Human CD36 deficiency is associated with elevation in low-density lipoprotein-cholesterol

To find out whether CD36 plays a role in the human lipoprotein metabolism, we studied lipoprotein profiles in subjects with CD36 deficiency. Apparently healthy Japanese volunteers (n = 790) were classified by flow cytometry into three groups of normal (platelet and monocyte CD36+, n = 741, 93.8%), type-II deficiency (platelet CD36- and monocyte CD36+, n = 45, 5.7%), and type-I deficiency (platelet and monocyte CD36-, n = 4, 0.5%). At least one of reported mutations in the CD36 gene was found in all four subjects with type-I deficiency and in 23 of the 45 subjects with type II. Among 779 subjects (731 normals, 44 type II, and four type I) with serum triglyceride levels of <400 mg/dL, serum total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly elevated in type-II deficiency (P = 0.0095 and 0.0382 versus normal, respectively, Scheffe's F-test), while differences were not significant in triglyceride and high-density lipoprotein-cholesterol. Similar tendency was observed in type-I deficiency, although the differences were not statistically significant because of small sample size. We conclude that CD36 deficiency elevates LDL cholesterol, indicating a contribution of CD36 to LDL metabolism.

[A case of acupuncture needle dermatitis]

A 65-year-old female visited our clinic with painful red vesicular dermatitis of the forehead and around the left eye. She had received acupuncture for headache and shoulder stiffness 6 days before visiting our clinic. A patch test with nickel sulfate gave positive results. We treated her with the greater occipital nerve block and trigger point injection which relieved her pain. We reached the diagnosis of greater occipital trigeminal syndrome with contact dermatitis from the acupuncture needle.

Relationships between the onset of pustulosis palmaris et plantaris, periodontitis and bacterial heat shock proteins

Relationships between the onset of pustulosis palmaris et plantaris, periodontitis and heat shock proteins were studied by using enzyme-linked immunosorbent assay to examine levels of immunoglobulin G (IgG) against Escherichia coli GroEL, a recombinant DnaJ of Actinobacillus actinomycetemcomitans heat shock protein, a synthetic peptide made from the 180th to the 188th amino acids of Mycobacterium bovis BCG Hsp65, and a recombinant human Hsp60, in sera obtained from 43 pustulosis palmaris et plantaris patients judged to have chronic infectious diseases of the oral cavity. We found that the titers of IgG against E. coli GroEL and A. actinomycetemcomitans DnaJ in the sera from pustulosis palmaris et plantaris patients were significantly higher than those in the control group, whereas the titers of IgG against the synthetic M. bovis Hsp65 and the recombinant Hsp60 did not differ significantly. Periodontal therapy and extraction of teeth with periapical infectious resulted in remission of pustulosis palmaris et plantaris and a statistically significant reduction in the levels of IgG against E. coli GroEL in 9 of the 22 patients (41%) examined. We also found that the IgG levels against A. actinomycetemcomitans DnaJ in 6 serum samples of 16 (37%) were reduced, but not significantly, after the treatment. These results suggest that the IgG responses to heat shock proteins partially induced by oral bacteria may be related to the onset of pustulosis palmaris et plantaris in some patients.

[Clinical study of cerebral blood flow in bilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT]

Cerebral blood flow(CBF) in 34 patients with bilateral chronic subdural hematoma was measured by 99mTc-HMPAO SPECT before operation. The regional CBF was measured in 26 regions of the 10 cortical regions, putamen, thalamus and cerebellar hemisphere on both sides. According to the thickness of subdural hematoma, the thicker hematoma side was measured and examined as the thick hematoma side, and the other side as the thin hematoma side. Thirty four cases with bilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms: 13 cases with headache(headache group), 10 cases with hemiparesis(hemiparesis group), 5 cases with tetraparesis(tetraparesis group) and 6 cases with consciousness disturbance or dementia(consciousness disturbance group), and into two groups according to the degree of midline brain shift on MRI: 14 cases of non-shifted group and 20 cases of shifted group. The average CBF of 34 patients in each region indicated a regional CBF reduction in the frontal, parietal and occipital cortices on the thin hematoma side, and in the putamen on the thick hematoma side. In the headache group, the regional CBF reduction on the thin hematoma side was found in the frontal, parietal and occipital cortices compared with the corresponding regions on the thick hematoma side, and in thalamus on the thick hematoma side. In the hemiparesis and tetraparesis groups, there was no statistically significant CBF reduction between the thick and thin hematoma sides. In the consciousness disturbance group, the CBF reduction in whole brain was remarkably significant. By the degree of the midline brain shift, the CBF reductions between the thick and thin hematoma sides were observed. Namely, in the shifted group, the CBF reductions were noted in the frontal, parietal and occipital cortices in the thin hematoma side, and in the putamen in the thick hematoma side. We concluded that the CBF reduction of bilateral chronic subdural hematoma was bilaterally found in the hemiparesis and tetraparesis groups, and which was finally observed in whole brain in the consciousness disturbance group.

MR appearance of adenomatoid tumor of the uterus

Reports on the radiological findings of adenomatoid tumor of the uterus are rare, and preoperative diagnosis is very difficult. To our knowledge, there have been no reports concerning the MR findings of adenomatoid tumor of the uterus. We report two cases of uterine adenomatoid tumor that showed the characteristic features of leiomyoma on MR images.

Transforming growth factor-beta(1) increases the expression of lectin-like oxidized low-density lipoprotein receptor-1

Lectin-like oxidized low-density lipoprotein (Ox-LDL) receptor-1 (LOX-1) is a novel cell-surface receptor for Ox-LDL, which can be expressed by vascular endothelial cells, smooth muscle cells, and macrophages. On the other hand, transforming growth factor (TGF)-beta(1), which plays crucial roles in vascular remodeling and the pathogenesis of atherosclerosis, has been shown to inhibit expression of class A scavenger receptors and CD36 in macrophages. Here we provide the evidence that TGF-beta(1) (0.1-10 ng/mL) induces LOX-1 protein and mRNA expression in both bovine aortic endothelial cells and smooth muscle cells in a dose- and time-dependent fashion, probably at the transcriptional level. TGF-beta(1) also upregulates LOX-1 mRNA expression in murine peritoneal macrophages. Thus TGF-beta(1) can highly induce LOX-1 expression in vascular endothelial cells, smooth muscle cells, and macrophages, suggesting that TGF-beta(1) appears one of the key regulators that modulates expression of scavenger receptors.

Comparison of occurrence of oro-maxillo-facial tumor types in different regions of the People's Republic of China

The frequencies of oro-maxillo-facial tumors, by type, seen at the Guangxi Medical College Hospital were surveyed in order to compare different regions of the People's Republic of China. Computer analysis was performed on data for all oro-maxillo-facial tumors, as confirmed by the hospital between 1957 and 1987, inclusive. The results were then used in a comparative study with those of five other medical colleges. Among a total of 4,052 cases, there were 1,593 benign tumors, 2,049 malignant tumors and 410 unknown tumors. Tumors derived from the epithelium were the most common type (42.0% of the total), whereas in the other five medical colleges the mean corresponding proportion was 27.8%, the difference being significant (p < 0.05). Epithelial tumors were also the most common type of malignant tumor (70.5% of the total), whereas the corresponding proportion reported by the other five institutions was 60.6%, which was also significantly different (p < 0.05). The proportion of malignant tumors among the total was more than 50.6%, which was higher than that reported by the other five colleges. This study shows that epithelium-derived tumors and malignant tumors were encountered more frequently at Guangxi Medical College than at the other five medical colleges in China.

Detection of vascular endothelial growth factor and its receptor expression in human hepatocellular carcinoma biopsy specimens

BACKGROUND

Vascular endothelial growth factor (VEGF) exerts its actions on the microvasculature, by interacting with specific endothelial cell receptors, and thus, contributes to angiogenesis and growth in many tumours.

METHODS

Using nested reverse-transcription-polymerase chain reaction, we examined the biopsy specimens of 14 patients with human hepatocellular carcinoma (HCC) and cirrhosis, for the expression of hepatic VEGF, and the VEGF receptors KDR and fit-1. To avoid the influence of hypoxia or ischaemia induced by surgical manipulation, we used biopsy specimens of the liver instead of resected specimens.

RESULTS

Vascular endothelial growth factor mRNA expression was detected in the tumour portion of the specimens in 13 of 14 patients (93%), and in the corresponding non-tumour portion of the specimens in eight patients (57%; P= 0.08). No differences were found between the tumour portion and the corresponding non-tumour portion in relative concentrations of VEGF mRNA. However, mRNA expression of the VEGF receptors, KDR and fit-1, was detected in 14 (100%) and 11 (79%) of the tumour portions, respectively, and in four (29%) and five (36%) of the corresponding non-tumour portions, respectively (chi2 test: KDR, P< 0.01; fit-1, P= 0.08). The relative concentration of KDR mRNA in the tumour portions was significantly higher than in the non-tumour portions (Mann-Whitney U-test: P<0.001) but no differences were detected for fit-1.

CONCLUSIONS

KDR mRNA is significantly overexpressed in HCC lesions and could be associated with the angiogenesis and tumour growth induced by VEGF.

Insect antifeedant flavonoids from Gnaphalium affine D. Don

The antifeedant flavonoids, 5-hydroxy-3,6,7,8,4'-pentamethoxyflavone (1), 5-hydroxy-3,6,7,8-tetramethoxyflavone (2), 5,6-dihydroxy-3, 7-dimethoxyflavone (3), and 4,4',6'-trihydroxy-2'-methoxychalcone (4), have been isolated from cudweed Gnaphalium affine D. Don (Compositae). Four natural flavonoids showed insect antifeedant activity against the common cutworm (Spodoptera litura F.). These flavonoids were detected in small amounts in the plant by HPLC analysis, but these natural compounds had strong antifeedant activity against the common cutworm. On the other hand, 4 was detected in a large amount in the plant, but this compound had only a slight activity. Therefore, these natural compounds were regarded as one of the plant's defensive systems against phytophagous insects along with the woolly plant surface. As for the structure-activity relationship, it is an advantage for antifeedant activity to have no oxy-substituents on the B-ring of the flavonoid but have an ether linkage such as a pyran in the chemical structure.

Immunohistochemical study of the neuropeptides in the stellate ganglion of the water buffalo

The localization of some neuropeptides including neuropeptide Y (NPY), substance P (SP), calcitonin gene related peptide (CGRP), vasoactive intestinal peptide (VIP), galanin (Gal), methionine enkephalin (M-ENK), tyrosine hydroxylase (TH) immunoreactivity was studied in the stellate ganglion (SG) of water buffalo. NPY, SP, Gal and TH immunoreactivities were present in almost all of the ganglion cells. NPY, SP, Gal, SP, CGRP, VIP and M-ENK immunoreactive nerve fibers were also seen in the SG. The localization and pattern of distribution of these peptides in the water buffalo stellate ganglion were compared with those in stellate ganglia of other mammalian species.

Modification of cullin-1 by ubiquitin-like protein Nedd8 enhances the activity of SCF(skp2) toward p27(kip1)

The periodic expression of cell cycle proteins is important for the regulation of cell cycle progression. The amount of CDK inhibitor, p27(kip1), one such protein, seems to be regulated by the ubiquitin-proteasome system. The ubiquitin ligase (E3) toward p27(kip1) is thought to be SCF(skp2). The activity of SCF(skp2) was increased by the addition of Roc1 protein to the complex. Furthermore, the ubiquitination of p27(kip1) seemed to be dependent on the phosphorylation of T187 of p27(kip1) because the mutant T187A was not ubiquitinated at all in an in vitro ubiquitination system. Cullin-1, a component of SCF, is modified by ubiquitin-like protein Nedd8. The modification site of cullin-1 was shown to be K696 because the K696R mutant was not modified. When the effect of the Nedd8 modification on the SCF(skp2) activity toward p27(kip1) was investigated, the activity was markedly decreased by using the Nedd8-unmodified mutant cullin-1 (K696R), indicating that the modification may play an important role on the SCF(skp2) activity toward p27(kip1).

Isolation of hemicellulose from a sorghum, Andropogon sorghum Brot, Kumadake no. 263, and determination of its constituent sugars

Hemicellulose was isolated from the stem of sorghum, Andropogon sorghum Brot, Kumadake no. 263, and the constituent sugars of this isolate were determined. The xylose concentration in the hemicellulose of SV263 was extremely high.

The mesh plug technique for adult inguinal herniation

We studied 112 adult patients who underwent the mesh plug method for inguinal hernia at our clinical division from August 1996 to September 1998. We compared the mesh plug method with conventional sutured repair, such as the Bassini method, the ileopubic tract repair method and the McVay method, according to the duration of operation, postoperative white blood cell count, postoperative CRP, the frequency of analgesics after surgery, and the recurrence rate. The duration of operation in patients with the mesh plug method was significantly short. According to postoperative white blood cell count and CRP, there was no significant difference between the two groups. Frequency of analgesics after surgery was 0.8 times in a patient with conventional sutured repair and 0.4 times in a patient with the mesh plug method, suggesting that it was significantly low in patients with the mesh plug method. The recurrence rate in patients with the mesh plug method was 3.57% (4 cases). All the recurrences had developed within 1 year after surgery, and all of the cases were repaired with the mesh plug method. We conclude that the mesh plug method for adult inguinal hernia was a useful operative procedure with shorter duration of operation, less postoperative wound pain, and almost the same recurrence rate compared with conventional sutured repair.

Posttreatment sequelae of palliatively treated cerebral arteriovenous malformations

OBJECTIVE

Posttreatment sequelae of palliatively treated cerebral arteriovenous malformations (AVMs) were studied to evaluate the significance of these nonradical treatments.

METHODS

Between 1987 and 1997, 46 patients with cerebral AVMs were managed with treatments such as partial embolization, radiosurgery, subtotal resection, or feeder ligation alone. Their AVMs were not radically resected because of difficulties in radical treatment, hesitance to treat eloquent area lesions, or residual nidi after subtotal obliteration. The patients' posttreatment sequelae were evaluated. The duration of follow-up ranged from 0.5 to 169 months (mean, 49.4+/-39.8 mo).

RESULTS

Twenty-six bleeding episodes from AVMs were documented in 18 patients. The annual risk of bleeding in this palliatively treated group was 14.6%. Persistent progressive neurological deficit was observed in one patient. Major neurological deficits occurred in 10 patients (23.3%), and the mortality rate was 9.3%.

CONCLUSION

Palliative treatments cannot prevent bleeding and may even worsen the posttreatment course compared with the natural history of cerebral AVMs. A more conservative indication is required in recommending palliative treatment alone.

Serum total bile acid level as a sensitive indicator of hepatic histological improvement in chronic hepatitis C patients responding to interferon treatment

BACKGROUND AND METHODS

Serum total bile acid (TBA) levels are used clinically as a sensitive and reliable index of hepatobiliary diseases. In the present study, to assess the clinical usefulness of determining TBA in interferon (IFN)-treated patients, changes in liver function test values, including TBA and liver histology, were examined in 36 chronic hepatitis C patients for 3 years after a sustained response to IFN treatment.

RESULTS

Alanine aminotransferase and gamma-glutamyl transpeptidase values significantly decreased during the period of IFN treatment compared to the same measures before IFN treatment. Albumin, cholinesterase, total cholesterol and platelet count values temporarily decreased during IFN treatment, then increased significantly and reached a plateau 6-12 months after the end of IFN treatment. The zinc sulphate turbidity test and TBA values began to decrease during IFN treatment and continued to decrease during the 3-year follow-up period. The histological activity index of the liver (Knodell's score) significantly decreased, whereas the staging score was unchanged 1 year after the end of IFN treatment. In patients who had a TBA value > 10 micromol/L before IFN treatment, a significant correlation was observed between the decrease of TBA and liver histology grading score.

CONCLUSIONS

A decrease in serum TBA level reflected histological improvement in the liver more precisely than did changes in the other liver function test values following IFN therapy.

[Clinical study of cerebral blood flow in unilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT]

Cerebral blood flow (CBF) measured by 99mTc-HMPAO SPECT before operation was studied in 60 patients with unilateral chronic subdural hematoma. The regional CBF was measured in 26 regions of the fronto-occipital 10 cortices, putamen, thalamus and cerebellar hemisphere on both sides. Sixty cases with unilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms: 17 cases with headache (headache group), 34 cases with hemiparesis (hemiparesis group) and 9 cases with consciousness disturbance or dementia (consciousness disturbance group), and into three groups on the basis of the degree of midline brain shift on MRI: 7 cases of mild shift group, 24 cases of moderate shift group and 29 cases of severe shift group. The average CBF in 60 patients in each region indicated that the regional CBF was reduced in frontal, occipital cortices and cerebellum on the non-hematoma side, and in putamen and thalamus on the hematoma side. In the headache group, the regional CBF reduction on the non-hematoma side was found in only frontal and occipital cortices compared with the corresponding regions on the hematoma side. In the hemiparesis group, the regional CBF was reduced in frontal and occipital cortices on the non-hematoma side and in putamen and thalamus on the hematoma side. The part of CBF reduction in both hemispheres was also noted in the hemiparesis group. In the consciousness disturbance group, the CBF reduction was markedly noted in whole brain. The CBF reductions in frontal and occipital cortices on the non-hematoma side and in putamen, thalamus and cerebellum on the hematoma side was not mutually related with the degree of midline brain shift. We concluded that the disturbance of CBF in chronic subdural hematoma was started from frontal and occipital cortices on the non-hematoma side observed in the headache group, and which was extended to putamen and thalamus on the hematoma side and a part of both hemispheres observed in the hemiparesis group. And such disturbance was finally observed as the CBF reductions in whole brain in the consciousness disturbance group.

Magnetic resonance imaging of calvarial eosinophilic granuloma with pericranial soft tissue reaction--case report

A 4-year-old girl presented with an eosinophilic granuloma in the cranial vault. Magnetic resonance (MR) imaging showed the mass as slightly low intensity on T1- and high intensity on T2-weighted images. The pericranial soft tissue was densely enhanced after gadolinium-diethylenetriaminepenta-acetic acid infusion. The mass was soft and successfully removed. Histological examination disclosed Langerhans' cell histiocytosis. MR imaging is useful for the diagnosis of calvarial eosinophilic granuloma with soft tissue involvement.

Histological analysis of murine colitis induced by dextran sulfate sodium of different molecular weights

In this study, we examined the relationship between the molecular weight of dextran sulfate sodium (DSS) and the features of colitis in a DSS-induced mouse model of human ulcerative colitis. DSS at three different molecular weights, 5 kD, 40 kD and 500 kD, was used in this study. DSS was administered in drinking water at 5% (w/v) to 6-7-week-old female BALB/c mice. After 7 days of treatment with DSS, the large intestine was examined histopathologically. Colitis was characterized by a loss of crypts, infiltration of inflammatory cells into the mucosa and submucosa, edema of the submucosa, erosion and ulceration and was observed in mice given the 5 kD and 40 kD forms but not the 500 kD. In the 5 kD group, colitis was observed predominantly in the cecum and upper colon. Colitis in the 40 kD group was more severe than that in the 5 kD group, and in the 40 kD group it was more severe in the lower colon than in the upper colon. These findings suggest the molecular weight of DSS to be an important factor in the murine model of colitis.

Optimal injection protocol for CT evaluation during hepatic arterial infusion chemotherapy

OBJECTIVE

As an imaging modality for follow-up during continuous or repeated hepatic arterial infusion chemotherapy using a hepatic intra-arterial indwelling catheter, the usefulness of CT while infusing contrast through the indwelling catheter (reservoir port) was examined.

METHODS

Using reservoir ports implanted in eight patients with hepatic metastasis from colon cancer, radioisotope perfusion scintigraphy (RI), CT (three rates of infusion of contrast were used), and digital subtraction angiography (AG) were performed to compare the modalities' ability to visualize the intrahepatic and abnormal extrahepatic distributions.

RESULTS

CT (infusion rate 0.1 mL/sec) was superior to AG and RI in terms of the ability to visualize intrahepatic distribution, particularly in small areas, and facilitated 3D delineation of the distribution. In evaluating extrahepatic distribution, CT also outperformed the other modalities.

CONCLUSIONS

For imaging study follow-up during hepatic arterial infusion chemotherapy, CT proved to be more useful than conventional RI and AG.

Lactic dehydrogenase virus infection inhibits allergic eosinophil reaction and IL-5 gene expression in vivo

The effects of lactic dehydrogenase virus (LDV) infection on allergic eosinophil reaction and IL-5 gene expression were studied. LDV infection suppressed antigen-induced eosinophil recruitment into the peritoneal cavity in sensitized mice. The elevation of IL-5 gene expression in the spleen and mesenteric lymph nodes 6 h after ovalbumin challenge was significantly suppressed in LDV-infected mice compared with uninfected (control) mice. The expression of the interferon-gamma and IL-2 genes in the spleen, but not in mesenteric lymph nodes, was significantly suppressed in LDV-infected mice compared with control mice. The present results suggest, that suppression of IL-5 gene expression by LDV infection may not be mediated by a mutual inhibitory mechanism between Th1 and Th2 cells.

Anti-HIV-1 activity of myo-inositol hexaphosphoric acid (IP6) and myo-inositol hexasulfate(IS6)

It is known that polysulfates have some anti-HIV-1 activity. We investigated the anti-HIV-1 activity of myo-inositol hexaphosphoric acid (IP6) and myo-inositol hexasulfate(IS6), low molecular weight carbohydrates. IP6 and IS6 inhibited the replication of HIV-1 in a T cell line as well as that of a freshly isolated strain in peripheral blood mononuclear cells. Neither substance inhibited HIV-1-induced giant cell formation, but addition of IS6 when infecting cells with HIV-1 inhibited the replication of HIV-1. Neither substance inhibited HIV-1 reverse transcriptase activity in vitro and no influence on late stage replication was noted. Although the mechanisms of IP6 and IS6 action remain unclear, it can be speculated that they act on HIV-1 early replicative stage. Although it is not possible to develop IP6 and IS6 themselves as anti-AIDS drugs, studies of these anti-HIV agents might be expected to provide seed for eventual production of superior drugs for AIDS treatment.

[Self-expanding stent (Wallstent) supported angioplasty for carotid artery stenosis]

We reported the preliminary results of percutaneous transluminal angioplasty (PTA) supported with a self-expanding stent (Wallstent) for the cervical internal carotid artery (i.c.) stenosis in 6 patients (7 lesions). All were male aged from 60 to 79 (mean 70.8). Three patients were symptomatic and 3 were asymptomatic. The procedure was attempted in patients with severe i.c. stenosis according to criteria of NASCET, ECST or ACAS studies and with high risk if carotid endarterectomy (CEA) were performed. In all cases, vascular access was from the femoral artery and angioplasty was performed without cerebral protection. Successful angioplasty was obtained in all cases with no mortality. Stenosis was improved from 82.7% (74-90%) to 17.4% (10-33%). Perioperative complications were seen in only one case with TIA during the postdilatation period, which was supposed to be due to a distal embolism. The preliminary results of PTA supported with self-expanding stent for severe i.c. stenosis were excellent. These results suggested that some patients with severe i.c. stenosis can be treated safely and effectively by stent-supported PTA. However, it is necessary to mark the indications clear and strict, and to follow up these lesions after the procedure, because of the possibility of perioperative ischemic complications and restenosis.

Lysophosphatidylcholine phosphorylates CREB and activates the jun2TRE site of c-jun promoter in vascular endothelial cells

Lysophosphatidylcholine (lyso-PC), a polar phospholipid increased in atherogenic lipoproteins and atherosclerotic lesions, has been shown to induce transcription of a variety of endothelial genes relevant to atherogenesis. Lyso-PC has been shown to activate c-jun N-terminal kinase (JNK) and activator protein 1 (AP-1) and thereby stimulate transcription of the c-jun gene. Here we provide evidence that lyso-PC can phosphorylate cyclic AMP responsive element binding protein (CREB) and thereby activate the jun2 12-O-tetradecanoylphorbol 13-acetate response element (jun2TRE) site of the c-jun promoter, which appears to be the major molecular mechanism involved in lyso-PC-induced c-jun gene expression in cultured bovine aortic endothelial cells (BAEC). Transient transfection of BAEC with a 1.6-kbp c-jun promoter and luciferase reporter fusion gene resulted in a 12.9-fold increase in luciferase activity by lyso-PC treatment. Serial deletion mutation in c-jun promoter and luciferase reporter gene assay revealed that the 5' promoter region between nucleotide numbers -268 and -127, which contains a jun2TRE binding sequence, was most crucial for lyso-PC-induced transcription. The 5' promoter region between -76 and -27, which contains an AP-1 site, also affected lyso-PC-induced transcription of the c-jun gene. Point mutation in the jun2TRE site reduced lyso-PC-induced transcription of the c-jun promoter-luciferase fusion gene by a 70.3% decrease in c-jun promoter activity. Electrophoretic mobility shift assays showed increased binding of (32)P-labeled oligonucleotides with jun2TRE in nuclear extracts isolated from lyso-PC-treated BAEC, which was abolished or supershifted by anti-CREB antibody. Immunoblotting with anti-phosphorylated CREB antibody showed rapid phosphorylation of this protein after lyso-PC treatment. These results indicate that lyso-PC phosphorylates CREB, which was then bound to the jun2TRE site of the c-jun promoter and activated transcription. Activation of jun2TRE may play a key role in the transcriptional activation of c-jun as well as other endothelial genes depending upon these transcription factors.

Lactic dehydrogenase virus inhibits allergic immunoglobulin E production: in vivo molecular analysis of cytokines

The effects of lactic dehydrogenase virus (LDV) infection on allergic immunoglobulin (Ig)E production and interleukin (IL)-4 gene expression were studied. LDV infection suppressed antigen-induced IgE production in sensitized mice. The elevations of IL-4 gene expression in spleen and mesenteric lymph nodes 3 and 7 days after ovalbumin challenge were suppressed significantly in LDV-infected mice compared with control mice. The expression of the interferon (IFN)-gamma gene of mesenteric lymph nodes was significantly increased in LDV-infected mice. These results suggest that LDV infection suppressed antigen-induced IgE production by decreasing IL-4 production, and that suppression of IL-4 gene expression may be mediated by a mutual inhibition mechanism between T helper (Th)1 and Th2 cells.

Changes in colonic mucosal permeability in mouse colitis induced with dextran sulfate sodium

In this study we examined changes in colonic mucosal permeability induced by dextran sulfate sodium (DSS) during the acute phase of mouse colitis. To induce colitis, the mice were given drinking water containing 5% (w/v) DSS (MW = 40,000) ad libitum. Colonic mucosal permeability was evaluated by the permeation of Evans blue (EB) from the lumen into the wall of the colon on 1, 2, 3 and 7 days postadministration of DSS. Mucosal changes were also histologically examined daily for 7 days postadministration. The permeation of EB increased significantly by days 3 and 7 postadministration. Histological analysis showed that crypt loss was the initial change, with no inflammatory process and the surface mucosal epithelial cells remained morphologically intact. These histological changes developed on 2 to 3 days postadministration. Erosion was first recognized at 5 days postadministration. These findings indicated that the increase in colonic mucosal permeability may have occurred in 3 days postadministration, and the increase in mucosal permeability occurred before the appearance of the inflammatory process. This suggests that an increase in colonic mucosal permeability, leading to the destruction of mucosal barrier function, may play an important role in the induction of DSS-induced murine colitis.

Efficacy of direct revascularization in adult Moyamoya disease: haemodynamic evaluation by positron emission tomography

To evaluate the efficacy of direct cerebrovascular reconstruction to prevent intracranial bleeding from the point of view of haemodynamic status, we performed positron emission tomography (PET) studies in 5 adult patients with Moyamoya disease before and after superficial temporal artery to middle cerebral artery (STA-MCA) anastomosis. Regional cerebral blood flow (rCBF), regional cerebral metabolic rate of oxygen (rCMRO2) and regional oxygen extraction fraction (rOEF) in the MCA territories and regional cerebral blood volume (rCBV) in the striatum were measured before and after STA-MCA anastomosis. Correlation between the change of these PET parameters and post-operative decreased opacification of Moyamoya vessels were analyzed. Pre-operatively, significant elevation of rCBV were observed in the basal ganglia as well as significant reduction of rCBF and elevation of rOEF with reduction of rCMRO2 in the MCA territories, indicating "misery" perfusion in the cerebral hemisphere and blood pooling in the Moyamoya vessels under increased haemodynamic stress. Post-operative PET study showed improvement of misery perfusion and reduction of rCBV in the basal ganglia. Reduction of rCBV in the basal ganglia generally compatible with decreasing Moyamoya vessels on angiographic findings. Our results suggests that direct bypass surgery could have a potential both for decreasing haemodynamic stress on Moyamoya vessels and to improve misery perfusion in the hemisphere.

Cosmetic osteoplastic craniotomy with a chisel and hammer

BACKGROUND

Osteoplastic craniotomy has been performed recently with microfixation systems such as miniplates, burr hole buttons, and/or ceramic dust. However, these are costly methods of treatment. Without the use of these devices, we performed cosmetic osteoplastic craniotomy using an inexpensive chisel and hammer.

METHODS

Our osteoplastic craniotomy with a chisel and hammer was used on 19 lesions in 15 patients. Using a chisel, the bone flap was cut gently from the calvarium to the skull base, the lamina externa to the diploe (finally the lamina interna), and both ends to the midportion between two holes. The lamina interna in the cranium was trimmed easily after removal of the bone flap. The bone defect was minimal because of the absence of a narrow cutting groove and because craniectomy was not performed. The bone flap was replaced by tapping and was tightly fixed. No special fixation system was needed, except for threads.

RESULTS

Follow-up (mean follow-up, 5 months; range, 5 weeks to 9 months) skull X-ray and 3D-CT showed good fusion and inherent normal configuration of the bone flap. There were two minor dural tears and two minor bony fractures.

CONCLUSION

A good cosmetic effect without the use of any additional instruments was accomplished with osteoplastic craniotomy using a chisel and hammer.

[Precision and accuracy of white blood cell differentiation by an automated blood cell analyzer]

Precision and accuracy are important to assure the quality of clinical laboratory tests. We investigated the precision and accuracy of white blood cell (WBC) differentiation by automated blood cell analyzers. The coefficients of variation (CVs) of neutrophil, lymphocyte, monocyte, eosinophil and basophil differentiation by GEN.S (Coulter), based on a flow system and VCS technology, were 1.1%, 1.5%, 4.6%, 2.1%, and 33.3%, respectively. Between-run precision for neutrophil, lymphocyte, monocyte, eosinophil and basophil differentiation by GEN.S using cell control, 5C in 26 serial days was 2.0%, 2.8%, 6.5%, 9.2%, and 29.5%, respectively. The precision of WBC differentiation by blood cell analyzers based on the flow system was excellent except for basophil. We studied the accuracy of WBC differentiation by blood cell analyzers based on the flow system in contrast with eye-count. The correlations between neutrophil, lymphocyte, monocyte, eosinophil, and basophil percentages counted by GEN.S and by eye-count were r = 0.968, 0.971, 0.902, 0.940, and 0.391, respectively. The agreement rate between WBC differentiation by Microx, a blood cell analyzer based on pattern recognition, and eye-count cell by cell was good except for basophils. The accuracy of WBC differentiation by blood cell analyzers was also excellent excluding basophils.

[Fibrous dysplasia of the skull presenting interesting neuroradiological findings]

A case of fibrous dysplasia of the frontal bone in a 51 year-old male is described. He was admitted to our hospital with a hard, painless growing mass in the left frontal region. A symmetrical protrusion of his forehead has been observed since several years before. Neurological examination and laboratory data revealed no abnormalities. Skull x-rays demonstrated two different lesions. One showed a ground glass appearance in the supraorbital region, and the other showed a radiolucent lesion with marginal sclerosis crossing the left coronal suture CT scan revealed an intradiploic multilocular mass. T1 and T2 MR images showed an abnormal low-intensity mass, and heterogeneous gadolinium-enhancement was noticed in both lesions. Selective external carotid angiography showed tumor stain in the left coronal mass fed by middle meningeal and superficial temporal arteries mimicking intraosseous meningioma. On the other hand, a supraorbital hyperostotic lesion showed no apparent vascularity. An operation was performed on the left coronal lesion to verify the nature of the progressively enlarging mass, which was histologically confirmed to be a fibrous dysplasia rich in numerous vessels. Postoperative course was uneventful. Correlation with clinical activity and enhancement pattern was not known, however, careful observation is required in hypervascular fibrous dysplasia such as was observed in this case.

Orthostatic hypotension improved after bilateral carotid endarterectomy--case report

A 60-year-old male with recurrent syncopal attacks presented with orthostatic hypotension on the head-up tilt test. Angiography also showed severe stenosis of the bilateral extracranial carotid arteries. He underwent two-staged bilateral carotid endarterectomy. After the operations, the orthostatic hypotension resolved and the syncopal attacks have disappeared completely. Orthostatic hypotension in this patient was due to vasodepressor-type carotid sinus syndrome caused by compression of the carotid baroreceptors by atherosclerotic plaques.

Tissue distribution of dextran sulfate sodium (DSS) in the acute phase of murine DSS-induced colitis

In the present study, we examined histochemically the tissue distribution of dextran sulfate sodium (DSS) in the acute phase of murine colitis induced by administering DSS in the drinking water. DSS was mainly observed in the Kupffer cells of the liver, in the macrophages of the mesenteric lymph node (MLN) and in the lamina propria of the large intestine after administration of DSS. We followed the time course of DSS distribution and found that DSS, which was considered as a large and negatively charged molecule that can not easily cross membranes, was distributed in the liver, the MLN, and the large intestine 1 day after the start of administration of DSS.

Percutaneous Transluminal Angioplasty (PTA) with Wallstent for Internal Carotid Artery Stenosis. A Case Report

SUMMARY

A 67 year-old male who had suffered from myocardial infarction, was admitted to our clinic to examine his internal carotid artery stenosis revealed by preoperative study for heart surgery. Although he had no neurological symptoms, the angiograms showed severe stenosis of his right internal carotid artery. To improve stenotic internal carotid artery, PTA was performed employing a selfexpanding stent. The stenotic right internal carotid artery was improved from 75% to 11% immediately after the stenting though restenosis mildly occurred up to 16% three months later. No complication occurred during this stenting procedure. Afterwards the patient uneventfully received coronary artery bypass grafting (CABG) surgery.

Comparison of positron emission tomography study results of cerebral hemodynamics in patients with bleeding- and ischemic-type moyamoya disease

The purpose of this study was to elucidate the difference in cerebral hemodynamics and metabolic status between patients with bleeding- and ischemic-type moyamoya disease. Regional cerebral blood flow (rCBF), regional cerebral metabolic rate of oxygen (rCMRO2), regional oxygen extraction fraction (rOEF), and regional cerebral blood volume (rCBV) in the cortex of the middle cerebral artery (MCA) territories and rCBV in the striatum were measured using positron emission tomography (PET) in 17 patients with moyamoya disease. Patients were divided into three subgroups according to type of disease manifestation and age: adult bleeding type (five cases), adult ischemic type (10 cases), and childhood ischemic type (two cases). When compared with adult controls, statistically significant reductions in rCBF and rCMRO2, elevation in rOEF in the MCA territories, and elevation of rCBV in the striatum were observed in PET studies for all three subgroups. Between the adult bleeding type and ischemic type, rCBF, rCMRO2, and rOEF in the MCA territories were not different, but rCBV in the striatum was higher in patients with ischemic-type moyamoya disease than in those with the bleeding type. In adult patients with bleeding and ischemic types, rOEF and rCBV in the MCA territories and rCBV in the striatum were significantly lower than in patients with childhood ischemic-type moyamoya disease. In adult patients with bleeding-type moyamoya disease, cerebral hemodynamics were impaired and similar to those in adult ischemic type.

Expression and purification of a mutant human growth hormone that is resistant to proteolytic cleavage by thrombin, plasmin and human plasma in vitro

The region having a sequence from amino acid 134 to 150 in human growth hormone (hGH) is known to be cleaved by proteases in human plasma, plasmin and thrombin. In this study, oligonucleotide primer-directed mutagenesis was used to produce recombinant mutant hGHs resistant to limited proteolysis by these proteases. Substitution of Arg134 and Thr135 of hGH with Asp134 and Pro135 yielded a thrombin-resistant hGH mutant, and substitution of Arg134, Thr135 and Lys140 with Asp134, Pro135 and Ala140 yielded a plasmin-resistant hGH mutant. The latter mutant hGH was also insensitive to in vitro proteolysis by human plasma incubated for 7 days. These alterations in amino acid residues of hGH did not disrupt its biological conformation and retained full growth promoting activities on rat Nb2 cells and human T-47D breast cancer cells.

[Epidural anesthesia for cesarean section in a twin pregnant patient with severe aortic stenosis]

A 35-year-old twin primigravida with aortic stenosis underwent cesarean section under epidural anesthesia. She had her ventricular septal defect repaired at 3 years of age. Preoperative ultrasonic study revealed severe aortic stenosis in which valve area was 0.77 cm2 and pressure gradient between the left ventricle and the aorta was 80 mmHg. We persuaded her and her husband to discontinue pregnancy and recommended aortic valve replacement surgery. They rejected our suggestions, and cesarean section was scheduled at 29 weeks' gestation. We chose epidural anesthesia. A 20-gauge catheter and a pulmonary artery catheter were inserted to monitor the hemodynamics. Two lumbar epidural catheters were placed at the L 1-2 and L 4-5 intervertebral spaces. Sixteen milliliters of 1.5% mepivacaine were injected, producing anesthesia up to T 6 level. The babies were delivered, and postnatal conditions of both infants were satisfactory. Methoxamine 1 mg was administered four times when systolic blood pressure decreased to 80 mmHg following deliveries. Otherwise, peripartal hemodynamics was stable, and she was transferred to the intensive care unit (ICU). Postoperative pain was controlled with epidural infusion of fentanyl. She did not complain of chest pain perioperatively and was discharged from the ICU next day.

Macroscopic distribution of coronary atherosclerotic lesions in cholesterol-fed rabbits

In the present study we macroscopically examined a change in the distribution of coronary atherosclerosis in cholesterol-fed rabbits. Rabbits were fed a cholesterol-enriched diet for 15 weeks, then replaced by a normal diet, and were sacrificed at 15, 24, 32 and 42 weeks after the start of the experiment. The coronary atherosclerosis in the cholesterol-fed rabbits was distributed more densely in the proximal portion than in the middle and distal portions, and the lesions were severe at 24 and 32 weeks after the start of the experiment. comparison of lesions in the three portions at these time points showed that the percentages of lesion areas in the proximal portion, the middle portion and the distal portion were approximately 51%, 21 to 25% and 0.2 to 3.7%, respectively. Macroscopic observation of the coronary atherosclerotic lesions showed that the lesions formed over the vessel lumen in the proximal portion within the range of approximately 5 mm from the orifice of the left coronary artery. In the middle portion, the lesions formed predominantly around the orifices of branches as small patchy lesions from 1 to 3 mm in diameter. These findings support previous histopathological reports that suggested that the incidence of stenosis in the proximal portion was high, and the incidence of lesion occurrence in the middle and the distal portions varied. The method, macroscopical investigation of the coronary artery, is useful for analyzing coronary atherosclerosis in the rabbit.

Interferon-gamma plays a role in pancreatic islet-cell destruction of reovirus type 2-induced diabetes-like syndrome in DBA/1 suckling mice

Reovirus type 2 (Reo-2) infection in DBA/1 suckling mice causes insulitis, which leads to pancreatic islet-cell destruction, resulting in a diabetes-like syndrome. T-helper (Th) 1 cytokines are thought to play a key role in islet inflammation in insulin-dependent diabetes mellitus. We examined this hypothesis in the Reo-2-induced diabetes-like syndrome. We used reverse transcriptase polymerase chain reaction (PCR) and quantitative PCR techniques to examine mRNA expression of interferon (IFN)-gamma (Th1 type cytokine), and interleukin (IL)-4 (Th2 type cytokine) in splenic cells. We observed that in Reo-2 infected mice the level of IFN-gamma expression increases with the development of insulitis, whereas expression of message for IL-4 is minimal to detectable with the immuno-inflammatory process 10 days after infection. The treatment of monoclonal antibody (mAb) against mouse IFN-gamma during the expansion phase of insulitis (5-9 days after infection) inhibited the development of insulitis and the elevation of blood glucose concentrations in a dose dependent manner. Furthermore altered CD4+/CD8+ cell ratio compared with uninfected mice in the splenic cells by the infection was recovered to the ratio of uninfected mice by the treatment of mAb against mouse IFN-gamma, suggesting normalization of T cell balance in immune system. These results suggest that Reo-2-triggered autoimmune insulitis may be mediated by Th1 lymphocytes and IFN-gamma may play a role in islet inflammation leading to islet cell destruction.

Overview and initial results of the very long baseline interferometry space observatory programme

High angular resolution images of extragalactic radio sources are being made with the Highly Advanced Laboratory for Communications and Astronomy (HALCA) satellite and ground-based radio telescopes as part of the Very Long Baseline Interferometry (VLBI) Space Observatory Programme (VSOP). VSOP observations at 1.6 and 5 gigahertz of the milli-arc-second-scale structure of radio quasars enable the quasar core size and the corresponding brightness temperature to be determined, and they enable the motions of jet components that are close to the core to be studied. Here, VSOP images of the gamma-ray source 1156+295, the quasar 1548+056, the ultraluminous quasar 0014+813, and the superluminal quasar 0212+735 are presented and discussed.

Effect of MDR antagonists on the cidal activity of vincristine for cells expressing MDR-1 is superior to those expressing MRP

In an attempt to identify the target protein, P-GP or mrp, of each MDR antagonist, verapamyl (Ver), dipyridamole (Dip), or cyclosporin A (Cy-A), this study was designed to compare the activity of the three afore-mentioned drugs and to test their combined effect on the cidal activity of vincristine (VCR) in five types of wild and the corresponding VCR-resistant cultured cell lines from human leukemia and lymphoma. Three of the VCR-resistant cell lines are characterized by the overexpression of mdr-1, while two cell lines overexpress mrp. We found that all three antagonists additively to synergistically enhanced the cidal activity of VCR for the five wild-type and VCR-resistant cell lines in a dose dependent manner when used singly. Combinations consisting of a 20% inhibitory concentration (IC20) of VCR plus two antagonists also showed additive to synergistic effects on both wild and VCR-resistant cell lines. It is of interest that the combined effect of IC20 VCR plus MDR antagonists on the three VCR-resistant cell lines expressing mdr-1 was significantly superior to those of the two cell lines expressing the mrp gene. These results suggest that the combined effect of MDR antagonists work better than their single use and that the MDR antagonists work more efficiently in cells showing drug resistance through mdr-1 than in those utilizing mrp.

[Pulmonary artery injury caused by mal-manipulation of a pulmonary artery catheter]

A 71-year-old male was scheduled for aortic valve replacement. After tracheal intubation under high-dose fentanyl anesthesia, a pulmonary artery balloon catheter was inserted via the right internal jugular vein. However, after withdrawing the catheter with the balloon inflated, we found abrupt massive bleeding from the endotracheal tube. Fortunately, hemorrhage stopped with PEEP (20-25 cmH2O). Bronchofiberscopy could not detect the bleeding point. Chest X-ray showed the pulmonary artery balloon catheter in the right pulmonary artery and atelectasis of the middle and lower lobes. Five days later, he was extubated without rehemorrhage. Three weeks after hemorrhage, the patient successfully underwent an aortic valve replacement, and was discharged on the 25th post-operative day.

[A case of a urachal sinus with umbilical infection]

A case of the urachal sinus accompanied by umbilical infection is reported. A 21-day-old female infant was seen at the hospital because of umbilical granuloma, redness and umbilical purulent discharge. The separation of the umbilical cord in her neonate was delayed. IVP and CT examination revealed a urachal diverticulum from the urinary bladder to the umbilicus. The patient was diagnosed to have internal and external urachal sinus. In spite of systemic administration of antibiotic agents, the umbilical infection did not get well. After extruding of the external urachal sinus from the umbilicus, she had not had any symptoms. After 3 months the IVP did not revealed in urachal diverticulum.

Lactic dehydrogenase virus infection enhances parasite egg production and inhibits eosinophil and mast cell responses in mice infected with the nematode Nippostrongylus brasiliensis

The effects of lactic dehydrogenase virus (LDV) infection on the protective immune responses to the nematode Nippostrongylus brasiliensis were studied. Mice with chronic LDV infection showed significantly higher levels of parasite egg production than non-LDV-infected (control) mice after N. brasiliensis infection. Concurrent LDV infection also suppressed peripheral blood eosinophilia and the lung mastocytosis induced by this nematode. LDV infection showed higher expression levels of the interferon-gamma (IFN-gamma) mRNA in lymph nodes compared with control mice before N. brasiliensis infection. In addition, the IgG2a production in LDV-infected mice was higher than that in control mice before and after N. brasiliensis infection. These results suggest that LDV infection modulates protective immune responses against N. brasiliensis infection by the activation of T-helper type 1 cells.

Expression of c-kit and stem cell factor mRNA in liver specimens from healthy adult dogs

OBJECTIVE

To determine expression of c-kit and stem cell factor (SCF) mRNA in liver specimens from healthy adult dogs and to investigate whether differentiation of mast cells in the liver of dogs is supported by the c-kit receptor tyrosine kinase/SCF system.

ANIMALS

3 healthy adult Beagles.

PROCEDURE

The nucleic acid sequence of the canine c-kit fragment of the intracellular tyrosine kinase domain was determined. Magnitudes of c-kit and SCF mRNA expression in liver samples was determined by means of northern blot analysis, using probes based on canine sequences. To determine which cells were expressing c-kit and SCF mRNA, in situ hybridization was performed.

RESULTS

Expression of c-kit and SCF mRNA in liver samples was weak but appreciable. In situ hybridization revealed that c-kit and SCF mRNA expression was restricted to mast cells and plasma cells, respectively.

CONCLUSION

Expression of SCF mRNA was detected in liver from healthy adult dogs. The c-kit receptor tyrosine kinase/SCF system may, possibly in combination with other growth factor and receptor systems, be involved in proliferation and differentiation of liver mast cells in dogs.

Expression of interferon receptor genes (IFNAR1 and IFNAR2 mRNA) in the liver may predict outcome after interferon therapy in patients with chronic genotype 2a or 2b hepatitis C virus infection

Hepatitis C virus (HCV) genotype 2a or 2b is associated with a favorable outcome after interferon therapy. However, 19% to 33% of patients do not respond to therapy. We investigated whether interferon receptor gene (IFNAR1 and IFNAR2 mRNA) expression in the liver before interferon therapy predicts long-term response to therapy in patients with genotype 2a or 2b HCV infection. Twenty-seven patients who subsequently received interferon-alpha therapy underwent liver biopsies before interferon therapy. Hepatic IFNAR1 and IFNAR2 mRNA were determined using a reverse transcription-polymerase chain reaction assay. Twenty (74%) patients responded to interferon therapy, while the remaining seven (26%) patients were nonresponders. The expression rates of IFNAR1 and IFNAR2 mRNA in the liver were significantly higher in responders than nonresponders (p < 0.01, by chi-square test). The presence of either IFNAR1 or IFNAR2 mRNA predicted complete response to interferon treatment, with a positive predictive value of 100%. Multiple logistic regression analysis showed that IFNAR1 and/or IFNAR2 mRNA expression was the only significant predictor of the effectiveness of IFN therapy (p = 0.0002). We conclude that expression of interferon receptor genes in the liver is a useful index for predicting the long-term efficacy of interferon therapy in patients with chronic genotype 2a or 2b HCV infection.

Polysaccharides from Agaricus blazei stimulate lymphocyte T-cell subsets in mice

Subset analysis of splenic lymphocytes using flow cytometry showed that the percentages of Thy1.2-(pan T-cells), L3T4-(CD4, helper T-cells), and Lyt2-(CD8, cytotoxic T-cells) positive cell populations were significantly increased in mice orally administered a hot water-soluble fraction from Agaricus blazei as compared with mice treated only with saline. 13C-NMR data indicates that the main component in the active polysaccharide is the complex of alpha-1,6- and alpha-1,4-glucan, which had already been shown to have anti-tumor activity against Sarcoma 180. It seems that the polysaccharide from Agaricus blazei may be an effective prophylactic, protecting humans against cancer by stimulating lymphocytes such as cytotoxic T-cells.