A novel hsp110-related gene, apg-1, that is abundantly expressed in the testis responds to a low temperature heat shock rather than the traditional elevated temperatures

We isolated a novel hsp110-related gene, apg-1, from a testis cDNA library. The apg-1 transcripts were constitutively expressed in the testicular germ cells and, in some degree, most tissues examined. In a mouse TAMA26 Sertoli cell line, apg-1 transcripts were induced in 2 h by a temperature shift from 32 to 39 degrees C, but not by a shift from 37 to 42 degrees C, the traditional heat stress, or a shift from 32 to 42 degrees C. The heat response pattern of hsp110 expression was similar to that of apg-1. Although induction of a hsp70 transcript was observed in 2 h by a shift from 32 to 39 degrees C, the induction was more apparent by a shift from 37 to 42 degrees C or from 32 to 42 degrees C. Essentially similar differential response patterns were observed among these genes in NIH/3T3 fibroblasts as well. The nuclear run-on assay and the native gel mobility shift assay demonstrated that, by the 32 to 39 degrees C temperature shift, the apg-1 gene was transcriptionally activated, and heat shock factor 1 bound to the heat shock elements in the 5'-flanking region of the apg-1 gene. These results demonstrated that expressions of apg-1, hsp110, and hsp70 could be heat-induced at a temperature lower than the traditional elevated temperatures in somatic cells of both testis and nontestis origin and suggest that the mechanisms regulating the transcript levels of apg-1 and hsp110 are different from those of hsp70. Furthermore, the constitutive expression in germ cells suggests that APG-1 plays a specific role in spermatogenesis as well as in stress response.

[Airway hyperresponsiveness and airway mucosal permeability]

The relationship between airway mucosal permeability and airway hyperresponsiveness was examined with tachykinins, their selective antagonists, and superoxide dismutase in male Hartley guinea pigs. In animals with ozone-induced airway inflammation, airway hyperresponsiveness and mucosal permeability increased concurrently but there was a time lag before the increase in airway vascular permeability. To study the role of tachykinins in the increases in mucosal permeability and in hyperresponsiveness, we used a neurokinin-receptor antagonist, CP-96345, and a neurokinin-2 receptor antagonist, SR-48968. CP-96345 had no significant effect, but SR-48968 reduced the increase in airway mucosal permeability; their effects on airway hyperresponsiveness were the opposite of their effects on airway permeability. Tachykinins themselves, both substance P and neurokinin A, significantly increased airway mucosal permeability. Superoxide dismutase, a scavenger enzyme of superoxide, reduced the ozone-induced airway hyperresponsiveness. These data suggest that the factors causing airway hyperresponsiveness differ from those that influence mucosal permeability, but it is possible that these pathophysiologic conditions are caused by the same substances or processes.

Inhibitory effect of a novel orally active GP IIb/IIIa inhibitor, SC-54684A on intimal thickening in the guinea pig femoral artery

The inhibitory effect of a novel orally active platelet membrane glycoprotein receptor complex IIb/IIIa (GP IIb/IIIa) inhibitor, SC-54684A is studied on intimal thickening in the guinea pig femoral artery. A segment of the femoral artery was occluded by a platelet-rich thrombus induced by photochemical reaction between systemically administered Rose Bengal and transluminal green light which causes endothelial injury followed by platelet adhesion and aggregation at the site of photochemical reaction. Three weeks after successful thrombolysis by tissue-type plasminogen activator, intimal thickening occurred at the irradiated site. SC-54684A (30 mg/kg), administered 2 h before photochemical reaction, significantly (P < 0.05) prolonged the time to occlusion of the femoral artery; in this respect aspirin (100 mg/kg) was ineffective. A combination of SC-54684A and recombinant tissue-type plasminogen activator (rt-PA) increased the frequency of reopening and significantly (P < 0.05) prolonged the duration of reflow compared with rt-PA alone. Further, SC-54684A administered orally twice a day for 3 weeks significantly (P < 0.05) inhibited intimal thickening but aspirin, administered orally once a day for 3 weeks, was ineffective. Scanning electron microscopy revealed extensive platelet adhesion and aggregation on the denuded vessel walls in the untreated group 24 h after successful thrombolysis. In separate experiments, SC-54684A markedly inhibited platelet aggregation ex-vivo. Inhibition of platelet adhesion and aggregation at the site of endothelial injury by SC-54684A (via GPIIb/IIIa inhibition) may account for its inhibitory effect on intimal thickening.

Altered prostaglandin metabolism induced by angiotensin-converting enzyme inhibitors in broncho-alveolar lavage fluid of the guinea pig

The aim of this study was to investigate if prostaglandin (PG) metabolism is altered by angiotensin-converting enzyme (ACE) inhibitors as determined in the broncho-alveolar lavage fluid (BALF) of the guinea pig. Enalapril or imidapril was orally administered once a day for 2 weeks to Hartley male guinea pigs. Twenty-four hours after the last treatment, BALF was collected and the concentrations of PGI2, thromboxane A2 (TXA2) and PGE2 were measured by enzyme immunoassay. Enalapril significanlty P < 0.05) increased the TXA2 content, which was inhibited by indomethacin treatment and significantly (P < 0.05) decreased the PGI2 content. Imidapril, however, did not affect TXA2 or PGI2 generation. These findings suggest that altered PG metabolism may be associated with coughing as a side effect of enalapril.

[Comparative study of mRNA expression of E-cadherin and collagenase IV in early and advanced cancers]

During the process of invasion, tumor cells must detach from the primary neoplasm and degrade host stroma. E-cadherin is responsible for the cell-cell adhesion and collagenase IV is the one of the matrix metalloproteinases. We determined whether the levels of mRNA for E-cadherin and collagenase IV were differently expressed within 12 cases of early and 13 cases of advanced gastric cancers using a rapid calorimetric in situ hybridization assay for mRNA. In 6 of 12 early cancers, we found a decreased expression of E-cadherin mRNA in the invasion edge compared to the main tumor. In advanced gastric cancers, 3 out of 13 cancers also exhibited this finding. Higher expression of the collagenase IV at the invasion edge of the tumor compared to the main tumor was observed in half of the early and advanced gastric cancer cases. Inverse expression levels of E-cadherin and collagenase IV mRNA were observed in 6 of 12 early cancers. However, only one of 13 advanced cancer cases expressed the same finding.

Midkine, a heparin-binding growth/differentiation factor, exhibits nerve cell adhesion and guidance activity for neurite outgrowth in vitro

By means of a baculovirus expression system, a large amount of mouse midkine (MK) was produced. The protein was purified to homogeneity by heparin-Sepharose column chromatography. The purified protein was of a mature type; the signal peptide was cleaved at the expected site. To examine the neurite-guiding activity of MK, rat embryonic brain cells (embryonic days 17-18) were cultured on plates coated with purified MK in a grid pattern. The cells attached to and extended their neurites along the substrate pattern. This interaction was strongly inhibited by heparin, but not by other glycosaminoglycans. Treatment of the cells with heparitinase was effective for inhibiting their adhesion to the substrate. These data suggest that the heparin-like domain on cell surface heparan sulfate proteoglycan is the primary site for MK binding upon interaction with nerve cells.

A chemiluminescent detection of superoxide radical produced by adherent leucocytes to the subendothelium following thrombolysis: studies with a photochemically induced thrombosis model in the guinea pig femoral artery

Reocclusion following thrombolysis is a major limitation of thrombolytic therapy with recombinant tissue-type plasminogen activator (rt-PA) because denuded vessel wall exposed to blood following thrombolysis is a favourable surface for platelet and leucocyte deposition. We have applied a chemiluminescence technique to detect superoxide radical (0(-2)) produced by leucocytes adherent to the femoral artery 24 h after photochemically induced thrombogenesis in the guinea pig in vivo and subsequent thrombolysis by rt-PA. Intravenous administration of MCLA, a specific chemiluminescence reagent for detecting O(-2), markedly increased photon emission. the photon emission was markedly potentiated by phorbol myristate acetate and was suppressed by superoxide dismutase. Reocclusion 24 h after rt-PA induced thrombolysis was observed in 10 of 16 animals. Histological observations revealed extensive polymorphonuclear leucocytes adherent to the vessel wall at the site of thrombogenesis and thrombolysis. A higher level of 0(-2) could be detected from the arteries in which thrombolysis was induced compared with those without thrombolysis. Further, the level 0(-2) detected was greater in reoccluded arteries compared with those in which reflow was established. These observations suggest that 0(-2) is produced by adherent leucocytes at the site of thrombolysis and that leucocytes are involved in reocclusion after thrombolysis.

[Intrapleural bleomycin for management of malignant pleural effusions]

We studied the efficacy of intrapleural administration of bleomycin for the management of malignant pleural effusions of non-small cell lung cancer in 24 cases. Bleomycin 60 mg was administered into the pleural space after tube drainage. If the effusion continued, one additional dose was given. The efficacy was seen in 18 cases (75%). The main adverse drug reaction was transient fever among others. There was little toxicity and no cases of pulmonary fibrosis. Intrapleural administration of bleomycin is useful in management of malignant pleural effusions.

[A recurrence of benign fibrous mesothelioma of the pleura: a case report]

A 64-year-old man who complained of the right chest pain was admitted in our hospital. A mass shadow which revealed the extrapleural sign was shown in the chest X-ray. This patient was performed thoracotomy and a tumor invading to the intercostal muscles was resected. Pathological diagnosis was benign fibrous mesothelioma. About 10 months after this operation, we suspected the local recurrence of the tumor on the chest X-ray. The re-operation was performed, and we resected the recurrent tumor and the 2nd and 3rd ribs. Pathologically the resected tumor was benign fibrous mesothelioma.

Platelet-activating factor mediates the ozone-induced increase in airway microvascular leakage in guinea pigs

In the present study, we asked whether platelet-activating factor (PAF) mediates the ozone-induced increase in airway microvascular leakage. To answer this question, we examined the effect of a PAF receptor antagonist on the ozone-induced increase in airway microvascular leakage quantified by the extravasation of Evans blue dye in the guinea pig trachea and main bronchi. Guinea pigs were pretreated with the PAF receptor antagonist, E6123 ((S)-(+)-6-(2-chlorophenyl)-3-cyclopropane-carbonyl-8,11-dimethyl-2,3,4, 5- tetrahydro-8H-pyrido[4',3':4,5]thieno[3,2- f][1,2,4]triazolo[4,3-a][1,4]diazepine) (0.01, 0.1 and 1.0 mg/kg i.v.) and then exposed to 3 ppm ozone for 30 min. The PAF receptor antagonist significantly reduced the ozone-induced increase in microvascular leakage in a dose-dependent manner in both the trachea and main bronchi. Our results indicate that PAF mediates the ozone-induced increase in airway microvascular leakage. We therefore suggest that PAF may be involved in ozone-induced airway inflammation.

Presence of alternative 5' untranslated sequences and identification of cells expressing ctk transcripts in the brain and testis

From a mouse brain cDNA library, two species of the Csk-type tyrosine kinase (ctk) gene containing different 5' untranslated sequences were cloned. Using the common as well as specific nucleotide sequences of the two clones as probes, we examined the expression of ctk in various mouse tissues by Northern blot analysis. The results indicated that both species of ctk were expressed in the brain, testis and bone marrow. By in situ histochemistry of the brain, ctk transcript was detected in neurons throughout the entire brain, especially those of the cortex, the hippocampus and the cerebellum. This distribution pattern is similar to that of the Src family kinases including Yes, Src, Fyn and Lyn. In the testis, the major transcript (0.7 kb) was shorter than that expressed in the brain and the bone marrow (2.0 kb). A subsequent Northern blot analysis of fractionated germ cell populations and in situ histochemistry revealed that the short and long transcripts were expressed in germ cells and somatic cells, respectively, and that the expression level was quantitatively regulated during germ cell development. These results suggest that Ctk is involved in the regulation of neural function and differentiation of male germ cells through interactions with member(s) of the Src family kinases.

[Concurrent chemoradiotherapy followed by surgery for advanced stage III non-small cell lung cancer (NSCLC)]

Forty-two patients with stage IIIA (bronchoscopically T3 and/or bulky N2) and stage IIIB NSCLC were treated with concurrent chemoradiotherapy (CRT). Treatment consisted of CDDP, 20 mg/m2 and etoposide, 40 mg/m2 by continuous infusion (day 1-5) of weeks 1 and 5 simultaneously with chest radiotherapy (RT), 50 Gy, 2 Gy/Fx, 5 Fx/week. Surgery was attempted 3-5 weeks after RT in pts clinically downstaged. Between 10/90 and 12/92, 43 previously untreated pts were enrolled and 42 were eligible. Pts characteristics were: male/female = 37/5; mean age, 61 yrs (range, 31-74 yrs); stage IIIA/IIIB = 10/32; 15 adenocarcinoma, 24 squamous cell, 2 large cell, 1 unclassified; PS 0/1/2 = 11/24/7. Excluding 1 ineligible pts, 42 pts were evaluated for CRT response. The response rate was 81% (1 CR, 33 PR, 5 NC, 1 PD, 2 NE). Clinical downstaging was achieved in 20 pts (48%). Twenty-one pts (50%) received surgery and 19 of them were completely resected. In 7 resection specimens, no tumor was observed. Toxicity of CRT was well tolerable (Grade 4 leukopenia, 15%; Grade 2-3 esophagitis, 15%). We conclude that this intensive combined modality therapy is acceptable and appears to increase the response rate as well as resectability. Prospective randomized studies should be conducted for further evaluation of this treatment modality.

Absent uptake on hepatobiliary scintigraphy in hepatic lobar infarction from portal vein occlusion in cholangiocarcinoma

Hepatic infarction is an uncommon entity because of the dual blood supply to the liver. We report a case in which multimodalities demonstrate infarction of the left lobe of the liver secondary to left portal vein occlusion by an invasive cholangiocarcinoma. A 99mTc-DISIDA hepatobiliary scan showed complete absence of activity to the left of the gallbladder fossa. The differential diagnosis of absent hepatic activity on a hepatobiliary scan must include hepatic infarction.

[Urinary erythrocyte morphology under optical microscopy: value in the urological outpatient clinic]

Urinary erythrocyte morphology was examined by optical microscopy 1,256 urological patients with hematuria, between 1990 and 1993. The patients were grouped according to whether their urinary red cells were glomerular origin or non-glomerular in origin or mixed form, or others. Of the 740 patients in the glomerular group 537 were examined urologically, and some urological disease was found in 78 (15%) patients. Urological disease was found in only 7 (2%) of the 316 patients in the glomerular group whose complaint was only asymptomatic microscopic hematuria. Examination of urinary erythrocyte morphology under optical microscopy is inexpensive and valuable in the urological outpatient clinic.

[Clinical and serological studies in six cases of chlamydial pneumonia]

Clinical and serological studies of chlamydial pneumonia were done in six patients (three men and three women). The other three patients had no avian contact and showed almost the same clinical symptom. Acute infection with Chlamydia psittaci and Chlamydia pneumoniae were diagnosed in two patients and in one patient, respectively, by MFA. Because in some cases Chlamydia psittaci pneumonia and Chlamydia pneumoniae pneumonia are difficult to differentiate, it is necessary to use a test that allows different chlamydia species to be distinguished.

Effect of long-term methotrexate-induced neutropenia on experimental periodontal lesion in rats

The effects of long-term methotrexate (MTX)-induced neutropenia on the periodontal lesion in rats were investigated histologically, histometrically and bacteriologically. A nylon thread was inserted into the interdental gingiva between the 1st and 2nd right maxillary molars of the animals 3 weeks before an application of MTX. The animals were then divided into Groups A and B. Group B were injected intraperitoneally with 1.0 mg/kg of MTX 3 times per week for 9 weeks. Group A received saline as a control. Five animals were killed at the 1st, 3rd, 5th, 7th, and 9th week. In Group A, the neutrophils did not decrease during these 9 weeks. In Group B, however, the neutrophils decreased during the 3rd to 9th week. Whereas the experimental side of Group A showed only moderate alveolar bone resorption between the 7th and 9th week, [in Group B] a marked alveolar bone resorption occurred in Group B occurred in the same period. Alveolar bone loss in the experimental side of Group B was significantly greater (p < 0.01) than in Group A in the 7th to 9th weeks. The percentage of gram-negative rods increased in both control and experimental sides of Group at the 9th week. The results of the present study indicate that neutropenia is induced by a long-term application of MTX in rats and that alveolar bone destruction increases as time goes by in the area where a nylon thread was inserted.

Enhancement of thrombolytic efficacy of tissue-type plasminogen activator by adjuvants in the guinea pig thrombosis model

Reocclusion following thrombolysis is a major limitation of thrombolytic therapy with recombinant tissue-type plasminogen activator (rt-PA). We investigated the effects of vapiprost ((1R-(1 alpha(Z),2 beta,3 beta,5 alpha))-7-(5-((1,1'-biphenyl)-4-yl-methoxy)- 3-hydroxy-2-(1-piperidinyl)cyclopentyl)-4-heptenoic acid, a thromboxane A2 receptor antagonist); argatroban ((2R,4R)-4-methyl-1-[N2-(3-methyl-1,2,3,4-tetrahydro-8-quinolinyl)sulfon yl] - L-arginyl)]-2-piperidine-carboxylic acid, a specific thrombin inhibitor) and MK-886 (3-[1-(4-chlorobenzyl)-3-t-butyl-thio-5-isopropylindol-2-yl]-2,2- dimethylpropanoic acid, a specific leukotriene biosynthesis inhibitor) on the thrombolytic efficacy of rt-PA. The guinea pig femoral artery was thrombotically occluded by photochemical reaction between rose bengal and green light. Thirty min after the occlusion, rt-PA was administered and the time (T1) for reopening of the vessel and the frequency of reocclusion (Fro) 24 h after thrombolysis were monitored. With rt-PA alone, T1 was 28 +/- 7 min (n = 10) and Fro was 70%. T1 was reduced to 9 and 20 min by a combination of rt-PA with vapiprost and argatroban respectively. Fro was reduced by all three adjuvants. Histological observations revealed extensive adherence of polymorphonuclear leucocytes to the damaged endothelium at the site of thrombolysis. It is concluded that thromboxane A2, thrombin and leucocytes are involved in reocclusion after thrombolysis.

[Phase II study of a continuous five-day intravenous infusion of cisplatin and etoposide with concurrent chest radiation therapy in limited stage small cell lung cancer]

The efficacy of continuous five-day intravenous infusion of cisplatin (CDDP) and etoposide with concurrent chest radiation therapy was evaluated in patients with limited stage small cell lung cancer. The first group of patients registered from February 1989 to September 1990 received three courses of chemotherapy (CDDP 20 mg/m2/day x 5 days, etoposide 40 mg/m2/day x 5 days) and concurrent chest radiation therapy on the third course with dose reduction of etoposide. The second group of patients registered after February 1991 received four courses of chemotherapy (CDDP 20 mg/m2/day x 5 days, etoposide 50 mg/m2/day x 5 days) and concurrent chest radiation therapy on the first and second courses with dose reduction of etoposide. The response rates were 91.7% and 93.3%, respectively. The median duration of survival was 32.0 months and 20.1 months, respectively. Major toxicity was leukocytopenia and 64% and 80% of patients encountered leukocytopenia of Grade 3 or 4. In conclusion, these regimens show remarkable efficacy with acceptable toxicity.

Capsaicin reduces ozone-induced airway inflammation in guinea pigs

We investigated whether neural pathways are involved in mediating ozone (O3)-induced airway inflammation. To determine this, we studied the contribution of adrenergic and cholinergic pathways to the O3-induced increase in airway vascular permeability, an indicator of airway inflammation, by measuring vascular permeability after giving guinea pigs propranolol or atropine to block these pathways. We also studied the contribution to O3-induced airway inflammation of neuropeptides localized in unmyelinated airway sensory nerves, by measuring vascular permeability after giving capsaicin to deplete neuropeptides from these nerves. We found that capsaicin reduced but did not abolish the increase in airway vascular permeability induced by 3 ppm O3 for 30 min. Propranolol and atropine had no effect on airway vascular permeability. These results indicate that neuropeptides released from sensory nerves, presumably by acting through the axon reflex, partly mediate O3-induced airway inflammation, and that adrenergic and cholinergic pathways are not involved.

[Surgery of bilateral pulmonary aspergilloma]

A 60-year-old man with cough and fever was admitted to our hospital. Chest radiography revealed multiple bullae and fungus balls in both lungs. He was treated with MCZ and FCZ for about 2 months, but the chest radiograph shadows did not improve and the fever continued. A two-stage operation was performed. The bullae were incised and the fungus balls were removed, then a muscle flap plombage was made with a pectoralis major muscle, a latissimus dorsi muscle and an intercostal muscle. The postoperative course was uneventful and respiratory function was preserved.

Effects of MS-551, a new class III antiarrhythmic drug, on programmed stimulation-induced ventricular arrhythmias, electrophysiology, and hemodynamics in a canine myocardial infarction model

We examined the effects of MS-551 (1,3-dimethyl-6-[(2-[N-(2-hydroxyethyl)-3-(4- nitrophenyl)propylamino]ethylamino] 2,4(1H,3H)-pyrimidinedione hydrochloride), a new class III antiarrhythmic drug, on programmed electrical stimulation (PES)-induced ventricular arrhythmias, the effective refractory period (ERP), intraventricular conduction, and hemodynamics in a canine myocardial infarction (MI) model. MS-551 was administered intravenously (i.v.) in two consecutive doses; the first dose (low dose) was 0.5 mg/kg/min after a bolus injection of 0.3 mg/kg, and a second dose (high dose) was 0.1 mg/kg/min after a bolus injection of 0.3 mg/kg. PES induced ventricular tachycardia (VT) or ventricular fibrillation (VF) in 10 of 12 animals. MS-551 abolished or lessened the ventricular arrhythmias in 7 of 10 animals at both doses. ERP was significantly prolonged by MS-551 in both the normal and infarcted zones in a dose-dependent fashion. Ventricular conduction of a premature excitation induced by a premature stimulation with various coupling intervals was decreased only at a coupling interval approximating that of ERP. MS-551 at either low or high dose did not significantly change the heart rate (HR), mean blood pressure (MBP), cardiac output (CO), or maximum rate of increase in left ventricular pressure (LVP) significantly. MS-551 produced a suppression of the PES-induced ventricular arrhythmias through prolongation of ERP without having any significant effect on hemodynamics in a canine MI model.

[A pilot study of induction chemotherapy with cisplatin, mitomycin C and vindesine for stage III N2 non-small cell lung cancer]

PURPOSE

The postoperative survival of patients with preoperatively identified stage III N2 non-small cell cancer (NSCLC) is poor. A pilot study of induction chemotherapy consisting of cisplatin, mitomycin C and vindesine (CMV) was undertaken in an attempt to improve the curative potential of surgery in this group of patients.

PATIENTS AND METHODS

Thirty-two patients with stage III N2a NSCLC received two cycles of CMV, (80 mg/m2 cisplatin i.v. on day 1, 8 mg/m2 mitomycin C i.v. on day 1, and 3 mg/m2 vindesine i.v. on day 1 and 8, every 4 weeks) preoperatively. The responding patients received a further two courses of CMV after surgery.

RESULTS

The response rate was 63% (20 PR). All patients underwent operation including radical mediastinal node dissection. Twenty-six resections were curative and six were absolute non-curative. The toxicity was generally mild, but there were two hospital deaths, due to bronchopleural fistula and postoperative pneumonia. Sixteen patients have shown recurrent disease up to now. When the recurrence patterns were classified by clinical response, 11 responding patients were disease-free (9-84 months), but all non-responding patients had recurrent diseases. The median survival of curatively resected patients with pathological N2 was 39 months with a 5-year survival of 29%.

CONCLUSIONS

This induction chemotherapy was well tolerated and revealed a high response rate. The current survival is obviously improved compared with the historical control, indicating that subsequent phase III clinical trials are urgently needed.

Magnetic resonance evaluation of the temporomandibular joint disc position and configuration

Although magnetic resonance imaging (MRI) is the modality of choice for evaluation of TMJ disc position, it is sometimes difficult to determine when it is displaced or reduced. The MR images of 273 Patients with a clinical diagnosis of TMJ disorders were assessed for disc position and configuration. Most (90-97%) of the slightly anteriorly displaced discs were reduced to the normal position in the open-mouth position. However, the greater part (76%) of the distorted discs was completely displaced anteriorly and without reduction. Since no distorted discs were found in the normal disc position, we conclude that discs are distorted after displacement.

Characterization of renal aldosterone receptors in genetically hypertensive rats

To investigate the aldosterone responsiveness of genetically hypertensive rats, we compared characteristics of renal cytosolic aldosterone receptors from the M strain of stroke-prone, spontaneously hypertensive rats (M-SHRSP) with normotensive Wistar-Kyoto rats (WKY). In M-SHRSP, blood pressure was elevated significantly at 6 wk of age, when their plasma aldosterone concentrations were similar to those in WKY. Decreases in urine volume and sodium excretion were also observed in M-SHRSP. At 10 wk of age, M-SHRSP plasma aldosterone concentrations became significantly higher than those in WKY. On the other hand, the concentration of renal cytosolic aldosterone receptors (type I, aldosterone specific) had already increased at 6 wk of age in M-SHRSP, with no difference in affinity, and levels remained increased thereafter. There were no significant differences in molecular weights or ionic charges of either "activated" or "non-activated" aldosterone-receptor complexes between M-SHRSP and WKY, indicating that the molecular properties were similar in both groups. These results suggest that the increased concentration of aldosterone receptors in the kidneys of M-SHRSP might increase their aldosterone responsiveness and contribute to the development of high blood pressure in these animals.

[Two cases of Morgagni's hernia]

Two cases of Morgagni's hernia comprising protrusion of the omentum alone are reported. The treated patients were 65- and 63-year-old obese women. They were referred to our hospital because of chest pain or vomiting accompanied by abnormal shadow in right cardiophrenic angle on chest roentgenogram. Computed tomogram (CT) demonstrated a mass of fat density behind the sternum for the both patients. The first patient was diagnosed as Morgagni's hernia by pneumoperitoneum, and surgical repair was done by the transabdominal approach. Magnetic resonance imaging (MRI) was carried out for the second patient, and showed intrathoracic mass lesion which was continuous with the subphrenic tissue. Although the second patient was diagnosed as mediastinal lipoma, median sternotomy revealed that the mass lesion was Morgagni's hernia. Postoperatively, both patients recovered uneventfully. The Morgagni's hernia has been reported to be about 3% of all diaphragmatic hernia. This disease may be discovered either because it causes respiratory or gastrointestinal complaints, or because an abnormal shadow in right cardiophrenic angle on a chest roentgenogram. If air-filled structures are present in the hernia, a barium study will confirm the diagnosis. In a case with a hernia containing only omentum, the diagnosis is difficult. CT has been regarded as the procedure of choice by several authors. The coronal and sagittal views of MRI can demonstrate the relationship between the herniated structures and the diaphragm, heart, pericardium. We emphasize the role of MRI for the diagnosis of Morgagni's hernia.

Combined effects of ozone and cigarette smoke on airway responsiveness and vascular permeability in guinea pigs

The effects of combined exposure to ozone and cigarette smoke on airway responsiveness and tracheal vascular permeability, compared with those of single exposure were examined in guinea pigs. Airway responsiveness was assessed by measuring the specific airway resistance (sRaw) as a function of increasing concentration of inhaled methacholine aerosol immediately, 5 hr, and 24 hr after exposure. In a parallel study, tracheal vascular permeability was quantified by measuring the tracheal extravasation of intravenously administered Evans blue dye. Neither exposure to 1 ppm ozone for 30 min nor 5 puffs of cigarette smoke increased airway responsiveness or vascular permeability at any time after exposure. Combined exposure to 1 ppm ozone for 30 min and 5 puffs of cigarette smoke caused airway hyper-responsiveness and increased vascular permeability immediately after exposure. Exposure to 1 ppm ozone for 90 min increased both airway responsiveness and vascular permeability immediately after exposure. Exposure to 10 puffs of cigarette smoke increased airway responsiveness but not vascular permeability immediately after exposure. Combined exposure to 1 ppm ozone for 90 min and 10 puffs of cigarette smoke increased both airway responsiveness and vascular permeability immediately after exposure. The combined exposure to ozone and cigarette smoke thus increased both airway responsiveness and tracheal vascular permeability to a greater extent than did exposure to a single agent, suggesting that a combination of air pollutants has a more deleterious effect both on airway responsiveness and on tracheal vascular permeability than does either agent alone in guinea pigs.

Postoperative venous thromboembolism and brain tumors: Part I. Clinical profile

Forty-six patients who underwent surgery for brain tumors were studied prospectively with 125I labeled Fibrinogen leg scans to detect postoperative venous thrombosis. The incidence of thrombosis was 72% for meningioma patients, 60% for glioblastoma patients, and 20% for brain metastasis patients. Correlation between the occurrence of venous thrombosis and the various clinical factors thought to be responsible for the high incidence of thrombosis generally failed to show statistical significance. This finding, along with the marked variation in the incidence of venous thrombosis between the different brain tumor groups, strongly suggests that biological factors play a more important role than clinical factors in determining which brain tumor patient will suffer a postoperative thrombotic event.

Reduced lysozyme in solution and its interaction with non-ionic surfactants

Reduced lysozyme at pH 2.5 bound poly(oxyethylene) alkylethers in two steps and the maximum bound amount Qmax of the surfactant reached as large as 0.5-0.7 mole per mole amino acid residue in the cooperative binding step. Binding isotherms were well superimposed when surfactant concentrations were normalized by respective values of the critical micelle concentration, cmc. In terms of the onset concentrations of the cooperative binding C*, hydrophobicity of reduced lysozyme was quantitatively defined as RT In (cmc/C*) which amounted to 670 J per mole surfactant and was unique to the protein irrespective of the kind of surfactant. Qmax could be used as another measure of the hydrophobicity of the protein. The binding isotherms were evaluated by two methods: equilibrium dialysis and surface tension. Their results were consistent with each other and rather complementary. Reduced lysozymes were molecularly dispersed at pH below 2.5 in 0.01 M NaCl but aggregation took place as pH increased. The aggregates could not be dissociated on dilution nor by the addition of nonionic surfactants but by lowering pH. The irreversible nature of the aggregation was reasonably interpreted with a model based on the 'entangled' arrangement of the beta-sheets, which could account for the irreversible aggregation of unfolded proteins in general.

Antianginal effects of amlodipine at a single dose on exertional angina patients using treadmill exercise testing--a randomized crossover study in comparison with placebo

With eight cases of stable exertional angina as subjects, the antianginal action and sustained effects of single 10 mg oral doses of new calcium antagonists amlodipine were assessed by treadmill exercise tests in randomized crossover trials with respect to a placebo. Exercise tests were conducted before as well as 4, 8, and 24 hours after administration, and plasma amlodipine concentration was investigated at the same times. The maximal exercise time was 299 +/- 43 seconds before as compared with 346 +/- 49 seconds 4 hours after administration and 368 +/- 50 seconds 8 hours after administration, a significant prolongation in each case (p < 0.01). Moreover, the exercise time elapsed until 1 mm of ST-segment depression, as well as the ST-segment depression measured at the same time, were both significantly improved as compared with the placebo results. The plasma amlodipine concentration reached a peak 8 hours after administration and displayed an effective level even 24 hours after administration. The value of delta PRP measured at the same time during the exercise test was also significantly reduced as compared with the placebo results, even 24 hours after administration of amlodipine. These findings supported the conclusion that single 10-mg doses of amlodipine provide stable antianginal action over a 24-hour period.

[A case of renal squamous cell carcinoma associated with giant hydronephrosis and ureteral stone: efficacy of imaging modality]

A rare case of squamous cell carcinoma of the right kidney associated with giant hydronephrosis and right ureteral stone was reported. A 60-year-old woman was referred to our department with a complaint of ileocecal dull pain. A plain computerized tomogram (CT) revealed giant hydronephrosis, and a kidney-ureter-bladder X-ray revealed a right lower ureteral stone. A right percutaneous nephrostomy was done and antegrade pyelography revealed giant hydronephrosis and a ureteral stone, but showed no intrapelvic filling defect. Under the diagnosis of right ureteral stone with hydronephrosis, right ureterolithotomy was done. However, since the inflammation did not subside after ureterolithotomy, right nephrectomy was done. The surgically removed right kidney did not show any evident tumor mass, a histological study revealed squamous cell carcinoma involving renal parenchyma. The patient received no adjuvant therapy and died 3 months after nephrectomy with sudden appearance of bone, liver and pulmonary metastases. The preoperative efficacy of imaging modalities for renal squamous cell carcinoma was discussed herein.

The clinicoradiologic predictability of perforations of the soft tissue of the temporomandibular joint

One hundred thirty-one arthrographic examinations of temporomandibular joints were performed on 119 patients. The relationships between clinical symptoms, tomographic findings, and soft-tissue perforation were examined. Perforations of the articular disk or posterior attachment were revealed in 58 joints. Joints with crepitation showed a high frequency of perforation (20 of 22). Pain in the joint area and limitation of opening correlated to disk reduction. Perforations were observed in 12 of 21 joints with continuous pain. Osseous changes were detected in 89 joints. Joints with abnormal radiodensity (erosion, sclerosis) combined with abnormal shape (pocket erosion, osteophyte formation, deformity) showed a high frequency of perforation (41 of 45), which corresponded to 84% in this study. In those cases with osseous change or crepitation, positive predictive values of perforation were both 91%. These types of osseous change and their clinical significance might predict soft-tissue perforation with high accuracy before an arthrogram is performed.

99mTc(V)-DMSA and 99mTc-MDP uptake and no 67Ga-citrate uptake in a case of primary pulmonary leiomyosarcoma

Tumor scintigraphy with 67Ga-citrate, 99mTc(V)-DMSA and 99mTc-MDP were performed on a patient with rare primary pulmonary leiomyosarcoma. While 67Ga-citrate accumulation to the tumor was not recognized, 99mTc(V)-DMSA and 99mTc-MDP scintigraphy showed relatively intense localization of the tracers in the lesion, and were very useful in suggesting the characteristics of the tumor.

[Male bladder leiomyoma: a case report]

A case of leiomyoma of the urinary bladder in a 40-year-old man is reported. Enucleation of the tumor was performed, because transurethral resection-biopsy revealed a bladder leiomyoma. Ninety nine cases of a bladder leiomyoma have been reported in Japan, but male cases are rare.

[Clinical study on cough variant asthma]

Chronic cough may be the sole presenting manifestation of bronchial asthma (reference 3; Corrao et al, 1979), and "cough variant asthma (CVA)" has been used to categorize such patients. In order to clarify the clinical picture of CVA, we evaluated the clinical history, laboratory data, sputum cytology and pulmonary function in 14 subjects (5 males and 9 females, aged 14 to 65 years) compatible with the following diagnostic criteria: (1) chronic cough persistent for more than 8 weeks, (2) no wheeze nor dyspnea, (3) no rales, (4) no past history of asthma, (5) bronchial hyperreactivity to methacholine proven by Takishima's method (reference 13), (6) effectiveness of bronchodilators against cough, (7) normal chest X-ray film, (8) afebrile and negative CRP, (9) absence of sinusitis and postnasal drip, or if present, they are proved not to be responsible for the cough, and (10) no other causes of cough such as heart disease, prescription of ACE inhibitors, current smoking. The results were as follows. 1) Many of the subjects were atopic, with positive skin tests to one or more common allergens in 10 subjects, elevated serum IgE in 4 subjects, and past history and family history of atopy in 4 and 7 subjects, respectively. 2) Respiratory infection preceded the onset of CVA in 3 subjects. 3) Cough was generally nocturnal, but 2 subjects coughed only in the daytime. 4) FEV1.0% was decreased (less than 70%) in only 2 subjects, whereas V25 was decreased (less than 80% of predicted value) in 11 out of 12 evaluable subjects, which suggested peripheral airway obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

1H-NMR spectroscopy of serum in SHN mice with and without spontaneous mammary tumours

Proton nuclear magnetic resonance (1H-NMR) spectra of serum were studied before and after the appearance of spontaneous mammary tumours in intact and anterior pituitary grafted SHN mice. In the sera of non-tumourous animals, the lipid CH2 and CH3 resonances at 1.31 and 0.88 ppm, possibly the peaks of very low density lipoprotein (VLDL), were unclear; however, such resonances were apparently observed in the sera of mammary tumour bearing mice. On the contrary, alanine, beta-hydroxybutyrate, valine and leucine, which peaked clearly in non-tumourous mice, declined greatly in tumourous mice. Livers of tumourous mice were heavier than those of non-tumourous animals. Quite similar trends in serum spectra and liver weight were observed in mice grafted with two anterior pituitaries. These findings indicate that tumour absorption of VLDL increases and other metabolic pathways are largely altered in association with mammary tumour progression. Prolactin, which is essential for mammary tumour development, had little effect on serum spectra of mice either with or without mammary tumours.

1H-NMR spectroscopy of urinary components of SHN mice in the course of spontaneous mammary tumourigenesis

Proton nuclear magnetic resonance (1H-NMR) spectroscopy of urine was studied before and after the development of spontaneous mammary tumours in SHN mice. Urinary allantoin and lactic acid levels declined from 2 weeks before mammary tumour appearance and increased with the tumour growth after its appearance. The level of component at 3.4 ppm, which reacted with Ninhydrin and was possibly assigned to taurine, continued to decline beginning 2 weeks before tumour appearance. No considerable changes were observed in urinary levels of creatine and creatinine before and after tumour development, however, these components as well as allantoin or lactic acid had positive correlations with mammary tumour size. A negative correlation was observed between the level of 3.4 ppm component and tumour size. Surgical removal of tumours resulted in an apparent decline in urinary levels of allantoin and lactic acid. At all stages, urinary allantoin level was approximately 4 times as high as the levels of lactic acid and 3.4 ppm component. All results suggest that urinary allantoin would be a good indicator for the development of spontaneous mammary tumours of mice.

[A resuscitated case of sleep apnea syndrome with cardiac arrest]

A 71-year-old man was noted to habitually snore loudly at night and have a predisposition to somnolence during the daytime. While dozing during the day, he developed cardiac arrest at the time when snoring stopped, and was resuscitated. By means of a respiration monitor, he was diagnosed as having sleep apnea syndrome (SAS) with a combination of obstructive, central, and mixed type. However, neither respiratory insufficiency nor cardiac insufficiency was observed, and there were no abnormal findings on laboratory tests and bronchoscopy. SAS complicated by cardiac arrest is usually seen in cases with concomitant symptoms such as excessive obesity, hypertension, arrhythmia, right heart insufficiency, secondary polycythemia, or mental disorder. The present case abruptly developed cardiac arrest in the absence of such symptoms. This case therefore suggests the importance of screening tests using a respiration monitor during sleep in subjects who have a loud snore or a predisposition to somnolence during the daytime. Although treatment with UPPP alone had no noticeable effect, UPPP treatment combined with sleeping in the lateral position was effective in the present case. The efficacy rate of UPPP has been reported to be 50 to 60%. The early establishment of a method for precise evaluation of the site of obstruction as well as criteria for appropriate application of UPPP are urgently required.

[Inferior vena caval resection for renal cell carcinoma: usefulness of renal venous pressure measurement]

Renal cell carcinoma with extended tumor thrombi densely adherent to the vena caval wall sometimes requires vena caval resection. If the tumor is on the right side and the collateral veins of the left renal vein are abundant, vena caval reconstruction may not be required. We recently performed radical nephrectomy and vena caval resection on 2 right renal cell carcinoma patients. To decide the necessity of vena caval reconstruction, left renal vein pressure was measured before and after clamping of the vena cava. In case 1, because the pressure was elevated from 21 cmH2O, to 61 cmH2O, total replacement with Gore-Tex graft was performed. In case 2, because the pressure change was from 22 cmH2O to 23 cmH2O, reconstruction was not performed. The most important test to decide the necessity of vena caval reconstruction is thought to be the change of renal venous pressure before and after clamping of the vena cava.

[Le Duc-Camey antireflux ureteroileal reimplantation for continent ileal reservoir]

Le Duc-Camey antireflux ureteroileal reimplantation was used on 15 patients with 30 ureters reimplanted into the ileum as part of a bladder substitution procedure (Kock pouch or ileal neobladder: U-bladder) or augmentation cystoplasty (Goodwin ileocystoplasty). In our experience, no reflux was observed, while hydronephrosis was identified in one ureter of ileal neobladder (4%). Le Duc-Camey antireflux ureteroileal reimplantation is suitable for reconstruction with the ileal reservoir.

Effects of CD-349, a dihydropyridine derivative, on contraction induced by vasoactive agents in canine basilar artery after subarachnoid hemorrhage

We investigated the effects of CD-349, a dihydropyridine derivative, on contraction induced by vasoactive agents in canine basilar artery after subarachnoid hemorrhage (SAH). Ca(2+)-induced contraction of basilar arterial strips preincubated with serotonin (5-HT, 3x10(-6)M) was potentiated in strips from SAH. However, Ca(2+)-induced contraction of arterial strips which were depolarized with isotonic K+ (64mM) was attenuated in strips from SAH. These Ca(2+)-induced contractions of the basilar arteries preincubated with 5-HT and K+ from both control and SAH dogs were significantly inhibited by CD-349 and nicardipine, both dihydropyridine derivatives. 5-HT contracted the basilar arterial strips in a concentration-dependent manner; however, the maximal contraction of the basilar arterial strips to 5-HT was enhanced in SAH. Endothelium-dependent relaxation in response to substance-P was attenuated in SAH when compared to that in control dogs. Early treatment with CD-349 (1 or 2mg/kg/day, i.m.) for 1 week reversed not only the enhanced contraction of the basilar artery in response to 5-HT but also the impairment of endothelium-dependent relaxation in response to substance-P in SAH. It is expected that CD-349 may be a useful agent for the treatment of cerebrovascular diseases such as SAH.

Changes in responsiveness of the canine basilar artery to endothelin-1 after subarachnoid hemorrhage

The effect of endothelin-1 (ET-1) on the basilar arteries from control and subarachnoid hemorrhage (SAH) dogs were examined. The maximal contraction of the basilar artery in response to ET-1 was markedly decreased in the SAH group. Treatment with 10(-8)M phorbol 12-myristate 13-acetate (PMA) reduced the contractile responses to ET-1 in the basilar arteries from control dogs. ET-1-induced contractions of the basilar arteries from control dogs were similar to those in strips from SAH dogs by the treatment with 10(-8) M PMA. Ca(2+)-induced contraction of the basilar arteries which were depolarized with isotonic K+ (64 mM) were significantly attenuated in SAH dogs. Treatment with PMA also reduced the contractile responses to Ca2+ in the basilar arteries from control dogs. These results indicate that decreased contractile responses of the basilar arteries to ET-1 and Ca2+ in the SAH group may be related to changes in the activity of the protein kinase C in vascular smooth muscle.

[A new method of intraarterial high dose chemotherapy for unresectable hepatocellular carcinoma--the effect of direct hemoperfusion under hepatic venous isolation]

We undertook hepatic artery infusion of high dose adriamycin (ADR) in three patients with unresectable hepatocellular carcinoma utilizing direct hemoperfusion (DHP) under hepatic venous isolation (HVI). 5 minutes continuous infusion of ADR at dosages of 100 and 150 mg/m2 was combined with DHP of 20 and 30 minutes, respectively. HVI was established by occlusions of suprahepatic and retrohepatic vena cava using a tourniquet tape and a cuff-cannula. During HVI, hepatic venous outflow was directed toward DHP and joined with the rest of the intra-caval blood before the centrifugal pump connected to a return cannula to the left axillary vein. Systemic levels of ADR were maintained less than 2 micrograms/ml during the treatments in three patients. The estimated drug removal rates were 72.3%, 51.2% and 31.1% respectively. Hematologic changes due to DHP were tolerable and transient. Highest values of serum transaminases were demonstrated on day 2 and rapidly recovered to the pretreatment levels within a week. Postoperative CT studies revealed also marked reduction in tumor size. We consider this method an attractive therapeutic option for patients with advanced hepatocellular carcinoma.

Extracorporeal removal of anticancer drugs in hepatic artery infusion: the effect of direct hemoperfusion combined with venovenous bypass

The effect of a new extracorporeal system combining direct hemoperfusion (DHP) with venovenous bypass was evaluated in the elimination of anticancer drugs in hepatic artery infusion. Adriamycin (3 mg/kg) and mitomycin C (1 mg/kg) were given to mongrel dogs through the hepatic artery with three different durations of 1, 10, and 20 minutes. Plasma drug levels were determined at the inlet and outlet of DHP and right external jugular vein (systemic level). Blood flow through DHP averaged 200 ml/min. In dogs without DHP (group I; n = 4), systemic levels of adriamycin and mitomycin C increased rapidly with 1-minute infusion, reaching the peak values of 6.61 +/- 2.44 (mean +/- SD) and 2.20 +/- 1.05 micrograms/ml, respectively. With DHP under single venous bypass (group II; n = 5), the peak values were reduced to 1.25 +/- 1.02 and 0.79 +/- 0.52 microgram/ml. Moreover, the peak levels were markedly reduced by DHP under hepatic venous isolation (group III; n = 6), the values being 0.41 +/- 0.15 and 0.13 +/- 0.07 microgram/ml with 1-minute infusion. The drug-removal rates were improved substantially in group III compared with group II. The longer the duration of infusion, the higher the removal rates tended to be in group III. These results indicate that effective elimination of anticancer drugs can be accomplished by this system during intraarterial chemotherapy of the liver.