Malignant transformation and EGFR activation of immortalized mouse liver epithelial cells caused by HBV enhancer-X from a human hepatocellular carcinoma

We have previously observed that all human hepatocellular carcinomas (HCCs) from HBV carriers examined had the integrated X region. In this study, HBV DNA was isolated from an integration site in one HCC that had a single, very small integrated viral DNA including the X region, but it had no expression of X gene as poly(A)RNA. It was found that HBV DNA was present between alphoid repetitive sequences, and it included Enhancer and X regions, encompassing the adr sequence from 910 to 1811. Nucleotides for 8 amino acids at the 3' end, a stop codon of X gene and a poly(A) signal downstream of X gene were lost by integration, and nucleotides for 7 amino acids and a stop codon were substituted by a connected alphoid sequence. When this cloned HBV DNA was transfected with an expression vector to an immortalized mouse liver epithelial cell line, MLE-10, malignant transformation occurred. Transformants having expressed poly(A)RNA of the X gene showed anchorage-independent growth in soft agar and tumor formation in the subcutis of nude mice. The mRNA level of EGFR was found to be remarkably enhanced in X-transformed cells, in contrast with the absence of this mRNA in parental and ras-transformed MLE-10. Our data provide evidence that the Enhancer-X region alone is the key contributor to the malignant change of pre-malignant liver cells in HBV carriers through activation of some specific genes, such as EGFR.

Detection of capillary protein leakage by indocyanine green and glucose dilutions in septic patients

OBJECTIVE

To determine whether indocyanine green (ICG) and glucose dilutions can detect generalized capillary protein leakage in septic patients without requiring repeated measurements.

DESIGN

Prospective, clinical study.

SETTING

General intensive care unit.

PATIENTS

Twelve consecutive patients who met the criteria of sepsis and 16 consecutive acute myocardial infarction (AMI) patients without any underlying pathology inducing generalized protein capillary leakage.

INTERVENTIONS

Both ICG 25 mg and glucose 5 g were administered simultaneously, to calculate the plasma volume determined by the ICG dilution method (PV-ICG) and the initial distribution volume of glucose (IDVG), on day 1 of sepsis or on day 1 of hospitalization for the AMI patients. The relationship between these two volumes and the PV-ICG/IDVG ratio was evaluated in two patient groups.

MEASUREMENTS AND MAIN RESULTS

Although the IDVG of the two patient groups was not statistically different, the PV-ICG in the septic patients was higher than that in the AMI patients (p < .01). Consequently, the PV-ICG/IDVG ratio in the septic patients was higher than that in the AMI patients (p < .01). Eight of the 12 septic patients had a PV-ICG/IDVG ratio of >0.45, which was not observed in any of the AMI patients. The PV-ICG/IDVG ratio in the septic patients correlated inversely with the total plasma protein concentration (r2 = .46, p < .025) and mean arterial pressure (r2 = .42, p < .05).

CONCLUSIONS

Our results indicate that overestimation of the PV-ICG can occur in septic patients and, further, suggest that simultaneous measurement of the two distribution volumes would help predict generalized capillary protein leakage in septic patients without repeated measurement.

Malignant transformation and EGFR activation of immortalized mouse liver epithelial cells caused by HBV enhancer-X from a human hepatocellular carcinoma

We have previously observed that all human hepatocellular carcinomas (HCCs) from HBV carriers examined had the integrated X region. In this study, HBV DNA was isolated from an integration site in one HCC that had a single, very small integrated viral DNA including the X region, but it had no expression of X gene as poly(A)RNA. It was found that HBV DNA was present between alphoid repetitive sequences, and it included Enhancer and X regions, encompassing the adr sequence from 910 to 1811. Nucleotides for 8 amino acids at the 3' end, a stop codon of X gene and a poly(A) signal downstream of X gene were lost by integration, and nucleotides for 7 amino acids and a stop codon were substituted by a connected alphoid sequence. When this cloned HBV DNA was transfected with an expression vector to an immortalized mouse liver epithelial cell line, MLE-10, malignant transformation occurred. Transformants having expressed poly(A)RNA of the X gene showed anchorage-independent growth in soft agar and tumor formation in the subcutis of nude mice. The mRNA level of EGFR was found to be remarkably enhanced in X-transformed cells, in contrast with the absence of this mRNA in parental and ras-transformed MLE-10. Our data provide evidence that the Enhancer-X region alone is the key contributor to the malignant change of pre-malignant liver cells in HBV carriers through activation of some specific genes, such as EGFR.

Exposure to cigarette smoke impairs alveolar macrophage functions during halothane and isoflurane anesthesia in rats

BACKGROUND

Smoking alters numerous alveolar macrophage functions and is an important risk factor for postoperative pulmonary complications. The authors therefore tested the hypothesis that smoke exposure impairs antimicrobial and proinflammatory responses in alveolar macrophages during halothane and isoflurane anesthesia with mechanical ventilation.

METHODS

Thirty control rats and 30 rats exposed to cigarette smoke were mechanically ventilated with 1.5 minimum alveolar concentration halothane and isoflurane. Ten smoke-exposed and control animals were assigned to one of three different anesthetic durations (0, 2, and 6 h). The fraction of aggregated cells and cell distribution were determined. Opsonized and unopsonized phagocytosis was measured. Microbicidal activity was determined as the ability to kill Listeria monocytogenes. The expression of interleukin (IL)-1alpha, IL-1beta, IL-6, macrophage inflammatory protein-2, interferon-gamma, and tumor necrosis factor-alpha was measured by semiquantitative reverse-transcription polymerase chain reaction. Pulmonary lavage concentrations of these cytokines were measured by enzyme-linked immunosorbent assay.

RESULTS

During both halothane and isoflurane anesthesia, the fraction of aggregated macrophages increased, whereas unopsonized and opsonized phagocytosis and microbicidal activity decreased significantly over time in both groups. Responses observed in smoke-exposed rats were almost twice as great as those observed in the control rats. Gene expression and production of all proinflammatory cytokines except IL-6 increased 2-20-fold during anesthesia. The increases in IL-1beta, interferon-gamma, and tumor necrosis factor-alpha in the control rats were 1.5-8 times greater than those in the smoke-exposed rats.

CONCLUSION

Antimicrobial and proinflammatory responses of alveolar macrophages during anesthesia were markedly suppressed by smoke exposure. Our data suggest that smoke exposure reduces the efficacy of immune defenses during anesthesia.

Expression of genes for proinflammatory cytokines in alveolar macrophages during propofol and isoflurane anesthesia

Anesthesia and surgery induce macrophage aggregation and neutrophil influx, responses that characterize an inflammatory reaction in the distal airway. We thus evaluated the time-dependent expression of genes for proinflammatory cytokines during propofol and isoflurane anesthesia. We studied patients anesthetized with propofol (n = 20) or isoflurane (n = 20). Alveolar macrophages were harvested by bronchoalveolar lavage immediately, 2, 4, and 6 h after induction of anesthesia, and at the end of surgery. RNA was extracted from harvested cells and cDNA was synthesized by reverse transcription. Expression of interleukin-1beta (IL-1beta), IL-6, IL-8, interferon gamma, and tumor necrosis factor-alpha was measured by semiquantitative polymerase chain reaction using beta-actin as an internal standard. We observed two 10-fold increases in gene expression of all proinflammatory cytokines except IL-6. The increases in IL-8 and interferon gamma were 1.5-3 times greater during isoflurane than propofol anesthesia. Expression of the genes for IL-1beta and tumor necrosis factor-alpha was similar with each anesthetic. Our data thus indicate that the pulmonary inflammatory response accompanying anesthesia and surgery is accompanied by the expression of proinflammatory cytokines, and that this expression was in some cases greater during isoflurane than propofol anesthesia.

IMPLICATIONS

Gene expression of proinflammatory cytokines in alveolar macrophages increased significantly over time. The increases were greater during isoflurane than propofol anesthesia, suggesting that inflammatory responses at transcriptional levels in alveolar macrophages are modulated by the type and duration of anesthesia.

Does indocyanine green accurately measure plasma volume independently of its disappearance rate from plasma in critically ill patients?

OBJECTIVE

To determine whether plasma volume determined by the indocyanine green (ICG) dilution method (PV-ICG) is equally accurate independently of its disappearance rate from plasma in the critically ill.

DESIGN

Retrospective clinical investigation.

SETTING

Intensive care unit of a university teaching hospital.

PATIENTS AND METHODS

192 adult patients were initially enrolled. The PV-ICG and the initial distribution volume of glucose (IDVG) were calculated utilizing a one-compartment model by simultaneous administration of ICG 25 mg and glucose 5 g on the first day of measurement in each patient. Twenty-one patients were excluded from the study because of a higher PV-ICG/IDVG ratio (> 0.45) indicating apparent overestimation of the PV-ICG associated with the generalized protein capillary leakage. The remaining 171 patients were divided into four groups according to the magnitude of their disappearance rate of ICG from plasma (Ke-ICG).

RESULTS

Convergence was assumed consistently in each ICG or glucose decay curve, even in the lower Ke-ICG less than 0.10/min. The relationship between the two volumes was not statistically different among groups.

CONCLUSIONS

The results suggest that the measurement of the PV-ICG can be equally accurate independently of its disappearance rate from plasma unless there is generalized protein capillary leakage.

Mimicry of CD40 signals by Epstein-Barr virus LMP1 in B lymphocyte responses

The effect of the Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1) on the activation and differentiation of normal B cells was investigated. B cells of transgenic mice expressing LMP1 under the control of immunoglobulin promoter/enhancer displayed enhanced expression of activation antigens and spontaneously proliferated and produced antibody. Humoral immune responses of LMP1 transgenic mice in CD40-deficient or normal backgrounds revealed that LMP1 mimics CD40 signals to induce extrafollicular B cell differentiation but, unlike CD40, blocks germinal center formation. Thus, these specific properties of LMP1 may determine the site of primary B cell infection and the state of infection in the natural course of EBV infection, whereas subsequent loss of LMP1 expression may affect the site of persistent latent infection.

Antioxidants from Lespedeza homoloba. (I)

The stems of Lespedeza homoloba yielded eight new and three known phenolic compounds. Their structures have been elucidated on the basis of their spectral data. These compounds had strong antioxidative activity against lipid peroxidation in the rat brain homogenate test. 3,9-Dihydroxypterocarp-6a-en and lespedezol A2 showed significant antiallergic activity in allergic (type I) mice.

An aberrant left subclavian artery aneurysm with right aortic arch: report of a case

The case of a 41-year-old man who developed an aneurysm in his aberrant left subclavian artery is described. The patient had a right aortic arch. After a successful aortosubclavian artery bypass, symptoms due to brain ischemia disappeared. This is a very rare disease that is sometimes associated with an aortic anomaly, therefore the optimal therapeutic procedure need to be carefully selected, including the operative indications and approach.

p57(Kip2) is degraded through the proteasome in osteoblasts stimulated to proliferation by transforming growth factor beta1

Cyclin-dependent kinase inhibitory proteins are negative regulators of the cell cycle. Although all the cyclin-dependent kinase inhibitory proteins may be involved in cell cycle control during a differentiation process, only p57(Kip2) is shown to be essential for embryonic development. However, the role of p57 in the control of the cell cycle is poorly understood. Using osteoblasts derived from the calvaria of rat fetus, we show that p57 is accumulated in cells starved by low serum. Cyclin-dependent kinase 2 activity was suppressed in these cells with a significant amount bound to p57. Treatment of the cells with transforming growth factor beta1 dramatically reduced the amount of p57, resulting in an activation of cyclin-dependent kinase 2 activity and the stimulation of cell proliferation. The decrease in p57 was inhibited by treating the cells with proteasome inhibitors, Z-Leu-Leu-Leu-aldehyde or lactacystin, but not with Z-Leu-Leu-aldehyde, which is an inhibitor of calpain, indicating that p57 is degraded through the proteasome pathway. p57 was also shown to be ubiquitinated in vitro. Because transforming growth factor beta1 not only stimulates the growth but also inhibits the differentiation of the cells in this system, our results may suggest a possible involvement of p57 in the control of osteoblastic cell proliferation and differentiation.

The effects of various GTP analogues on microtubule assembly

We synthesized 27 GTP analogues with modification or substitution at positions C2, C6, C8 and ribose moiety to investigate their effect on microtubule (Mt) assembly. It was found that C2 and C6 are both functional for the analogues supporting Mt assembly. It was surprising to find that 2-amino- ATP (n2ATP) substantially supports assembly, and that the appearance of the assembled Mts was indistinguishable from those assembled in the standard GTP assembly buffer solution. Furthermore, 2-amino dATP and dGTP are even more potent than GTP in supporting assembly. The substitution of oxo group at C6 with reactive thiol largely reduced the activity of the analogue to support assembly. When free rotation of the glycosidic linkage of GTP was blocked by the introduction of sulfur atom between C8 and C2' of ribose moiety, it resulted in total suppression of assembly. Purine nucleoside triphosphate was found to support assembly better than GTP, and even more efficient was 2-amino purine nucleoside triphosphate. Interestingly, their deoxy-type analogues were totally inhibitory. Although 2-amino 8-hydroxy ATP and other analogues supported assembly much better than did GTP, their diphosphate analogues were totally incapable of supporting assembly. Finally, bulky fluorescent probes were introduced at C3' of ribose moiety (Mant-8-Br-GTP or Mant-GTP) to visualize the fluorescent signal in assembled Mts. Even in this case, the number of most protofilaments was found to be 14, consistent with that found in Mts assembled in GTP standard buffer solution.

Our treatment of cleft lip and cleft palate

Our principle in cleft lip and cleft palate repair is all-round personal treatment. That is, treatment concentrates not only on cleft lip and cleft palate repair, but also considers the patient comprehensively in terms of his or her personality. In this report, we present patients with cleft lips and/or cleft palates for whom we performed surgical treatments in the past 25 years. We performed primary operations for 402 patients and secondary operations for 120. Cleft lip and cleft palate should be managed with consideration for otolaryngeal aspects as well as plastic surgical ones because of the nature of the disease. We therefore treated our patients from the standpoints of both medical fields, and gained much appreciation from parents whose children suffered from the congenital anomaly.

Twenty years of statistics and observation of facial bone fracture

We analyse the details of patients with facial bone fractures who visited us from 1993 to 1997, and compare past cases treated from 1978 to 1992. From 1993 to 1997, the total numbers of patients and fractures were 633 and 697, respectively. Thus, we had 127 patients and 139 fractures annually. The number of patients has increased over the years. The highest occurrence rate of facial bone fracture was in the nasal bone (half of all), followed by the malar bone, blowout fractures and the mandibular bone. The rate was the lowest in the maxillary bone. The ratio of males to females was 7:3. Facial bone fractures were most often seen in the 10-29 age group.

Surgical treatment for greater sphenoid wing fracture (orbital blow-in fracture)

The authors present 2 patients with greater sphenoid wing fractures that were treated surgically. This type of fracture is classified as a blow-in fracture of the lateral orbital wall. The first patient was a 16-year-old boy who was involved in a motor vehicle accident. Computed tomography (CT) disclosed a medial displacement of the inner wall of the greater sphenoid wing of the left orbit. He was unconscious for 3 days. After he recovered consciousness, he presented limited abduction of the left eye with diplopia in all gaze directions and mild left proptosis. Although these symptoms did not improve for 1 week, displaced bone fragments of the greater sphenoid wing were removed via the lateral orbital approach. The patient had a good postoperative course with progressive improvement in eye movement over the next several weeks. The second patient was a 22-year-old man whose face was hit in a fight. CT disclosed medial displacement of the inner wall of the greater sphenoid wing of the left orbit. Although the patient also presented limited abduction of the left eye on admission, this symptom improved gradually. However, diplopia in all gaze directions and mild left proptosis did not improve. Therefore, the displaced inner wall of the greater sphenoid wing was reduced via the lateral orbital approach. The patient showed a good postoperative course with progressive improvement over the next several weeks. This type of orbital fracture, which is classified as an orbital blow-in fracture, is relatively rare. This type of greater sphenoid wing fracture is caused by buckling of the orbital wall secondary to severe compression of the orbital rim. Surgical treatment using the lateral orbital approach through a hemicoronal skin incision afforded a wider operative field and better cosmetic result.

Intraoperative modulation of alveolar macrophage function during isoflurane and propofol anesthesia

BACKGROUND

Alveolar macrophages are a critical part of the defense against pulmonary infection. Thus the authors determined time-dependent changes in alveolar macrophage functions in patients having surgery who were anesthetized with isoflurane or propofol.

METHODS

Patients anesthetized with propofol (n = 30) or isoflurane (n = 30) during orthopedic surgery were studied. Alveolar macrophages were harvested by bronchoalveolar lavage immediately, and 2, 4, and 6 h after induction anesthesia and at the end of surgery. The fraction of aggregated and nonviable macrophages was determined. Then phagocytosis was measured by ingestion of opsonized and unopsonized particles. Finally, microbicidal activity was determined as the ability of the macrophages to kill Listeria monocytogenes directly.

RESULTS

Demographic and morphometric characteristics of the patients given propofol and isoflurane were similar, as were their levels of pulmonary function and hemodynamic responses. The fraction of alveolar macrophages ingesting opsonized and unopsonized particles, and the number of particles ingested, decreased significantly over time, with the decrease slightly but significantly greater during isoflurane anesthesia. Microbicidal function decreased progressively during anesthesia and surgery, with the decrease almost twice as great during isoflurane compared with propofol anesthesia. The fraction of aggregated macrophages and recovered neutrophils increased over time in the patients given each anesthetic.

CONCLUSIONS

Pulmonary immunologic function changed progressively during anesthesia and surgery. The data from this study suggest that pulmonary defenses are modulated by the type of anesthesia and by the duration of anesthesia and surgery.

Plasma dehydroepiandrosterone sulfate in unipolar major depression. Short communication

We investigated plasma dehydroepiandrosterone sulfate (DHEAS) and cortisol levels in 12 patients with unipolar depression and 11 matched normal controls. The depressed patients showed significantly higher values of plasma DHEAS and cortisol than the controls. After 4 weeks of treatment with antidepressants (mainly clomiplamine), the high plasma DHEAS levels recovered. This finding showed the possible relationship between plasma DHEAS levels and depression, as well as cortisol levels.

Osteolipoma in the parapharyngeal space

We report our experience in managing a 58-year-old Japanese woman with a rare parapharyngeal interstitial cell tumor. Her main complaint was that of a submandibular swelling, which was diagnosed as osteolipoma histologically after resection.

A study of intestinal dysfunction induced by restraint stress in rats

BACKGROUND

The pathogenesis of intestinal dysfunction induced by stress has not been established. We tried to clarify possible causal mechanisms of irritable bowel syndrome.

METHODS

An experimental model of intestinal dysfunction was designed using loading restraint stress in rats. A cannula was inserted into the origin of the duodenum or colon, with the other end leading to the skin. To provide intestinal content, a semi-solid colored marker was used for monitoring intestinal transit. After 1 week the marker was injected into the intestine through the cannula under unanesthetized wakefulness.

RESULTS

Under restraint stress, transit in the small intestine was suppressed, but actual suppression took place only in the upper half, where the contents normally moved fast. Transit time in the colon was reduced by restraint stress. This reduction was attributed to the disappearance of the stagnant region, which was present under normal conditions.

CONCLUSIONS

These results suggested that restraint stress affects the function of the pacemaker site of the intestine.

Genotoxicity of ribo- and deoxyribonucleosides of 8-hydroxyguanine, 5-hydroxycytosine, and 2-hydroxyadenine: induction of SCE in human lymphocytes and mutagenicity in Salmonella typhimurium TA 100

The induction of SCE by ribo- and deoxyribonucleosides of 8-hydroxyguanine, 5-hydroxycytosine, and 2-hydroxyadenine was tested using human peripheral blood lymphocytes. All of these compounds caused an increase in SCE frequency. The potency of SCE induction was as follows: 5-OH-C, 5-OH-dC > 8.OH-G > 8-OH-dG > 2-OH-A, 2-OH-dA. These results suggest that the oxidized nucleosides are incorporated into DNA with different efficiencies (or are repaired with different efficiencies) and exhibit genotoxicity in human blood cells. Ribo- and deoxyribo-derivatives of 5-OH-Cyt and 2-OH-Ade also showed mutagenic activity in Salmonella typhimurium TA 100.

Effects of carbon monoxide exposure on serotonergic neuronal systems in rat brain

It is well known that some psychiatric sequelae exist after CO poisoning, but few animal studies on serotonergic neuronal function after CO exposure have been carried out. We investigated the effects of successive carbon monoxide (CO) exposure (6000 ppm, 10 min, 3 repetitions) on serotonergic neuronal systems in rat brain. Serotonin (5-HT) concentrations were significantly decreased only in the frontal cortex from 1 hr to 7 days after CO exposure. 5-Hydroxyindoleacetic acid (5-HIAA) concentrations were significantly increased at 1 hr in all six brain regions measured (frontal cortex, striatum, hypothalamus, hippocampus, midbrain, and pons). 5-HT synthesis, measured by the accumulation of 5-hydroxytryptophan (5-HTP) after the administration of m-hydroxybenzylhydrazine (NSD-1015), was significantly decreased in all regions from 1 hr to 7 days after CO exposure. [3H]Ketanserin (5-HT2A) binding sites in the frontal cortex were not affected by CO exposure. DOI-induced head shakes, a 5-HT2A receptor mediated behavior, were not changed after CO exposure. These findings indicated that CO exposure caused presynaptic serotonergic neuronal dysfunctions that consisted mainly of decreased concentration of 5-HT in the frontal cortex or a decrease of 5-HT synthesis in all six regions, without compensatory hyperfunction of 5-HT2A receptors.

Synthesis of guanosine 5'-triphosphate analogues and their effect on microtubule assembly

More than 20 base-modified analogues of guanosine 5'-triphosphate including 2'-deoxyguanosine derivatives were synthesized and examined their effect on tubulin polymerization into microtubules (Mts). Among those, 2,6-diamino-8-oxopurineriboside 5'-triphosphate (1d), 2,6-diamino-2'-deoxypurineriboside 5'-tri phosphate (1b) and 8-bromoguanosine 5'-tri phosphate (1g) were shown to have remarkable effect to promote microtubule assembly.