[Epidemiological evaluation of the protective effect for dying of stomach cancer by screening programme for stomach cancer with applying a method of case-control study--a study of a efficient screening programme for stomach cancer]

An epidemiological evaluation of the protective effect for dying of stomach cancer by screening programme for stomach cancer was conducted with applying a method of case-control study. And also in order to carry out an efficient screening programme, the age groups who should be intensively recommended to receive screening and an optimal screening time interval since the last test were analyzed. 527 cases of men and 273 of women, dying of stomach cancer in the years 1981-1989 in the Awa region of Chiba prefecture, were identified from Chiba Cancer Registry. For each case, 3 controls were drawn at random from Awa living residents (about 162000 inhabitants at 1989 national census), with being matched strictly according to the district of residence, sex and born within 3 years of birth-year. For both cases and controls, the information about the screening history until the date of diagnosis of the case in each matched set was collected respectively from comparison with the screening certification. The results showed a relative risk of 0.417 (99% CI 0.284-0.612) in ever screened men compared with never screened and 0.480 (99% CI 0.280-0.823) in women. The significant reduction in risk was intensively observed on age groups 40-74 years among men and 50-69 years among women and the protective effect continued at most in the following three years since last screening. For an efficiency of screening programme, these age groups should be intensively recommended to receive screening and it is allowable that an optimal screening time interval since last negative test is at most 3 years for general attendance.

Fulminant Mycoplasma pneumoniae pneumonia with marked elevation of serum soluble interleukin-2 receptor

We treated a married couple who developed Mycoplasma pneumonia at the same time, and whose clinical courses and serum soluble interleukin-2 receptor (sIL-2R) levels were markedly different. The 30-year-old wife developed acute respiratory failure and her sIL-2R levels were extremely increased. After pulse therapy, her clinical state was improved, with a marked decrease in sIL-2R. In contrast, the 36-year-old husband, also suffered from the pneumonia with a moderate increase of sIL-2R, and recovered without any complications. The difference in their clinical states may be reflected in their serum sIL-2R levels, a marker of T cell activation in vivo.

Detection of minimal residual disease by reverse transcriptase polymerase chain reaction for the PML/RAR alpha fusion mRNA: a study in patients with acute promyelocytic leukemia following peripheral stem cell transplantation

Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia (AML) that is characterized by the presence of a PML/RAR alpha fusion gene resulting from t(15;17). Peripheral stem cell transplantation (PSCT) has been used to treat patients with AML. To assess the presence of minimal residual disease (MRD) and the contamination of leukemic cells in peripheral stem cells (PSCs), we examined six patients with APL who were undergoing PSCT, using reverse transcriptase polymerase chain reaction analysis to detect the mRNA of the PML/RAR alpha fusion gene. The fusion gene was expressed in the bone marrow cells during the early phase of a complete remission and in some of the PSCs. Detection of the fusion gene can be useful in monitoring for leukemic cell contamination of PSCs and for predicting a relapse of APL.

Reduced expression of neurofibromin in the soft tissue tumours obtained from patients with neurofibromatosis type I

1. We analysed the expression of neurofibromin mRNAs, encoded by the gene responsible for neurofibromatosis type 1, and of neurofibromin protein in nine soft tissue tumours by S1 nuclease mapping and Western blot analyses. Four tumours were obtained from patients with neurofibromatosis type 1, comprising two neurofibromas, one fibrolipoma and one malignant schwannoma, and five neurogenic tumours were obtained from non-neurofibromatosis type 1 patients. 2. All tumours, except for a malignant schwannoma, similarly expressed three species of mRNA encoding neurofibromin, an isoform with the insertion of 21 amino acids in the domain related to ras GTPase-activating protein, and an N-terminal isoform lacking this domain. 3. Western blot analysis demonstrated deficiency of neurofibromin in the tumours derived from three out of the four neurofibromatosis type 1 patients: a fibrolipoma, a malignant schwannoma and a neurofibroma. In contrast, reduction in neurofibromin was not detected in the five tumours obtained from non-neurofibromatosis type 1 patients. Furthermore, the expression of ras GTPase-activating protein was detected in all nine tumours examined. 4. The undetectable or reduced level of neurofibromin in the tumours obtained from neurofibromatosis type 1 patients suggests that this deficiency is closely related to their tumourigenesis.

Antitumor effects of liposomes containing adriamycin on chemically-induced rat malignant fibrous histiocytoma

Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma. No effective chemotherapeutic agents, however, have been reported. Here we report our evaluation of the antitumor effects of liposomes containing adriamycin (LADM) against chemically-induced rat MFH. Either free adriamycin (ADM) or LADM was administered at dosages of 4.0, 8.0 or 12.0 mg/kg by intravenous injection. The tumor responded to LADM with prolonged growth delay, but equivalent doses of free ADM were less effective. Additionally, LADM prolonged the life span of rats longer than did free ADM. Also, the body weight loss was less with LADM than with equivalent doses of free ADM. In tissue distribution studies, we observed that the ADM level in the blood and in the tumor with LADM remained higher than with free ADM. These results indicate that liposomes alter in vivo ADM tissue distribution and increase antitumor activity against rat MFH with reduced toxic side effects.

Isolation and structure of the Enterococcus faecalis sex pheromone, cOB1, that induces conjugal transfer of the hemolysin/bacteriocin plasmids, pOB1 and pYI1

A bacterial sex pheromone, cOB1, which induces conjugal transfer of the Enterococcus faecalis hemolysin-bacteriocin (Hly/Bac) plasmid, pOB1, was isolated from the culture broth of pOB1-free E. faecalis. Its structure was found to be a hydrophobic octapeptide, H-Val-Ala-Val-Leu-Val-Leu-Gly-Ala-OH. The cOB1 peptide induced the mating response of not only pOB1 but also another incompatibility group Hly/Bac plasmid, pYI1.

[A case of productive aspergilloma on the inner wall of a cavity, in which perbronchial fiberoptic bronchoscopy within the cavity was useful for the diagnosis and therapeutic evaluation]

A 45-year-old man complaining of bloody sputum was admitted. He had been treated for pulmonary tuberculosis since October 1988. He had bloody sputum in October 1989. His chest X-ray findings showed a cavitary lesion with a thickened and irregular wall in the right upper lobe. Fiberoptic bronchoscopy revealed white nodules on the cavity wall and the biopsy specimen from the nodule yielded a fungus granuloma. Aspergillus fumigatus was cultured from the sputum obtained after the bronchoscopy. Based on these findings, endobronchial aspergillosis and productive aspergilloma on the inner wall of a cavity was diagnosed. He was treated with oral anti-fungal drugs for 4 years. On chest X-ray films taken in June 1993, the cavity had enlarged, and the thickening and irregularity of the cavity wall had disappeared. Transbronchial fiberoptic bronchoscopy within the cavity showed whitish nodules and the cytology specimen obtained from the nodules by brushing yielded fungi, he was treated with oral itraconazol. Six months later, re-examination of the cavity revealed that the wall had become thinner and that the nodules on the inner wall had disappeared. This case illustrates the importance of bronchoscopy, in the diagnosis and evaluation of treatment of productive aspergilloma on the inner wall of a cavity.

A case of microscopic testicular tumour

A 34-year-old male was referred to us for further examination of gynaecomastia. Serum tests revealed high levels of alpha-foeto protein, human chorionic gonadotropin, oestradiol and prolactin. He had a history of testicular pain and mass, and had been under a local physician's care. With the physician's record of the course of regression we made a diagnosis of microscopic testicular tumour. Serial histopathological sections of the testis revealed a 0.8 mm lesion of chorionic and embryonal carcinoma. We discuss the course of spontaneous regression with a review of the literature.

Identification of IL-1 inhibitory activity as IL-1 receptor antagonist (IL-1ra) in vitro and kinetics of IL-1ra and IL-1 beta in experimental rabbit lung granuloma

This study investigated whether interleukin-1 (IL-1) inhibitory activity in LPS-stimulated culture supernatants of alveolar macrophages and epithelioid cells obtained from rabbit lung granulomas induced by complete Freund's adjuvant (CFA) was identical to IL-1 receptor antagonist (IL-1ra) and examined the changes of IL-1ra and IL-1 beta levels in lung tissue during the natural course of granulomatous inflammation. In the thymocyte proliferation assay, prostaglandin E2 (PGE2)-free culture supernatants from each cell population revealed a bell-shaped IL-1 titration curve with IL-1 activity suppressed at dilutions of 1:1 to 1:2, and gel chromatography of serum-free culture supernatants showed an IL-1 inhibitory peak at 21-25 kD. Suppression of IL-1 activity in the supernatants at lower dilutions and the gel-purified IL-1 inhibitory activity both almost disappeared after IL-1ra depletion with an anti-rabbit IL-1ra immunoaffinity column, indicating that IL-1ra was responsible for this in vitro IL-1 inhibitory activity. Pulmonary tissue levels of IL-1 beta pecked at 24 h (52.0 +/- 9.5 pg/mg) after CFA injection, whereas IL-1ra levels peaked at 4 weeks (23.1 +/- 4.0 ng/mg) when granuloma development was maximal, and the molar excess of IL-1ra to IL-1 beta peaked from 4 weeks onward at over 800-fold. These observations suggest that IL-1ra may be effective for IL-1 regulation, especially in the later stage of granulomatous responses. Immunohistochemical studies demonstrated that the cellular source of IL-1ra within the pulmonary granulomas was mainly epithelioid cells.

Mechanism underlying the ATP-induced increase in the cytosolic Ca2+ concentration in chick ciliary ganglion neurons

We examined the mechanism underlying the ATP-induced increase in the cytosolic Ca2+ concentration ([Ca]in) in acutely isolated chick ciliary ganglion neurons, using fura-2 microfluorometry. The ATP-induced increase in [Ca]in was dependent on external Ca2+, was blocked in a dose-dependent manner by reactive blue 2, and was substantially inhibited by both L- and N-type Ca2+ channel blockers. ATP was effective in increasing [Ca]in in the presence of a desensitizing concentration of nicotine (100 microM), and simultaneous addition of maximal doses of ATP and nicotine caused an additive increase in [Ca]in, suggesting that ATP acts on a site distinct from nicotinic acetylcholine receptors. ATP also increased the cytosolic Na+ concentration as determined by sodium-binding benzofuran isophthalate microfluorometry. These results suggest that ATP increases Na+ influx through P2 purinoceptor-associated channels resulting in membrane depolarization, which in turn increases Ca2+ influx through voltage-dependent Ca2+ channels. However, ATP still caused a small increase in [Ca]in under Na+-free conditions, and this [Ca]in increase was little affected by Ca2+ channel blockers. ATP also increased Mn2+ influx under Na+-free conditions, as indicated by quenching of fura-2 fluorescence. These results suggest that nonselective cationic channels activated by ATP are permeable not only to Ca2+ but also to Mn2+, in addition to monovalent cations.

75- but not 55-kDa tumor necrosis factor receptor is active in the homotypic aggregation and proliferation of human lymphokine-activated T killer (T-LAK) cells in vitro

Lymphotoxin (LT) and tumor necrosis factor (TNF) play important roles in the maturation and growth of human lymphokine-activated T killer (T-LAK) cells in vitro. The role of 55- and 75-kDa TNF receptor (TNF-R) in the aggregation and proliferation of T-LAK cells was investigated using agonistic anti-TNF-R rabbit polyclonal antibodies. Human peripheral blood T cells and T-LAK cells predominantly express 75-kDa TNF-R. The proliferation of T-LAK cells during the generation phase is supported by innate LT and TNF. In this phase, the proliferation was upregulated by anti-75- but not 55-kDa TNF-R antibody. Homotypic aggregation of T-LAK cells was induced by LT, TNF, and anti-75- but not by anti-55-kDa TNF-R antibody. The increase of homotypic aggregation was accompanied by up-regulation of intercellular adhesion molecule 1 but not lymphocyte function-associated antigen 1 expression on cells and by an elevation of membrane fluidity, both of which were up-regulated by anti-75- but not 55-kDa TNF-R antibody. Interestingly, LT and TNF suppressed the proliferation of mature T-LAK cells. Anti-75- but not 55-kDa TNF-R antibody suppressed the proliferation, mimicking LT and TNF. These findings indicated that 75- but not 55-kDa TNF-R is biologically active in the modulation of aggregation and proliferation of human T-LAK cells in vitro.

Auditory brainstem response and temporal bone and brainstem pathology in brainstem death, with special reference to autolysis of red blood cells

We studied the pathological changes in the temporal bone and brainstem, with particular attention to the autolysis of red blood cells in and around the blood vessels, in six cases of brainstem death determined by auditory brainstem responses (ABRs). Our findings showed that the cochlea, the visceral organs and the spinal cord below a certain level of the cervical segments continued to live after brainstem death. Red blood cells in the vessels of the brainstem and cerebellum exhibited severe autolysis, whereas most red blood cells in the cochlea were preserved. Our findings of autolytic changes in red blood cells in the brainstem, and the preservation of red blood cells in the cochlea, imply initial loss of brainstem function and delayed loss of cochlear function after prolonged absence of ABRs.

Expression of bovine heart fructose 6-phosphate,2-kinase:fructose 2,6-bisphosphatase and determination of the role of the carboxyl terminus by mutagenesis

Bovine heart fructose 6-P,2-kinase:fructose 2,6-bisphosphatase was expressed in Escherichia coli. In order to determine the role of the carboxyl-terminal peptide, 49 and 78 amino acids from the C-terminus were deleted using oligonucleotide-directed mutagenesis. The expressed wild-type and mutant enzymes were purified to homogeneity, and the steady-state kinetics of the mutant enzymes were compared to those of the wild-type enzyme. Deletion of 49 residues (Del 49) resulted in a 35% decrease in KmFru6P, a 36% increase in Vmax, and a 2-fold increase in Kcat/Km of the kinase. There was no change in the kinetic properties of the phosphatase activity. Deletion of 78 residues (Del 78) resulted in a 4.5-fold decrease in KmFru6P, a 2.5-fold increase in Vmax, a 12-fold increase in kcat/Km of the kinase, and a 3-fold increase in kcat/Km of the phosphatase. Phosphorylation of the wild-type and Del 49 enzymes resulted in decreased KmFru6P and activation of the kinase without affecting the phosphatase activity. Thermal inactivation rates of the wild-type and Del 49 enzymes were similar, but the rate of Del 78 was more rapid. The phosphorylated wild-type and Del 49 enzymes were more sensitive to thermal inactivation than the dephospho forms. Urea inactivation of the kinase and phosphatase of wild-type and Del 49 were similar, but Del 78 was more sensitive to urea. All phosphorylated enzymes were more susceptible to urea inactivation.(ABSTRACT TRUNCATED AT 250 WORDS)

Molecular identification of guanine-nucleotide-binding regulatory proteins which couple to endothelin receptors

The coupling of two endothelin receptor subtypes (ET(A) and ETB) to several types of guanine-nucleotide-binding regulatory protein (G protein) was examined. Two subtypes of receptor cDNAs were transfected alone or together with four different G protein alpha subunit cDNAs in COS-7 cells. In ET(A) receptor-transfected cells, endothelin-1 (ET-1) activated phosphatidylinositol-specific phospholipase C as measured by the production of phosphatidylinositol 1,4,5-trisphosphate [Ins(1,4,5)P3]. ETB-receptor-transfected cells also produced Ins(1,4,5)P3 on stimulation by ET-1. The ET-1-induced production of Ins(1,4,5)P3 was markedly higher in G alpha q-cotransfected or G alpha 11-cotransfected cells than in cells transfected with each receptor alone. ET-1 also stimulated production of cAMP in ET(A) or ETB receptor-transfected cells. The production of cAMP was synergistically amplified by G alpha s co-transfection with each receptor. In contrast, when G alpha i2 was co-transfected with the ET(A) or ETB receptor, ET-1 displayed an inhibitory action on forskolin-stimulated cAMP accumulation. Pertussis-toxin treatment of the G alpha i2-transfected cells resulted in abolition of the endothelin-induced inhibition of cAMP accumulation. These observations indicate that both ET(A) and ETB receptors are able to couple to Gq, G11, Gs and Gi2, and suggest that endothelin receptors stimulate multiple effectors via several types of G protein simultaneously. The overall effects induced by endothelin may differ in cell types depending on the level of expression of each G-protein subtype in the cell.

Effects of a synthetic rat adrenomedullin on regional hemodynamics in rats

The effects of rat adrenomedullin, a novel vasorelaxant peptide, on systemic and regional hemodynamics were examined in conscious Sprague Dawley (SD) rats and spontaneously hypertensive rats (SHR). The intravenous infusion of adrenomedullin at rates of 1.67 and 5 micrograms/kg per min decreased the mean arterial pressure in a dose-dependent fashion in both types of rats. Adrenomedullin at a rate of 5 micrograms/kg per min increased the heart rate and cardiac output. As a result, the total peripheral resistance significantly decreased. With regards to the regional hemodynamics, adrenomedullin significantly increased the flow rates in the lungs, heart, spleen, kidneys, adrenal glands and small intestine of SHR. The flow rates in the brain and skin did not change and the flow rates in the skeletal muscle and testis were decreased. These regional hemodynamic changes were also observed in SD rats and there was no qualitative difference in the regional responses to adrenomedullin between SHR and SD rats. Thus, adrenomedullin predominantly increased the flow rates in organs in which adrenomedullin gene was highly expressed. It therefore seems that adrenomedullin may act as a local vasodilatory hormone rather than as a circulatory hormone.

A clinical trial of therapeutic electrical stimulation for amyotrophic lateral sclerosis

This paper describes the effects of therapeutic electrical stimulation (TES) on the wasting muscles in a patient with amyotrophic lateral sclerosis. The patient is a 47-year-old male, and he has a history of progressive muscle weakness and atrophy, affected more in the right side. Percutaneously indwelling intramuscular electrodes were implanted to the affected muscles in the right upper and lower extremities but no electrode in the corresponding left region. Within a month of TES therapy, a rapid improvement of extremity motion appeared in the TES treated side. Long-term application of TES more than 3 months increased the strength of the muscle which had been evidently weaker than the non-treated side. CT findings of both the upper and lower extremities with TES therapy showed an increase in the density and a reduction in the moth-eaten image. An increase in the thickness of the muscles was also observed in the TES treated side while deterioration was observed in the muscles on the non-treated side.

Identification and biochemical characterization of human plasma neutrophil inhibitor in vitro

In this study, assessment by a flow cytometric method using dichlorhydroxy fluorescin diacetate (DCFADH) in vitro revealed that human peripheral blood inhibits the production of active oxygen species by human peripheral neutrophils. It was also revealed that among the blood components, the plasma fraction inhibits active oxygen production most strongly. This plasma inhibitory activity was dose-dependent. Human serum also exerted an inhibitory activity; however, its activity was only one-third that of plasma. Moreover, when HL-60 human promyelocytic leukemic cells, with or without differentiation into the neutrophils by culturing with dimethyl sulfoxide (DMSO), active oxygen, which was also inhibited by plasma, was produced. Heat inactivation of the plasma did not alter the inhibitory activity, and gel filtration analysis showed that the peak activity was associated with a molecular mass of 70,000. The results of this study indicate that human plasma contains one or more substances that inhibit the active oxygen production of neutrophils, which may play an important role in inhibiting unneeded neutrophil activation in the bloodstream.

Direct mechanical assistance of the right ventricle with the Hemopump in a porcine model

In 6 pigs, a 14F Hemopump was placed through the pulmonary artery into the right ventricle. The pulmonary artery was banded proximal to the outflow port of the Hemopump, and tightening the band increased right ventricular peak systolic pressure by 50%. There were significant falls in right ventricular stroke volume (from 43 +/- 7.3 mL [+/- the standard deviation] to 27 +/- 8.0 mL; p < 0.001) and cardiac output (from 4.94 +/- 0.76 L/min to 3.70 +/- 0.95 L/min; p < 0.01) and increases in right ventricular peak systolic pressure (from 28 +/- 9.7 mm Hg to 42 +/- 17.1 mm Hg; p < 0.01) and end-diastolic pressure (from 2 +/- 0.8 mm Hg to 12 +/- 6.4 mm Hg; p < 0.02). Mean aortic pressure fell (from 65 +/- 29.9 mm Hg to 61 +/- 9.6 mm Hg; p < 0.01), but systemic vascular resistance was unchanged, thus indicating a fall in left ventricular output reflected by a decrease in mixed venous oxygen saturation (from 60% +/- 8.9% to 47% +/- 7.6%; p < 0.01). After 15 minutes with the Hemopump at maximum speed, these variables returned to control levels (stroke volume, 38 +/- 4.5 mL; cardiac output, 4.50 +/- 0.63 L/min; right ventricular peak systolic pressure, 29 +/- 8.3 mm Hg; right ventricular end-diastolic pressure, 4 +/- 2.0 mm Hg; mean aortic pressure, 72 +/- 10.4 mm Hg; mixed venous oxygen saturation, 56% +/- 4.6% [all, p = not significant versus controls]).(ABSTRACT TRUNCATED AT 250 WORDS)

[Spatial distribution of atrial late potentials on body surface mapping in patients with paroxysmal atrial fibrillation]

We investigated the spatial distribution of atrial late potentials (ALP) in patients with paroxysmal atrial fibrillation (Paf) by use of body surface signal-averaged ECG. The P wave-triggered signal-averaged ECG was recorded in 20 patients with Paf and 34 control patients from precordial 16 unipolar leads (standard V1-V6 and two intercostal spaces below and above V1, V2, V4-V6). The duration (Ad) and number of fragmented deflection (Nf) of filtered P wave were measured on each lead. % Area was also calculated by dividing the area for the last 20 msec by the total area of filtered P wave. The lead having any of a significantly longer Ad, larger Nf and smaller % Area in patients with Paf than the controls was designated as ALP positive lead. ALPs were observed in all other than two intercostal spaces above V5 and V6. This finding suggests that the electrophysiological disparity in the whole atrial muscle might be involved in patients with Paf.

Finite element and Weibull analysis to estimate failure risk in resin-bonded retainers

Three-dimensional finite element analysis and Weibull analysis were used to evaluate the effect of the thickness and the rigidity of the retainers on the risk of failure of an anterior resin-bonded prosthesis. Retainer thickness ranged from 0.4 to 1.4 mm. The physical properties of metals similar to Ni-Cr and type IV gold alloys were used. A concentrated load (100 N) was applied to the incisal edge of the finite element analysis modeled pontic, and the data of other loads (150 to 500 N in 50-N increments) were calculated from the data of 100 N. Subsequent Weibull analysis revealed that failure probability diminished when there was an increase in metal thickness at loads of 300 to 350 N, particularly for the retainer made of a type IV gold alloy. The reduction in failure probability caused by increasing the thickness of the metal was greater when type IV gold alloy was used than when Ni-Cr alloy was used. This investigation suggests that the longevity of resin-bonded retainers can be prolonged by thickening the retainers, rather than using more rigid metals.

ATP responses in the embryo chick ciliary ganglion cells

The ATP responses in ciliary neurons acutely dissociated from chick ciliary ganglia were investigated using the nystatin perforated patch recording mode. ATP induced a transient inward current at a holding potential of -50 mV in a concentration-dependent manner. The half-maximum effective concentration of ATP was 8.2 microM and the Hill coefficient was 0.9. The current-voltage relationship of the ATP response revealed a strong inward rectification at potentials more positive than -30 mV and the reversal potential was near 0 mV. The relative potencies of purinoceptor agonists were in the order of ATP > 2-methylthio-ATP > ADP. Neither adenosine, AMP nor alpha, beta-methylene-ATP induced any response. The ATP-induced inward current was blocked by suramin, a selective P2 purinoceptor antagonist, in a concentration-dependent manner. The half-maximum inhibitory concentration was 4.5 microM. The cytosolic Ca2+ concentration was increased by ATP and suramin inhibited the increase in a concentration-dependent manner. These results suggest that ATP operates non-selective cation channels by acting on P2y purinoceptors and has a role in the excitation of ciliary neurons.