Regulatory conservation and divergence of sigma32 homologs from gram-negative bacteria: Serratia marcescens, Proteus mirabilis, Pseudomonas aeruginosa, and Agrobacterium tumefaciens

The heat shock response in Escherichia coli is mediated primarily by the rpoH gene, encoding sigma32, which is specifically required for transcription of heat shock genes. A number of sigma32 homologs have recently been cloned from gram-negative bacteria that belong to the gamma or alpha subdivisions of the proteobacteria. We report here some of the regulatory features of several such homologs (RpoH) expressed in E. coli as well as in respective cognate bacteria. When expressed in an E. coli delta rpoH strain lacking its own sigma32, these homologs activated the transcription of heat shock genes (groE and dnaK) from the start sites normally used in E. coli. The level of RpoH in Serratia marcescens and Pseudomonas aeruginosa cells was very low at 30 degrees C but was elevated markedly upon a shift to 42 degrees C, as found previously with E. coli. The increased RpoH levels upon heat shock resulted from both increased synthesis and stabilization of the normally unstable RpoH protein. In contrast, the RpoH level in Proteus mirabilis was relatively high at 30 degrees C and increased less markedly upon heat shock, mostly by increased synthesis; this sigma32 homolog was already stable at 30 degrees C, and little further stabilization occurred upon the shift to 42 degrees C. The increased synthesis of RpoH homologs in all these gamma proteobacteria was observed even in the presence of rifampin, suggesting that the induction occurred at the level of translation. Thus, the basic regulatory strategy of the heat shock response by enhancing the RpoH level is well conserved in the gamma proteobacteria, but some divergence in the actual mechanisms used occurred during evolution.

Palindrome with spacer of one nucleotide is characteristic of the cis-acting unfolded protein response element in Saccharomyces cerevisiae

When unfolded proteins are accumulated in the endoplasmic reticulum (ER), an intracellular signaling pathway termed the unfolded protein response (UPR) is activated to induce transcription of ER-localized molecular chaperones and folding enzymes in the nucleus. In Saccharomyces cerevisiae, at least six lumenal proteins including essential Kar2p and Pdi1p are known to be regulated by the UPR. We and others recently demonstrated that the basic-leucine zipper protein Hac1p/Ern4p functions as a trans-acting factor responsible for the UPR. Hac1p binds directly to the cis-acting unfolded protein response element (UPRE) responsible for Kar2p induction. Moreover, we showed that the KAR2 UPRE contains an E box-like palindrome separated by one nucleotide (CAGCGTG) that is essential for its function. We report here that the promoter regions of each of five target proteins (Kar2p, Pdi1p, Eug1p, Fkb2p, and Lhs1p) contain a single UPRE sequence that is necessary and sufficient for induction and that binds specifically to Hac1p in vitro. All of the five functional UPRE sequences identified contain a palindromic sequence that has, in four cases, a spacer of one C nucleotide. This unique characteristic of UPRE explains why only a specific set of proteins are induced in the UPR to cope with ER stress.

The prediction of the prognosis for rectal carcinoma down-staged by pre-operative radiotherapy by transrectal ultrasonography

BACKGROUND

We attempted to determine whether the results of transrectal ultrasonography (TRUS) could provide any prognostic information about patients with rectal carcinoma treated with pre-operative radiotherapy (RT).

METHODS

Ninety-eight patients with rectal carcinoma were treated with pre-operative RT and radical surgery. We categorized the TRUS results with respect to TNM classification before the RT (Pre-RT staging), those after the RT (Post-RT staging), and the results of the pathological examination (Post-OP staging). We analysed the associations among these three stagings, and the survival time of the patients.

RESULTS

The prevalence of under T2-stage (TNM classification) in the pre-RT staging was significantly lower than that in both the Post-RT and Post-OP staging. The number of tumours diagnosed as T4 stage in both the Post-RT and Post-OP staging was significantly lower than that before irradiation. The survival periods of the patients with tumours remaining as T4 after radiation were significantly shorter than those of the patients diagnosed as having T4 tumours at the Pre-RT staging (Pre-RT versus Post-RT, p = 0.019; Pre-RT versus Post-OP, p = 0.030). These results suggested that radio-insensitive residual cells might associate with the poor prognosis.

CONCLUSION

We could predict the possible prognosis in rectal carcinoma patients treated with pre-operative radiotherapy before operation by TRUS.

Association of asthma and the interleukin-4 promoter gene in Japanese

BACKGROUND

Susceptibility to the development of asthma and other atopic diseases is known to be associated with genetic components. Several investigator have linked the interleukin-4 (IL-4) gene and nearby markers located on chromosome 5 to atopy and asthma. Recent study has demonstrated that the T allele of a polymorphism in the IL-4 gene promoter region (C-590T) is associated with elevated levels of total serum IgE.

OBJECTIVE

The objective of this study was to evaluate the possible role of this IL-4 polymorphism (C-590T) in modulating the allergic response and asthma in Japanese children.

METHODS AND RESULTS

The study was conducted in two different populations: families ascertained through asthmatic children (asthmatic group, 306 members) in whom linkage of asthma and atopy to chromosome 5q31-33 is suggested and a random general population (control group, 215 members). The IL-4 C-590T polymorphism was genotyped by PCR-restriction fragment length polymorphism analysis. Frequency of the T allele was 0.73 in the asthmatic group and 0.70 in the control group. No significant difference in the levels of total serum IgE and specific IgE to house dust mite was observed between subjects with homozygote for the C allele, a heterozygote and a homozygote for the T allele by intrafamilial and interfamilial comparisons. Using the transmission disequilibrium test, however, we found a significantly frequent transmission of the T allele to asthmatic children (chi2=5.72, P=0.023).

CONCLUSION

Our data suggest that the IL-4 promoter C-590T polymorphism may be associated with the development of asthma in Japanese children, but not through modulating total serum IgE levels.

Length measuring device for transrectal ultrasonography of anorectal lesions

We, herein, describe an attachable measuring device for transrectal ultrasonography. It is a useful piece of equipment for measuring the precise length of a lesion and for fixing the position of the transducer under examination for sphincteric dynamics.

Unconventional splicing of HAC1/ERN4 mRNA required for the unfolded protein response. Sequence-specific and non-sequential cleavage of the splice sites

Accumulation of unfolded proteins in the endoplasmic reticulum (ER) activates an intracellular signaling pathway from the ER to the nucleus, termed the unfolded protein response. We and others recently identified transcription factor Hac1p/Ern4p responsible for the response in Saccharomyces cerevisiae and found that Hac1p expression is controlled by the regulated splicing of HAC1 mRNA. Walter and co-workers (Sidrauski, C., Cox, J. S., and Walter, P. (1996) Cell, 87, 405-413) further showed that the splicing requires tRNA ligase but not spliceosome. In this report, we carried out mutational analysis of HAC1 mRNA and revealed several unique features of the splicing. First, a mutation or deletion of the branchpoint-like sequence present in HAC1 intron did not affect the splicing. Second, cleavage of the splice sites was sequence-specific and thus completely blocked by some point mutations introduced at the 5' or 3' splice site. Third, cleavage of the 5' and 3' splice sites could occur independently as judged by the nature of splicing intermediates accumulated. Fourth, swapping the nucleotide sequences of the 5' and 3' splice sites inhibited the ligation but not the cleavage step. We conclude that signaling from the ER activates putative endonucleases that can carry out sequence-specific cleavage of the splice sites in a random order.

Synergistic roles of HslVU and other ATP-dependent proteases in controlling in vivo turnover of sigma32 and abnormal proteins in Escherichia coli

Production of abnormal proteins during steady-state growth induces the heat shock response by stabilizing normally unstable sigma32 (encoded by the rpoH gene) specifically required for transcription of heat shock genes. We report here that a multicopy plasmid carrying the hslVU operon encoding a novel ATP-dependent protease inhibits the heat shock response induced by production of human prourokinase (proUK) in Escherichia coli. The overproduction of HslVU (ClpQY) protease markedly reduced the stability and accumulation of proUK and thus reduced the induction of heat shock proteins. In agreement with this finding, deletion of the chromosomal hslVU genes significantly enhanced levels of proUK and sigma32 without appreciably affecting cell growth. When the deltahslVU deletion was combined with another protease mutation (lon, clpP, or ftsH/hflB), the resulting multiple mutations caused higher stabilization of proUK and sigma32, enhanced synthesis of heat shock proteins, and temperature-sensitive growth. Furthermore, overproduction of HslVU protease reduced sigma32 levels in strains that were otherwise expected to produce enhanced levels of sigma32 due either to the absence of Lon-ClpXP proteases or to the limiting levels of FtsH protease. Thus, a set of ATP-dependent proteases appear to play synergistic roles in the negative control of the heat shock response by modulating in vivo turnover of sigma32 as well as through degradation of abnormal proteins.

[Toxicity studies of landiolol hydrochloride (ONO-1101) (3). 4-week repeated dose intravenous toxicity study in dogs with 4-week recovery test]

4-week repeated dose toxicity study with 4-week recovery test of landiolol hydrochloride (ONO-1101), a novel ultra short acting beta-blocker, was conducted in beagle dogs. ONO-1101 was administered intravenously to dogs of both sexes at a dose level of 0 (control), 12.5, 25 or 50 mg/kg/day. No deaths occurred throughout the treatment period. Transitory licking chops, vomiting, nausea, diarrhea and soft feces were observed occasionally in both sexes dosed 25 and 50 mg/kg/day and the incidence seemed dose-dependent. However, those incidence declined in the course of the treatment period. Hematology showed a decrease in red blood cell count, hematocrit and hemoglobin value in both sexes receiving 25 and 50 mg/kg/day. ONO-1101 did not effect on body weight, food consumption, respiratory rate, pulse, rectal temperature, heart rate, blood pressure, electrocardiography, renal or hepatic function, ophthalmology, urinalysis, occult blood in feces, blood chemistry, organ weights, necropsy and microscopic findings at any doses. These results indicate that the no-adverse-effect level of ONO-1101 in dogs is 12.5 mg/kg/day for both sexes in this study.

[Toxicity studies of landiolol hydrochloride (ONO-1101) (2). 4-week repeated dose intravenous toxicity study in rats with 4-week recovery test]

4-week repeated dose toxicity study with 4-week recovery test of landiolol hydrochloride (ONO-1101), a novel ultra short acting beta-blocker, was conducted in Sprague-Dawley (SD) rats. ONO-1101 was administered intravenously to rats of both sexes at a dose level of 0 (control), 12.5, 25, 50 or 100 mg/kg/day. In the 100 mg/kg/day group, bradypnea or dyspnea was seen in all animals, pale in ear, eye and foot, tremor, reddish lacrimation and loss of righting reflex were also observed in some animals right after administration, and then those signs disappeared within 1 min after administration. During the treatment period, 3/20 animals of each sex in the 100 mg/kg/day showed clonic convulsion and died within 2 min after administration. No clinical changes were seen in the 50 mg/kg/day group or lower. Histopathological findings showed atrophy of the submaxillary gland in females and vessel-wall thickening and perivascular fibrosis of the injection site (tail) in both sexes at 100 mg/kg/day, however those changes were reversible. ONO-1101 did not effect on body weight, food consumption, ophthalmology, urinalysis, hematology, blood chemistry, organ weights or necropsy at any doses. These results indicate that the no-adverse-effect level of ONO-1101 in rats is 50 mg/kg/day for both sexes in this study.

The trimerization domain of human heat shock factor 2 is able to interact with nucleoporin p62

Heat shock factor 2 (HSF2) acquires DNA binding activity during hemin-induced differentiation of human K562 erythroleukemia cells. To investigate the mechanisms responsible for the regulation of HSF2 activity, we searched for proteins that can associate with HSF2 by the yeast two-hybrid system. Nucleoporin p62, a major component of the nuclear pore complex, was cloned from cDNA libraries of K562 cells. We demonstrated physical interaction between HSF2 and p62 both by a glutathione S-transferase (GST) pull-down assay in vitro and by a two-hybrid assay in K562 cells. HSF1 is also able to interact with p62 on a GST pull-down assay, but not on a mammalian two-hybrid system. Furthermore, it was shown that this interaction occurred between the trimerization domain of HSF2 and the C-terminal alpha-helical coiled-coil domain of p62. These data suggest the possibility that p62 is involved in the activation or regulation of HSF2.

Stapled fistulectomy to treat enteroenteric fistulas in Crohn's disease

We report herein our technique of performing stapled fistulectomy as minimum surgery for the resection of nine entero-enteric fistulas in six patients with Crohn's disease. The surgical outcome was successful in all patients. It would seem that fistulous sites without a severe affected lesion are a favorable indication for this procedure and we recommend this simplified fistulectomy for selected conditions in Crohn's disease.

Endoplasmic reticulum stress-induced mRNA splicing permits synthesis of transcription factor Hac1p/Ern4p that activates the unfolded protein response

An intracellular signaling from the endoplasmic reticulum (ER) to the nucleus, called the unfolded protein response (UPR), is activated when unfolded proteins are accumulated in the ER under a variety of stress conditions ("ER stress"). We and others recently identified Hac1p/Ern4p as a transcription factor responsible for the UPR in Saccharomyces cerevisiae. It was further reported that Hac1p (238 aa) is detected only in ER-stressed cells, and its expression is mediated by unconventional splicing of HAC1 precursor mRNA. The splicing replaces the C-terminal portion of Hac1p; it was proposed that precursor mRNA is also translated but the putative product of 230 aa is rapidly degraded by the ubiquitin-proteasome pathway. We have identified and characterized the same regulated splicing and confirmed its essential features. Contrary to the above proposal, however, we find that the 238-aa product of mature mRNA and the 230-aa-type protein tested are highly unstable with little of no difference in stability. Furthermore, we demonstrate that the absence of Hac1p in unstressed cells is due to the lack of translation of precursor mRNA. We conclude that Hac1p is synthesized as the result of ER stress-induced mRNA splicing, leading to activation of the UPR.

Anoabdominal rectal resection and colonic J pouch-anal anastomosis: 10 years' experience

BACKGROUND

Coloanal anastomosis and radiotherapy for the treatment of lower rectal carcinoma have been receiving increasing attention.

METHODS

Patients with rectal cancer were divided into two groups: anoabdominal rectal resection and colonic J pouch-anal anastomosis (CAA) plus preoperative intraluminal brachytherapy (IBT) (group 1; 68 patients) and CAA without IBT (group 2; 23 patients). Group 3, comprising 59 patients who underwent abdominoperineal excision (APE), was examined as a control group. Comparative results were reviewed.

RESULTS

Postoperative complications occurred more frequently in group 1 than in group 2. Actuarial 5-year survival rates were 73 per cent in group 1, 64 per cent in group 2 and 63 per cent in group 3. Cumulative local recurrence rates at 5 years were 11 per cent in group 1, 38 per cent in group 2 and 21 per cent in group 3. Intestinal continuity breakdown was seen in 14 per cent of all patients at 5 years after initial operation.

CONCLUSION

The combination of CAA and preoperative IBT resulted in decreased local recurrence. IBT followed by CAA can be a good restorative option for combating lower rectal cancer.

[Characterizations of elderly recipient of home-care and their caregivers. A questionnaire survey of elderly members of a health insurance union]

The characteristics of elderly being cared for at home and their caregivers were analyzed based on a questionnaire about health and care for the elderly. We also assessed the problems of home care in view of activities of daily living (ADL) of the home-care recipient. Subjects were members of a health insurance union or their families and ages were more than 65 years old. Results were as follows; 1. The total number of released questionnaires was 5,472, of which responses totally 2,567 (46.9%) were received. Frequencies of the elderly at home without care, at home with care, and in hospitals or nursing home were 86.3%, 9.6% and 4.1%, respectively. 2. We categorized the home care recipient according to their ADL and analyzed their status. The frequency of using health care equipment for home care was significantly higher in the low ADL groups than in the high ADL groups. Caregivers in low ADL groups felt much more care burden than those in high ADL groups. 3. There was a tendency for differences in the use of community welfare services such as visiting nurses or short-stay between the home care recipient with dementia (group D) and the bedfast home care recipient (group C). Approximately 30% of caregivers in group D wanted to transfer the care of the elderly to hospitals or nursing home. 4. In Tokyo and nearby prefectures, there was a highly frequency that main caregivers were recipients' children. In the rural prefecture it was more frequent that the main caregiver was recipients' wife or husband only.

Results of preoperative intraluminal brachytherapy combined with radical surgery for middle and lower rectal carcinomas

BACKGROUND

Radiation therapy in the treatment of rectal carcinoma has received attention. We attempted to learn whether preoperative intraluminal brachytherapy (IBT) gives an advantage in local control and/or prolongation of survival.

METHODS

One hundred and fifteen patients with middle and lower rectal carcinoma with penetration into or through the rectal wall were consecutively treated with preoperative IBT and radical operation. Patients were divided into the moderate-dose group (group A: 16-40 Gy; n = 96) and the high-dose group (group B: 40-80 Gy; n = 19). A control group of 115 rectal carcinoma patients who received no radiation prior to radical surgery was compared (group C).

RESULTS

The rate of sphincter-saving resection was 72% in group A, 63% in group B, and 42% in group C (group A vs. group C; P < 0.0001). The local recurrence rate at 5 years was 11% in group A, 6% in group B, and 26% in group C (group A vs. group C; P = 0.005). The 5-year survival rate was similar among the three groups.

CONCLUSIONS

These results suggested that IBT contributed to the improvement of local control but not survival after radical resection of rectal carcinomas. The application of IBT might be useful in preserving the intestinal continuity for rectal carcinomas.

A possible correlation between p53 overexpression and prognosis after radiotherapy combined surgery for rectal carcinoma

One hundred and twenty patients with rectal carcinoma in the lower two-thirds of the rectum were treated with preoperative radiotherapy and radical surgery between October 1986 and March 1996. The expression of p53 was examined in 58 of these patients, all of whom had undergone surgery more than 5 years previously and whose prognosis had been recorded. Eighteen of 58 (31%) cases showed pS3 overexpression. Clinicopathological variables other than pathological T stage did not correlate with p53 expression. The proportion of residual tumor cells in p53 positive group was significantly higher than that in the negative group. Survival time was significantly shorter in p53 positive than in p53 negative patients (p = 0.0042). The proportion of cumulative local recurrence in the p53 negative group was 2.8%, while that of the p53 positive group was 43.2% (p = 0.01). The cumulative survival rate in the p53 negative group was 76.3%, while that in the p53 positive group was 24.4% (p = 0.04). The amount of p53 positive cells in both local and distant recurrence cases was significantly higher than that without recurrence (p < 0.0001, p = 0.0016) respectively. These results suggest that p53 overexpression might predict a poor outcome at the resection of the irradiated rectal carcinoma.

The regrowth of rectal adenocarcinoma after pre-operative radiotherapy with a report of two cases

To evaluate the factors that contribute towards the regrowth of rectal carcinoma after pre-operative radiotherapy. Of 120 patients, we pre-operatively treated with intraluminal brachytherapy or external beam radiotherapy since 1986, two showed regrowth of rectal carcinoma. For them, the case reports and findings for the resected specimen obtained using immunohistochemical staining for the P53 tumor suppressor gene (P53) and proliferating cell nuclear antigen (PCNA) were retrospectively evaluated. The regrowth of rectal carcinoma was observed 40 days after intraluminal brachytherapy in one patient, and 33 days after external radiotherapy in the other. Both P53 and PCNA staining was seen in the recurrent tumors or during the examination of the resected specimen. These results suggest that polypoid tumors with regrowth have a malignant potential. The interval between radiotherapy and operation reported in the literature varies widely. The potential for regrowth should be considered in the preoperative radiotherapy for rectal cancer.

[School-based intervention trial for cardiovascular health]

The effectiveness of a school-based intervention trial for the primary prevention of cardiovascular disease was studied by measuring cardiovascular risk factors in 701 children with intervention and 663 children without intervention. Outcomes were assessed using preintervention measures at 10 years old (fall 1991) and follow-up measures at 13 years old (fall 1994). In girls with intervention, HDL-cholesterol level was significantly higher and atherogenic index was significantly lower than that in girls without intervention. In obese girls with intervention, frequency of reduced obesity index was significantly higher than that in obese girls without intervention. In boys, however, body size and cholesterol measures did not differ significantly between intervention groups and nonintervention groups. These results indicate that school-based intervention for cardiovascular health can produce a reduction in risk factors for atherosclerosis in girls over a period of 3 school years.

[A study on supporting methods for house-bound home care elderly to get independent life (1st report)--relation between ADL and daily hours out of bed]

It is important to prevent the House-Bound home care elderly from getting worse to the Bed-bound. We studied the relation between "daily hours out of bed" and the activity of daily living (ADL) estimated by FIM (Functional Independence Measure) in 50 house-bound home care elderly persons. Result are as follows; (1) The level of independence of "Toileting", one of the FIM self-care items, was most highly correlated with the "daily hours out of bed" in the house-bound home care elderly. (2) The level of independence of "Mobility to the Toilet" and "Bowel Control" were also highly correlated with the "daily hours out of bed" in the house-bound home care elderly. (3) The level of independence of "Toileting" had high correlation with a total score of FIM moter items in the house-bound home care elderly (r = 0.83, p < 0.001).

Cloning and expression of cDNA encoding the human 150 kDa oxygen-regulated protein, ORP150

We have cloned a cDNA encoding the human 150 kDa oxygen-regulated protein (ORP150) from hypoxia-treated astrocytoma U373 cDNA library. The deduced amino acid sequence of 999 residues contains a signal peptide and an ER retention-like signal at the N- and C-termini, respectively. It has a striking sequence similarity (91% identity) with Chinese hamster 170 kDa glucose-regulated protein (GRP170). The N-terminal half of ORP150 exhibits significant similarity to the ATPase domain of HSP70 family proteins with well-conserved ATP binding motifs. Northern blot analysis revealed that induction of ORP150 in U373 cells was not limited to hypoxia but also observed by 2-deoxyglucose or tunicamycin treatment. Furthermore, tissue specificity of expression of ORP150 was quite similar to that of GRP78. These findings suggest that ORP150 participates in quality control of proteins in the ER in response to diverse environmental stresses.

Second-look hepatectomy after 5FU arterial infusion in patients with primary unresectable hepatic colorectal metastases

We treated primary unresectable hepatic colorectal metastases by hepatic arterial chemotherapy (HAC) combined with resection of the tumor. Patients underwent a resection of the primary colorectal tumor and a placement of HAC system, and received a 5-fluorouracil (5FU) administration once a week (320 mg/m(2)/day). Five patients underwent a 'second-look' hepatectomy in this series. Their shrinkage rate of the primary lesion ranged from 80-99%, as seen by computed tomography. The resected liver tumors were characterized as p53-positive and proliferating cell nuclear antigen-positive. The levels of fluorodeoxyuridylate (FdUMP) and thymidylate synthetase inhibition were low in the tumor tissue. These results might reflect a kind of resistance to 5FU therapy. Hepatectomy is one of the possible options to eradicate the residual SFU-resistant component of the malignancy. Our preliminary experience possibly indicates longer survival from combination approach than from HAC alone.

[Effect of dibucaine and lidocaine on histamine release from mouse bone marrow-derived cultured mast cells]

We examined the effects of dibucaine and lidocaine on histamine release from mouse bone marrow-derived cultured mast cells. The effects of these drugs on intracellular calcium were also monitored by assessing Fura-2 signals. Additionally, the inhibitory effects of lidocaine on IgE dependent and independent stimuli were examined. Though dibucaine induced histamine release and increases in intracellular calcium from mast cells dose-dependently, lidocaine did not. Lidocaine inhibited both the IgE-dependent and independent histamine release from mast cells in a dose dependent manner. However, the ability of lidocaine to inhibit the IgE-dependent response was greater. Lidocaine also inhibited increases in intracellular calcium to a greater extent after IgE-dependent stimulation as compared with IgE-independent stimulation. The degree of the inhibition of histamine release by lidocaine appeared to parallel decreases in calcium mobilization.

Preoperative detection of distal intramural spread of lower rectal carcinoma using transrectal ultrasonography

PURPOSE

Usefulness of transrectal ultrasonography (TRUS) for detecting distal intramural spread of rectal carcinoma was investigated.

METHODS

Thirty-seven patients with advanced rectal carcinoma, who had not received preoperative adjuvant therapy, underwent TRUS before surgery. Distal intramural spread was evaluated by TRUS and by pathologic examination of resected specimens.

RESULTS

Distal intramural spread was found in 7 of 37 patients (19 percent) by pathologic examination. Presence or absence of distal intramural spread was correctly diagnosed by TRUS in 86 percent of the 37 patients. Misdiagnosis by TRUS mainly occurred when distal intramural spread was 5 mm. Tumor penetration of muscularis propria, lymph node involvement, and a higher histologic grade of malignancy showed a significant relationship with the presence of distal intramural spread.

CONCLUSION

TRUS was useful for detecting distal intramural spread > 5 mm in patients with lower rectal carcinoma and may be helpful for selecting appropriate surgery.

150-kD oxygen-regulated protein is expressed in human atherosclerotic plaques and allows mononuclear phagocytes to withstand cellular stress on exposure to hypoxia and modified low density lipoprotein

The 150-kD oxygen-regulated protein (ORP150) was initially characterized based on its selective expression in astrocytes subjected to oxygen deprivation (Kuwabara, K., M. Matsumoto, J. Ikeda, O. Hori, S. Ogawa, Y. Maeda, K. Kitagawa, N. Imuta, K. Kinoshita, D.M. Stern, et al. 1996. J. Biol. Chem. 279:5025-5032). We have found that exposure of cultured human aortic smooth muscle cells and mononuclear phagocytes (MPs) to hypoxia (pO2 approximately 12-14 torr) induces ORP150 transcripts and production of the antigen, whereas incubation with either hydrogen peroxide, sodium arsenite, heat shock, or 2-deoxyglucose was without effect. Tissue extracts prepared from human atherosclerotic lesions demonstrated expression of ORP150 mRNA and antigen, vs lack of ORP150 in samples from nonatherosclerotic areas. In situ hybridization using ORP150 riboprobes showed the mRNA to be predominantly [correction of predominately] present in macrophages in in atherosclerotic plaques. Furthermore, autoantibody to ORP150 was demonstrated in the serum of patients with severe atherosclerosis, consistent with inducible in vivo expression of ORP150. Introduction of antisense oligonucleotide for ORP150 selectively diminished hypoxia-mediated induction of ORP150 antigen and reduced the viability of hypoxic MPs, especially in the presence of modified (oxidized/acetylated) LDL. In support of a role for ORP150 in the MPs' response to the microenvironment of an atheroma, the presence of oxidized LDL enhanced by approximately 10-fold ORP150 expression in hypoxic cultures. These data indicate that cells of the atherosclerotic vessel wall express ORP150 as part of a protective mechanism, potentially triggered by local hypoxia/hypoxemia and augmented by modified lipoproteins. The presence of antibody to ORP150 in sera of patients with severe atherosclerosis emphasizes the possibility that ORP150 may be a marker of vascular pathology.

Effect of lidocaine on histamine release and Ca2+ mobilization from mast cells and basophils

BACKGROUND

Various anesthetic drugs have been known to induce allergic reactions, which have been caused by histamine release from mast cells/basophils. Although lidocaine is reported to suppress allergic reactions, there have been no reports about lidocaine's direct effects to inhibit histamine release from mast cells/basophils.

METHODS

We examined the effect of lidocaine on histamine release in vitro from freshly extracted as well as cultured mast cells and basophils. Additionally, the effects of lidocaine on intracellular calcium concentration were monitored by assessing Fura-2 signals in cultured cells.

RESULTS

Lidocaine (10(-3)-10(-2) M: approximately 234-2340 micrograms/ ml) inhibited both the IgE-dependent and IgE-independent histamine release from all mast cells/basophils in a dose-dependent manner. However, lidocaine inhibited the IgE-dependent response more than the IgE-independent response (P < 0.01). Lidocaine also inhibited increases in intracellular Ca2+ to a greater extent after IgE-dependent stimulation as compared with IgE-independent stimulation. The degree of the inhibition of histamine release by lidocaine appeared to parallel decreases in Ca2+ mobilization.

CONCLUSIONS

Our results indicate that lidocaine directly inhibits histamine release from both rodent mast cells and human basophils in vitro at concentrations from 10(-3) to 10(-2) M (234 to 2340 micrograms/ml). That may be influenced by Ca2+ mobilization. Although these results are not immediately relevant to clinical practice, allergic reaction caused by direct effect of lidocaine seems to be impossible.

Colonic J pouch-anal reconstruction with gluteus maximus transposition for a post-irradiation rectovaginal fistula

A 44-year-old female with rectal cancer underwent anoabdominal rectal resection and colonic J pouch-anal anastomosis after preoperative intraluminal brachytherapy. Pelvic sepsis developed a rectovaginal fistula. We attempted to close the fistula and restore the anal function with coloanal re-anastomosis and bilateral gluteus maximus transposition. She regained good anal function without recurrence of the fistula.

Signalling from endoplasmic reticulum to nucleus: transcription factor with a basic-leucine zipper motif is required for the unfolded protein-response pathway

BACKGROUND

Accumulation of unfolded proteins in the endoplasmic reticulum (ER) triggers the transcriptional induction of molecular chaperones and folding enzymes localized in the ER. Thus, eukaryotic cells possess an intracellular signalling pathway from the ER to the nucleus, called the unfolded protein-response (UPR) pathway. In Saccharomyces cerevisiae, such induction is mediated by the cis-acting unfolded protein-response element (UPRE) which has been thought to be recognized by one or more transcription factor(s).

RESULTS

Extensive mutational analysis revealed that UPRE contains a partial palindrome with a spacer of one nucleotide (CAGCGTG) that is essential for its function. We then cloned the ERN4 (presumably identical with HAC1) gene using yeast one-hybrid screening, in which the GAL4-ERN4 fusion gene constitutively activates the UPR pathway. The ERN4 gene encodes a basic-leucine zipper protein (Ern4p) that specifically binds to UPRE in vitro and activates transcription in vivo. Cells lacking Ern4p are unable to induce transcription of any of the five target genes tested and exhibit sensitivity to ER stress and inositol requirement for growth.

CONCLUSION

We concluded that Ern4p represents a major component of the putative transcription factor (UPRF) responsible for the UPR leading to the induction of ER-localized stress proteins.

[Relationship between dietary life style in youth and osteoporosis]

The relationship between the dietary life style and osteoporosis was examined by comparing 71 osteoporotic women [age--65.5 +/- 8.9 (mean +/- SD)] with 76 women age-matched as controls. All subjects lived in and around Tsukuba City. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. The frequencies of drinking milk and eating meat, fish, or potatoes, etc. both in their youth (about 18-25 years old) and at the present were investigated. The results were as follows: 1) The frequency of having unbalanced diets in their youth was significantly higher in osteoporotic patients than in controls. 2) During their youth, osteoporotic patients had significantly lower frequency of drinking milk, and significantly higher frequency of eating meat, dried fish or eggs, compared with controls. 3) High milk-consumers during their youth (milk-drinking: > or = 3 times per week) were significantly less frequent in osteoporotic patients than that in controls. 4) In the controls, the frequencies of drinking milk and eating meat during their youth were significantly positively correlated with lumbar BMD. The frequency of eating potatoes was significantly negatively correlated with the BMD in controls. 5) No strong relationships between present dietary life and osteoporosis or BMD were found. These findings suggest that drinking milk in their youth may influence BMD and associate with osteoporosis in women.

Use of transrectal ultrasonography to select type of surgery for villous tumors in the lower two thirds of the rectum

OBJECTIVE

To determine the accuracy of transrectal ultrasonographic (TRUS) staging of rectal villous tumors when used to select a surgical procedure.

DESIGN

Case series.

SETTING

College hospital, Hyogo, Japan.

PATIENTS

From 1988 to 1995, 24 patients were treated for villous tumors after diagnosis by TRUS, and were followed up for 0.5 to 7.5 years.

MAIN OUTCOME MEASURES

Ultrasonographic tumor stage (u-T), pathologic tumor stage (p-T), biopsy findings, and surgical procedures were studied.

RESULTS

Overall, 71% of the tumors were accurately staged by TRUS. However, 4 u-T1 and 3 u-T2 tumors were overstaged, with pathological examination showing 2 adenomas and 5 p-Tis tumors. Three of these 7 patients were overtreated surgically. The results of a biopsy predicted adenoma in 2 of the u-T1 tumors and 2 of the u-T2 tumors that were overstaged by TRUS. Pathological examination revealed that an enlarged lymphoid follicle in the mucosa had deformed the thin muscle layer of the rectal wall and abolished its continuity on TRUS imaging. The weakness of TRUS would seem to be in the accuracy of p-Tis staging.

CONCLUSIONS

Transrectal ultrasonography had the advantage of predicting malignant infiltration in rectal villous tumors. The surgeon should know the limitations of TRUS diagnosis to select the most appropriate operation for each patient.

Fibrinogen, coagulation factor VII, tissue plasminogen activator, plasminogen activator inhibitor-1, and lipid as cardiovascular risk factors in chronic hemodialysis and continuous ambulatory peritoneal dialysis patients

Mortality rates associated with cardiovascular disease (CVD) are high in long-term dialysis patients. Increased levels of plasma fibrinogen (FBG), coagulation factor VII (FVII), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) as well as hyperlipidemia are regarded as important risk factors for CVD. To investigate whether there are differences in the risk of CVD between chronic hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients, serum lipid levels and plasma FBG, FVII, t-PA, and PAI-1 levels were measured in 17 patients on HD and 17 patients on CAPD. FBG was measured by the thrombin time method, FVII activity (FVIIc) by the chromogenic prothrombin time method, and t-PA and PAI-1 activity by the chromogenic substrate assay. No difference was found in body mass index (BMI) between HD and CAPD patients. Total cholesterol (TC), TC/high-density lipoprotein (HDL)-C ratio, low-density lipoprotein (LDL)-C, and triglycerides (TG) were significantly increased, and HDL-C was significantly decreased in CAPD patients compared with HD patients. FBG and FVIIc were significantly elevated in CAPD patients compared with controls or HD patients. T-PA activities were significantly higher in HD and CAPD patients than in controls. CAPD patients showed significantly higher PAI-1 activities than controls or HD patients. Significant positive correlations were found between FBG or FVIIc and TC, between FBG and LDL-C or TG, and between FVIIc and LDL-C in these patients. T-PA showed significant negative correlations with FBG, PAI-1, TC, LDL-C, and TG. There was a significant positive correlation between PAI-1 and TG and a significant negative correlation between PAI-1 and HDL-C. We conclude that CAPD patients may have a greater risk of CVD than do HD patients, and that coagulation and fibrinolytic activity are correlated with lipid disorders in these patients.

Purification and characterization of a novel stress protein, the 150-kDa oxygen-regulated protein (ORP150), from cultured rat astrocytes and its expression in ischemic mouse brain

As the most abundant cell type in the central nervous system, astrocytes are positioned to nurture and sustain neurons, especially in response to cellular stresses, which occur in ischemic cerebrovascular disease. In a previous study (Hori, O., Matsumoto, M., Kuwabara, K., Maeda, M., Ueda, H., Ohtsuki, T., Kinoshita, T., Ogawa, S., Kamada, T., and Stern, D. (1996) J. Neurochem., in press), we identified five polypeptide bands on SDS-polyacrylamide gel electrophoresis, corresponding to molecular masses of about 28, 33, 78, 94, and 150 kDa, whose expression was induced/enhanced in astrocytes exposed to hypoxia or hypoxia followed by replacement into the ambient atmosphere (reoxygenation). In the current study, the approximately 150-kDa polypeptide has been characterized. Chromatography of lysates from cultured rat astrocytes on fast protein liquid chromatography Mono Q followed by preparative SDS-polyacrylamide gel electrophoresis led to isolation of a approximately 150-kDa band only observed in hypoxic cells and which had a unique N-terminal sequence of 15 amino acids. Antisera raised to either the purified approximately 150-kDa band in polyacrylamide gels or to a synthetic peptide comprising the N-terminal sequence detected the same polypeptide in extracts of cultured rat astrocytes exposed to hypoxia; expression was not observed in normoxia but was induced by hypoxia within 24 h, augmented further during early reoxygenation, and thereafter decreased to the base line by 24 h in normoxia. ORP150 expression in hypoxic astrocytes resulted from de novo protein synthesis, as shown by inhibition in the presence of cycloheximide. In contrast to hypoxia-mediated induction of the approximately 150-kDa polypeptide, neither heat shock nor a range of other stimuli, including hydrogen peroxide, cobalt chloride, 2-deoxyglucose, or tunicamycin, led to its expression, suggesting selectivity for production of ORP150 in response to oxygen deprivation, i.e. it was an oxygen-regulated protein (ORP150). Northern and nuclear run-off analysis confirmed the apparent selectivity for ORP150 mRNA induction in hypoxia. Subcellular localization studies showed ORP150 to be present intracellularly within endoplasmic reticulum and only in hypoxic astrocytes, not cultured microglia, endothelial cells, or neurons subject to hypoxia. Consistent with these in vitro results, induction of cerebral ischemia in mice resulted in expression of ORP150 (the latter was not observed in normoxic brain). These data suggest that astroglia respond to oxygen deprivation by redirection of protein synthesis with the appearance of a novel stress protein, ORP150. This polypeptide, selectively expressed by astrocytes, may contribute to their adaptive response to ischemic stress, thereby ultimately contributing to enhanced survival of neurons.

Chloride-selective electrode based on molecular oriented membrane

In order to improve durability of chloride ion selective electrode based on molecular oriented membrane (MO2), a novel polymer system (MO4) was developed. In the polymer, ion sensitive sites are immobilized by covalent bonds to prevent dissolution of membrane components to sample solution. And molecular orientation was observed in the new system by X-ray measurement. MO4 system showed the same selectivity profile as the previous system with improved durability.

Modification of the stapled functional end-to-end anastomosis for ileostomy closure

The use of stapling devices simplifies ileostomy closure; however, the original functional end-to-end anastomotic technique creates intersecting staple lines, generally causing disruption of the anastomosis at the intersections. Therefore, we modified the stapling technique to prevent the two staple lines from crossing. After the everted ileostomy spout is turned back, a stapled side-to-side anastomosis is made. Everting traction sutures are then placed around the ileostomy orifice prior to closure with a linear stapler, thus ensuring that this staple line does not cross the V-shaped staple line of the intestinal anastomosis. This modified technique was employed in the treatment of 20 patients, none of whom developed any signs of anastomotic leakage or intestinal obstruction.

Defecographic assessment after colonic J pouch-anal anastomosis

Colonic J pouch anal anastomosis is widely employed after rectal resection. In the 36 patients who participated in our retrospective study, although postoperative continence was retained/maintained in each individual, a survey questionnaire indicated some difficulties in neoanorectal function. Therefore, defecography was performed in 20 of these patients. Patients experiencing soiling were found to have an increased ano-pouch angle and pelvic floor descent. Loss of sensation and incomplete evacuation were also associated with an abnormally large pelvic floor descent. However, stool frequency, urgency, and the need for medication showed no correlation with any of the defecography parameters. These findings thus suggested that the puborectal muscle and the levator ani muscle played an important role in postoperative function. Defecography was also found to provide a dynamic assessment of the postoperative state of colonanal reconstruction.

Cloning and characterization of the mitochondrial HSP60-encoding gene of Schizosaccharomyces pombe

We report the isolation and characterization of a gene (designated mcp60) encoding the mitochondrial (mt) 60-kDa heat-shock protein (HSP60) in the fission yeast Schizosaccharomyces pombe. The deduced amino-acid sequence (582 aa) of this gene is highly similar to the known mt HSP60 from diverse organisms. When its sequence was related to the known functional domains of bacterial HSP60 (GroEL), the similarity was particularly high for the intermediate domains that connect the apical domain with the equatorial domain. The mRNA level of mcp60 increased several-fold upon temperature upshift (from 25 to 35 degrees C), while gradually decreased during sporulation. Gene disruption experiments revealed that mcp60 is essential for cell viability at all temperatures.

Early detection of pancreatic glucagonoma

Glucagonoma is a rare islet cell tumor of pancreas. Only 122 proven cases have been reported in the English literature so far. Diagnosis of glucagonoma has usually been delayed. The average size of clinically detected glucagonomas was 5.8 cm, and 54.7% of them exhibited metastasis. We describe the case of a 0.7-cm asymptomatic pancreatic glucagonoma. A 45-yr-old female was demonstrated to have a demarcated, small, low echoic mass in the pancreatic head by routine ultrasonography. Table incremental dynamic computed tomography showed a small well-enhanced mass recognized only in an early phase. A 0.7 x 0.7 cm firm nodule on the pancreatic head was excised at operation. Immunohistochemical and ultrastructural studies revealed that this tumor was a glucagon-producing adenoma. This may be the smallest glucagonoma detected by image diagnostics that has been reported in the English literature. Possible early detection of glucagonoma was discussed in this report.

Isolation and sequence analysis of rpoH genes encoding sigma 32 homologs from gram negative bacteria: conserved mRNA and protein segments for heat shock regulation

The rpoH genes encoding homologs of Escherichia coli sigma 32 (heat shock sigma factor) were isolated and sequenced from five gram negative proteobacteria (gamma or alpha subgroup): Enterobacter cloacae (gamma), Serratia marcescens (gamma), Proteus mirabilis (gamma), Agrobacterium tumefaciens (alpha) and Zymomonas mobilis (alpha). Comparison of these and three known genes from E.coli (gamma), Citrobacter freundii (gamma) and Pseudomonas aeruginosa (gamma) revealed marked similarities that should reflect conserved function and regulation of sigma 32 in the heat shock response. Both the sequence complementary to part of 16S rRNA (the 'downstream box') and a predicted mRNA secondary structure similar to those involved in translational control of sigma 32 in E.coli were found for the rpoH genes from the gamma, but not the alpha, subgroup, despite considerable divergence in nucleotide sequence. Moreover, a stretch of nine amino acid residues Q(R/K)(K/R)LFFNLR, designated the 'RpoH box', was absolutely conserved among all sigma 32 homologs, but absent in other sigma factors; this sequence overlapped with the segment of polypeptide thought to be involved in DnaK/DnaJ chaperone-mediated negative control of synthesis and stability of sigma 32. In addition, a putative sigma E (sigma 24)-specific promoter was found in front of all rpoH genes from the gamma, but not alpha, subgroup. These results suggest that the regulatory mechanisms, as well as the function, of the heat shock response known in E.coli are very well conserved among the gamma subgroup and partially conserved among the alpha proteobacteria.

Ileoanal anastomosis and ileoanal canal anastomosis in Japan: comparative retrospective study

A questionnaire survey of ten institutions in Japan revealed that restorative proctocolectomy accounted for 81.8% of the surgical procedures performed in patients with UC in the last 5 years (1989-1993); ileoanal anastomosis (IAA) and ileo-anal canal anastomosis (IACA) were performed in 63% and 33% of these patients, respectively. Comparison of the two series showed that IACA was technically simpler and yielded better continence, but that it entailed a potential risk of recurrence of the disease in the remaining anal canal mucosa. Although IACA seems to be a useful surgical option for UC, until the long-term outcome of the procedure can be elucidated. It may be better regarded as a very low variation of IRA rather than as an improved technical version of IAA.

Preoperative detection of local extension of carcinoma of the rectum using magnetic resonance imaging

BACKGROUND

We evaluated the ability of magnetic resonance imaging (MRI) to define local extension of rectal carcinoma.

STUDY DESIGN

Thirty-three patients with rectal carcinoma were preoperatively assessed by MRI.

RESULTS

When sagittal or coronal images, or both, were added to transverse images as needed, the sensitivity rate was 84.2 percent and the specificity rate was 92.9 percent. False-positive results when using only transverse images were mainly related to slight extramural spread, to an anterior location in the lower rectum (partial volume effect), and to massive extramural spread of the middle rectal tumors.

CONCLUSION

Preoperative MRI was helpful to define tumor extension three-dimensionally.

A novel complex mutation in the LDL receptor gene probably caused by the simultaneous occurrence of deletion and insertion in the same region

A novel complex mutation with the presence of both deletion and insertion in very close proximity in the same region was detected in exon 8 of the LDL receptor gene from two apparently unrelated Japanese families with familial hypercholesterolemia (FH). In this mutant LDL receptor gene, the nine bases from nucleotide (nt) 1115 to nt 1123 (AGGGTGGCT) were replaced by six different bases (CACTGA), and consequently the four amino acids from codon 351 to 354, Glu-Gly-Gly-Tyr, were replaced by three amino acids, Ala-Leu-Asn, in the conserved amino acid region of the growth factor repeat B of the LDL receptor. The nature of the amino acid substitution and data on the families suggest that this mutation is very likely to affect the LDL receptor function and cause FH. The generation of this complex mutation can be explained by the simultaneous occurrence of deletion and insertion through the formation of a hairpin-loop structure mediated by inverted repeat sequences. This this mutation supports the hypothesis that inverted repeat sequences influence the stability of a given gene and promote human gene mutations.