New adsorption column (Lixelle) to eliminate beta2-microglobulin for direct hemoperfusion

The Lixelle column is an adsorbent column used to eliminate beta2-microglobulin (beta2M) selectively from circulating blood of dialysis related amyloidosis (DRA) patients, which is used in combination with a dialyzer in series. The column has such a high capacity for adsorbing beta2M that the most intensive removal of beta2M has been possible. In clinical trials of the column, the obvious improvement of subjective symptoms such as decreases in the frequency of nocturnal awakening, the joint pain severity index, and the joint mobility index were observed. Hypotension has been the most frequent adverse event observed during treatment since the column was put on the market. It is very important to clarify the causes of both the efficacy and the side effects. A controlled prospective study is now in progress to clarify the efficacy more scientifically. The results will be published soon elsewhere.

On the treatment of recurrent tonsillitis by vaccination

This paper reports on the experience of using vaccination in the treatment of recurrent tonsillitis. All of the 82 patients, who were aged between 5 and 67 years and who suffered from recurrent tonsillitis, were given an injection of a bacterial vaccine (Broncasma Berna, Swiss Serum Institute, Berne) that has been used in many countries for three decades. A dose of 0.05 ml was given once every 4 to 14 days (average once a week) on 3 to 20 occasions (average 8). The treatment prevented 75 of the 82 patients (91%) from having attacks of recurrent tonsillitis for extended periods. These 75 patients included three who relapsed into recurrent tonsillitis in spite of having tonsillectomies. As the dose used was relatively small, none of the patients complained of spontaneous pain or fever although three complained of slight tenderness at the injection point on the following day. The effect on recurrent tonsillitis of the Paspat intracutaneous injection (Luitpold Werk, Munich) has also been investigated recently. It was effective in two patients who did not respond to Broncasma Berna. In this retrospective study, low doses of bacterial vaccine reduced the incidence of recurrent tonsillitis and were well tolerated.

Developmentally regulated release of intraretinal neurotrophic factors in vitro

The effects of conditioned media either from aggregates or from explants of embryonic chick retinae and of recombinant neurotrophins were tested upon the survival in vitro of ganglion cells in dissociated cell cultures from the retina of newborn rats. Ganglion cells were identified by the detection of retrogradely transported horseradish peroxidase injected bilaterally into the superior colliculus. Conditioned media increased significantly the survival of ganglion cells after 2 days in culture, at a wide range of plating densities, and had no effect upon adhesion of rat retinal cells. Media conditioned by cell ensembles from chick retinae from embryonic day 8 (E8) to E16 had neurotrophic effects. Release of neurotrophic activity peaked at E10 E12, irrespective of the numbers of cells or total concentration of protein in the conditioned media. The active molecules were non-dialyzable and were released either in the presence or in the absence of fetal calf serum. The neurotrophic activity was abolished by trypsinization, and recovered by salting-out with 25 75% ammonium sulfate. NT-4, BDNF and, to a lesser extent, NT-3, increased the survival of ganglion cells in our assay, while NGF had no effect. The data show that chick retinal cells release soluble trophic proteins according to a developmentally regulated pattern. These neurotrophic factors may be involved in local competitive interactions that help control naturally occurring neuron death among ganglion cells of the vertebrate retina.

Death in a dish: controls of apoptosis within the developing retinal tissue

Studies of programmed cell death in the developing retina in vitro are currently reviewed. The results of inhibiting protein synthesis in retinal explants indicate two mechanisms of apoptosis. One mechanism depends on the synthesis of positive modulators ('killer proteins'), while a distinct, latent mechanism appears to be continuously blocked by negative modulators. Extracellular modulators of apoptosis include the neurotrophic factors NT-4 and BDNF, while glutamate may have either a positive or a negative modulatory action on apoptosis. Several protein kinases selectively modulate apoptosis in distinct retinal layers. Calcium and nitric oxide were also shown to affect apoptosis in the developing retinal tissue. The protein c-Jun was found associated with apoptosis in various circumstances, while p53 seems to be selectively expressed in some instances of apoptosis. The results indicate that the sensitivity of each retinal cell to apoptosis is controlled by multiple, interactive, cell type- and context-specific mechanisms. Apoptosis in the retina depends on a critical interplay of extracellular signals delivered through neurotrophic factors, neurotransmitters and neuromodulators, several signal transduction pathways, and the expression of a variety of genes.

Separation mechanism of pullulan solution-filled capillary electrophoresis of sodium dodecyl sulfate-proteins

The separation mechanism of capillary electrophoresis of sodium dodecyl sulfate (SDS)-proteins using pullulan with a molecular mass range of 50,000-100,000 as a separation matrix was investigated. The pullulan solution was filled into fused-silica capillaries whose inner walls were coated with linear polyacrylamide through chemically stable Si-C linkages. Baseline separations of SDS proteins were achieved at concentrations ranging from 3-10% w/v of pullulan. The entanglement threshold of pullulan solution was found to be around 0.5% w/v, indicating migration of SDS-proteins through an entangled pullulan network. Ferguson plots exhibited a linear relationship between log mobility and pullulan concentration. Linear relationships were also obtained for double logarithmic plots of the electrophoretic mobility and protein molecular mass. These results show that the separation is based on mass discrimination in accordance with the Ogston theory.

Mitochondrial respiratory impairment in streptozotocin-induced diabetic rat heart

The purpose of this study was to examine mitochondrial respiratory impairment in the diabetic heart. Diabetes mellitus was induced in male Wistar rats by intravenous injection of streptozotocin (STZ) for 2 to 16 weeks (Group D). In some of the diabetic rats, insulin was injected for 2 or 3 weeks prior to sacrifice (Group I). Fasting blood glucose was markedly elevated to greater than 300 mg/dl in Group D and was similar to normal glucose levels in Group I. At 2 weeks after STZ injection, state 3 was only 59.1% of that in the control. Complex I and complex V activities were also significantly reduced to 43.4% and 71.7% of those in the control, respectively. These reductions recovered with insulin treatment. This phenomenon persisted for 16 weeks. Morphological studies revealed swelling of the mitochondria and an increase in lipid droplets in diabetic cardiomyocytes, and these were also improved with insulin treatment. We conclude that in the diabetic heart, disturbance of energy production in cardiac mitochondria is generated by the impairment of oxidative phosphorylation due to depression of complex I and complex V. These changes may contribute the cardiac dysfunction that is a complication of diabetes mellitus.

S-methylmethionine sulfonium in fruits of citrus hybrids

The S-methylmethionine sulfonium (MMS) concentrations in fruits of citrus hybrids were measured, and found to increase during ripening of the fruit. However, there of eleven hybrids of 'Seto unshiu' crossed with 'Morita ponkan' and four of 9 hybrids of 'Murcott' tangor crossed with 'Seto unshiu' had low MMS concentrations even at late harvest stage. Crossbreeding is useful in producing new citrus fruits that have juices with the desirable characteristics of their parents without formation of dimethyl sulfide which is an off-flavor.

Cultural differences in attitudes, values, and beliefs about osteoporosis in first and second generation Japanese-American women

This study examines attitudinal differences related to osteoporosis between first and second generation Japanese-American women. In an interview, the women completed a battery of tests assessing their attitudes, values, and beliefs about the diagnosis, treatment, and follow-up care of osteoporosis. The groups differed in their general knowledge of osteoporosis, perceptions of the disease, attributions of its causes, anticipated and preferred support mechanisms for care, and anticipated areas of concern for self-or other-care. There were also considerable differences in treatment compliance and feelings toward physicians. The findings were discussed in relation to the effects of culture on health-care attitudes and behaviors.

Effect of temperature and viscosity of sieving medium on electrophoretic behavior of sodium dodecyl sulfate-proteins on capillary electrophoresis in presence of pullulan

Pullulan was used as a sieving medium in high-performance capillary gel electrophoresis to study the effect of temperature and viscosity on electrophoretic behavior of sodium dodecyl sulfate (SDS)-proteins with molecular masses in the range of 14,400-116,000 Da. The migration time decreased with increasing capillary temperature. Equations were derived relating mobility of SDS-proteins to capillary temperature and viscosity of pullulan solution. Linear relationships were obtained from experiments between logarithm of mobility and reciprocal temperature and between double logarithmic values of mobility and viscosity of pullulan solution. The experimental results agree well with the equations.

[The epidemiological determinant aspects in the maintenance of visceral leishmaniasis in the state of Maranhão, Brazil]

The authors analysed the visceral leishmaniasis (VL) aspects in the state of Maranhão, Brazil, from 1982 to 1993. The disease happens to occur predominantly in São Luís Island (MA) and during the epidemic period, town of São Luís was pointed out as the main endemic area. The greatest frequency of cases occurred in 1993, despite the use of insecticide and dogs control. There was predominance of age between 0- to 4-year-old population with 58.04% of cases. Neither the human disease nor the rainfall index had significant seasonal variation. However they were correlated moderately, with high number of cases after the period of great precipitation of rain. After this study, the data obtained will allow a better control of the disease, despite some factors such as: the urbanization, localization and dynamic of transmission in endemic areas in the Maranhão state.

Acute hemodynamic deterioration during rapid atrial pacing in patients with hypertrophic cardiomyopathy

BACKGROUND AND HYPOTHESIS

Supraventricular tachycardia and ventricular tachycardia are often observed in patients with hypertrophic cardiomyopathy (HCM) and they often alter the clinical features of HCM. We examine the influence of supraventricular tachycardia on cardiac function and assess the clinical characteristics of patients with HCM.

METHODS

We studied 32 patients with HCM and 8 normal volunteers using echocardiography under transesophageal rapid atrial pacing.

RESULTS

Presyncope-associated hypotension was observed during rapid atrial pacing in 8 HCM patients, but in none of the normal controls. During rapid atrial pacing (144 +/- 8 beats/min in HCM, 146 +/- 5 beats/min in controls), systolic blood pressure (SBP), the product of left ventricular filling volume (FV) and heart rate, and fractional shortening (%FS) in the HCM patients decreased significantly compared with the basal values (138 +/- 19 mmHg vs. 99 +/- 24 mmHg, 5.0 +/- 1.2 l/min vs. 2.9 +/- 0.9 l/min, 41.7 +/- 6.2% vs. 35.2 +/- 6.0%, respectively), but these decreases were not observed in normal controls. The decrement of SBP during rapid atrial pacing in HCM patients with a history of syncope was more marked than that in those without such history. The decrement correlated positively with the indices of left ventricular hypertrophy (maximal wall thickness and wall thickness index) and with %FS, and correlated negatively with the endsystolic left ventricular diameter at rest.

CONCLUSIONS

In some patients with HCM, supraventricular tachycardia causes marked hemodynamic deterioration that may be related to a history of syncope, marked hypertrophy, hyperkinesis, small cavity size, and small filling volume of the left ventricle.

Chemical stability of polyacrylamide-coating on fused silica capillary

The chemical stability of polyacrylamide coatings on a fused silica capillary for capillary electrophoresis was investigated with respect to temperature of capillary and pH as well as salt concentration of running buffer solution by evaluating their effects on electroosmotic mobility. The capillary covalently bonded to linear polyacrylamide through Si-C linkage was stable in buffer solutions of pH 2.3-8.0 at 30 degrees C for 30 days, whereas the capillary bonded through Si-O-Si-C linkage was damaged at pH above 4.6. The electroosmotic mobility observed in both capillaries increased with increasing temperature, though the degree of increase was smaller in the Si-C linked capillary than in the Si-O-Si-C linked capillary. The increase in the buffer concentration resulted in increased electroosmotic mobility in the Si-O-Si-C linked capillary, but no effect was observed for the Si-C linked capillary.

[The influence of electrical time interval indices and aging on the left atrial systolic time intervals]

The influence of aging and heart rate on left ventricular systolic time intervals is well known, but the effects on left atrial systolic time intervals, a new index of left atrial function, remain unknown. The influence of aging and heart rate on left atrial systolic time intervals was investigated in 43 normal subjects (13-72 years of age) by Doppler echocardiography. Atrial pre-ejection period, atrial ejection time, and corrected atrial pre-ejection period were obtained by transmitral Doppler echocardiography. Simple regression analysis showed atrial pre-ejection period significantly correlated with P wave duration (PP; r = 0.78), and PR interval (PR; r = 0.60), but not with RR interval (RR). However, multiple regression analysis showed atrial pre-ejection period significantly correlated only with PP. Simple regression analysis found atrial ejection time significantly correlated with PP (r = 0.38), and PR (r = 0.39), but not with RR. However, multiple regression analysis found atrial ejection time did not correlate with any factor significantly. Aging was significantly correlated with corrected atrial pre-ejection period (r = -0.37), but not with corrected atrial ejection time and atrial pre-ejection period. Atrial ejection time significantly correlated with corrected atrial pre-ejection period (r = -0.37), but not with atrial pre-ejection period. Corrected atrial pre-ejection period is a clinically useful index of left atrial systolic function.

Role of basic and acidic fragments in delicious peptides (Lys-Gly-Asp-Glu-Glu-Ser-Leu-Ala) and the taste behavior of sodium and potassium salts in acidic oligopeptides

The role of the acidic fragment (Asp-Glu-Glu) in delicious peptides was investigated in detail by using the Na+ or K+ salts of acidic oligopeptides so that amount of Na+ or K+ intake of peptides composed of acidic amino acids could be varied by changing their sequences. The taste of these peptides was confirmed to vary with Na+ or K+ intake. Additionally, in order to study the role of basic (Lys-Gly) and acidic (Asp-Glu-Glu) fragments in delicious peptides for producing the taste, five delicious peptide analogs, Ser-Leu-Ala-Lys-Gly-Asp-Glu-Glu, Ser-Leu-Ala-Asp-Glu-Glu-Lys-Gly, Lys-Gly-Ser-Leu-Ala-Asp-Glu-Glu, Lys-Gly-Asp-Glu-Glu, and Glu-Glu-Asp-Gly-Lys, were synthesized. The intensity of the umami and/or salty taste of these peptides and their Na salts was almost the same, despite their chemical structures being different. These results indicate that the acidic fragment as well as the basic fragment plays an important role in the taste production and intensity of delicious peptides, and that an umami or salty taste can be produced by the localization of the cation of the basic fragment and the anion of the acidic fragment.

High-performance capillary electrophoresis of SDS-proteins using pullulan solution as separation matrix

Sodium dodecyl sulphate (SDS) capillary electrophoresis using pullulan solution as a separation matrix was developed for the separation and molecular mass determination of proteins. The silanol functions on the inner surface of a fused-silica capillary were deactivated by coating with linear polyacrylamide through Si-C linkages, into which the pullulan solution was filled. The stability of the coating was examined by exposure to an alkaline buffer solution (pH 9.2) for up to 30 days. Compared with conventional coatings with linear polyacrylamide through siloxane linkages, the present capillary was more stable even under alkaline conditions and markedly reduced electroosmotic flow. Thus, polymer solutions of low viscosity such as pullulan solution could be stabilized in the capillary, resulting in a prolonged life-span of the capillary and improved reproducibility of separations. An excellent linear relationship was obtained between the mobility and the logarithm of the molecular mass of SDS-proteins. The relative standard deviation of migration times was below 0.5% when the pullulan solution was refilled in each analysis (n = 10). The calibration plots of the integrated peak areas at 214 nm vs. concentration of standard proteins were linear in the range 5 micrograms/ml-0.1 mg/ml.

Preparation and characterization of a stable polyacrylamide sieving matrix-filled capillary for high-performance capillary electrophoresis

A stable sieving matrix of polyacrylamide filled in a capillary was developed. The inner wall of a fused-silica capillary was covalently bonded with a linear polyacrylamide through Si-C linkages, in which cross-linked polyacrylamide gel or linear polyacrylamide solution was filled. The stability of the coating was examined by exposure of the capillaries to alkaline buffer (pH 8) for up to 30 days. Compared with the coatings with linear polyacrylamide bonded through siloxane linkages, the present capillary markedly reduced the electroosmotic flow. Thus, the sieving matrix in the capillary was stabilized, resulting in a prolonged lifetime of the capillary and good reproducibility of separations. The migration behaviours of oligonucleotides were compared for the cross-linked gel and linear polyacrylamide solution at the same concentration.

Sodium dodecyl sulfate-polyacrylamide solution-filled capillary electrophoresis of proteins using stable linear polyacrylamide-coated capillary

Sodium dodecyl sulfate (SDS)-linear polyacrylamide solution-filled capillary electrophoresis using a stable coated fused silica capillary has been developed for the separation and molecular weight determination of proteins. A fused silica capillary was coated with linear polyacrylamide through Si-C bond which suppressed the electro-osmotic flow and reduced the adsorption of proteins. Acrylamide solution containing SDS was filled into the coated capillary and polymerized. Compared with a conventional fused silica capillary coated with 3-methacryloxypropyltrimethoxysilane through siloxane linkage (Si-O-Si-C), the developed capillary was much more stable, even in the alkaline condition. Consequently, the durability of the polymer matrices and the reproducibility of separation were markedly improved. An excellent linear relationship was obtained between the mobility and the logarithm of the protein molecular weight. The relative standard deviation of migration times was below 1%.

A new treatment for dialysis-related amyloidosis with beta 2-microglobulin adsorbent column

Dialysis-related amyloidosis (DRA) is characterized by the presence of beta 2-microglobulin (beta 2-m) in the plasma. In order to eliminate beta 2-m from the circulating blood, the beta 2-m selective adsorbent for direct hemoperfusion (DHP) was developed. A DHP column (BM-01), containing 350 ml of the adsorbent, was subjected to clinical trials. The column was connected with a PAN (AN69) membrane dialyzer in series and used 3 times a week for 1 week (11 patients), 4 weeks (5 patients), 6 months (1 patient) and 12 months (2 patients). The percent reduction (%) of beta 2-m was for 16 patients (for 1 or 4 weeks), more than 65, and for 3 patients (for more than 6 months), 76.5 +/- 4.9, 73.5 +/- 5.7, 72.2 +/- 6.2. At the end of each session, beta 2-m plasma levels were found to be below 10 mg/L, with 3.4 mg/L being the lowest. The total amounts of beta 2-m removed were 172.5 +/- 22.3, 257.0 +/- 75.6, 157.6 +/- 32.2 and 429.8 mg/session at max. Two out of these three patients had a favorable effect on joint symptoms and ocular fundus. It can be concluded that this selective adsorption therapy may delay the progression of DRA, and is worth considering for wide application.

[Blood leukotriene B4 response to endotoxin in fish oil fed rats]

Six-week-old male Wistar rats were given a low fat diet containing 15% cod liver oil (FO; n = 30) or 15% safflower oil (SO; n = 30) for 6 weeks. In the polymorphonuclear leukocytes, arachidonic acid (AA) was significantly lower in the FO group than in the SO group (p < 0.001), and eicosapentaenoic acid (EPA) in the FO group was present in large amounts showing the EPA/AA ratio of 1.76. When lipopolysaccharide (LPS; 10mg/kg) was intraperitoneally injected, white blood cell counts in the blood significantly decreased in both groups (p < 0.001) compared to the controls 2 hours later, and at 4 hours, the counts in the SO group (2,033 +/- 151/mm3) were lower than in the FO group (3,189 +/- 624/mm3), (p < 0.01). In both groups, leukotriene B4 (LTB4) in the whole blood increased at 4 hours following LPS-administration compared to the controls (1,219 +/- 167.3pg/ml in the SO group and 600.0 +/- 109.0pg/ml in the FO group, p < 0.001). It should be noted that the level of LTB4 in the SO group was significantly higher than in the FO group (p < 0.001). Changes of the metabolites including decreased LTB4 production in the arachidonic cascade related to the increase of EPA may play a role in the inhibition of the decrease in white blood cell counts.

Aspartic acid-66 is the only essential negatively charged residue in the putative hydrophilic loop region of the metal-tetracycline/H+ antiporter encoded by transposon Tn10 of Escherichia coli

Of the 16 acidic amino acid residues located in the hydrophilic region of the metal-tetracycline/H+ antiporter of transposon Tn10, five glutamic acids and three aspartic acids are conserved among the tetracycline/H+ antiporters of Gram-negative bacteria. When these conserved acidic residues were each replaced by a neutral polar residue, glutamine or asparagine, only the Asp66 substitution mutants completely lost their transport activity. The substitution of Glu274, Asp120, Glu181, or Asp38 caused significant reduction of the transport activity, whereas the substitution of the other three residues had no detectable effect on the activity. These findings led to the conclusion that only Asp66 is essential for the transport function.

[Augmentation of left ventricular slow filling in hypertrophic cardiomyopathy]

To investigate the significance of augmentation of left ventricular slow filling, trans-mitral flow (TMF) was echocardiographically observed through pulsed Doppler method in 116 patients with hypertrophic cardiomyopathy (HCM), 74 with dilated cardiomyopathy (DCM), 27 with mitral regurgitation (MR), 86 with old myocardial infarction (OMI) and 80 normal controls (C). The slow filling-wave (SFW) in TMF was defined as the filling wave with obvious peak velocity during slow filling phase. The peak velocities (E, A, S) of the early filling, the atrial contraction and the slow filling waves were measured. The SFW was divided into two patterns according to the S and E ratio: large SFW (S/E greater than or equal to 1/2) and small SFW (S/E less than 1/2). 1) The small SFW was more frequently, but not significantly, observed patients with MR (37%) than in normal subjects (18%), patients with HCM (10%), DCM (4%) and OMI (7%). However large SFW was observed in 16 patients (14%) with HCM, but not in normal subjects and patients with other cardiac diseases excluding one patient with DCM. 2) In normal subjects and patients with DCM, OMI and MR, those with small SFW had larger E and smaller A/E than those without small SFW. However in patients with HCM, there was no difference in these indices (E and A/E) according to whether the patients were with or without SFW. 3) In HCM, patients with large SFW had significantly smaller E and significantly larger isovolumic relaxation time than those without SFW. Thus, appearance of the large slow filling wave, which might be caused by abnormal relaxation of the left ventricle, was frequently observed in patients with HCM.

[The controversy on the treatment of aortic dissection]

It is obvious that there are many controversies regarding to the treatment of aortic dissection. In this report, we discuss following points such as 1) classification, 2) thrombosed type dissection, and 3) simultaneous graft replacement of ascending and aortic arch with the reconstruction of cervical branches. From the patho-morphological status, dissection will be classified into two types, localized and extended types. From the anatomical and surgical points of view, it will be also classified as 1) ascending-arch, 2) descending-thoracoabdominal, and 3) abdominal. With the combination of these two, dissection will be classified more clearly. The thrombosed type will be incorporated into localized type. We have experienced 76 cases of this dissection, and clinical features and outcome by medical treatment only are presented. The simultaneous reconstruction of ascending aorta and aortic arch for the dissection at ascending-arch type was undertaken in total of 35 patients. The surgical results as well as follow up data are presented and the benefit of this extended procedure is presented as well.