Chronic angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor blockade: effects on cardiovascular remodeling in rats induced by the long-term blockade of nitric oxide synthesis

We have shown previously that angiotensin-converting enzyme (ACE) inhibitors prevent coronary vascular remodeling (medial thickening and perivascular fibrosis) and myocardial remodeling (fibrosis and hypertrophy) in rats induced by long-term inhibition of nitric oxide (NO) synthesis with oral administration of N omega-nitro-L-arginine methyl ester (L-NAME). ACE inhibitors inhibit both the formation of angiotensin II and the catabolism of bradykinin. In this study, we aimed to determine the relative contribution of the latter two mechanisms to the beneficial effects of an ACE inhibitor on structural remodeling. First, we examined the effects of the ACE inhibitor temocapril and the angiotensin II AT1 subtype receptor antagonist CS-866 on the structural remodeling induced by administering L-NAME for 8 weeks. Temocapril and CS-866 were equally effective in preventing remodeling. Second, we examined whether the effect of temocapril on the remodeling induced by L-NAME was reduced by the bradykinin receptor antagonist HOE140. The latter drug did not alter the beneficial effect of temocapril on remodeling. In conclusion, although species differences must be considered to apply our conclusion to clinical conditions, the present results suggest that the inhibition of angiotensin II activity, mediated via the AT1 receptors, is responsible for the beneficial effects of an ACE inhibitor in our animal model of coronary vascular and myocardial remodeling induced by the long-term inhibition of NO synthesis.

Glibenclamide, a specific inhibitor of ATP-sensitive K+ channels, inhibits coronary vasodilation induced by angiotensin II-receptor antagonists

The purpose of our study was test the hypothesis that endogenous angiotensin II contributes to the basal coronary artery tone by acting at vascular ATP-sensitive K+ (K+ATP) channels. Coronary blood flow (CBF) and other hemodynamic parameters were measured in anesthetized dogs. Intracoronary infusion of the selective antagonists of angiotensin II AT1 receptors (L-158,809 and E4177) increased CHF without affecting other hemodynamic parameters, indicating that endogenous angiotensin II caused coronary vaso-constriction through the AT1 subtype receptors. Coronary vasodilation in response to AT1 receptor antagonists was blunted by pretreatment with glibenclamide (a specific inhibitor of K+ATP channels; p < 0.01) but not by either an adenosine-receptor antagonist or an inhibitor of nitric oxide synthesis. Coronary vasodilation in response to AT1-receptor antagonists was partly reduced (p < 0.01) by PD-123319 (the AT2-receptor antagonist). Glibenclamide had no effect on coronary vasodilation induced by sodium nitroprusside. These results indicate that in dogs in vivo, coronary vasodilation in response to AT 1-receptor antagonists inhibited markedly by glibenclamide and partly by PD-123319, suggesting that endogenous angiotensin II contributes to the maintenance of basal coronary vascular tone by acting at K+ATP channels through its receptors.

Correlation between arteriographic and electrocardiographic features during spasm in the left anterior descending coronary artery

BACKGROUND

The clinical role of collateral vessels, which are transiently augmented during coronary artery spasm, remains controversial.

OBJECTIVE

To examine the correlation between coronary arteriographic and electrocardiographic features during spasm in the left anterior descending artery (LAD).

METHODS

We studied 45 patients in whom LAD spasms were induced by administration of acetylcholine or ergonovine maleate into the left coronary artery, or in whom spontaneous LAD spasms were documented during diagnostic cardiac catheterization.

RESULTS

During spasm, only three patients had transient appearance or augmentation of collateral flow opacifying the LAD. In these three patients, electrocardiograms obtained from anterior precordial chest leads during LAD spasm showed ST-segment depression, ST-segment elevation followed by ST-segment depression, and only T-wave change, respectively. Except for these three patients, ST-segment elevations were observed in all other patients (31 of 34) with main-branch spasm of the LAD. However, ST-segment elevation was observed in only two of 11 patients in whom spasm of the diagonal branch alone was induced.

CONCLUSIONS

Our observations suggest that the electrocardiographic changes during spasm are not always a sensitive indicator of LAD side branch spasm or LAD main-branch spasm associated with collateral circulation. From consideration of the angiographic features of the collaterals in the three patients with LAD main-branch spasm, we speculate that the balance of tonus of both the recipient and donor arteries, and the degree of organic stenosis of the recipient artery, may have important roles in the mechanism responsible for the change in the appearance of collaterals in patients with coronary spasm.

Effect of oral adsorbent AST-120 on cyclosporin absorption in rats

The oral adsorbent AST-120 is used to inhibit the progression of renal failure by adsorbing uraemic toxins in the gastrointestinal tract. When AST-120 is administered to patients receiving immunosuppressive medicines, it is important to study the effect of AST-120 on the amount of these and other drugs absorbed. We have, therefore, studied the in-vitro adsorption of cyclosporin by AST-120 and investigated the effect of oral administration of AST-120 on the absorption of cyclosporin in rats. The in-vitro adsorption ratios of AST-120 for cyclosporin were more than 80%. When pure cyclosporin powder was administered with AST-120, blood cyclosporin concentrations were significantly higher than when cyclosporin was administered alone. When cyclosporin dissolved in medium-chain triglyceride was administered to rats by intramuscular injection there was no significant difference in the blood cyclosporin concentration of rats given combined AST-120 and cyclosporin and those given cyclosporin alone. There was no significant difference between the serum concentration of total bile acids, in rats receiving combined oral AST-120 and cyclosporin dissolved in olive oil, and those receiving orally solely a solution of cyclosporin dissolved in olive oil. These results suggest that oral administration of AST-120 accelerates the absorption of orally administered cyclosporin from the gastrointestinal tract and does not affect the metabolism of cyclosporin. When a solution of cyclosporin in olive oil is administered orally, however, oral administration of AST-120 has no influence on cyclosporin absorption and does not affect the enterohepatic circulation of bile acids.

Sphingosine induces apoptosis in androgen-independent human prostatic carcinoma DU-145 cells by suppression of bcl-X(L) gene expression

Our recent studies have suggested that sphingosine, an endogenous protein kinase C (PKC) inhibitor, may mediate apoptosis induced by a phorbol ester (PMA) in human promyelocytic leukemia HL-60 cells [Ohta et al. Cancer Res. 1995;55:691-697], and that the apoptotic induction by both PMA and sphingosine is accompanied by down-regulation of bcl-2, a gene which acts to prevent apoptotic cell death [Sakakura et al. FEBS Lett. 1996;397:177-180]. In this study, we examined the sphingosine-induced apoptosis of the androgen-independent human prostatic carcinoma cell line DU-145, which expresses bcl-X(L) and Bax but not bcl-2, and found that treatment of DU-145 cells with sphingosine suppressed bcl-X(L) in both mRNA and protein levels but did not change bax expression at all. In contrast, in apoptotic cells treated with a PKC inhibitor, staurosporine, no effect on bcl-X(L) or bax expression was observed. The initial metabolites of sphingosine in the cells, ceramide and sphingosine 1-phosphate, failed to induce apoptosis. These results indicate that, in DU-145 cells, sphingosine, but not its metabolites, induces apoptosis through down-regulation of bcl-X(L), independently of PKC inhibition. Our present results, together with previous observations, strongly suggest that apoptosis regulatory genes differ according to cell type and apoptosis induction through sphingosine is accompanied by inhibition of either bcl-2 or bcl-X(L) activity in these cells.

Metanestin, a glycoprotein with metastasis-associated expression in transitional cell carcinoma of the urinary bladder

A 60-kDa glycoprotein named metanestin was identified by molecular cloning. The glycoprotein had a twice-repeated motif of Pro-Gly-Pro-Gly and carried metastasis-associated carbohydrate epitopes. The antibody to the protein portion of metanestin strongly reacted with lymph-node metastasis of transitional-cell carcinoma of the urinary bladder, but the reactivity to the primary tumor was generally weaker and the normal urothelium was scarcely reactive. Thus both metanestin and the carbohydrate on it showed metastasis-associated expression. In addition, we identified a 100-kDa glycoprotein with a 4-times-repeated motif of Pro-Ala-Pro-Ala. The antibody to the 100-kDa glycoprotein showed reactivity similar to that to metanestin.

Important role of tissue angiotensin-converting enzyme activity in the pathogenesis of coronary vascular and myocardial structural changes induced by long-term blockade of nitric oxide synthesis in rats

The long-term administration of N(omega)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthesis, produces coronary vascular remodeling and myocardial hypertrophy in animals. This study used a rat model to investigate the role of angiotensin I converting enzyme (ACE) in the pathogenesis of such changes. We studied the following groups, all of which received drug treatment in their drinking water: untreated controls, and those administered L-NAME, L-NAME, and an ACE inhibitor (ACEI), and L-NAME and hydralazine. Cardiovascular structural changes and tissue ACE activities were evaluated after the first, fourth, and eighth week of treatment. In rats treated with L-NAME alone, vascular remodeling was evident at the fourth and eighth week, and myocardial hypertrophy was present at the eighth week of treatment. The vascular and myocardial remodeling were characterized by increased tissue ACE activities and immunodetectable ACE in those tissues. These changes were markedly reduced by ACEI, but not by hydralazine treatment. Increased local ACE expression may thus be important in the pathogenesis of cardiovascular remodeling in this model.

[Clinical evaluation of intra-arterial infusion chemotherapy for advanced or recurrent pelvic tumors with or without radiotherapy]

We analyzed 97 cases of various advanced or recurrent pelvic tumors which were cervix, rectal, ovarian and other tumors treated by intra-arterial infusion chemotherapy (IAIC) with or without radiotherapy. The IAIC regimen was separated into two groups: group I consisting of 5-FU + MMC +/- ADR (54 cases) and group II consisting of CDDP + MMC +/- 5-FU (43 cases) from 1985. The catheter was placed in the bifurcation of abdominal aorta, and from 1990, the catheters were placed in bilateral internal iliac arteries (8 cases). The overall response rate (CR + PR) was 65%, 74% in patients receiving radiotherapy, and 47% in those without radiotherapy. There were no significant differences between each primary site and presence of radiotherapy combination in survival rate. Two-year survival rate and 5-year survival rate was 32% and 15% for all cases, and 65% and 33% for CR cases, respectively. A significantly better survival rate was obtained in patients with CR. Five-year survival rate was 4% in group I, and 35% in group II (p = 0.00216) by chemotherapy regimen. Severe (more than grade III) hematological acute side effects were 45% for all cases. In 8 cases in which the catheters were placed in internal iliac arteries, there were severe skin ulcers in 2 cases, and severe pain of leg or gluteal region requiring narcotics in 3 cases. These data suggest that IAIC mainly with cisplatin with or without radiotherapy is one of the effective treatment for advanced or recurrent pelvic tumors. Also, we should check blood flow distribution periodically, and control the concentration of drugs.

Chronic inhibition of nitric oxide synthesis causes coronary microvascular remodeling in rats

The aim of the present study was to investigate the effects of long-term blockade of nitric oxide synthesis with the L-arginine analogue N omega-nitro-L-arginine methyl ester (L-NAME) for 8 weeks on coronary vascular and myocardial structural changes. Four groups of Wistar-Kyoto rats were studied: those with no treatment, those treated with L-NAME 1 g/L (3.7 mmol/L in drinking water), those treated with L-NAME 0.1 g/L (0.37 mmol/L in drinking water), and those treated with L-NAME 1.0 g/L and hydralazine 120 mg/L (0.6 mmol/L in drinking water). After 8 weeks, the heart was excised, and the degrees of structural changes in coronary arteries (wall-to-lumen ratio and perivascular fibrosis), myocardial fibrosis, and myocyte size were quantified by an image analyzer. Chronic inhibition of nitric oxide synthesis increased arterial pressure compared with control animals. Chronic inhibition of nitric oxide synthesis caused significant microvascular remodeling (increased wall-to-lumen ratio and perivascular fibrosis). Cardiac hypertrophy was also observed after chronic inhibition of nitric oxide synthesis. Coadministration of hydralazine prevented arterial hypertension but did not affect microvascular remodeling and cardiac hypertrophy induced by the chronic inhibition of nitric oxide synthesis. In addition, chronic inhibition of nitric oxide synthesis caused scattered lesions of myocardial fibrosis, which was significantly attenuated by cotreatment with hydralazine. These results suggest that long-term blockade of nitric oxide synthesis caused coronary microvascular remodeling and cardiac hypertrophy in rats in vivo by a mechanism other than arterial hypertension. In contrast, arterial hypertension contributed to the development of myocardial fibrosis induced by long-term blockade of nitric oxide synthesis.

[Malignant fibrous histiocytoma of the lung]

A 68-year-old man had a malignant fibrous histiocytoma of the lung that was found at autopsy. The patient was admitted to our hospital because of exertional dyspnea. A chest X-ray film and chest CT scan showed atelectasis in the left upper lobe. Examination with a fiberoptic bronchoscope revealed a necrotic mass in the left mainstem bronchus. Microscopic examination of a biopsy specimen disclosed several atypical giant cells but was not diagnostic. He underwent chemotherapy with CBDCA, IFM and VP-16, because a malignant tumor of the lung was strongly suspected. After three cycles of chemotherapy, the tumor had shrunk, as demonstrated on repeated bronchoscopy. The patient's condition improved temporarily, but he began to complain of dyspnea, and died of respiratory insufficiency despite radiotherapy. Postmortem examination was done. The tumor in the lung was mainly composed of spindle-shaped fibroblast-like cells and several pleomorphic giant cells with multiple nuclei, with storiform and fascicular patterns. Immunohistochemically, these tumor cells were shown to contain vimentin, alpha-1-antitrypsin, and LN-5. These findings were compatible with malignant fibrous histiocytoma of the lung.

[Antigenicity tests of tazobactam/piperacillin, tazobactam and piperacillin]

The antigenicity tests of Tazobactam/piperacillin (TAZ/PIPC), tazobactam (TAZ:beta-lactamase inhibitor) and piperacillin (PIPC:penicillin antibiotic) were performed in mice and guinea pigs. The following results were obtained. 1. TAZ/PIPC, TAZ or PIPC had no immunogenicity and allergenicity in either passive cutaneous anaphylaxis (PCA) test using BALB/c and C3H/He mice or in PCA test using guinea pigs. 2. Guinea pigs sensitized with TAZ/PIPC, TAZ or PIPC showed no anaphylactic symptoms in active systemic anaphylaxis (ASA) test. 3. Guinea pig PCA tests using protein conjugates as sensitizing and challenging antigens showed positive reactions. Immunological cross-reactivity tests were performed by using these conjugates in guinea pig PCA reaction. Results showed that TAZ/PIPC and PIPC cross-reacted with penicillin G (PCG) and ampicillin (ABPC), but not with cephalothin (CET) and cephmetazol (CMZ). TAZ did not cross-react with PCG, ABPC, CET or CMZ. 4. From the results of the passive hemagglutination (PHA) test, no antibody against TAZ/PIPC, TAZ or PIPC was detected. 5. In direct Coombs' test using human blood, TAZ/PIPC, TAZ, PCG and CET showed positive reactions at 20-80, 5-20, 80 and 10-20 mg/ml, respectively. 6. The results of a test on in vitro covalent binding activity with human serum albumin indicated that the order of binding potency was CET > CMZ > ABPC > PCG = PIPC > TAZ under the physiological condition (pH 7.2-7.4), and was CMZ > CET > ABPC > PIPC > TAZ > PCG under the alkaline condition (pH 10.0-10.5), respectively.

Effects of body weight on responses of serum prolactin to metoclopramide and thyrotrophin-releasing hormone in secondary amenorrhoeic women

The present study was designed to investigate the influence of body weight on the prolactin responsiveness to metoclopramide and thyrotrophin-releasing hormone (TRH) in secondary amenorrhoeic women. The responses of serum prolactin to metoclopramide and TRH were assessed in relation to body mass index (BMI). Doses of 10 mg of metoclopramide hydrochloride and 500 micrograms of TRH were administered i.v. to 42 secondary amenorrhoeic women and six women with primary ovarian failure. The increment of serum prolactin at 30 min after the administration of metoclopramide was significantly lower (P < 0.01, respectively) in amenorrhoeic women with a BMI of > or = 30 or < 19 than in amenorrhoeic women with a BMI of 19-24. A significant correlation ration (eta = 0.63; P < 0.01) was found between the BMI and the increment of serum prolactin at 30 min after metoclopramide administration in amenorrhoeic women. The increment of serum prolactin at 15 min after TRH administration was slightly lower in amenorrhoeic women with a BMI of > or = 30 or < 19 than in amenorrhoeic women with a BMI of 19-24, but these differences were not statistically significant. These results indicate that the body weight influences the responsiveness of serum prolactin to metoclopramide in secondary amenorrhoeic women.

A case of nodular fasciitis of the bladder

A case of nodular fasciitis occurring at the bladder vertex in a 34-year-old male is reported. The tumor was about 1 cm in diameter. A urachal tumor was diagnosed, and excised en bloc from the umbilicus to the bladder vertex. This tumor was diagnosed as nodular fasciitis from the histopathological findings. No recurrence has been seen for 3 years. Nodular fasciitis occurs mainly in the limbs or trunk. Occurrence in the bladder is very rare. Only 14 cases (including our case) of nodular fasciitis occurring in the bladder are known.

Synthesis of optically active alpha-phenylpyridylmethanols with baker's yeast

We have synthesized optically active alpha-phenylpyridylmethanols by using free baker's yeast (FBY) in water, immobilized baker's yeast (IMBY) in water, and IMBY in hexane.

Auto-antibody against adenine nucleotide translocator in dilated cardiomyopathy and myocarditis--incidence and relation to cardiac function and morphology

Using an enzyme-linked immunosorbent assay, we measured anti-adenine nucleotide translocater (ANT) antibody in control subjects and in patients with dilated cardiomyopathy (DCM), myocarditis, and other heart disease. Analysis with sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Western blotting, and immunoabsorption tests confirmed accurate purification of the ANT protein and correct measurement of anti-ANT auto-antibody. Anti-ANT antibody was detected in 6 of 37 cases (16%) of DCM and in 5 of 12 cases (42%) of myocarditis. This antibody was not positive in other heart diseases or in apparently healthy controls. There were no differences between anti-ANT autoantibody-positive and -negative DCM or myocarditis patients in any of the cardiac parameters examined (left ventricular ejection fraction, LVEF; left ventricular end-diastolic dimension, LVDd; and cardiothoracic ratio, CTR). Moreover, in patients who were positive for anti-ANT auto-antibody, no positive correlations were found between the parameters and anti-ANT antibody titers in either DCM or myocarditis. Although these results indicate that the detection of anti-ANT antibody was achieved at a high specificity and could have certain diagnostic value in DCM and myocarditis, there was no statistically significant relationship between the cardiac parameters (LVEF, LVDd, and CTR) and anti-ANT antibody titers in either DCM or myocarditis. Some compensatory mechanism of ventricular function may mask the effects of the anti-ANT auto-antibody or alternatively, this auto-antibody may have mimic effects on the pathogenesis and/or progression of DCM and myocarditis.

Induction of true precocious puberty by neonatal treatment with danazol in female rats

Female rats at 5 days of age were given a single subcutaneous injection of varying doses of danazol or vehicle. Rats treated with 300 micrograms of danazol showed significant (P < 0.01, respectively) advancement in the day of vaginal opening (37.50 +/- 0.49 days vs. 25.20 +/- 0.19 days; mean +/- S.E.M.), first estrus (38.19 +/- 0.62 days vs. 29.10 +/- 0.26 days) and onset of estrous cycle (49.63 +/- 1.30 days vs. 37.07 +/- 1.50 days). All rats treated with danazol showed 4- or 5-day estrous cycle in the adulthood. Rats treated with 300 micrograms of danazol at 5 days of age discharged luteinizing hormone in the late stage of first proestrus. These results demonstrate that neonatally administered danazol produces the true precocious puberty in female rats, and this sexual precocity rat represents a unique model for analysis of the onset of puberty.

A case of multilocular cystic nephroma

The patient was a 23-year-old female. Excretory urography, abdominal CT scanning, and renal angiography revealed a large multilocular cystic nephroma on the right kidney.

Retroperitoneal ganglioneuroma: a case report

A primary extra-adrenal retroperitoneal ganglioneuroma was found incidentally in a 17-year-old boy during a series of examinations for hematopyuria. Computed tomography and magnetic resonance imaging revealed a homogenous mass located between the right proximal ureter and the inferior vena cava just below the right kidney. Subtotal resection of the tumor was performed through a transabdominal approach. The resected specimen measured 8.5 x 6 x 5.5 cm and weighed 70 g. Histological examination showed that the lesion was an extra-adrenal retroperitoneal ganglioneuroma composed of mature ganglion cells and nerve fibers without any malignant features. The patient has shown no signs of recurrence in the 4 months after surgery. We provide a review of the Japanese literature on extra-adrenal retroperitoneal ganglioneuroma and also discuss the clinical features of this tumor.

Adenomyomatosis of the gallbladder: a clinical survey of 30 surgically treated patients

Thirty patients with adenomyomatosis of the gallbladder (AMG) were operated on between January 1983 and June 1990. They were made up 3.3% of patients who underwent cholecystectomy during the same interval. Of the 30 patients, ages ranged from 22 to 77 years (mean 52.3 years) and the male-to-female ratio was 8:7. Among the macroscopic types, 10 cases of generalized, 12 of segmental (S) and 8 of fundal (F) were noted, and the size of the affected portion in type S (0.8 +/- 0.2 cm, mean +/- SD) was significantly thinner than in other two types (p less than 0.05). Although the main symptom was abdominal pain, the majority of patients with type F had no complaints. Twenty patients (27%) were accompanied by gallstones including cholesterol stones in 60% of cases, and all six cases showing microbes in the bile had gallstones. Only six patients were diagnosed as AMG by preoperative imaging techniques. Other diagnoses comprised 15 of chronic cholecystitis and 3 of suspected gallbladder carcinoma. To identify the expanded Rokitansky-Aschoff sinuses, endoscopic retrograde cholangiography and/or ultrasonography of the abdomen were most useful. No preponderant coexistent lesion other than gallstones was noted. Levels of carcinoembryonic antigen in gallbladder bile in cases of AMG (2.5 +/- 1.5 ng/ml, mean +/- SD) were significantly lower than in gallbladder carcinoma (p less than 0.01). All the patients were easily treated with cholecystectomy, and 24 patients who have been followed up after surgery are doing well.(ABSTRACT TRUNCATED AT 250 WORDS)

[Platelet membrane glycoprotein V and clinical significance of plasma GPVf 1 level]

Thrombin hydrolyzes platelet membrane glycoprotein V (GPV) which has leucine rich repetitive modules specifically, and releases GPVf1 (fragment of N terminal in GPV). The GPV related antigen level in plasma will thus reflect activation of platelet in vivo. The ELISA assay to measure the concentration of GPV and GPVf1 in plasma using polyclonal anti-GPV antibody, was established. The concentration of GPV and GPVf1 in plasma by using polyclonal anti-GPV antibody was established. The concentration of GPV related antigen in plasma is significantly higher in patients with thrombosis and correlated well with thrombotic episodes. It was suggested that the measurement of plasma-GPV-related antigen level is a useful marker for the diagnosis of thrombosis or prethrombotic states.

Synthesis of the 2',3'-dideoxynucleoside derivatives of the specific binding peptide part of CD4

The 2',3'-dideoxynucleoside derivatives of the specific binding peptide part of CD4 to HIV envelope protein gp120 were synthesized.

Synthesis of optically active lipopeptide analogs from the outer membrane of Escherichia coli

The synthesis of optically active lipopeptide derivatives has been accomplished by the use of chiral glycerol derivatives. Lipopeptide derivatives with (R)-glycerol moieties showed higher mitogenic activities than those with the (S)-configuration. N-2,2,2-Trichloroethoxycarbonyl lipopeptide derivatives increased mitogenic activity.

Pituitary hormone response to thyrotropin-releasing hormone in secondary amenorrheic women associated with simple weight loss

OBJECTIVE

To investigate endocrine dysfunction in simple weight loss amenorrhea.

DESIGN

We studied pituitary hormone responses to thyrotropin-releasing hormone (TRH) in 10 women with simple weight loss amenorrhea.

SETTING

Department of Obstetrics and Gynecology, University Hospital, University of Tokushima at Tokushima, Japan.

PATIENTS, PARTICIPANTS

Secondary amenorrheic women associated with simple weight loss who did not have anorexia nervosa.

INTERVENTIONS

Intravenous injection of 500 micrograms of synthetic TRH.

MAIN OUTCOME MEASURE

Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyrotropin, and prolactin were measured before and 15, 30, and 60 minutes after TRH injection.

RESULTS

In normally menstruating women on day 7 of the cycle TRH did not affect serum LH and FSH levels. In women with simple weight loss amenorrhea, however, TRH raised serum LH and FSH levels significantly (P less than 0.01, respectively). Prolactin response to TRH was significantly (P less than 0.05) lower in women with simple weight loss amenorrhea than in normally menstruating women.

CONCLUSIONS

These results indicate that TRH causes a significant rise in serum LH and FSH and the impaired prolactin response in women with simple weight loss amenorrhea.

Cloning, characterization and taxonomic significance of genes for the 5S ribosomal RNA of Leptonema illini strain 3055

The genes encoding the 5S ribosomal RNA (rRNA) for Leptonema illini strain 3055 were isolated and sequenced. The 5S RNA molecule encoded was 117 nucleotides long. The genome of strain 3055 contained two genes for 5S rRNA that were located close together. The nucleotide sequences of the Leptonema illini genes exhibited less similarity to the rRNA gene of Leptospira interrogans strain Moulton and also to those of typical eubacterial genes than did the rRNA genes of other leptospires. However, the overall secondary structure of the 5S rRNA encoded exhibited a strong similarity to that of typical eubacterial 5S rRNA. Southern hybridization of the 5S rRNA gene probe with the genomic DNA of strain 965, which is currently classified as Leptospira biflexa, showed the latter to have close similarity to that of strain 3055. The physical map of strain 965 was quite similar to that of strain 3055 and was greatly different from that of any other strains of L. biflexa. In the organization of 5S rRNA genes, strain 965 is sufficiently different from other members of the genus Leptospira to be regarded as a member of the genus Leptonema.

Association between high grade ventricular arrhythmia and extent of left ventricular hypertrophy in hypertrophic cardiomyopathy

The association between the extent of left ventricular (LV) hypertrophy and severity of ventricular or atrial arrhythmias are examined. Two-dimensional echocardiography and 24-h Holter electrocardiography monitoring were performed in 60 patients with hypertrophic cardiomyopathy (HCM). According to the distribution of the LV hypertrophy, the patients were divided into three groups: 1. Apical hypertrophy (APH), 2. Septal hypertrophy, and 3. Extensive hypertrophy. Ventricular arrhythmias were found in 82% of the patients and supraventricular arrhythmias were detected in 70% of the patients. Lown grade III and IV arrhythmias occurred significantly more frequently in patients with extensive than with septal hypertrophy. Lown grade III to IV arrhythmias did not occur in patients with APH. Present results show a significant association between the extent of LV hypertrophy and the severity of ventricular arrhythmias in HCM.

[Clinical studies of isosorbide dinitrate spray in postoperative patients]

We investigated the effect of isosorbide dinitrate (ISDN) single spray, containing 1.25 mg of ISDN, on cardiovascular and respiratory functions in eight postoperative patients. Concentrations of plasma ISDN and its metabolites were also investigated. Hemodynamic as well as blood gas studies were performed at 4 points (before, plus 10, 30 and 60 minutes after administration of ISDN) and the blood levels of ISDN and its metabolites were measured at 5 points (before, plus 5, 10, 30 and 60 minutes after administration of ISDN). Mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), cardiac index (CI), pulmonary capillary wedge pressure (PCWP) and central venous pressure (CVP) decreased significantly and heart rate (HR) increased significantly at 10 and 30 minutes after the spray. The maximum changes observed of each parameters were MAP 7%, MPAP 22%, CI 9%, PCWP 33%, CVP 36% and HR 6%. Systemic and pulmonary vascular resistance indices did not change significantly throughout the study. PaO2 decreased significantly only at 10 minutes after the spray. Plasma ISDN concentration showed the maximum value of 56.3 ng.ml-1 at 5 minutes after the spray. After this value, the concentrations decreased rapidly. From this study, we conclude that single spray of ISDN is effective in decreasing preload promptly, but it is not effective in decreasing afterload. When using the spray, we should pay attention to pulmonary oxygenation.

Comparison of biologic activities of synthetic lipopentapeptide analogs of bacterial lipoprotein in mice

Mitogenicity, lethal toxicity, induction of tumor necrotizing factor (TNF), and antitumor activity against Meth A fibrosarcoma of four chemically synthesized lipopentapeptide analogs, S-[2,3-bis(palmitoyloxy)-2R (designated as KAB-1), -2S(KAB-3)-propyl]-N-palmitoyl-(R)-cysteinyl-(S)-seryl- (S)-seryl-(S)-asparaginyl-(S)-alanine, S-[2,3-bis(palmitoyloxy)-2R(KAB-2), and -2S(KAB-4)-propyl]-N-[(2,2,2)-trichloroethoxycarbonyl]-(R)- cysteinyl-(S)-seryl-(S)-seryl-(S)-asparaginyl-(S)-alanine, of bacterial lipoprotein were investigated. These four analogs, as well as bacterial lipopolysaccharide (LPS) or synthetic Escherichia coli-type lipid A (506), were capable of increasing of [3H]thymidine into splenocytes of C3H/He mice. Although LPS and 506 did not exhibit the mitogenic activity in C3H/HeJ mice, KAB compounds showed remarkable mitogenicity. These analogs did not show the lethal toxicity at a high dose of 50 micrograms/mouse in galactosamine-loaded C57BL/6 mice. Peritoneal macrophages, stimulated with four analogs, caused the production of TNF which induces the L929 cell lysis in vitro. Twice, intravenous injections of 50 micrograms/mouse of these analogs showed weak growth inhibition of Meth A fibrosarcoma in BALB/c mice. The inhibitory effect of KAB-2 compound, which caused the strong TNF-induction among the four analogs, was the most potent. These results indicate that the biological activity of KAB-2 (R-configuration of the C-2 position in glycerol moiety with dipalmitoyl) is stronger than that of the other three analogs.

Rapid purification and characterization of human platelet glycoprotein V: the amino acid sequence contains leucine-rich repetitive modules as in glycoprotein Ib

Glycoprotein V (GPV) is a membrane-associated, 82 Kd platelet glycoprotein that is hydrolyzed during thrombin activation to yield 69 Kd fragment. We have developed a rapid and simple method for isolation of the protein from platelet extracts using a combination of gel permeation, anion-exchange, and lectin affinity chromatography. The partial amino acid sequence was determined by analysis of peptides generated by digestion of the S-carboxyamido-methylated protein with Achromobacter protease I or cyanogen bromide. The sequence shows a remarkable periodicity of leucine residues, which is homologous to the consensus sequence of a highly diversified protein super-family with a common repetitive module. Thrombin cleavage site was determined to be located at the C-terminal region of GPV by analysis of the products separated by sizing and reversed-phase high performance liquid chromatography. By lectin blot analysis, the existence of mucin-type carbohydrate chains was indicated, as well as the existence of asparagine-linked carbohydrate chains shown by the amino acid sequence analysis. From these data, we report a structural model of GPV that is analogous to glycoprotein Ib.

[Antigenicity test of mofezolac (N-22)]

Antigenicity studies of mofezolac (N-22) were examined in mice and guinea pigs and the following results were obtained. The findings of active systemic anaphylaxis, passive hemagglutination test, 4 hour passive cutaneous anaphylaxis (4-hr PCA) and 8-day PCA in guinea pigs revealed that N-22 possessed neither immunogenic nor eliciting potentiality. However, N-22 was shown to be eliciting antigenicity in mice when given N-22-ovalbumin conjugate plus Freund's complete adjuvant (FCA) as immunogen.

Reappeared pancreatic cyst after surgical treatment of cystic lesions of the pancreas

An extremely high incidence of reappearing cyst of the pancreas (24.1%; 7 out of 29 patients) was noted in the present survey. However, reappearance could have been avoided in the majority of cases with the use of thorough pre- and peri-operative assessments of the extent of cystic lesion of the pancreas. The recurrence rate after surgical treatment for pseudocysts (13.6%; 3 out of 22 patients) was similar compared with usual recurrence rate of approximately 10 percent. If the reappearing cyst is a retention cyst or a pseudocyst, a minimally aggressive procedure should initially be considered to aid its resolution. A part of this study was reported at the 51st meeting of the Japanese Society for Clinical Surgery on November 2, 1989 at Kobe, Japan.

Analysis of platelet cytoskeleton assembly during platelet activation in Hermansky-Pudlak syndrome and thrombasthenia

Time course change of the platelet cytoskeletal protein component in the Triton X-100 insoluble fraction after stimulation was analyzed in Hermansky-Pudlak syndrome and thrombasthenia. In Hermansky-Pudlak syndrome (HPS), a 31 kDa protein, myosin, actin, and a 100 kDa protein assembled as in the normal platelets at the shape change and release reaction phases after ADP or collagen stimulation, suggesting that, the deficient dense granule content do not lead to an abnormal platelet cytoskeletal protein assembly. In thrombasthenia (Type I), myosin increased at the shape change and release reaction phases as it does in normal platelets, but actin and the 100 kDa protein increased only at the initial activation phase, and then subsequently decreased to the level of the resting phase. The actin-binding protein (ABP) and the 31 kDa protein increased a little following stimulation. Similar cytoskeletal protein change after stimulation were found in normal platelets which were prevented from the aggregation process by chelating the external Ca2+ or by using synthetic decapeptide of fibrinogen gamma-chain of carboxyl terminus. The decreased platelet cytoskeletal protein assembly in thrombasthenia or in platelets stimulated without aggregation, was derived from a loss of the platelet aggregation process due to the defect of GP IIb-IIIa complex or an interaction failure between GP IIb-IIIa complex and fibrinogen. The interaction between platelets and either fibrinogen or fibrin can induce a more stable platelet cytoskeletal protein assembly, however, agonistic stimulation without these interactions cannot do it directly.

[Acute granulocytic leukemia with near-tetraploid chromosome constitution appearing in the late stage of the disease with survival of almost 9 years]

A near-tetraploid clone was observed at the 5th relapse in a 34 year-old female with acute granulocytic leukemia. She was referred to Hiroshima University Hospital presenting with palpitation in May 1978. On admission she had a WBC count of 2,900/microliters with 31.5% blasts, platelet count of 2.4 x 10(4)/microliters and hemoglobin of 2.8 g/dl. A bone marrow aspirate showed hypercellular with 88.5% blasts. Most of them were weakly positive for peroxidase reaction. Occasional Auer rod and/or fine azurophilic granules were observed. DCMP therapy (daunorubicin, cytosine arabinoside, 6-mercaptopurine, and prednisone) was started and the first complete remission was achieved in August 1978. Afterward, the 5th relapse occurred in August 1986 and several kinds of drugs were given without effects. She died 8 years and 9 months after the diagnosis. Karyotype prior to treatment showed a normal diploidy without tetraploid mitoses. However, cells with near-tetraploid (mode: 91) were observed predominantly on the 5th relapse sample and almost all mitoses were occupied with near-tetraploidy at the terminal stage. Results of serial cytogenetic and hematologic study showed a close correlation between the incidence of near-tetraploid mitoses and that of very large blast cells. The significance of tetraploidy in previously reported 44 cases including our case was discussed.

Chronic myelogenous leukemia and Klinefelter's syndrome

A case of chronic myelogenous leukemia with Klinefelter's syndrome mosaicism in a 27-yr-old male is reported. Cytogenetic analysis provided evidence that the Philadelphia chromosome occurred monoclonally in the XXY cells but not in the XY cells.

[Antigenicity test of cefodizime sodium]

The antigenicity studies of a beta-lactam antibiotic, cefodizime sodium (THR-221), were examined in mice and guinea pigs and the following results were obtained. 1) In passive cutaneous anaphylaxis (PCA) with sera from BALB/c or C3H/He mice, a slight PCA reaction was observed only in BALB/c mice by using THR-221-ovalbumin (OVA) plus Freund's complete adjuvant (FCA) as the immunogen and THR-221 itself as the eliciting antigen. 2) Immunological cross-reactivity between THR-221 and CTX was present at the rat PCA reaction. 3) Antibodies against THR-221 were detected by PCA in guinea pigs. The anti-THR-221 antibodies gave PCA responses smaller than those of CMZ by using antibiotic plus FCA as the immunogen and the antibiotic-bovine serum albumin (BSA) as the eliciting antigen. 4) In the observation of active systemic anaphylaxis (ASA), no symptoms were observed in guinea pigs sensitized with THR-221 and provoked with THR-221-BSA. On the other hand, guinea pigs sensitized with THR-221 plus FCA by injecting THR-221-BSA showed fetal anaphylactic reactions. 5) The results of passive hemagglutination (PHA) also indicated that the PHA titer of THR-221 was lower than that of CMZ. 6) Protein binding property of THR-221 with human serum albumin was lower than other beta-lactam antibiotics. 7) Antibodies against THR-221-OVA by using THR-221-BSA as the eliciting antigen were detected in any tests above mentioned. It is concluded from these results that immunological activity of THR-221 was equivalent to the other beta-lactam antibiotics.

[Penetration of cefmetazole and netilmicin into the cerebrospinal fluid]

1. Cefmetazole (CMZ) and netilmicin (NTL) were administered by one-shot intravenous and intramuscular injection, respectively, and measurements were made on their concentrations in the serum as well in the cerebrospinal fluid (CSF) which was collected using a drainage tube inserted into the cisterna basalis after the operation of ruptured cerebral aneurysm. 2. Concentrations of CMZ and NTL in the CSF changed nearly in parallel to those in the serum. 3. A one-shot intravenous injection of these drugs seemed to achieve their high concentrations in the CSF, though high concentrations may not last very long.

Coexisting adenocarcinoma and malignant lymphoma of the stomach: case report and review of the Japanese literature

After a diagnosis of advanced carcinoma, a 77-yr-old female underwent gastrectomy. A 6 X 5 cm ulcerative mass in the angle was shown to be differentiated adenocarcinoma in the surrounding wall, and malignant lymphoma in the bottom. Carcinomatous infiltration was limited to the muscularis mucosae. Neither generalized lymphoma nor locoregional lymph node metastasis of either neoplasm was noted. A survey of 35 Japanese patients, including our own case with the two coexistent neoplasms in the stomach, revealed that the male-to-female ratio was 2.3:1, with no significant difference between the mean age of the sexes. The prevalence of adenocarcinoma in its early stage (60% of 35 patients) and of a histologically differentiated type (85% of 27 patients) of adenocarcinoma is quite different from that of usual Japanese gastric carcinoma, and it may suggest that there are some factors influencing the coexistent development of both neoplasms.

Mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes with recurrent abdominal symptoms and coenzyme Q10 administration

A male with mitochondrial myopathy, encephalopathy, lactic acidemia, and strokelike episodes is reported. He had also recurrent episodes of ileus. Muscle biopsy revealed ragged-red fibres. The cytochemistry of cytochrome c oxidase (CCO) showed scattered nonstained fibres, while all muscle fibres were heavily stained by immunocytochemistry using CCO antibody. These findings suggest that partical CCO deficiency may be present in the skeletal muscles of the patient. NADH cytochrome c reductase in the patient's muscle mitochondria was low compared with normal controls (about 26%), although succinate cytochrome c reductase was normal. Coenzyme Q10 administration (90 mg/day) did not improve CSF lactate levels, but did decrease plasma lactate levels. His muscle weakness slightly improved.