Processing of CD109 by furin and its role in the regulation of TGF-beta signaling

CD109 is a glycosylphosphatidylinositol (GPI)-anchored glycoprotein, whose expression is upregulated in squamous cell carcinomas of the lung, esophagus, uterus and oral cavity. CD109 negatively regulates transforming growth factor (TGF)-beta signaling in keratinocytes by directly modulating receptor activity. In this study, we further characterized CD109 regulation of TGF-beta signaling and cell proliferation. We found that CD109 is produced as a 205 kDa glycoprotein, which is then processed in the Golgi apparatus into 180 kDa and 25 kDa proteins by furin (furinase). 180 kDa CD109 associated with GPI-anchored 25 kDa CD109 on the cell surface and was also secreted into the culture medium. To investigate whether furinase cleavage of CD109 is necessary for its biological activity, we mutated arginine 1273 in the CD109 furinase cleavage motif (amino acid 1270-RRRR-1273) to serine (R1273S). Interestingly, CD109 R1273S neither significantly impaired TGF-beta signaling nor affected TGF-beta-mediated suppression of cell growth, although it was expressed on the cell surface as a 205 kDa protein. Consistent with this finding, the 180 kDa and 25 kDa CD109 complex, but not CD109 R1273S, associated with the type I TGF-beta receptor. These findings indicate that processing of CD109 into 180 kDa and 25 kDa proteins by furin, followed by complex formation with the type I TGF-beta receptor is required for the regulation of TGF-beta signaling in cancer cells and keratinocytes.

Phenotypic spectrum of hereditary neuralgic amyotrophy caused by the SEPT9 R88W mutation

BACKGROUND

Hereditary neuralgic amyotrophy (HNA), also known as hereditary brachial plexus neuropathy, has phenotypic and genetic heterogeneity. Mutations in the septin 9 (SEPT9) gene were recently identified in some HNA patients. The phenotypic spectrum of HNA caused by SEPT9 mutations is not well known.

OBJECTIVE

To characterise the phenotype of a large family of HNA patients with the SEPT9 R88W mutation.

METHODS

We report clinical, electrophysiological, neuroimaging and genetic findings of six HNA patients from a Japanese family.

RESULTS

All 17 neuropathic episodes identified were selectively and asymmetrically distributed in the upper-limb nerves. Severe pain was an initial symptom in 16 episodes (94%). Motor weakness occurred in 15 (88%) and sensory signs in 10 (59%). A minor dysmorphism, hypotelorism, was seen in all. Nerve conduction studies revealed focal demyelination as well as prominent axonal degeneration changes. Needle electromyography revealed chronic neurogenic patterns only in the upper limbs. An MRI study showed a gadolinium-enhanced brachial plexus. The missense mutation c.262C>T; p.R88W was found in exon 2 of SEPT9 in all patients.

CONCLUSIONS

The SEPT9 R88W mutation in this family causes selective involvement of the brachial plexus and upper-limb nerves. Wider and more universal recognition of clinical hallmarks and genetic counselling are of diagnostic importance for HNA caused by the SEPT9 mutation.

Daily concurrent chemoradiotherapy with docetaxel (DOC) and cisplatin (CDDP) using superselective intra-arterial infusion via superficial temporal artery for T3 and T4 head and neck cancer: Possibility of organ preservation in advanced head and neck cancer

e17020

Background: Superselective intra-arterial chemotherapy via a superficial temporal artery (HFT method) has become feasible for daily concurrent radiotherapy and chemotherapy for head and neck cancer. We used this novel method for head and neck cancer, and evaluated its efficacy. Treatment consisted of superselective intra-arterial infusions (docetaxel total 60 mg/m2, cisplatin total 100 mg/m2) and concurrent radiotherapy (total 40 Gy) for 4 weeks as preoperative therapy. Thirty-five patients with stage III and IV oral cancer underwent surgery after this treatment, of whom pathological complete response (CR) was obtained in 31 (88.6%). In this study, the possibility of organ preservation in cases of advanced head and neck cancer was evaluated based on this result. Methods: Eligibility included T3 or T4 squamous cell carcinoma of head and neck. Treatment consisted of superselective intra-arterial infusions (docetaxel, total 60 mg/m2, cisplatin, total 150 mg/m2) and concurrent radiotherapy (total 60 Gy) for 6 weeks. Organ preservation was demonstrated in cases when the biopsy specimen of the primary lesion showed grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) after the completion of all treatments. Results: Thirty two patients (21 male and 11 female) were eligible for evaluation. A relapse was detected in 11 cases (34.4%): primary sites, 7 cases (21.9%); cervical lymph node and distant metastasis, 2 cases (6.3%); primary site and distant metastasis, 1 case (3.1%); cervical lymph node, 1 case (3.1%). Seven patients (21.9%) died. The Kaplan-Meier method was used to estimate the 3-year and 5-year survival rates, which were 81.3% and 78.1%, respectively, and the 3-year and 5-year locoregional control rates, which were 68.8% and 64.5%, respectively. No major complications such as cerebral infarctions or other neurological complications developed in any patient. Conclusions: These results of the present study demonstrate that this is a promising new treatment strategy for advanced head and neck cancer, thus contributing to patients’ QOL.

No significant financial relationships to disclose.

Performance of indirect immunofluorescence assay, immunochromatography assay and reverse transcription-polymerase chain reaction for detecting human respiratory syncytial virus in nasopharyngeal aspirate samples

Comparison of the use of indirect immunofluorescence assay (IFA), immunochromatography assay (ICA-BD) and reverse transcription-polymerase chain reaction (RT-PCR) for detecting human respiratory syncytial virus (HRSV) in 306 nasopharyngeal aspirates samples (NPA) was performed in order to assess their analytical performance. By comparing the results obtained using ICA-BD with those using IFA, we found relative indices of 85.0% for sensitivity and 91.2% for specificity, and the positive (PPV) and negative (NPV) predictive values were 85.0% and 91.2%, respectively. The relative indices for sensitivity and specificity as well as the PPV and NPV for RT-PCR were 98.0%, 89.0%, 84.0% and 99.0%, respectively, when compared to the results of IFA. In addition, comparison of the results of ICA-BD and those of RT-PCR yielded relative indices of 79.5% for sensitivity and 95.4% for specificity, as well as PPV and NPV of 92.9% and 86.0%, respectively. Although RT-PCR has shown the best performance, the substantial agreement between the ICA-BD and IFA results suggests that ICA-BD, also in addition to being a rapid and facile assay, could be suitable as an alternative diagnostic screening for HRSV infection in children.

Prothymosin-alpha plays a defensive role in retinal ischemia through necrosis and apoptosis inhibition

Prothymosin-alpha (ProTalpha) causes a switch in cell death mode from necrosis to neurotrophin-reversible apoptosis in primary cultured cortical neurons. In the present study, post-ischemic administration (3 or 24 h, intravenously) of recombinant mouse ProTalpha without neurotrophins completely prevented ischemia-induced retinal damage accompanying necrosis and apoptosis, as well as dysfunction assessed by electroretinogram. Treatments with anti-erythropoietin (EPO) or brain-derived neurotrophic factor (BDNF) immunoglobulin G (IgG) reversed ProTalpha-induced inhibition of apoptosis. ProTalpha upregulated retinal EPO and BDNF levels in the presence of ischemia. Moreover, intravitreous administration of anti-ProTalpha IgG or an antisense oligodeoxynucleotide for ProTalpha accelerated ischemia-induced retinal damage. We also observed that ischemia treatment caused a depletion of ProTalpha from retinal cells. Altogether, these results suggest that the systemic administration of ProTalpha switches ischemia-induced necrosis to apoptosis, which in turn is inhibited by neurotrophic factors upregulated by ProTalpha and ischemia. ProTalpha released upon ischemic stress was found to have a defensive role in retinal ischemia.

Portal vein complications in pediatric living donor liver transplantation using left-side grafts

The aim of this report is to assess the rate of portal vein complications (PVCs), the success rate of treatment for PVCs and the prognosis of patients with PVCs for pediatric living donor liver transplantation (LDLT). Pre- and postoperative records of 521 pediatric LDLTs, using left-side grafts were retrospectively reviewed. The overall rate of PVC was 9%, with early PVC occurring in nine patients (1.7%) with a mortality rate of 67% and late PVC in 38 patients (7.3%). Fifteen of these patients with late PVC showed complete portal vein occlusion despite various treatments, and in six of them the graft was lost. Histological examination revealed fibrosis in portal areas in 13 patients, around the central veins associated with cholestasis in the parenchyma in 10, and hepatocyte ballooning in 12. Correction of portal vein flow or retransplantation is necessary for the rescue of patients with early PVCs. Graft loss in the long term may be high with the occurrence of liver failure or portal hypertension related causes, such as hepatopulmonary syndrome and gastrointestinal bleeding in patients with late PVCs. For the rescue of these patients, especially for patients with body weight < 6 kg, regular monitoring of portal vein flow is essential.

Ganglioside complexes containing GQ1b as targets in Miller Fisher and Guillain-Barre syndromes

BACKGROUND

Serum antibodies to GQ1b are associated with Miller Fisher syndrome (MFS) and Guillain-Barré syndrome (GBS) with ophthalmoplegia. Antibodies to ganglioside complexes (GSCs) have not yet been examined in a large population of patients with MFS or GBS. This study aimed to determine the clinical significance of antibodies to GSCs in MFS and GBS.

METHODS

The study investigated serum anti-GSC antibodies and the clinical features in 64 MFS patients, 53 GBS patients with ophthalmoplegia (GBS-OP(+)) and 53 GBS patients without ophthalmoplegia (GBS-OP(-)).

RESULTS

Thirty patients with MFS (47%), 25 with GBS-OP(+) (47%) and none with GBS-OP(-) had antibodies to GSCs containing GQ1b or GT1a. Patients with MFS and GBS-OP(+) were subdivided according to the antibody reactivities; patients with antibodies specific to GQ1b and/or GT1a (without anti-GSCs antibodies) were placed in Group 1, those with antibodies against GSCs with a total of two sialic acids in the terminal residues, such as GQ1b/GM1, were placed in Group 2, and those with antibodies against GSCs with a total of three sialic acids in the terminal residue, such as GQ1b/GD1a, were placed in Group 3. In MFS, sensory disturbances were infrequent in Group 2 compared with the other groups (p<0.0001). Antibodies specific to GQ1b were observed more often in MFS than in GBS-OP(+) (p = 0.0002).

CONCLUSIONS

IgG antibodies to GSCs containing GQ1b or GT1a were closely associated with the development of ophthalmoplegia in GBS, as well as MFS. Both GQ1b and clustered epitopes of GSCs containing GQ1b or GT1a may be prime target antigens for MFS and GBS-OP(+).

d-wave collapse and explosion of a dipolar bose-einstein condensate

We investigate the collapse dynamics of a dipolar condensate of 52Cr atoms when the s-wave scattering length characterizing the contact interaction is reduced below a critical value. A complex dynamics, involving an anisotropic, d-wave symmetric explosion of the condensate, is observed. The atom number decreases abruptly during the collapse. We find good agreement between our experimental results and those of a numerical simulation of the three-dimensional Gross-Pitaevskii equation, including contact and dipolar interactions as well as three-body losses. The simulation indicates that the collapse induces the formation of two vortex rings with opposite circulations.

Cell therapy for facial anti-aging

Two types of cell therapy for facial anti-aging in my clinical experience are introduced in this presentation. One therapy is cultured gingival fibroblasts injection. This procedure lasts for at least one year, making it a good option for patients. The other is platelet rich plasma injection. The results of the preliminary data are promising, but not yet well understood. More clinical data and long-term follow-up is needed.

Method for isolation of mouse pancreatic stem cells

Replacement of beta-cell mass offers an alternative to standard insulin treatment for diabetes and may overcome the long-term side effects associated with current therapies. Pancreatic stem/progenitor cells could become a useful target for beta-cell replacement therapy in diabetic patients. We have established a method for isolating mouse pancreatic stem cells. In this study, pancreatic stem cells were isolated from 8-week-old mice. After purification on a density gradient, the density range of 1.062-1.11 contained pancreatic stem cells. The islets from the layers were deleted by dithizone staining and hand-picking under a dissecting microscope. The remnant cells were then cultured, inoculated into 96-well plates, and cloned by limiting dilution. One of the wells contained cells, named HN#5 cells, which expressed ductal cell markers, such as cytokeratin-19. HN#5 cells differentiated into insulin-producing cells and albumin-producing cells by induction medium. The isolation technique described here may be useful for identification and isolation of human pancreatic stem/progenitor cells.

Glial elements contribute to stress-induced torsinA expression in the CNS and peripheral nervous system

DYT1 dystonia is caused by a single GAG deletion in exon 5 of TOR1A, the gene encoding torsinA, a putative chaperone protein. In this study, central and peripheral nervous system perturbations (transient forebrain ischemia and sciatic nerve transection, respectively) were used to examine the systems biology of torsinA in rats. After forebrain ischemia, quantitative real-time reverse transcriptase-polymerase chain reaction identified increased torsinA transcript levels in hippocampus, cerebral cortex, thalamus, striatum, and cerebellum at 24 h and 7 days. Expression declined toward sham values by 14 days in striatum, thalamus and cortex, and by 21 days in cerebellum and hippocampus. TorsinA transcripts were localized to dentate granule cells and pyramidal neurons in control hippocampus and were moderately elevated in these cell populations at 24 h after ischemia, after which CA1 expression was reduced, consistent with the loss of this vulnerable neuronal population. Increased in situ hybridization signal in CA1 stratum radiatum, stratum lacunosum-moleculare, and stratum oriens at 7 days after ischemia was correlated with the detection of torsinA immunoreactivity in interneurons and reactive astrocytes at 7 and 14 days. Sciatic nerve transection increased torsinA transcript levels between 24 h and 7 days in both ipsilateral and contralateral dorsal root ganglia (DRG). However, increased torsinA immunoreactivity was localized to both ganglion cells and satellite cells in ipsilateral DRG but was restricted to satellite cells contralaterally. These results suggest that torsinA participates in the response of neural tissue to central and peripheral insults and its sustained up-regulation indicates that torsinA may contribute to remodeling of neuronal circuitry. The striking induction of torsinA in astrocytes and satellite cells points to the potential involvement of glial elements in the pathobiology of DYT1 dystonia.

Short-term plasticity of central benzodiazepine receptors in status epilepticus: case report

(123)I-iomazenil SPECT is of value in determining an epileptogenic focus, however, transient uptake change has been rarely reported in epileptic disorders. A 78-year-old woman diagnosed as status epilepticus (SE) showed transient reduction in (123)I-iomazenil uptake within the epileptic foci on SPECT images during a couple of weeks. It suggests a seizure-related 'short-term' plasticity in the central benzodiazepine receptors and dynamic change in the regulatory mechanisms of inhibitory neurotransmitter system within the epileptic foci in patients with SE.

Effect of liver transplantation on transthyretin Tyr114Cys-related cerebral amyloid angiopathy

OBJECTIVE

Patients with amyloidogenic transthyretin (ATTR) Tyr114Cys develop amyloid deposits in cerebral blood vessels, cerebral hemorrhage, and rapidly progressive dementia that presents with hereditary cerebral amyloid angiopathy (CAA). However, no treatment has been identified for CAA. Although liver transplantation has become an acceptable treatment of TTR-related amyloidosis, liver transplantation may not successfully treat CNS manifestations of the disorder. In this study, we examined the effect of liver transplantation on these manifestations of TTR-related CAA.

METHODS

We compared clinical courses of three patients with CAA associated with ATTR Tyr114Cys who underwent liver transplantation with those of five patients with the disorder who did not undergo liver transplantation.

RESULTS

The mortality and occurrence of cerebral hemorrhage and dementia in patients having transplantations were reduced compared with those in patients not having transplantations. The two groups did not differ with regard to the frequency of episodes of fluctuating consciousness and TIAs. The group undergoing transplantations had significantly smaller volumes of intracranial hemorrhage than did the no-transplantation group.

CONCLUSION

Liver transplantation was effective for CNS manifestations of cerebral amyloid angiopathy associated with amyloidogenic transthyretin Tyr114Cys.

Adverse effects of ivermectin on the dung beetles, Caccobius jessoensis Harold, and rare species, Copris ochus Motschulsky and Copris acutidens Motschulsky (Coleoptera: Scarabaeidae), in Japan

Effects of the antiparasitic drug, ivermectin, on the dung beetles, Caccobius jessoensis Harold, 1867 and the rare species, Copris ochus Motschulsky, 1860 and Copris acutidens Motschulsky, 1860 were studied in laboratory and field experiments in Hokkaido, Japan. Ivermectin was detected in dung from 1 to 21 or 28 days following treatment, with a peak on the first day after treatment in two pour-on administrations (500 microg kg(-1)), although there were considerable differences between the two peaks. In C. jessoensis, brood balls constructed by the female were not reduced in the dung of treated cattle except for seven days after treatment in experiment 2. Also, there was no significant difference in the mean weight of brood balls between dung from treated and control cattle. However, the emergence rates were significantly reduced in dung 1-3 days after treatment. In the field study, brood balls constructed by C. jessoensis were more abundant in dung from treated cattle in experiment 1, but adult emergence was significantly reduced at one and seven days after treatments. Adult mortality of C. ochus Motschulsky at 90 days after the beginning of rearing was 11.1% in dung from control cattle with 22 brood balls constructed, whereas it was 84% in dung from treated cattle with no brood balls and/or ovipositioning. Also, in C. acutidens Motschulsky, adult mortality at 90 days after the beginning of rearing was 3.6% in dung from control cattle with 13 brood balls constructed, whereas it was 94.1% in dung from treated cattle with no brood balls or ovipositioning. The environmental risk in the use of ivermectin during breeding period of dung beetles in pasture is discussed.

Neutrophil elastase inhibitor improves postoperative clinical courses after thoracic esophagectomy

Sivelestat sodium hydrate is a selective inhibitor of neutrophil elastase (NE), and is effective in acute lung injury associated with systemic inflammatory response syndrome (SIRS). The effect of Sivelestat for postoperative clinical courses after transthoracic esophagectomy was investigated. Consecutive patients with carcinoma of the thoracic esophagus who underwent transthoracic esophagectomy between 2003 and 2004 were assigned to the Sivelestat-treated group (n = 18), and those between 1998 and 2003 were assigned to the control group (n = 25). The morbidity rate, duration of postoperative SIRS, mechanical ventilation, and intensive care unit (ICU) stay, and the sum of the sequential organ failure assessment scores at all time points after the operation were compared. Serum NE activities and serum concentrations of TNF-alpha, IL-1beta, IL-6, and high mobility group box chromosomal protein 1 (HMGB1) were measured. Postoperative complications developed in three patients in the control group, and one in the Sivelestat-treated group. The durations of SIRS, mechanical ventilation, and ICU stay were significantly shorter in the Sivelestat-treated group. Even in patients without complications, the durations of mechanical ventilation, and ICU stay were also significantly shorter, and the arterial oxygen pressure/fraction of inspired oxygen ratio at postoperative day 1 was significantly higher in the Sivelestat-treated group. Serum NE activities and serum concentrations of IL-1beta, IL-6, and HMGB1 were significantly suppressed in the Sivelestat-treated group. Postoperative Sivelestat treatment after transthoracic esophagectomy improves the condition of SIRS and postoperative clinical courses, even in patients without complications.

Choosing an immunosuppressive regimen for liver transplantation

Immunosuppressive therapy for liver transplantation has been greatly improved with the introduction of immunosuppressive agents such as cyclosporin and tacrolimus in the 1980s and the 1990s, respectively. These agents inhibit transcription of the messenger RNA for cytokines such as interleukin-1, interleukin-2 and interferon-gamma, thus inhibiting cytokine release from activated T cells, which in turn leads to inhibition of proliferation of killer T cells after transplantation. These cytokine inhibitors are combined in multidrug therapy with corticosteroids and/or other immunosuppressive agents with different mechanisms of action to obtain maximal efficacy and minimal adverse effects. This article focuses on immunosuppressive regimens using the highly selective immunosuppressant tacrolimus for liver transplantation, based on our 6 years experience of living-related liver transplantation and on the reports of cadaveric liver transplantation from other centres. Tacrolimus, like cyclosporin, has reduced the required dosage of corticosteroids, leading in several centres to successful corticosteroid withdrawal in 6 months to 1 year after transplantation. Further modification of immunosuppressive regimens in long term patients, including withdrawal of tacrolimus, will be required.

Side population cells expressing ABCG2 in human adult dental pulp tissue

AIM

To investigate the presence of side population (SP) cells by the Hoechst exclusion method in human adult dental pulp tissue.

METHODOLOGY

Human adult dental pulp-derived cells were generated from third molar teeth. The cells were stained with Hoechst 33342 and sorted into SP cells or non-SP cells [main population (MP) cells]. Both cell types were compared with cell growth and RT-PCR analyses.

RESULTS

SP cells that express ABCG2, Nestin, Notch-1 and alpha-smooth muscle actin were found at frequencies ranging from 0.67% to 1.02%. This SP profile disappeared in the presence of verapamil. These SP cells expressed dentine sialophosphoprotein and dentine matrix protein-1 when cultured in osteogenic medium.

CONCLUSION

Human adult dental pulp tissue contains SP cells that differentiate into odontoblast-like cells.

Endovascular trapping for a giant aneurysm of the cervical internal carotid artery: a case report

SUMMARY

We describe a case of giant cervical internal carotid aneurysm successfully treated by endovascular trapping. A 57-year-old woman with a history of maxillary contusion seven years before presented with pharyngeal discomfort during swallowing. MRI revealed a 4 cm mass in the right parapharyngeal space. A common carotid angiogram revealed a giant aneurysm with a wide neck originating from the cervical internal carotid artery; kinking of the internal carotid artery was noted at a point distal to the carotid bifurcation. Analysis of cerebral blood flow by SPECT during a balloon occlusion test showed no hypoperfusion areas, and the patient underwent endovascular trapping. There were no neurological or other complications after the procedure. A follow-up MRI revealed complete thrombosis of the aneurysm. Our results show that endovascular trapping for pseudoaneurysm of the cervical internal carotid artery can be a reliable and effective treatment in patients who tolerate a balloon occlusion test.

Transcriptional expression of survivin and its splice variants in cervical carcinomas

The objective of this study was to evaluate transcriptional expression of survivin and the two splice variants (survivin-2B and survivin-ΔEx3) in cervical carcinomas. The gene expression levels of survivin and its splice variants in 11 human cervical carcinoma cell lines and 20 malignant and 12 normal cervical tissue samples were analyzed using quantitative reverse transcription–polymerase chain reaction analysis. Gene expression levels of survivin and survivin-ΔEx3 in cell lines were higher than those in normal cervical tissues (P= 0.0193 and 0.0489). Transcript levels of survivin and survivin-ΔEx3 in carcinoma tissues were also higher than those in normal controls (P= 0.0016 and 0.0011). Gene expression levels of survivin and survivin-ΔEx3 in adenocarcinomas were statistically higher than those in squamous cell carcinomas (P= 0.0260 and 0.0487). There was no significant difference in survivin-2B gene expression between malignant and normal cervical samples or different histologic types. The ratios of survivin-2B/survivin and survivin-ΔEx3/survivin in carcinoma tissues were higher than those in normal controls (P= 0.0288 and 0.0081). Interestingly, the ratio of survivin-2B/survivin was increased in the patients with higher stages and with pelvic lymph node metastasis (P= 0.0205 and 0.0437), respectively. We conclude that survivin and its splice variants might be involved in the pathogenesis and development of cervical carcinomas.

Molecular mechanisms involved in anti-inflammatory effects of proton pump inhibitors

OBJECTIVE

Interleukin (IL)-8 has been reported to participate in neutrophil infiltration in Helicobacter pylori (H. pylori)-induced gastritis in humans. In this study, we investigated the anti-inflammatory actions beyond the suppression of acid secretion by proton pump inhibitors (PPI), such as omeprazole and lansoprazole, on IL-8 production by gastric epithelial cells (MKN45) and human umbilical vein endothelial cells (HUVEC) and on the transendothelial migration of polymorphonuclear neutrophils (PMN).

MATERIALS AND METHODS

MKN45 and HUVEC were stimulated with H. pylori water extract (HPE) and IL-1beta, respectively, and nuclear factor kappa B (NFkappaB) activation and subsequent IL-8 production was assessed in the absence or presence of PPI. We also assessed the effect of PPI on IL-8-induced PMN transendothelial migration and on the alteration of cytoplasmic calcium concentration in formyl-methionyl-leucyl-phenylalanine (fMLP)-stimulated PMN.

RESULTS

HPE and IL-1beta induced a significant increase in IL-8 production by MKN45 and HUVEC, respectively, along with NFkappaB activation, which was significantly inhibited by PPI. PPI also inhibited the IL-8-induced transendothelial migration of PMN and the fMLP-induced cytosolic calcium increase in PMN.

CONCLUSIONS

PPI attenuate PMN-dependent gastric mucosal inflammation partly by interfering with NFkappaB activation in vascular endothelial cells and gastric epithelial cells, and partly by modulating the calcium concentration of PMN.

A shear-induced in vitro platelet function test can assess clinically relevant anti-thrombotic effects

Morphological features of haemostatic plugs formed in vitro under high shear forces were investigated. Electron microscopy confirmed the relevance of such haemostatic plug to a platelet-rich arterial thrombus, which is formed in vivo . In rat blood samples, the effects of anticoagulants and various antiplatelet agents on platelet reactivity (rate of haemostatic plug formation) and subsequent coagulation of the flowing blood were investigated. Haemostasis did not occur in citrated blood, and heparin greatly inhibited the shear-induced platelet reaction. Aspirin (1 mM), a thromboxane A(2) receptor antagonist (5 microM), a stable prostacyclin (0.55 nM), a stable prostaglandin E(1) (141 nM) and a phosphodiesterase inhibitor (100 microM) were tested. All these agents exerted significant inhibitory effect on shear-induced platelet reaction, including the inhibition of the very first phase of platelet plug formation, due to aggregation of shear-activated platelets. Except for the phosphodiesterase inhibitor, which prolonged clotting time, none of the above agents affected dynamic coagulation. These results suggest that the employed in vitro shear-induced thrombosis/haemostasis test can reveal in vivo the antithrombotic effect of various agents independently of their mechanism of action.

Neopterin is associated with plaque inflammation and destabilisation in human coronary atherosclerotic lesions

BACKGROUND

Previous studies have shown that recent activation of the inflammatory response in coronary atherosclerotic lesions contributes to rapid progressive plaque destabilisation. Neopterin, a by-product of the guanosine triphosphate pathway, is produced by activated macrophages and serves as an activation marker for monocytes/macrophages.

OBJECTIVE

To elucidate the role of neopterin in coronary plaque destabilisation by immunohistochemical study of the presence of neopterin in coronary atherectomy specimens obtained from patients with stable angina pectoris (SAP) and unstable angina pectoris (UAP).

PATIENTS AND METHODS

All patients underwent atherectomy of the primary atherosclerotic lesions responsible for SAP (n = 25) and UAP (n = 25). Frozen samples were studied with antibodies against smooth muscle cells, macrophages, T cells, neutrophils and neopterin.

RESULTS

In 22/25 patients with UAP, abundant neopterin-positive macrophages were found at the sites of coronary culprit lesions. However, in 25 lesions from patients with SAP, only 11 lesions showed neopterin positivity. Quantitatively, the neopterin-positive macrophage score was significantly higher (p<0.001) in patients with UAP than in patients with SAP. Moreover, the neopterin-positive macrophage score showed a significant positive correlation with the number of neutrophils or T cells, respectively (neutrophils, r = 0.55, p<0.001; T cells, r = 0.70, p<0.001).

CONCLUSIONS

Neopterin can be considered as one of the significant factors in the process of plaque inflammation and destabilisation in human coronary atherosclerotic lesions. Its exact role in the process needs to be investigated further.

Spontaneous infarction of an intraductal papilloma of the breast: cytological presentation on fine needle aspiration

A relatively rare case of spontaneous infarction of an intraductal papilloma of the breast is presented which was considered to be suspicious for malignancy on fine needle aspiration (FNA) cytology. The aspirate revealed several groups of atypical cells featuring a high nuclear-cytoplasmic ratio, coarsely granular chromatin, and somewhat prominent nucleoli. There was abundant necrotic cellular debris in the background. These cellular features were considered evidence of ductal carcinoma of the breast. The correct diagnosis was made by open biopsy which revealed necrosis involving the breast due to infarction of an intraductal papilloma.