factors among a large population of Japanese women. Two hundred and fifty-six pre-menopausal women and 585 post-menopausal women who underwent a voluntary medical check-up for osteoporosis in 1996-1997 were analyzed. There were significant positive correlations between the bone density (designated as the stiffness value) vs the weight, the height and the body mass index of the subjects only in the post-menopausal group. Negative correlations were also found between the bone density vs the age and the years since menopause. Our data using ultrasonographic technique agree well with previous studies using other devices. In both groups, subjects with current or past exercise habits had higher stiffness values. Dietary habits had no effects on the stiffness value. Smoking habits had a trend towards negative effects and alcohol consumption seemed to have a trend towards positive effects on the stiffness value in post-menopausal women, but these effects did not reach statistical significance. Positive effects of current exercise on bone density were maintained after adjustment for past exercise habits. These results support the effectiveness of exercise begun in adulthood. Having a good exercise habit is one of the most effective ways of maintaining good bone health.

Differences between the Lewis and Sprague-Dawley rats in chronic inflammation induced norepinephrine sensitivity of cutaneous C-fiber nociceptors

We investigated whether there are any differences between the Lewis and Sprague-Dawley (SD) rats in chronic inflammation-induced norepinephrine (NE) sensitivity of nociceptors. Activities of C-fiber nociceptors innervating rat hairy hindpaw skin were recorded in an in vitro skin-nerve preparation. Sixty-five percent of C-fibers from inflamed Lewis rats were excited by NE (10 microM), against only 38% of C-fibers from inflamed SD rats. The average of the total impulses evoked in response to NE was also significantly higher in Lewis rats. The alpha2-adrenoceptor antagonist CH 38083 (10 microM) and yohimbine (10 microM) consistently blocked the NE-excitation of both strains. These results show that after chronic inflammation, C-fiber nociceptors of Lewis strain rats have a stronger sensitivity to NE, and that alpha2-adrenoceptors are predominately involved in the NE-sensitivity of inflamed rats in both strains.

Effects of lowering barometric pressure on guarding behavior, heart rate and blood pressure in a rat model of neuropathic pain

We investigated whether lowering barometric pressure by 20 mmHg (LP) aggravates the guarding behavior suggestive of spontaneous pain following sciatic nerve chronic constriction injury (CCI) in rats. Systemic blood pressure (BP) and heart rate (HR) of unrestrained rats were recorded telemetrically during LP both before and after the CCI surgery. CCI rats showed guarding posture in normopressure conditions, and LP increased the cumulative time of this behavior. Baseline BP but not HR was increased following CCI. LP increased BP and HR of the rats only before the CCI surgery. Animals after CCI surgery showed variable (BP, HR) and transient (HR) responses to LP. These results indicate that (1) LP aggravated spontaneous pain and increased BP and HR in the CCI rats, and (2) CCI surgery influenced BP and HR of rats.

Methods for averaging irregular respiratory flow profiles in awake humans

Respiratory flow profiles have been of interest as an output of the respiratory controller. In determining average flow profiles, however, previous methods that align individual breaths in the time domain are susceptible to distortions caused by the great variability, both between breaths and within breaths. We aimed to develop a method for determining typical flow profiles that circumvents such distortions. Our method aligns different breaths by phase of respiratory cycle, which is defined as the angle associated with the point on the normalized flow-volume diagram (a phase-plane plot). Over a number of breaths, median values for flow, volume, and elapsed time from the start of the breath at each phase angle are determined. Because these estimates are mutually semi-independent and in general violate the laws of mass balance, an adjustment was performed such that the volume was precisely the time integral of the flow. The method produced typical flow profiles with characteristics that were significantly closer to the mean values obtained from the individual cycles than those obtained by the technique of Benchetrit and co-workers (Benchetrit G, Shea SA, Dinh TP, Bodocco S, Baconnier P, and Guz A, Respir Physiol 75: 199-210, 1989), which reconstructs the typical flow profile from Fourier coefficients.

Pituitary chromophobe carcinoma with a low level of serum gonadotropin and an aspermatogenesis in a dog

A 5-year-old male Shiba dog with progressive neurologic signs was examined by computed tomography (CT). A CT image of the brain disclosed a large, spherical high-density lesion in the thalamus and diencephalon. Serum LH, FSH and testosterone levels were all low. Macroscopically the large mass was connected with the sella turcia, and it was histopathologically diagnosed as a pituitary chromophobe carcinoma. An aspermatogenesis was observed in the testes. Therefore, it was suggested that the low levels of gonadotropin secretion from the pituitary gland due to the pituitary tumor resulted in the failure of maturation of spermatozoa and spermatids.

Risk of colorectal cancer in patients with hematologic disease

BACKGROUND AND AIMS

A relatively large number of patients with multiple myeloma have been reported to develop a secondary malignancy such as cancer of the breast, biliary system or bowel.

METHODS

A retrospective study was perfomed in 734 patients with hematologic disease diagnosed at Nippon Medical School Hospital between May 1984 and September 1994 to determine the incidence of colorectal cancer in these patients based on a history review, colonoscopic findings, and surgical or autopsy data.

RESULTS

Of the 734 patients, 14 (1.9%) had colorectal cancer; two of 11 patients (18.2%) had pure red cell aplasia; two of 25 patients (8%) had multiple myeloma; and three of 46 patients (6.5%) had aplastic anemia. Patients with pure red cell aplasia, multiple myeloma or aplastic anemia had colorectal cancer at a significantly higher rate compared to those with leukemia (P< 0.005, P< 0.02, P< 0.01, respectively).

CONCLUSIONS

It is possible that a relatively large number of patients with pure red cell aplasia, multiple myeloma or aplastic anemia will develop a colorectal cancer.

Activation of intestinal mucosal immunity in tumor-bearing mice by lactoferrin

We have previously demonstrated that oral administration of bovine lactoferrin (bLF) markedly increases CD4(+) and CD8(+) T cells and NK (asialoGM1(+) ) cells in the blood of tumor-bearing mice and enhances anti-metastatic activity. In this paper, we document that oral administration of bLF and bLF-hydrolysate (bLFH) is associated with strong increases in CD4(+) and CD8(+) T, as well as asialoGM1(+) cells in lymphoid tissues and lamina propria of the small intestine in mice, especially in tumor-bearing animals in which Co26Lu cells were implanted subcutaneously. Moreover, IgM(+) and IgA(+) B cells in lamina propria of the small intestine were also significantly increased by bLF and bLFH. Bovine apo-transferrin (bTF) did not exhibit such activity. In the colon, only CD8(+) cells were significantly increased by treatment with bLF, while asialoGM1(+) cells were significantly decreased. bLF and bLFH induced cytokines to activate T, B and asialoGM1(+) cells. Administration of bLF and bLFH, but not bTF, increased production of interleukin-18 (IL-18), interferon-gamma (IFN-gamma) and caspase-1 in the mucosa of the small intestine. Particularly high levels of IL-18 were found in the epithelial cells of the small intestine. Moreover, administration of bLF and bLFH, but not bTF, induced IFN-gamma presenting cells in the small intestine. Caspase-1, which processes proIL-18 to mature IL-18, was also induced in the epithelial cells of the small intestine following treatment with bLF and bLFH, but not with bTF. These results suggest that enhanced production of IL-18 and IFN-gamma and caspase-1 induction by treatment with bLF may be important for elevation of intestinal mucosal immunity.

Effects of anti-VLA-4 monoclonal antibody treatment in murine model of allergic rhinitis

In order to study the role of VLA-4 in allergic rhinitis, the effects of anti-mouse VLA-4 monoclonal antibody (mAb) were evaluated in a murine model. BALB/c mice were sensitized first by i.p. injections (general sensitization) and then by daily nasal dripping of antigen (local sensitization) before performing a nasal antigen challenge. The mAb was applied either before the antigen challenge (BC group), before the local sensitization (BL group) or before the general sensitization (BS group). The effects were evaluated in terms of antigen-induced early-phase nasal symptoms (sneezing), late-phase nasal eosinophilia and the serum level of antigen-specific IgE. Antigen-induced nasal eosinophilia was significantly (p = 0.009) reduced in the BL group but not in the BC group (number of eosinophils = 114 +/- 15.1, 244 +/- 52.8 and 347 +/- 50.5 in the BL, BC and control groups, respectively). The serum level of the specific IgE was also significantly (p = 0.038) reduced in the BL group but not in the BC group (optical density = 1.18 +/- 0.07, 1.28 +/- 0.13 and 1.58 +/- 0.14 in the BL, BC and control groups, respectively). The suppressive effect on sneezing was not significant in either the BL or BC groups. In the BS group, suppressive effects on antigen-induced nasal responses and the specific IgE level were not statistically significant. These findings suggest that VLA-4 plays an important role in the topical booster or priming effects during repeated nasal antigen exposures in pre-sensitized animals.

Starvation increases the amount of pyruvate dehydrogenase kinase in several mammalian tissues

Covalent modification of the pyruvate dehydrogenase complex provides an important regulatory mechanism for controlling the disposal of glucose and other compounds metabolized to pyruvate. Regulation of the complex by this mechanism is achieved in part by tissue-specific expression of the genes encoding isoenzymes of pyruvate dehydrogenase kinase (PDK). Starvation is known from our previous work to increase PDK activity of heart and skeletal muscle by increasing the amount of PDK isoenzyme 4 (PDK4) present in these tissues. This study demonstrates that increased expression of both PDK4 and PDK2 occurs in rat liver, kidney, and lactating mammary gland in response to starvation. PDK4 and PDK2 message levels were also increased by starvation in the two tissues examined (liver and kidney), suggesting enhancement of gene transcription. Changes in PDK2 message and protein were of similar magnitude, but changes in PDK4 message were greater than those in PDK4 protein, suggesting regulation at the level of translation. In contrast to these tissues, starvation had little or no effect on PDK2 and PDK4 protein in brain, white adipose tissue, and brown adipose tissue. Nevertheless, PDK4 message levels were significantly increased in brain and white adipose tissue by starvation. The findings of this study indicate that increased expression of PDK isoenzymes is an important mechanism for bringing about inactivation of the pyruvate dehydrogenase complex during starvation in many but not all tissues of the body. The absence of this mechanism preserves the capacity of neuronal tissue to utilize glucose for energy during starvation.

eNOS gene transfer to vascular smooth muscle cells inhibits cell proliferation via upregulation of p27 and p21 and not apoptosis

OBJECTIVE

Smooth muscle cell (SMC) proliferation is a critical component of vascular diseases such as atherosclerosis and restenosis. Nitric oxide (NO) donors and gene transfer of endothelial nitric oxide synthase (eNOS) have been shown to inhibit SMC proliferation. NO may cause this effect by delaying cell cycle progression and/or induction of apoptosis. The aim of the current study was to examine the mechanism of eNOS-mediated inhibition of SMC proliferation. In addition, the effect of eNOS expression in vascular SMCs on the expression of the cyclin dependent kinase inhibitors, p27 and p21 was examined.

METHODS

SMCs were transduced with an adenoviral vector encoding eNOS (AdeNOS) or beta-galactosidase (Ad beta Gal) at a multiplicity of infection of 100. Non-transduced cells served as additional controls. Transgene expression was sought by NADPH diaphorase staining, immunohistochemistry and Western Blotting. Functionality of the recombinant protein was assessed by measurement of cGMP. Cell cycle analysis was performed by flow cytometry and p27 and p21 expression were studied by western blot analysis. Apoptosis was sought by Annexin V staining and DNA laddering.

RESULTS

eNOS expression was detected in transduced SMCs. cGMP levels were increased in eNOS-transduced compared to control cells. Expression of eNOS in SMCs resulted in a delay in cell cycle progression and upregulation of p27 and p21. There was no increase in apoptosis detected in eNOS transduced cells after 24 or 72 h.

CONCLUSION

eNOS gene transfer to vascular SMCs inhibits cell proliferation via upregulation of p27 and p21 resulting in a delay in cell cycle progression.

Effects of lowering ambient temperature on pain-related behaviors in a rat model of neuropathic pain

To clarify the mechanism by which changes in chronic pain are induced by cold environments, rats rendered neuropathic by a chronic constriction injury (CCI) to the sciatic nerve were exposed to low ambient temperature (LT; 7 degrees C decrease from 22 degrees C) in a climate-controlled room. LT exposure aggravated pain-related behaviors in CCI rats, i.e., decreased the threshold to von Frey hair and paw pressure stimulation, prolonged the duration of foot withdrawal to pinprick stimulation, and increased the cumulative duration of guarding posture. Lumbar sympathectomy (SYX) did not inhibit LT-induced augmentations of pain-related behaviors in CCI rats. LT exposure decreased the skin temperatures of both hind paws to the same degree in the sham-operated control and SYX rats, while in the CCI and SYX+CCI rats it caused a larger temperature decrease in the injured paw than in the uninjured one. These results indicate that LT exposure augments abnormalities in pain-related behaviors of neuropathic rats, and also suggest that sympathetic nervous activity is not a predominant factor in the augmenting mechanism.

Water content and thickness of the stratum corneum contribute to skin surface morphology

Skin surface morphology has long been recognized as reflecting skin pathology. In the present study, we evaluated skin surface morphology using hairless mice under contrasting conditions of humidity. The skin surface microrelief was recorded with opaque quick-drying silicone rubber, and examined under a microscope. A binary image was produced by density slicing. Within 3 days of exposure to dry conditions, skin roughness was significantly increased. The skin roughness was partially mitigated by topical application of an aqueous solution of glycerol or hydration by immersion in water. A significant correlation between skin roughness and stratum corneum thickness was also observed. These results suggest that skin surface morphology is associated with both water content and thickness of the stratum corneum.

Acute changes in bladder volume produce minimal cardio-respiratory responses in lightly anesthetised humans

PURPOSE

To examine whether changes in bladder volume elicit reflex cardiovascular and respiratory responses in humans under general anesthesia with sevoflurane and nitrous oxide.

METHODS

Fourteen patients free of autonomic disorders were anesthetized with sevoflurane 0.5% and nitrous oxide 60% in oxygen that were approximately equivalent to 0.9 MAC. Warmed saline (6 ml x kg(-1), 37 degrees C) was instilled into the pre-emptied urinary bladder, and then the bladder was kept distended for five minutes. Following the distension, the instilled saline was drained to the pre-instilled volume of the bladder Arterial blood pressure, respiratory flow, and intra-vesicle pressure were continuously measured, and mean arterial pressure, pulse rate, respiratory rate, tidal volume, and minute ventilation were estimated offline from these signals.

RESULTS

Bladder emptying produced small decreases in mean blood pressure (from 83.4+/-4.3 to 80.0+/-4.4 mm Hg, mean +/- SE, P = 0.017) and pulse rate (from 72.2+/-2.9 to 69.4+/-2.7 bpm, mean +/- SEM, P = 0.004). Only minimal respiratory reflexes were invoked by the bladder volume changes.

CONCLUSION

In lightly anesthetized humans, the acute changes in bladder volume produce only mild cardiovascular and respiratory responses.

Increased numbers of dendritic cells in the bronchiolar tissues of diffuse panbronchiolitis

Dendritic cells (DCs) are potent antigen-presenting cells (APCs); they are considered to be the most important APC in the lung. Recently, the number of DCs in the large airways was demonstrated to increase in patients with atopic asthma, leading to the concept that DCs play an important role in airway inflammation. However, little is known about the distribution of lung DCs in the small airways under other pathological conditions. The aim of the present study was to examine the distribution of DCs in the bronchiolar tissues in patients with diffuse panbronchiolitis (DPB), which is a chronic inflammatory disorder of the airways histologically characterized by peribronchiolitis. We investigated the distribution of DCs in the bronchiolar tissues of the lungs in 11 patients with DPB and 7 control subjects with normal lungs using immunohistochemical methods. Marked increases in the number of CD1a(+), CD1c(+), and CD83(+) DCs were found in both the bronchiolar epithelium and submucosal tissues of patients with DPB, compared with control subjects with normal lungs. The most striking increase occurred in the number of DCs expressing CD83, a marker of mature DCs, in the submucosal tissues of patients with DPB. The increases of these positive cells in patients with DPB were more marked in the submucosal tissues than in the epithelium. The bronchiolar epithelial cells in patients with DPB strongly expressed GM-CSF protein, which is an important cytokine for the differentiation and function of DCs, suggesting that the increased local production of GM-CSF may be responsible for the accumulation and differentiation of DCs in the bronchiolar tissues of patients with DPB. These results suggest that increased DCs in the bronchiolar tissues, together with their phenotypical maturation, may play an important role in the mucosal immune response in patients with DPB through their potent antigen-presenting function.

Gastric stromal tumor with CD34 immunoreactivity--a case report

Gastric stromal tumors are the most common mesenchymal tumors, and such submucosal mass lesions of the upper gastrointestinal tract occur frequently. A 54-year-old woman with no major complaint was admitted to our hospital for evaluation of a mass located between the stomach and the pancreas. Abdominal ultrasonography, computed tomography and endoscopic ultrasonography demonstrated a mass lesion which was located near the lesser curvature of the stomach. Selective left gastric arterial angiography revealed a hypervascular mass, and we diagnosed it as a leiomyosarcoma of the stomach. At laparotomy, there was a large solid mass 5 cm in diameter along the minor curvature of the stomach. Tumor resection with partial gastrectomy was performed, and the histological diagnosis was a gastric stromal tumor with CD34 immunoreactivity. We report a case of stromal tumor of the stomach with extramural growth and review the literature.