[Sarcoidosis of the skin]

Sarcoidosis is characterized by formation of epithelioid-cell tubercules, without caseation, of the affected organ systems. The mediastinum, peripheral lymph nodes and eyes, in addition to the skin, are most frequently affected. Between 10% and 30% of patients with systemic sarcoidosis in Japan have skin lesions. Skin sarcoidosis is morphologically classified into three basic groups, erythema nodosum, scar sarcoidosis and skin sarcoid. Skin sarcoid is characterized by specific cutaneous lesions of sarcoidosis, and may take nodular, plaque, angiolupoid, subcutaneous and some other forms. Clinical manifestations of the cutaneous lesions are usually asymptomatic and polymorphous. Skin biopsy is, however, often highly useful for confirming a diagnosis of sarcoidosis.

Stoichiometry of the reaction catalyzed by skin sulfhydryl oxidase

The stoichiometry of the reaction catalyzed by skin sulfhydryl oxidase was investigated. Dithiothreitol (DTT) was used as the substrate for skin sulfhydryl oxidase. The consumption of DTT, consumption of oxygen, and production of hydrogen peroxide were measured during the enzyme reaction. The molar ratio of DTT:O2:H2O2 in the enzyme reaction was 1:1.02:0.89. Correspondingly, the stoichiometry of the enzyme reaction was calculated to be [formula: see text]

Changes in properties of neuronal responses in two cortical taste areas in rats of various ages

Changes in the features of responses of cortical taste neurons were studied in granular insular (GI) and dysgranular insular (DI) areas of urethane-anesthetized SD rats of four age groups (4-10, 14-20, 25-35 and > 90 days). Stimuli included four basic taste stimuli, 0.1 M NH4Cl, and the water extract of a food pellet, applied to the entire oral cavity. At the age of 4-10 days, taste neurons showed no spontaneous discharge, and most responded to NH4Cl in a phasic fashion. In older age groups, however, there was a spontaneous discharge, and tonic taste responses were evident; some responded better to the four basic stimuli and to the food than to NH4Cl. With only a few days' difference in age, inhibitory responses were also noted in both areas. Average taste responses increased or decreased at different ages, depending on the type of taste stimulus and recording area. When taste responses were plotted against the four basic taste stimuli in the order of sucrose, NaCl, HCl and quinine along the abscissa, some neurons showed double-peaked response profiles. This suggests the convergence and mutual inhibition of afferents at single cortical neurons. The fraction of neurons with double-peaked response profiles increased at the age of 25-35 days in both areas. Neurons in rats aged 25-35 days were predominantly sensitive to either NH4Cl or NaCl, or to either food or sucrose. Neurons in rats of other ages, during the preweanling and the adult stages, tended to respond to both these stimuli. Our observations suggest that cortical taste neurons develop in the rat brain in accordance with the maturation of both the taste receptors and the neural networks.

Preproenkephalin gene expression in the rat cerebral cortex during chronic tracheal stenosis

To evaluate whether the endogenous opioid system is activated in the higher brain centre while a chronic resistance to airflow, we examined changes of mRNAs for preproenkephalin (PPE)-A, which is a precursor of enkephalin, and for 70 kD heat shock protein (HSP70) in the cerebral cortex of rat brain during chronic tracheal stenosis. Northern blot revealed that PPE-A mRNA was induced at 3 days of airway stenosis. In situ hybridization revealed that PPE-A mRNA was gradually induced in frontal cortex. The significant induction of PPE-A mRNA was observed at 3 and 7 days. However, no significant induction of HSP70 gene was observed. These results suggest that the endogenous opioid system may be at work as an important compensatory mechanism to reduce the respiratory sensation during chronic respiratory stress.

Effect of malocclusion on mandibular movement during speech

To investigate the effect of malocclusion on mandibular movement during speech, the Sirognathograph Analyzing System was used to analyze the form of the envelope of motion during speech, as well as the relationship between the envelope of motion and eccentric movement paths, in 10 normal subjects and 60 subjects having malocclusion. Location of the envelope of motion, and the relationship between the envelope of motion and eccentric movement paths, were closely related to specific malocclusions. It is suggested that analysis of the envelope of motion during speech has diagnostic value in speech function assessment and that its detailed analysis offers valuable information for diagnosis and initiation of dental treatment.

Variation of differentiation in nail and bovine hoof cells

Human nail plate contains two distinct types of keratins, skin-type and hair-type keratins. To elucidate that nature of the differentiation pathway of nail, we examined the expression of these keratins in human nail as well as in cultured cells taken from bovine hoof matrix. In this study we succeeded in showing that human nail matrix is characterized by the segregated localization of skin- and hair-type keratins except for the apical matrix in which both types of keratins are co-expressed. These results allow us to infer that some of the nail cells possibly divert the pattern of keratin expression during differentiation in vivo. Cultured cells taken from the ventral matrix of bovine hoof, which undergo the pathway of hair-type differentiation in vivo, expressed skin-type keratins together with hair-type keratins, thereby indicating that these cells develop into another pathway of differentiation (skin-type differentiation) from hair-type differentiation developed in vivo. These results provide us with a further insight into nail differentiation under which nail cells develop into multiple patterns of differentiation in vivo and in vitro.

Endothelin-1 acts as an autocrine growth factor for normal human keratinocytes

Endothelin-1 (ET-1) is an endothelium-derived 21 amino acid vasoconstrictor peptide possessing two intrachain disulfide bridges. Recently it has become evident that isoforms of ET (ET-1, -2, and -3) have a wide range of pharmacological effects in various tissues and act as autocrine/paracrine factors. We demonstrate here that ET-1 is secreted from normal human keratinocytes and may work as an autocrine growth factor through a specific receptor. In this study, human foreskin keratinocytes were cultured in serum-free MCDB 153 medium. Cell growth and [3H] thymidine incorporation in low and high Ca++ concentration media was stimulated by ET-1, -2, and -3 with similar potencies. The strongest response was observed at 10 nM ETs, whereas stimulatory activity was reduced at 100 nM. ETs suppressed keratinocyte differentiation as measured by reactivity with involucrin antibody. Plasminogen activator activity (mainly urokinase) in the medium was also stimulated by the addition of 10 nM ETs. ET-1-like immunoreactivity measured by radioimmunoassay was 1.4 fmol/day/10(6) cells in non-treated condition medium. Among the various cytokines, tumor necrosis factor-alpha (TNF-alpha), interleukin-1 alpha, and transforming growth factor-beta stimulated ET-1 secretion in a dose-dependent manner. The strongest response (ten-fold) was observed upon the addition of 10 ng/ml TNF-alpha. Scatchard plot analysis of [125I] ET-1 binding to keratinocytes revealed the presence of a single class of high affinity receptors (KD 50 pM, 9 x 10(3) sites/cell). Binding was competitively inhibited by the addition of unlabeled ET-1 and -2 with similar affinities and by ET-3 with weaker affinity. ET-1 mRNA expression in keratinocytes was detected by reverse transcription-polymerase chain reaction and was increased by treatment with 10 ng/ml TNF-alpha. These results suggest that ET-1 acts as an autocrine growth factor for keratinocytes through a specific receptor.

Rod-like intracytoplasmic inclusions in large neurons of the caudate nucleus: frequent appearance in myotonic dystrophy

Brain autopsy materials from 5 patients diagnosed clinicopathologically as having myotonic dystrophy (MyD) were studied. All of the cases showed many rod-like intracytoplasmic inclusions, which have never been reported in the disease, in the large neurons of the caudate nucleus. The rod-like inclusions were observed in the cytoplasm near the nucleus, and showed eosinophilic staining with HE, blue with PTAH, red with Masson's trichrome, and blue with toluidine blue. Electron microscopically, the inclusions had an internal structure composed of parallel beaded dark filaments and clear spaces. In transverse section, the inclusions showed tetragonal arrays of filaments. These histological characteristics of the inclusions were similar to those of inclusions reported previously in the same location in various disorders, showing increasing incidence with aging. Quantitative investigation on the 5 patients and 24 control subjects revealed that the number of neurons containing the inclusion in the caudate nucleus of MyD patients was about twice as many as the control subjects, and that the occurrence rate of the inclusion body to the large neurons in the caudate nucleus in MyD was far higher than that of the controls. The finding indicates that the inclusion body is important for the diagnosis of the disease, and may have a close relationship with the neurological symptoms and pathogenesis of the disease.

Highly polarized expression of carbohydrate-binding protein p33/41 (annexin IV) on the apical plasma membrane of epithelial cells in renal proximal tubules

p33/41 is a Ca(2+)-dependent carbohydrate-binding protein and is identical to annexin IV, a member of the annexin protein family. The localization of p33/41 in bovine kidney specimens was investigated immunohistochemically by use of specific polyclonal antibodies. The most interesting finding on immunostaining was that p33/41 was highly concentrated in the apical plasma membrane of the epithelial cells in the proximal tubules contrary to the distribution throughout the cytoplasm in the papillary ducts and papilla epithelium. The enrichment of p33/41 in the apical membrane was confirmed by immunoblotting of the brush border membrane fraction prepared from a kidney homogenate. Sequential extraction with EDTA and Triton X-100, and a partition experiment with Triton X-114 revealed that most p33/41 associates with the renal brush border membrane in a Ca(2+)-independent manner and is integrated into the membrane like intrinsic membrane proteins.

[Effects of succinylcholine on neuromuscular transmission during recovery from vecuronium]

Effects of succinylcholine (SCC), 1 mg.kg-1, given following incomplete recovery from muscle paralysis induced by vecuronium were investigated in 27 female patients undergoing elective surgery, which was performed under epidural anesthesia. Anesthesia was induced with thiamylal 5 mg.kg-1 followed by SCC to facilitate orotracheal intubation. Vecuronium bromide 0.08 mg.kg-1 was given and the lungs were ventilated with 67% N2O in O2 and 0.6% sevoflurane. Neuromuscular function was monitored by means of the induced EMG. The ulnar nerve was stimulated at the wrist. Supramaximal trains of four stimuli (2 Hz for 2 s: pulse width 0.2 ms) were administered every 20 s. The effect of SCC varied depending upon the degree of recovery from vecuronium. At the 25% recovery point, the response to SCC was biphasic, showing an initial reversal followed by an increase of the partial vecuronium block which recovered showing a fade phenomenon on train-of-four stimulation. At the 50% recovery point, an initial reversal was slight. Administered at 75% recovery from vecuronium, SCC produced total neuromuscular blockade without initial recovery. The overall duration of the SCC effect (time from the administration to 90% recovery) was 7-18 min. No prolonged paralysis from SCC occurred.

Oncostatin M, leukemia inhibitory factor, and interleukin 6 induce the proliferation of human plasmacytoma cells via the common signal transducer, gp130

We analyzed the stimulatory effect of oncostatin M (OSM), leukemia inhibitory factor (LIF), interleukin 6 (IL-6), IL-11, and the inhibitory effect of anti-IL-6 antibody (Ab), anti-IL-6 receptor monoclonal antibody (mAb), and anti-gp130 mAb on the growth of human plasmacytoma cells freshly isolated from a patient with multiple myeloma. The purified cells showed a plasmacytoid morphology and expressed CD38, CD54, and CD56 antigens but no CD3, CD5, CD10, CD19, CD20, or very late antigen 5. IL-6 receptor (IL-6R) and its signal transducer, gp130, were expressed on their cell surface at a low level. Dose-dependent proliferation of the cells in response to OSM, LIF, and IL-6, but not to IL-11, was observed using [3H]TdR incorporation in vitro. Both anti-IL-6 Ab and anti-IL-6R mAb inhibited the growth of the cells in the presence or absence of exogenous IL-6. These cells release IL-6 but not OSM or LIF into the culture supernatant during short-term culture. Therefore, an autocrine growth mechanism mediated by IL-6, but not by OSM or LIF, was confirmed. Furthermore, anti-gp130 mAb completely inhibited the proliferation of the cells induced by OSM, LIF, as well as IL-6. These data indicate that OSM, LIF, and IL-6 can act as growth factors of human plasmacytoma cells through a common signal transducer, gp130, on their cell surface, and also suggest the potential therapeutic application of anti-gp130 mAb, as well as anti-IL-6R mAb against myeloma/plasmacytomas.

Germinoma in siblings: case reports

We present the first reported cases of germinoma occurring in siblings of different genders. One tumor occurred in the left basal ganglia of a 7-year-old boy and the other in the suprasellar region of his 9-year-old sister. Both tumors were diagnosed as germinoma of two-cell pattern based on light and electron microscopic studies. Possible genetic factors responsible for this phenomenon are discussed.

The effect of the neurokinin antagonist FK-224 on the cough response to inhaled capsaicin in a new model of guinea-pig eosinophilic bronchitis induced by intranasal polymyxin B

Eosinophilic bronchitis without asthma can cause a persistent non-productive cough which is resistant to bronchodilator therapy. To understand the mechanism of the cough in this disorder, an animal model of eosinophilic bronchitis was developed. Guinea-pigs were treated with transnasal administration of polymyxin B or saline twice a week for 3 weeks. The number of eosinophils in bronchoalveolar lavage fluid increased in polymyxin B-treated animals when compared with those treated with saline. In addition, histological examination showed that the number of eosinophils infiltrated into the tracheal epithelium increased; injury to the tracheal epithelium was greater in polymyxin B-treated animals. The numbers of coughs induced by saline and each concentration of capsaicin (10(-18), 10(-16), 10(-14) M) were greater in the polymyxin B-treated animals. FK-224 (a neurokinin receptor antagonist) decreased the heightened cough reflex in this animal model of eosinophilic bronchitis. These findings suggest that neuropeptides, and particularly neurokinins, are involved in the heightened cough receptor sensitivity in eosinophilic bronchitis without asthma. This has implications for better understanding of this disorder and its treatment.

The role of cysteine 78 in fluorosulfonylbenzoyladenosine inactivation of rat liver S-adenosylhomocysteine hydrolase

Inactivation of rat liver S-adenosylhomocysteine hydrolase by the site-directed reagent 5'-p-fluorosulfonylbenzoyladenosine (FSBA) is associated with the formation of a disulfide bond between Cys-78 and Cys-112 (Takata, Y., and Fujioka, M. (1984) Biochemistry 23, 4357-4362; Gomi, T., Ogawa, H., and Fujioka, M. (1986) J. Biol. Chem. 261, 13422-13425). To characterize the inactivation mechanism more precisely, the properties of four hydrolase proteins mutated at Cys-78 or Cys-112 were compared to those of the wild-type enzyme. When Cys-78 was mutated to either a serine or an alanine, proteins with greatly reduced enzymatic activity were obtained, large effects on kinetic constants were observed, and enzymatic activity was not affected by incubation with FSBA. When Cys-112 was mutated to either a serine or an alanine, the activity was similar to the wild-type protein, only small changes in the kinetic constants were observed, and the enzyme was inactivated more rapidly upon incubation with FSBA. FSBA inactivation of the C112A mutant protein was accompanied by the formation of a disulfide between Cys-78 and Cys-52. The data indicate that FSBA initially reacts with Cys-78 and that Cys-78 has an important role in the structure of the enzyme.

Improvement of regional wall motion in medically treated myocardial infarction with single-vessel coronary artery disease

Long-term changes in regional wall motion (RWM) following acute myocardial infarction (AMI) in 42 patients with uncomplicated single-vessel disease were examined retrospectively by repeat cardiac catheterizations. The first and second cardiac catheterizations were performed at an average of 28 days and 6.6 years after the onset of AMI, respectively. All 42 patients underwent first and second cardiac catheterizations without undergoing coronary artery bypass surgery or coronary angioplasty. Regional left ventricular functions were analyzed by the centerline method using a right anterior oblique left ventriculogram. The wall motion abnormality score (WMAS) was defined as [# chord below -2SD] x [mean SD chord below -2SD]. The improvement in the WMAS was more prominent in cases with an occluded infarct-related artery. Thus, we concluded that 1) RWM improves significantly with medical treatment in long-term follow-up in cases of uncomplicated AMI with single-vessel disease, and 2) the improvement of RWM is completed within the first few weeks after AMI in cases with a patent infarct-related artery.

[Recent advances in imaging diagnosis of pancreatic neoplasma with special reference to early diagnosis of the cancer]

Recent advance in various diagnostic imagings has enabled the early diagnosis of pancreatic tumors. In pancreatic cancer, the tumor-demonstrability by US, CT, and MRI has reached 80% in the recent 6 years, which is superior to the rate in the past decade from 1978 and 1987. However, the prognosis of pancreatic cancer is still poor even if the cancer can be resected. To improve the outcome of surgical intervention, early detection of small cancers (< or = 2 cm in diameter) and appropriate intervention based on preoperative diagnosis of the tumor extension are proposed. The tumor detectability of small pancreatic cancer by US, CT, MRI was 67%, 25%, 20%, respectively, and thus US was the most valuable tool. In the prediction of tumor extension of serosal invasion (S factor), retroperitoneal invasion (Rp factor) and vessel invasion (PV factor), both US and CT were efficacious with an accuracy of more than 70%. In conclusion, recently-advanced imaging seems to be useful for detecting a small pancreatic cancer and evaluating the tumor extension, but it remains difficult to diagnose a carcinoma in situ; a truly early cancer.

Circadian variation in fibrinolytic activity in patients with variant angina

BACKGROUND

Coronary artery spasm induces activation of the coagulation system. Turnover and maintenance of thrombus depend not only on formation but also on lysis. The relation between coronary spasm and fibrinolytic system has not been elucidated.

OBJECTIVE

To examine whether there is impairment of or a circadian variation in fibrinolytic activity in patients with variant angina.

METHODS

Plasminogen activator inhibitor (PAI) activity and concentrations of tissue plasminogen activator (t-PA) antigen were measured in venous plasma samples taken at 2200, 0600, and 1400 and 24 h Holter tapes were recorded in 15 patients with variant angina, 12 patients with stable exertional angina, and 12 controls.

RESULTS

There were significant circadian variations in PAI activity and t-PA antigen with peak values at 0600 in all three groups. Mean (SEM) PAI activity (IU/ml) at 2200, 0600, and 1400 was 6.1 (1.1), 11.0 (1.3), and 4.4 (0.6) in the variant angina group; 1.8 (0.7), 5.6 (1.1), and 1.2 (0.3) in the stable exertional angina group; and 1.1 (0.5), 4.5 (0.8), and 0.7 (0.3) in the control group. Furthermore, both plasma PAI activity and t-PA antigen concentrations were significantly higher in the variant angina group than in the stable exertional angina group and the control group at each sampling time.

CONCLUSIONS

In patients with variant angina there was a circadian variation in fibrinolytic activity, which was lowest in the early morning, and impaired fibrinolytic activity particularly in the early morning, when attacks of angina occur most frequently.

Long-term prognosis of medically treated patients with acute myocardial infarction and one-vessel coronary artery disease

Long-term prognosis was studied in 156 patients with acute myocardial infarction (AMI) with 1-vessel coronary artery disease (CAD). During a mean follow-up period of 110 months, 19 patients (14%) had reinfarction, 15 (9.6%) died (including 7 deaths of cardiac origin) and 15 (9.6%) were hospitalized for worsening of angina. A coronary arteriogram was obtained twice in 54 patients. The coronary arteriogram revealed multivessel CAD in all cases with reinfarction (n = 14). Ten percent of the patients with multivessel disease experienced a reinfarction during the initial 3 years after the onset of the first AMI. The recurrence rate of AMI in patients with 1-vessel disease increased gradually from the third year after the onset of their first AMI, reaching 10% in 6.7 years. The recurrence of AMI at the same region as the original infarction was detected in only 1 patient. Six of 19 patients (32%) with recurrence of AMI died and 13 survived after the reinfarction. It was difficult to predict future progression from the outcome of the comparison between the first and second coronary arteriograms. Thus, in patients with uncomplicated AMI with 1-vessel CAD, the prognosis is relatively good and the frequency of reinfarction is very low with conservative treatment.

Memory deficit accompanying cerebral neurodegeneration after stroke in stroke-prone spontaneously hypertensive rats (SHRSP)

Memory performances of SHRSP with chronic stroke were examined on the three-panel runway task in addition to the histological evaluation and magnetic resonance imaging (MRI) of the brain. After recovery from the neurological symptoms with stroke. SHRSP were subjected to acquisition training on the memory tasks, and they exhibited both a delay and a persistent impairment of acquisition on the memory tasks, compared to the non-stroke SHRSP. T2-weighted MRI with the stroke SHRSP suggested marked edematous formation in the cortex, caudate putamen and/or thalamus, preferentially in the frontal and/or occipital cortex. The histological evaluation showed edematous degeneration such as edema, gliosis and cyst preferentially in the cortex, but no degeneration in the hippocampus. Thus, SHRSP with chronic stroke was found to exhibit impairment of learning and memory, which may be due to the cortical edematous degeneration.

Neural activities in the fronto-opercular cortex of macaque monkeys during tasting and mastication

We recorded responses from 298 units in the fronto-opercular cortex (Fop) of three Japanese macaque monkeys. The units were activated while animals were drinking or eating. Three types of units could be defined: units with transient responses to the delivery of all the fluid into the mouth (ON-type units; n = 123); units activated in association with certain oral movements, e.g., licking (MO-type units; n = 90); and units responsive specifically to a certain fluid (taste units; n = 85). In both ON-type and MO-type units were included mechanoreceptive units with receptive fields in the oral cavity, mainly on the tongue and teeth. All but two taste units responded exclusively to gustatory stimuli. ON-type units were found mainly in the precentral opercular area (PrCO), and MO-type units were recorded predominantly in PrCO and area 6. Taste units were concentrated at the gustatory area and at a part of area 1-2. These results indicate the lack of convergence of somatic and taste input on single neurons. In awake monkeys, Fop units of a given function tended to be clustered at certain loci, thereby forming separate functional regions.

[Blood coagulation and fibrinolysis in ischemic heart disease]

Intracoronary thrombus formation has been thought to play an important role in the genesis of acute myocardial infarction an unstable angina. To examine whether the coagulation and fibrinolytic systems are altered in such ischemic heart diseases, the plasma levels of fibrinopeptide A (FPA) and plasminogen activator (PAI) were measured. The plasma level of FPA was increased in patients with variant angina as compared with those with stable exertional angina and there was a significant circadian variation in the plasma level of FPA in parallel with that of the frequency of the attacks with the peak level occurring from midnight to early morning in patients with variant angina. The plasma FPA level increased in patients with coronary spastic angina after the ischemic attack induced by hyperventilation. Furthermore, FPA was released into the coronary circulation after the anginal attack induced by intracoronary injection of acetylcholine. These findings suggest that the coronary artery spasm may induce thrombin generation and trigger thrombus formation in the coronary artery. On the other hand, the plasma level of PAI activity was higher in patients with unstable angina and coronary spastic angina than in those with stable exertional angina. Moreover, the PAI activity in patients with unstable angina decreased to the level in patients with stable exertional angina after the stabilization of their symptoms by drugs. Our findings suggest that the increased plasma PAI activity may reduce fibrinolytic activity and attenuate removal of the thrombus and may ultimately lead to acute myocardial infarction in some patients with unstable angina and coronary spastic angina.(ABSTRACT TRUNCATED AT 250 WORDS)