Electron microscopic studies of the early cellular events occurring in oral mucosa of rats affected by graft-versus-host disease (GVHD)

Previous histologic studies of tongue lesions in graft-versus-host disease (GVHD) in non-irradiated (Brown Norway x Lewis) F1 rats given parental spleen cells have demonstrated an increase in the number of MHC class II+ cells with dendritic shape in the lamina propria to be the earliest event in the development of the lesion. We studied this histologic finding by electron microscopy to increase understanding of the early cellular events occurring in the lesion. Electron microscopically, the most prominent cell type observed in the lamina propria was the cell with a dendritic shape. These dendritic cells possessed large nuclei that often showed irregular indentations and ample cytoplasm containing numerous filaments and mitochondria. A few lysosomal or phagocytic structures were also seen in the cytoplasm. No Birbeck granules were identified. These findings were very similar to those of indeterminate cells in the epidermis and dermis. Our data strongly support the hypothesis that MHC class II+ cells with dendritic shape present antigen during the induction of local immunological responses in the tongue of GVHD rats.

Solitary and multiple pyogenic liver abscesses: characteristics of the patients and efficacy of percutaneous drainage

OBJECTIVES

Although percutaneous drainage has emerged as one of the first line of therapies for pyogenic liver abscesses, the presence of multiple abscesses may warrant surgical drainage, which remains controversial in the literature. We studied whether the multiplicity of the lesions influences the outcome of the treatment.

METHODS

Ultrasonography-guided percutaneous drainage was carried out in 48 patients with pyogenic liver abscesses. The abscesses were solitary in 38 patients and multiple (two to seven lesions) in 10 patients. Clinical characteristics and the efficacy of the treatment were compared between these two groups.

RESULTS

Biliary diseases and malignancies were more frequently observed in the solitary cases than multiple cases. A past history of surgery for cholelithiasis was seen exclusively in the multiple cases. E. coli was more frequently cultured from the abscesses in the multiple cases. Three of the multiple cases required more than a single catheter. All of the multiple cases and 36 of the 38 solitary cases were successfully treated. Two patients died of biliary peritonitis as a complication of the procedure, and three died of other underlining diseases.

CONCLUSION

Ultrasonography-guided percutaneous drainage is effective even in patients with multiple pyogenic liver abscesses by adding catheters to obtain sufficient drainage.

Gastric stump carcinosarcoma with rhabdomyosarcomatous differentiation

Gastric carcinosarcoma is an unusual tumor and its occurrence in the gastric stump is extremely rare. A report is presented here of a unique case of gastric stump carcinosarcoma with rhabdomyosarcomatous differentiation in a 74-year-old man. The patient had undergone partial gastrectomy with gastrojejunostomy (Billroth II method) 30 years previously. The tumor had both adenocarcinoma and sarcoma components, and an immunohistochemical study suggested a focal transition between these components. The main sarcomatous components showed fibrosarcomatous features with a scattered distribution of rounded tumor cells, whose rhabdomyosarcomatous differentiation was immunohistochemically determined. Ultrastructural examination supported the rhabdomyosarcomatous natures. Experience with the present tumor indicates that carcinosarcoma with rhabdomyosarcomatous differentiation can occur in the gastric stump and that this disease is capable of aggressive behavior.

[Lesion-related factors associated with restenosis after percutaneous transluminal coronary angioplasty in the absence of patient-related factors]

Restenosis after percutaneous transluminal coronary angioplasty (PTCA) is one of the biggest problems in the treatment of coronary artery disease. Although many studies have been performed on lesion-related factors, they are influenced by patient-related factors such as smoking, hyperlipidemia, and the presence of acute coronary syndrome. In this study, lesion-related factors were assessed in the absence of other factors by univariate and multivariate analysis. One hundred and nine lesions were reviewed in 37 consecutive patients with both restenotic lesion(s) and non-restenotic one(s) confirmed by coronary arteriography performed 4.4 +/- 2.2 months after PTCA. Angiographic findings before and immediately after angioplasty were compared between restenotic and non-restenotic lesions. The overall lesion-restenosis rate was 42%. Univariate analysis revealed that calcified lesions (p < 0.05), multiple irregularities (p < 0.01) before angioplasty, residual percentage stenosis (p < 0.05), and angiographical intraluminal haziness (p < 0.05) were related to restenosis. Intimal dissection after PTCA was not associated with restenosis. Multivariate analysis with multiple logistic regression revealed that multiple irregularities (t = 2.8) was the most predictive of restenosis before PTCA and residual percent stenosis (t = 2.6) after the procedure. Coronary lesions with calcification or multiple irregularities indicate high risk of restenosis after PTCA. Optimal dilatation of the lesions without intraluminal haziness regardless of intimal dissection is important to prevent restenosis.

Do repolarization abnormalities in hypertrophic cardiomyopathy represent impaired fatty acid utilization? An observation with QRST isointegral maps

To identify the clinical significance of the isointegral body surface map of the QRST interval (QRST map) and the occurrence of repolarization abnormalities in patients with hypertrophic cardiomyopathy (HCM), the QRST map and signal-averaged electrocardiogram were evaluated in 50 patients with HCM, in 33 of whom the results were compared with nuclear images both for radioiodine-labeled fatty acid metabolism and for radiothallium perfusion. The QRST departure map was used to determine two parameters of difference between patient and control recordings: the subnormal area (the number of lead points at which the departure index values were negative and lay more than 2 SDs from the mean of the normal control group) and the subnormal minimum (the absolute value of the minimum in the departure map). Late potentials were detected in 6 (12%) of the 50 patients; they were observed in 3 of the 5 patients with dilated-phase HCM but in only 3 (7%) of the other 45 patients. The subnormal area and minimum values were lower in nonobstructive HCM than in dilated-phase HCM. Of the 33 patients examined by myocardial imaging, 28 (33%) had a filling defect or decreased uptake, as shown on fatty acid metabolic images, and 10 of the 28 also showed abnormal myocardial perfusion images, while the 18 others showed normal perfusion images. These 28 patients showed significantly larger values of the subnormal area and minimum than patients with normal results in both image tests, regardless of whether or not myocardial perfusion imaging abnormalities were present. The localization of filling defects or of decreased uptake presented in fatty acid metabolic images corresponded to the position of the minimum on the QRST departure map. These results suggest that the QRST map is useful for detection of repolarization abnormalities in HCM and that these abnormalities are highly related to impaired fatty acid utilization of the myocardium.

Modeling of a Micro-streamer Initiation and Development of ArF Excimer Laser Discharges

The dynamics of a constricted filamentary or ‘micro-streamer’ discharge in a discharge-excited ArF excimer laser has been examined using a two-dimensional fluid model. The entire process on a micro-streamer, from its initiation and development to extinction, is shown. In the present model, a micro-streamer is triggered at protrusions which always exist on cathode surfaces, and develops in the direction of the anode assisted by the high field induced by space charge. A rise in the gas temperature in the micro-streamer in the vicinity of a cathode is seen, and which is found to play an important role in its development. The effect of preionisation electron density ne0 on the streamer development is also examined, and the streamer is found to extend significantly when ne0 becomes low. The results are explained in connection with experimental observations.

The physiological property and function of the electrolyzed-ionized calcium Aquamax on water molecular clusters fractionization

Aquamax, the ionized mineral (Ca, 21 mg/ml; MG, 0.068 mg/ml; Na 0.13 mg/ml; K, 0.006 mg/ml) is a fermented organic mineral extract. The fundamental physiological property and function of this mineral is to promote the molecular level mineral supply to the cell inside. The contained minerals exist at a molecular level to fractionize the molecular clusters of water and to make water's penetration ratio into objects higher only at 0.1-0.2% concentration. Existing minerals, especially the calcium, were barely dissolved in water, and its low penetration was caused by its low electrolyzed behavior plus the effects from an anion mineral, such as phosphorous, sulfur, nitrogen, or any oxalic acid combining with a colloidal calcium to construct and crystallize as the calcium phosphate and the calcium sulfate. Aquamax minerals penetrate into objects to fractionize water molecular clusters and to make water functional, neutralize in the anion mineral and oxalic acid elements, raise the object's electric conductivity, and preserve perishables.

Ischemic stricture of the rectosigmoid colon caused by division of the superior rectal artery below Sudeck's point during sigmoidectomy: report of a case

Despite Sudeck's cautionary report regarding the risk of colon necrosis following a pull-through procedure, published in 1907, most colorectal surgeons do not pay close attention to Sudeck's critical point when operating in the rectosigmoid region. We report herein the case of a patient who developed an ischemic stricture, 6 cm in length, in the rectosigmoid colon distal to the anastomosis following a radical sigmoidectomy with division of the superior rectal artery immediately distal to Sudeck's point. This is the first documentation of a patient developing an ischemic stricture attributable to sigmoidectomy. Division of the artery distal to Sudeck's point most probably impaired the blood supply to the rectosigmoid colon, which subsequently resulted in occlusive ischemic colitis. Thus, there is a risk that division of the superior rectal artery distal to Sudeck's point may lead to colonic ischemia in the remaining rectosigmoid region following sigmoidectomy.

Isolation and amino acid sequence of flavostatin, a novel disintegrin from the venom of Trimeresurus flavoviridis

Flavostatin, a novel disintegrin purified from the venom of Trimeresurus flavoviridis, consists of 68 amino acids, including an Arg-Gly-Asp sequence and 12 Cys residues at positions highly conserved among disintegrins. The N-terminal sequence of flavostatin was identical to those of triflavin and flavoridin, previously reported disintegrins from the Trimeresurus flavoviridis venom. Differences among the C-terminal sequences of these disintegrins are considered to affect their biological potencies. Isolated flavostatin inhibited ADP collage, and thrombin receptor agonist peptide-induced platelet aggregation in human platelet-rich plasma with an IC50 range of 59 to 98 nM. Contrary to expectations, these values were similar to those for triflavin.

Induction of apoptosis in a human hepatocellular carcinoma cell line by a neutralizing antibody to transforming growth factor-alpha

A cell line derived from a Japanese man with hepatocellular carcinoma was established in culture and designated OCUH-16. The cell line has the morphological and chromosomal features of hepatocellular carcinoma cells and has a short doubling time (approximately 33 h). OCUH-16 cells were shown to express transforming growth factor-alpha (TGF-alpha) in addition to albumin, DNA polymerase-alpha, c-JUN, and the retinoblastoma gene product. Electron microscopy revealed TGF-alpha immunoreactivity associated with the cell membrane, but TGF-alpha was not detected in medium conditioned by OCUH-16 cells by enzyme-linked immunosorbent assay. Reverse transcription and polymerase chain reaction analysis revealed the presence of TGF-alpha messenger RNA in these cells. Culture of OCUH-16 cells in the presence of a neutralizing antibody to TGF-alpha inhibited cell proliferation and induced many cells to undergo apoptosis (programmed cell death). These observations suggest that endogenous TGF-alpha is necessary for OCUH-16 cell growth.

Ischemic colitis arising in watershed areas of the colonic blood supply: a report of two cases

There are several weak points in the colonic blood supply, known as watershed areas, which result from incomplete anastomoses of the marginal arteries. These watershed areas are more vulnerable to ischemic injury than other parts of the colon. We report herein the cases of two patients who developed ischemic colitis well localized in the cecum, and in the rectosigmoid region at Sudeck's point, respectively. This report and our review of the literature suggest that watershed areas, including the splenic flexure, or Griffith's point, Sudeck's point, and the ileocecal region, are high-risk regions for the development of ischemic colitis.

Primary structures of fungal fructosyl amino acid oxidases and their application to the measurement of glycated proteins

Fructosyl amino acid oxidase (FAOD), which is active toward model compounds of the glycated proteins in blood, N epsilon-fructosyl N sigma-Z-lysine and N-fructosyl valine, was purified to homogeneity from Aspergillus terreus GP1. Though the enzyme did not use glycated proteins directly as its substrate, it used glycated human serum albumin (HSA) when HSA was treated with a protease. Linear relationships between both the concentration and the increase in absorbance and the glycation rate of glycated HSA and the increase in absorbance were observed. cDNAs coding for FAODs were cloned from cDNA libraries of A. terreus GP1 and Penicillium janthinellum AKU 3413. The coding region for both fungal FAODs consisted of 1314 bp encoding 437 amino acids. The sequence of a dinucleotide-binding motif, GXGXXG, was in the deduced N-terminal region and a similar sequence to that the active site of bacterial sarcosine oxidases was found near the C-terminal region of FAOD. The of C-terminal tripeptides SKL and AKL of FAODs from A. terreus and P. janthinellum, respectively, represent typical peroxisomal-targeting signals. Finally, FAOD protein was produced in Escherichia coli transformants in an active form, and at the same level as in the original fungi.

Non-peptidic inhibitors of human neutrophil elastase: the design and synthesis of sulfonanilide-containing inhibitors

A novel series of pivaloyloxy benzene derivatives has been identified as potent and selective human neutrophil elastase (HNE) inhibitors. Convergent syntheses were developed in order to identify the inhibitors which are intravenously effective in an animal model. A compound of particular interest is the sulfonanilide-containing analogues. Structure-activity relationships are discussed. Structural requirements for metabolic stabilization are also discussed.

Cloning and characterization of Xenopus laevis xSox7 cDNA

A family of SRY-related genes has been termed SOX. We have isolated and sequenced a cDNA encoding a novel Sox protein from Xenopus laevis ovary. This cDNA contains an open reading frame (ORF) coding for 362 amino acids, which encompasses an HMG box and exhibits a strong (90%) identity to that of mouse Sox7; the cDNA was named xSox7 in this study. Northern analysis revealed that the xSox7 mRNA was 2.0 kb in length. Various adult frog tissues were tested by reverse transcription/polymerase chain reaction for xSox7 mRNA, and the results showed that xSox7 is expressed in a wide range of tissues. Furthermore, electrophoretic mobility shif assay indicated that recombinant xSox7 is capable of binding to AACAAT sequence.

Expression of polymorphonuclear leukocyte adhesion molecules and its clinical significance in patients treated with percutaneous transluminal coronary angioplasty

OBJECTIVES

This study evaluated the role of neutrophil adhesion molecules LFA-1 (CD11a/CD18), Mac-1 (CD11b/CD18) and p150,95 (CD11c/CD18) in patients undergoing percutaneous transluminal coronary angioplasty (PTCA).

BACKGROUND

Several recent studies have suggested that cell adhesion molecules on both neutrophils and vascular endothelial cells play an important role in the process of tissue inflammation.

METHODS

Thirty-eight patients (30 men, 8 women; mean [+/-SE] age 56 +/- 5 years, range 38 to 76) with single-vessel coronary artery disease of the left anterior descending artery underwent coronary angioplasty. Peripheral blood was sampled at baseline before, immediately after and 12, 24, 48 and 144 h after PTCA. The expression of CD18, CD11a, CD11b and CD11c on the surface of polymorphonuclear leukocytes was examined by flow cytometry with monoclonal antibodies.

RESULTS

In patients without subsequent restenosis, there was no change in mean channel fluorescence intensity (MFI) of CD18 at each sampling time. However, in the patients with restenosis, the MFI of CD18 significantly increased at 48 h after PTCA (from 57 +/- 6 to 73 +/- 8, p = 0.0008). The MFI of CD11b increased slightly at 48 h after PTCA in patients without restenosis (from 584 +/- 121 to 735 +/- 114, p = 0.037). In patients with restenosis, the MFI of CD11b was slightly increased at 24 h after PTCA (from 586 +/- 122 to 768 +/- 214, p = 0.018) and significantly increased at 48 h after PTCA (to 1,534 +/- 268, p = 0.0006). The expression of CD11a and CD11c did not change at any sampling points after PTCA in either of the two patient groups. Percent change in the expression of CD18 at 48 h after PTCA (from baseline) and that of CD11b were correlated (r = 0.73, p = 0.0008) in patients with restenosis.

CONCLUSIONS

Inflammatory stimuli within the coronary vessels associated with coronary angioplasty may upregulate Mac-1 expression on the surface of polymorphonuclear leukocytes. This process may be more marked in patients who experience later restenosis. Thus, activation of neutrophil adhesion molecule Mac-1 at 48 h after PTCA may have value as a predictor of subsequent restenosis.

Comparisons of porcine hepatocyte spheroids and single hepatocytes in the non-woven fabric bioartificial liver module

We previously developed a new bioreactor of the bioartificial liver composed of non-woven fabric. We have also experimented with hepatocyte spheroids, with the aim of improving the efficiency of this NWF bioreactor. In this study, we compared the efficiencies of NWF bioreactors employing hepatocyte spheroids versus single hepatocytes. Hepatocytes were isolated from a whole pig liver by Seglen's method. 1.0 x 10(10) single hepatocytes were immobilized in the NWF bioreactor. Another 1.0 x 10(10) hepatocytes were allowed to form spheroids by 24 hr suspension culture in a 4-L culture vessel, before being immobilized in the bioreactor. Hepatocyte spheroids were found to be functionally superior, on a per-cell basis, to single hepatocytes in the NWF bioreactor. However, the NWF bioreactor employing hepatocyte spheroids exhibited lower efficiency than thaT employing single hepatocytes, because the total number of the hepatocytes had decreased during the 24 hr suspension culture.

Comparative study of a mutant tissue-type plasminogen activator, YM866, with a tissue-type plasminogen activator in a canine model of femoral arterial thrombosis

Because tissue-type plasminogen activator (tPA), used to treat myocardial infarction, has several disadvantages thought to be connected with its low half-life, mutants of tPA have been prepared with longer half-lives. We have compared the thrombolytic effect of such a mutant, YM866, with that of tPA in copper-coil-induced femoral arterial thrombosis in dogs. One hour after thrombus formation, YM866 was administered by intravenous bolus injection, while tPA was given by the same method or by 60-min infusion under adequate heparinization. Both agents exhibited dose-dependent thrombolysis without systemic fibrinogenolysis. The recanalization rate and recanalization time of YM866 by bolus at 0.2 mg kg-1 were, however, equivalent to those of tPA by infusion at 0.4 mg kg-1 (total dose), whereas the recanalization rate of tPA by bolus was low (0.4 mg kg-1). No significant difference in reocclusion rate, reocclusion time, or patency status after successful thrombolysis was seen. These results suggest that YM866 administered at a lower dose by intravenous bolus injection exerted a thrombolytic effect equivalent to that of tPA by infusion, and that heparin could not prevent reocclusion after successful thrombolysis even under adequate anticoagulation.

Rescue of Sendai virus cDNA templates with cDNA clones expressing parainfluenza virus type 3 N, P and L proteins

Several years ago, we reported that a Sendai virus (SeV) defective genome (DIH4UV) could be rescued in vivo with human parainfluenza virus type 1 (hPIV1) and bovine PIV3 but not by measles virus or vesicular stomatitis virus. It was concluded that the cis-acting RNA sequences were conserved within the SeV/PIV1/PIV3 group but that interactions between the polymerase complex (P-L) and the template protein N were unique for each virus. We have re-examined these conclusions using proteins expressed from cloned N, P and L genes for SeV and PIV3. The results demonstrate the specificity of the protein-protein interactions between polymerase and template, and confirm the prediction of the earlier work that PIV3 N, P and L proteins are capable of assembling and replicating SeV mini-genomes also expressed from a cDNA clone.

Peroral insertion techniques of self-expanding metal stents for malignant gastric outlet and duodenal stenoses

Self-expanding metal stents (EMS) have gained widespread popularity for the palliative treatment of various stenoses in blood vessels, biliary ducts, bronchi, and the gastrointestinal tract. Regarding stenoses of the upper gastrointestinal tract, EMS insertion for gastric outlet and duodenal stenoses is considerably more difficult than for esophageal stenoses. We describe a reliable EMS insertion technique for malignant gastric outlet and duodenal stenoses.