[Results of radical cystectomy for bladder cancer]

During 7 years and 3 months from October 1983 to December 1990, 68 patients underwent radical cystectomy for primary bladder cancer at Yamanashi Medical College. Of these 68 bladder cancers, 16 were superficial and 52 were invasive. Among the 52 patients with invasive cancer, a combination chemotherapy of methotrexate and cisplatin and/or radiotherapy were given in 18 as an adjuvant therapy. All the adjuvant therapies were performed after the operation except for 2 patients with T4 bladder cancer who received chemotherapy before the operation. There were 23 recurrences and 25 deaths, 20 from bladder cancer and 5 from other causes. Of 20 bladder cancer deaths, 17 deaths (85%) were observed within 2 years after the operation. The 5-year survival rates were 92% for stage pTa-pT1, 83% for stage pT2, 80% for stage pT3a, 24% for stage pT3b and 43% for stage pT4-T4, respectively. A significant difference (p < 0.05) in survival curve was observed between pT3a and pT3b. The 5-year survival rate for pT2-pT3a without nodal metastases was as high as 89% (95% confidence limits 75 to 100%) although 18 out of 19 patients received no adjuvant therapy. On the other hand, the 5-year survival rate for pT3b-pT4 without nodal metastases (25%) was as low as that of patients for any T category with nodal metastases (35%). Most patients with tumor confined within bladder wall seemed to be cured by surgery only. Therefore, any adjuvant chemotherapy with severe side effects seemed not to be justified for these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Renal functional reserve in obstructive nephropathy]

This study was designed to evaluate renal functional reserve (RFR) in obstructive nephropathy using amino acid loading and the effect of angiotensin converting enzyme (ACE) inhibitor on RFR. We divided 24 rabbits into 4 groups, consisting of a control, 6-hours-bilateral ureteral obstruction (BUO), 24-hour BUO and 24-hour BUO pretreated with ACE inhibitor. Following the ligation of the bilateral ureters at the vesicoureteral junction, a unilateral ureter was released after a 6-hour or 24-hour duration in the obstructive groups. We measured RFR and renal vascular resistance after releasing a unilateral ureter in BUO. The baseline GFR values in the 6-hour and 24-hour BUO groups were significantly lower than that in the control. RFR were 0.34 + 0.04 ml/min/kg (control), 0.10 + 0.03 (6-hour BUO), 0.01 + 0.03 (24-hour BUO) and 0.10 + 0.01 (ACE inhibitor), respectively. RFR in the 6-hour BUO group was well preserved compared with that in the 24-hour BUO group. Pretreatment with ACE inhibitor in the 24-hour BUO group enhanced RFR to the extent of 6-hour BUO. Our results demonstrated that angiotensin II plays an important role in decreased GFR with obstructive nephropathy. Moreover, the present data suggested that evaluation of RFR might play a key role in the recovery of the post-obstructive renal function.

[Functional parameters calculated by 99mTc-MAG3 in transplanted kidney]

A newly developed 99mTc-labeled renal tubular agent, 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) was evaluated and compared with 99mTc-DTPA and 123I-OIH in 10 patients with a transplanted kidney. Renal uptake of MAG3 correlated well with both DTPA and OIH; however, these uptake values of MAG3 were lower than those of OIH and higher than those of DTPA. Renogram parameters also correlated well with each other, but excretion of MAG3 was slower than that of OIH and faster than that of DTPA. The bladder to kidney ratio of MAG3 also correlated well, but these ratios of MAG3 were lower than those of OIH and higher than those of DTPA. In conclusion, MAG3 is a promising agent for evaluating the function of transplanted kidney.

Senegoses F--I, oligosaccharide multi-esters from the roots of Polygala senega var. latifolia Torr. et Gray

From the roots of Polygala senega var. latifolia Torr. et Gray four new oligosaccharides, called senegoses F--I, were isolated and their structures were elucidated by spectroscopic and chemical means. These oligosaccharides were esterified with acetic, benzoic and ferulic acids.

Phenylethanoid glycosides of Sesamum indicum

From a water extract of whole plants of Sesamum indicum, two new, and six known phenylethanoid glycosides, and three new triglycosides which had the same sugar sequence were isolated. The structures of the new compounds were elucidated from chemical and spectroscopic evidence.

Scrophulasaponins II-IV, new saikosaponin homologs from Scrophularia kakudensis FRANCH

From the whole plants of Scrophularia kakudensis, three new saikosaponin homologs, named scrophulasaponins II-IV, were isolated, together with six known and four artifact saponins; their structures were elucidated by spectroscopic data and chemical evidence.

Clinoposaponins VI and VIII, two oleanane-triterpene saponins from Clinopodium micranthum

From the whole plants of Clinopodium microanthum two new saponins, called clinoposaponins VI and VIII, were isolated together with five known and two artifact saponins, and their structures were elucidated by spectroscopic data and chemical evidence. Each aglycone of these saponins was genuine saikogenin-type which had an 11-ene and a five-membered ether ring, and they were 3,16-bisdesmosidic glycosides.

Angiotensin II receptors in the rat urinary bladder smooth muscle: type 1 subtype receptors mediate contractile responses

Angiotensin II (Ang II) receptors in the rat urinary bladder smooth muscle were investigated by in vitro responses of smooth muscle strips to exogenous Ang II stimulation and in radioligand binding assays. Ang II (10(-10) M. to 10(-5) M.) caused a potent contractile response in a concentration-dependent manner. Using the recently developed nonpeptide subtype-selective antagonists, the Ang II-induced contractile response was further characterized. The Ang II-induced contractile response was inhibited weakly by the type 2 subtype (AT2)-selective antagonist PD123319 but was potently inhibited by the type 1 subtype (AT1)-selective antagonist DuP 753 with a pA2 value of 9.03, suggesting that the response is mediated predominantly by AT1 receptors. [125I]Ang II was used to specifically label a single class of binding sites with a dissociation constant of 0.31 nM. and a maximal binding capacity of 41.5 fmol./mg. of protein. DuP 753 could completely antagonize the binding of Ang II in a particulate fraction of rat bladder (Ki = 14 nM), whereas PD123319 did not have any effect in the concentration range of 10(-9) to 10(-5) M. The results suggest that AT1 receptors rather than AT2 receptors predominantly mediate Ang II-induced contraction in the rat urinary bladder.

[The local relapse of prostatic cancer and initial local treatment]

We treated fifty cases of prostatic cancer that had no distant metastasis and no other primary cancers between October 1983 and September 1990. Our initial treatment for clinical stages A2, B1, B2 included radical prostatectomy, pelvic lymphadenectomy, and bilateral orchiectomy. Staging lymphadenectomy with bilateral orchiectomy was applied to patients with clinical stage C tumor, and if there was no lymph node metastasis, external beam radiation therapy for the prostate was performed. Patients who did not consent to major surgeries or had poor general status or had clinical stage D1 tumor underwent bilateral orchiectomy. Mean observation period was forty-one months. Eleven cases relapsed. Of the eleven cases, ten had local relapse at the diagnosis of relapse (two of them had distant metastasis simultaneously, six of them had distant metastasis later, and two of them had no distant metastasis in the observation period). All these ten cases had no underwent the initial local treatment. The remainder who had underwent radical prostatectomy relapsed with distant metastasis alone. This study suggests that the local relapse tends to precede distant metastasis as the mate of relapse of prostatic cancer excluding stage D2. There is a possibility that initial local treatment is useful improving the prognosis of the patients for clinical stage A2-D1 prostatic cancer.

Carbonic anhydrase inhibitors from the pericarps of Punica granatum L

Seven highly active inhibitors against carbonic anhydrase (CA, EC 4.2.1.1), punicalin (2), punicalagin (3), granatin B (5), gallagyldilactone (7), casuarinin (8), pedunculagin (9) and tellimagrandin I (10), and four weakly active inhibitors, gallic acid (1), granatin A (4), corilagin (6) and ellagic acid (11), were isolated from the pericarps of Punica granatum L. (Punicaceae). They are ellagitannins. The type of inhibition by 3 and 7 using p-nitrophenyl acetate as a substrate, is noncompetitive. The structure-activity relationship of inhibitory effects on CA is discussed.

[A case of retroperitoneal fibrosis forming a pelvic tumor--a type of multifocal fibrosclerosis]

We experienced a case of retroperitoneal fibrosis with formation of a pelvic tumor. The patient was a 55-year-old female who showed right-side hydronephrosis on examination and was admitted to this department for consultation. Retrograde pyelography clearly showed that the hydronephrosis was due to lower ureteral obstruction resulting from a pelvic tumor. Ultrasound, CT and MRI showed a tumor adhering to the right posterior surface of the bladder, and it was thought that the tumor was probably malignant. Transdermal/transvesical needle biopsy and transvaginal needle biopsy showed a minimal invasion and allowed the diagnosis of retroperitoneal fibrosis to be made. Ureterolysis was not carried out, and the patient was treated with steroid monotherapy. She was begun on 30 mg of prednisolone, and administration was continued for approximately 3 months while gradually decreasing the dosage. On completion of administration, the intrapelvic tumor had completely disappeared, showing that treatment was markedly effective. The patient had a history of an orbital pseudotumor, and it was concluded that this was a rare case coming under the heading of multifocal fibrosclerosis.

Cellular and humoral immune responses to vascular components in thromboangiitis obliterans

Cellular and humoral immune responses to vascular components were studied in 10 patients with thromboangiitis obliterans (TAO), including 3 in the mild stage of the disease and 7 in the active or severe stage. In this study the authors used the following vascular components: collagen Types I, III, IV, and V; elastin; and laminin. The cell-mediate reactivity (CMR) to these proteins was measured with an antigen-specific proliferation of peripheral mononuclear cells and evaluated by the stimulation index (SI), which is the ratio of thymidine incorporation in the presence and in the absence of antigen. The humoral immunologic response (HIR) to these vascular components was measured by an enzyme-linked immunosorbent assay (ELISA) and evaluated by the optical density (OD) index, which is the ratio of optical density (OD) in the patients' serum to that in the healthy male controls' serum. The stimulation index of collagen Types I and IV was significantly higher in patients with TAO than in healthy controls (p < 0.02). CMR to collagen Type V, elastin, and laminin was high in patients with active or severe TAO as well. However, similar statistical differences in mild TAO did not exist in the CMR. The OD index in collagen Types I, IV, and V was statistically higher in the patients than in the healthy controls (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Clinoposaponins I-V, new oleanane-triterpene saponins from Clinopodium gracile O. Kuntze

From the whole plants of Clinopodium gracile five new saponins, called clinoposaponins I-V, were isolated together with two known and four artifact saponins, and their structures elucidated from spectroscopic data and chemical evidence. These saponins were composed of saikosaponin a and additional glucose moieties.

Senegoses A--E, oligosaccharide multi-esters from Polygala senega var. latifolia Torr. et Gray

From the roots of Polygala senega var. latifolia Torr. et Gray five new oligosaccharides, called senegoses A--E, were isolated and their structures were elucidated by spectroscopic and chemical means. These oligosaccharides were esterified with acetic, benzoic, trans-ferulic and cis-ferulic acids.

Studies on the differentiation inducers of myeloid leukemic cells from Citrus species

An attempt was made to isolate differentiation inducers from Aurantii Nobilis Pericarpium and the fruit peel of Citrus reticulata Blanco (Rutaceae). Twenty-seven kinds of flavones, including five new flavones, were isolated after repeated chromatography from methanol extracts of these plants and their structures were established, from their physicochemical data, to be highly methoxylated flavones. Each compound, except for two flavone glucosides, showed the differentiation inducing activity toward mouse myeloid leukemia cells (M1), and the cells came to have phagocytic activity. Furthermore, differentiation inducing activity was tested using human acute promyelocytic leukemia cell line (HL-60).

[Computerized recording system during cardiopulmonary bypass utilizing the "GEM 6 PLUS analyzer"]

We developed a new computerized recording system to reduce artificial errors by perfusionists during cardiopulmonary bypass. This system included the efficient functions to record the progress of perfusion flow, perfusion pressure, urine output and temperatures from several sources. Furthermore, it could automatically record considerable data of the "GEM 6 PLUS analyzer" which was developed for monitoring of pH, PCO2, PO2, BE, Ca2+, K+ and hematocrit during cardiopulmonary bypass. We considered it very important that the errors of hematocrits associated with electrolytic concentrations. Therefore, we corrected the hematocrit according to a formula based on our experiments, i.e., HCT = GEMHCT + 0.28 x ([Na+]+[K+]) -44. And also we expect that the "GEM 6 PLUS analyzer" will be improved to measure Na+ value in near future.

Hypercoagulable state induced by thrombocytapheresis

The influence of the continuous-flow automated blood cell separator. Fenwal CS-3000, on blood coagulation and the fibrinolytic system in blood donors was studied. Blood samples were taken from the collection line of donors undergoing extracorporeal circulation, before and after platelet pheresis. Of the molecular markers, prothrombin fragment-F1 + 2 (PF1 + 2) markedly increased from 0.8 +/- 0.3 to 2.9 +/- 2.0 nM/ml (P < .004), thrombin antithrombin III complex (TAT) also markedly increased from 2.6 +/- 1.3 to 56.0 +/- 24.0 micrograms/L (P < .001), fibrinopeptide A (FPA) increased slightly from 0.8 +/- 0.9 to 3.8 +/- 4.2 micrograms/L (P < .05), and alpha 2-plasmin inhibitor (alpha 2-PI) decreased slightly from 95 +/- 8 to 91 +/- 9% (P < .05). In one donor with the highest level of PF1 + 2, TAT, FPA, and plasmin inhibitor complex after platelet pheresis, protein C, protein S, C4b-binding protein, ATIII, plasminogen, alpha 2-PI, and coagulation factors were decreased. In blood donors undergoing platelet pheresis using the continuous-flow automated blood cell separator, Fenwal CS-3000, a hypercoagulable state was observed. Changing the materials of the plastic disposables to a more thromboresistant material may prevent the hypercoagulable state in donors induced by platelet pheresis using the blood cell separator.

Effects of sialagogues on ornithine decarboxylase induction and proto-oncogene expression in murine parotid gland

The mechanism of a sialagogue-induced increase in ornithine decarboxylase (ODC) activity and the expressions of proto-oncogenes in murine parotid gland were investigated by use of isoproterenol (IPR), carbachol (CC), and methoxamine (MTX). The results were as follows: (1) The three sialagogues had similar effects on the parotid in vivo (mouse parotid after a single injection of IPR) and/or in vitro (rat parotid explants cultured on siliconized lens paper floating on 199 medium containing IPR, CC, or MTX), the order of their effectiveness being IPR > CC > MTX. (2) Northern/dot and Western blot analyses revealed that the sialagogues elevated the steady-state levels of ODC mRNA and ODC protein to maxima at two h and six h, respectively, after stimulation. The increases were roughly proportional to those in ODC activity, suggesting that sialagogue-dependent enzyme induction is regulated at the transcriptional level. (3) The mRNAs of four of nine proto-oncogenes examined showed sialagogue-dependent increases to maxima at 30 min (c-fos) or 60 min (c-jun, c-myc, and c-src) after the beginning of stimulation. These increases were all transient, with the levels returning to the control values (without sialagogue) within 60 min. (4) The IPR-dependent elevations of ODC activity and the mRNAs of ODC, c-fos, and c-jun were inhibited by monensin, but not by polymyxin B. On the other hand, the CC-dependent increases in these parameters were inhibited by polymyxin B but not by monensin.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibitory effect of taxol, a microtubule stabilizing agent, on induction of DNA synthesis is dependent upon cell lines and growth factors

Growth-arrested rat fibroblasts, 3Y1, and human diploid fibroblasts, TIG-1, were induced to synthesize DNA by stimulation with various agents such as fetal bovine serum (FBS), epidermal growth factor (EGF), colcemid, or colchicine. Taxol, a microtubule-stabilizing agent, blocked the induction of DNA synthesis after stimulation with colcemid or colchicine in both cell lines. Taxol inhibited the induction of DNA synthesis after stimulation with FBS or EGF in TIG-1, but did not in 3Y1. 12-O-tetradecanoylphorbol-13-acetate (TPA) induced DNA synthesis in TIG-1, which was reduced only partly by taxol. Taxol stabilized or polymerized microtubules in both cell lines. These results indicate that the inhibitory effect of taxol on the induction of DNA synthesis varied among cell lines and among growth factors, and suggest that signal transduction processes may be differentiated by taxol sensitivity. In TIG-1 cells, when taxol was added within 6 h, about halfway into the initiation of DNA synthesis after the addition of FBS or EGF, the inhibition of DNA synthesis still occurred. Taxol did not inhibit the induction of c-fos and c-myc genes by FBS or EGF stimulation. Colchicine itself did not induce these genes in TIG-1. Thus, taxol appeared to inhibit the induction of DNA synthesis not by blockage in the early transduction process of the growth signal from the cell surface to nuclei but by blockage in processes operating in the mid- or late-prereplicative phase.

Studies on natural antioxidants in citrus species. I. Determination of antioxidative activities of citrus fruits

The antioxidative activities of twenty types of citrus fruits were investigated with a screening method which is based on rat liver microsomal lipid peroxidation induced by dihydronicotinamide adenine dinucleotide phosphate (NADPH) and adenosine diphosphate (ADP). The activities of the exocarp were greater than those of the sarcocarp and the activities from immature fruits (collected in July-August) were greater than those from mature fruits. The strongest antioxidative activity was found in ponkan (Citrus reticulata Blanco) collected in July.

Suppression of myoelectrical activity of gastric smooth muscle by endogenous gastric prostaglandin E2

The myoelectrical activity of the gastric smooth muscle, recorded by a bipolar electrode placed at the gastric antrum in rats, could be recorded when the stomach was distended with 5 ml of physiological saline. This activity may be induced by a mucosal reflex and was inhibited both by atropine and by pirenzepine. Replacement of physiological saline with solutions of NaCl suppressed this myoelectrical activity. This suppression was dependent on the concentrations of NaCl in the solutions, from 0.3 to 1.0 M. Pretreatment with indomethacin (10 mg/kg, intravenous) completely prevented this suppression induced by different concentrations of NaCl solutions. Intragastric administration of 1.0 M NaCl in solution caused an increase in the levels of PGE2 in the gastric lumen. Intragastric administration of OU-1308, a synthetic derivative of PGE1, also suppressed the myoelectrical activity in a dose-dependent manner. It is concluded that the suppression of gastric myoelectrical activity by hyperosmolar NaCl may be attributable to the generation of endogenous PGE2 in the stomach.

Netropsin specifically enhances RNA polymerase II termination at terminator sites in vitro

We describe an in vitro system that emulates the specific and efficient transcriptional termination associated with the human gastrin gene terminator in vivo. The system involves a dC-tailed DNA template containing the gastrin gene terminator sequence, purified RNA polymerase II, and purified elongation factor TFIIS. In this system, the basal level of termination by RNA polymerase II at the gastrin gene terminator is specifically enhanced by netropsin, an (A + T)-rich minor groove-binding peptide. This enhanced termination is maintained even with TFIIS, which normally suppresses termination at this site. In vitro termination is terminator sequence-specific. Mutant sequences that reduce or abolish termination in vivo show corresponding reductions in activity in the in vitro system. This in vitro emulation of in vivo activities of wild-type and mutant terminators strongly suggests that netropsin and a putative termination factor may share some aspects of their biochemical mechanisms. The general applicability of this system to the study of RNA polymerase II elongation and termination is suggested by the enhancement of termination seen at both the gastrin and human histone H3.3 gene terminators.

[Chest wall reconstruction with a prosthetic material molded from a extirpated specimen]

A new molding technique of the Acryl-resin Marlex-mesh sandwich method is described. After the wide extirpation of the chest wall, the defect size tends to grow up more larger than the specimen. For making a just fit size prosthesis, we cut off a cardboard as the same size as the specimen and the Acryl-resin Marlex sandwich is molded from the cardboard. Other some know-how are in the text.

Studies on differentiation-inducing activities of triterpenes

Differentiation-inducing activity of over 180 extracts of crude drugs and plants was tested using mouse myeloid leukemia cell line (M1). The methanol extracts of clove (Syzygium aromaticum Merrill et Perry, Myrtaceae) showed remarkable induction of differentiation of M1 cells into macrophage-like cells. From the extract, oleanolic acid (1) and crategolic acid (2) were isolated as the active components. We also tested other triterpenes, such as oleananes, ursanes and dammaranes, to investigate the structure-activity relationship. Some triterpene aglycones showed differentiation-inducing activity, but triterpene glycosides showed little activity. Furthermore, the differentiation-inducing activity of these triterpene compounds was tested against human acute promyelocytic leukemia cell line (HL-60).

Interference in the radioimmunoassay of gastric prostaglandins by cimetidine, a histamine H2 blocker

The present study was undertaken to assess whether cimetidine alters the levels of endogenous prostaglandin (PG) E2 and 6-keto-PGF1 alpha in the rat stomach. When cimetidine was mixed in vitro with a suspension of dextran-coated charcoal, to which [3H]-PGE2 had been adsorbed, levels of free [3H]-PGE2 were increased by cimetidine at concentrations above 1.0 mM, because of preferable adsorption of this blocker to the charcoal. Dextran-coated charcoal is used for the separation of antibody-bound [3H]-PGs from the free labelled compounds in the radioimmunoassay of PGs. Addition of cimetidine to standard solutions of PGE2 shifted the PGE2 calibration curve upward. Thus, when PGs in cimetidine-containing samples were quantitated by reference to the normal calibration curve, the assessed levels of PG were lower than the actual levels. Removal of cimetidine from the assay samples was successfully achieved by use of SEP-PAK C18 columns. Rats were injected intraperitoneally with 100 mg/kg of cimetidine only once or with 20 mg/kg twice daily for 7 days. Using this cleaning method, we found that both the basal levels of PGE2 and 6-keto-PGF1 alpha and those levels increased by intragastric administration of 1.0 M NaCl solution did not differ between rats treated with cimetidine and those treated with vehicle. It can be, therefore, concluded that cimetidine does not affect the gastric PG production.

Stimulation of transcript elongation requires both the zinc finger and RNA polymerase II binding domains of human TFIIS

The eukaryotic transcriptional factor TFIIS enhances transcript elongation by RNA polymerase II. Here we describe two functional domains in the 280 amino acid human TFIIS protein: residues within positions 100-230 are required for binding to polymerase, and residues 230-280, which form a zinc finger, are required in conjunction with the polymerase binding region for transcriptional stimulation. Interestingly, a mutant TFIIS with only the polymerase binding domain actually inhibits transcription, whereas a mutant in which the polymerase binding and zinc finger domains are separated by an octapeptide is only weakly active. The zinc finger itself has no effect on transcription, but in contrast to the wild-type protein, it binds to oligonucleotides. These findings suggest that TFIIS may interact with RNA polymerase II such that the normally masked zinc finger can specifically contact nucleotides in the transcription elongation zone at a position juxtaposed to the polymerization site.

Immobilized-enzyme electrode for nicotinamide adenine dinucleotide (reduced form) (NADH) sensing and application to the kinetic studies of NADH dependent dehydrogenases

Amperometric determination of nicotinamide adenine dinucleotide (reduced form) (NADH) at an immobilized-diaphorase (Dp) electrode is described. The measurement was conducted using ferrocenylmethanol as a mediator in a stirred solution at 0.20 V versus a saturated calomel electrode. A linear relationship between the steady-state current and the concentration of NADH was found over the range 0.005-0.125 mmol dm-3. The immobilized-Dp electrode showed outstanding stability and the current response reached a steady state within 2-3 seconds upon addition of NADH. The proposed electrode was used to follow the reactions of pig heart lactate dehydrogenase and horse liver alcohol dehydrogenase. The kinetic investigation using the immobilized-Dp electrode gave the kinetic parameters (Michaelis constants, Km values, and maximum velocities, Vm values), which were in satisfactory agreement with those determined by a conventional spectrophotometric method.

Systemic study of the hemodynamic effects of sublingual nitroglycerin in unanesthetized dogs

The cardiovascular effects of nitroglycerin, given sublingually and intravenously in a clinical dose range, were studied in unanesthetized and unrestrained normal dogs. The parameters examined included coronary blood flow, coronary conductance arterial diameter, internal diameter of the left ventricle, blood flow in the aorta and vena cava, diameters of the aorta, carotid, mesenteric, iliac, internal thoracic and pulmonary arteries and vena cava, pressures in the left ventricle, abdominal aorta and pulmonary arteries, organ thickness of the spleen, liver and sartorius muscle, and rate of rise in arterial pressure pulses. It was suggested that nitroglycerin does not dilate the veins in the splanchnic area and hind limb, but efficiently dilates conductance arteries. It was concluded that the therapeutically important effects of nitroglycerin involve the dilatation of conductance arteries, including both coronary and general systemic arteries. The effect of the former would be directly on stenotic lesions in the epicardial large coronary artery, improving blood flow to the ischemic part of the myocardium, whereas the latter might be beneficial for reducing cardiac work and lowering systolic pressure by increasing the Windkessel volume. Therefore, the heart regains its ventricular function and pumps stagnant blood from heart, lungs and veins to the arterial side, resulting in a reduction of the elevated preload to normal levels in anginal patients.

[Studies on the anticomplementary activity of Jozann. Anticomplementary activity of steroid derivatives]

Methanol extracts of 53 crude drugs were tested on the anticomplementary activity. Of these, 12 samples showed the potent activity. Of these 12 samples, the extract of Jozann (Dichrome Radix) was studied on the isolation and structural elucidation of the anticomplementary constituents. As active constituents, 3 beta-hydroxystigmast-5-en-7-one was isolated and its structure was confirmed by deriving this compound from beta-sitosterol. The activity of such steroid derivatives as stigmastane, cholestane, androstane and pregnane type steroids were further studied. Of these, several kinds of steroids showed the potent activity. From these experiments, the structure and activity relationship was discussed.

[A case of Morgagni's hernia: availability of CT scan, ultrasonography, and trans-abdominal surgical approach]

A 60-year-old obese woman was admitted to our hospital to receive surgical treatment for "slow-growing mediastinal lipoma". With the non-invasive examination such as CT scan and ultrasonography, she was revealed as Morgagni's hernia containing a greater omentum. With a trans-abdominal approach, we could take a good surgical field for the bilateral foramina of Morgagni. Several discussions were described for availability of CT scan, ultrasonography and a trans-abdominal approach.

Induction of ornithine decarboxylase by sialagogues in a human parotid gland adenocarcinoma cell line

Ornithine decarboxylase in a human parotid gland adenocarcinoma cell line was induced by both cholinergic (carbachol) and beta-adrenergic (isoproterenol) sialagogues. The enzyme protein level, measured with anti-peptide antiserum, as well as the enzyme activity, was found to be high in unstimulated cells and to increase approximately 2-fold on stimulation, while the mRNA level increased 3-4 fold, as revealed by Northern hybridization. The rise in activity was completely blocked by the simultaneous addition of antagonists or actinomycin D. These results suggest that receptor-mediated stimulation of ornithine decarboxylase activity by sialagogues involves alterations in the level of mRNA and that the proliferative responses of human parotid cells to these sialagogues resemble those of the murine parotid gland.

Cloning, expression and characterization of the human transcription elongation factor, TFIIS

The cDNA for the human elongation factor, TFIIS, has been cloned and expressed in E. coli with the T7 expression system. This 280-amino acid TFIIS protein is shorter by 21 residues than that of the mouse. The missing 21 residues are located in the amino-terminal region, which is not thought to be required for transcriptional stimulation. Apart from this gap, human and mouse proteins reveal 96% overall identity and 98.5% sequence similarity if conservative substitutions are taken into account. The bacterially expressed human protein and the purified calf thymus proteins are indistinguishable in their ability to stimulate transcript elongation by purified RNA polymerase II. Estimation of the native molecular size of the human protein in solution indicates that it exists as a dimer.

Dual effect of protein kinase C on the induction of DNA synthesis by colcemid in G0-arrested human diploid fibroblasts

G0-arrested human diploid fibroblasts, TIG-1, was stimulated to induce DNA synthesis by serum, epidermal growth factor (EGF), colchicine, colcemid, or 12-O-tetradecanoylphorbol-13-acetate (TPA). The induction of DNA synthesis was mediated by protein kinase C (PKC) when stimulated with TPA but not when stimulated with other agents. When TPA-stimulated cells were immediately treated with colcemid, induction of DNA synthesis was reduced. This reduction diminished when colcemid was added more than 6 h after TPA treatment. Conversely, when colcemid-stimulated cells were treated with TPA, induction of DNA synthesis was also reduced. This reduction was enhanced when the interval between the addition of two stimulants was extended. PKC-deprivation abolished both stimulatory and inhibitory effects of TPA on DNA synthesis. Staurosporine blocked an induction of DNA synthesis by TPA but appeared to be ineffective on the inhibitory action of TPA on DNA synthesis by colcemid. These results suggest that the inhibitory effect of TPA on the induction of DNA synthesis by colcemid is mediated by down regulation-sensitive and staurosporine-insensitive PKC.

[Intravesical instillation of bacillus Calmette-Guerin for superficial bladder carcinoma: study on significance of additional maintenance instillations of bacillus Calmette-Guerin]

The efficacy of maintenance bacillus Calmette-Guerin (BCG) instillations for superficial bladder tumors was studied by prospective randomized trial. From June 1985 to October 1988, 42 newly diagnosed patients with superficial bladder carcinoma (pTa or pT1) were treated by transurethral tumor resection and subsequent five daily instillations of mitomycin C. Then they were divided into non-maintenance group (22 patients) and maintenance group (20 patients) by randomization. The patients received six weekly instillations of 80 mg of BCG. Tokyo strain (Japan BCG manufacturing Co., Tokyo, Japan), suspended in 40 ml of physiological saline, and the patients in the maintenance group received four additional instillations of BCG every three months. We could not complete the six-week course of BCG instillations in three patients due to adverse effects (two in non-maintenance group and one in maintenance group) and we lost six patients from follow-up within one year (one in non-maintenance group and five in maintenance group). The mean follow-up period of the remaining 33 patients was 28.1 months. Of these 33 patients, six patients had been found to have recurrent tumors, and the over-all three-year non-recurrence rate was 82%. Before employing BCG, when we used only mitomycin C after TUR-Bt, the three year non-recurrence rate was 58%. This indicates prophylactic effect of BCG instillations. The stage of the initial tumor of the six recurrent cases were all pT1b. The non-recurrence rate of the patients with pT1b tumor was significantly lower than that of the patients with pTa and pT1a tumor. However, multiplicity and grade of tumors did not affect the non-recurrence rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Sialagogue-stimulated protein phosphorylation related to ornithine decarboxylase induction in cultured rat parotid explants

Both beta-adrenergic (isoproterenol) and cholinergic (carbachol) sialagogues increase amylase secretion, ornithine decarboxylase activity and DNA synthesis in murine parotid gland in vivo and in vitro. These agonists enhanced the incorporation of labelled inorganic orthophosphate into parotid proteins in rat parotid explants cultured on siliconized lens paper floating on serum-free 199 medium. Analysis of the labelled proteins by SDS-PAGE and autoradiography revealed that isoproterenol enhanced the phosphorylation of four proteins with apparent molecular weights of 17, 20, 31 and 32 kDa and carbachol stimulated the phosphorylation of 31 and 32 K proteins. Isoproterenol-dependent ornithine decarboxylase induction and phosphorylation of the proteins were selectively suppressed by monensin but not by polymyxin B, whereas carbachol-dependent ornithine decarboxylase induction and protein phosphorylation were inhibited by polymyxin B but not by monensin. Neither monensin nor polymyxin B suppressed isoproterenol- or carbachol-stimulated amylase secretion. Time course experiments showed that sialagogue-stimulated protein phosphorylation preceded the increase of ornithine decarboxylase activity and had almost disappeared when it was maximal. Propranolol and atropine, antagonists of isoproterenol and carbachol, respectively, completely inhibited not only amylase secretion and ornithine decarboxylase induction but also protein phosphorylation stimulated by the corresponding agonists. These findings suggest that increased phosphorylation of specific proteins is associated with sialagogue-stimulated ornithine decarboxylase induction but not amylase secretion.

Efficacy of endoscopic retrograde cholecystoendoprosthesis (ERCCE) for cholecystitis

Fourteen patients with cholecystitis were treated by endoscopic placement of an endoprosthesis into the cystic duct. In these patients the administration of antibiotics had failed to change the clinical picture of cholecystitis. Clinical and ultrasonographic findings before and two months after stenting were compared. There was an improvement in abdominal pain in 9 out of 14 cases (64%); fever, present in 5 patients, disappeared in all. No clinical complications were observed. Sonographic findings in terms of gallbladder wall thickening and sludge present within the gallbladder improved in 57% and 88%, respectively. Our results indicate that this endoscopic procedure may be effective in the treatment of cholecystitis.

[Glomerular function and renal functional reserve]

Protein intake has been shown to raise glomerular filtration rate (GFR). The difference between peak and baseline GFR following acute protein load indicates renal functional reserve (RFR). In this paper, we review 1) normal glomerular function and its regulating factors, 2) the concept of RFR and the mechanism by which the acute protein load induces hyperfiltration response in healthy subjects and 3) the RFR in patients with renal disease.

Repair of coarctation with persistent fifth arterial arch and atresia of the fourth aortic arch

Coarctation of the aorta with persistent fifth arterial arch and atresia of the fourth aortic arch between the left common carotid and left subclavian arteries was treated surgically in a two-month-old boy with transposition of the great arteries and double-outlet right ventricle. The aortic arch was repaired using side-to-side anastomosis of the left common carotid and left subclavian arteries, patch repair of the coarctated segment at the origin of the left subclavian artery, and ligation of the patent ductus arteriosus. Pulmonary arterial banding and balloon atrioseptostomy were performed for associated anomalies.

Use of an alpha 1-blocker, YM617, in the treatment of benign prostatic hypertrophy. YM617 Clinical Study Group

A recently synthesized alpha 1-blocker, (R)(-)-5-[2-[[2-(o-ethoxyphenoxy)ethyl]amino]propyl]-2- methoxybenzenesulfonamide hydrochloride (YM617), was evaluated in 270 patients with benign prostatic hypertrophy in a double-blind study. After 2 weeks on placebo the patients were assigned at random to 4 groups: group P--placebo, group L--0.1 mg., group M--0.2 mg. and group H--0.4 mg. of YM617. Comparing the placebo to the treatment period, subjective symptoms, such as nocturia and urgency, were significantly decreased in group H (p less than 0.01). The sensation of incomplete voiding was significantly improved in groups M and H (p less than 0.01). However, the differences among the groups were statistically insignificant. Residual urine volume was significantly decreased in groups L, M and H after instillation of saline into the bladder (p less than 0.01) but not in group P. The maximum and average flow rates were significantly increased in groups L, M and H (p less than 0.01) but not in group P. Average flow rate showed significant differences between groups M or H versus group P. Neither orthostatic hypotension nor a decrease in blood pressure was noted. Adverse side effects and changes in laboratory data were all slight and disappeared when the second tests were performed. In summary, the irritative and obstructive symptoms caused by benign prostatic hypertrophy were decreased and urodynamic studies were markedly improved by the alpha 1-blocker, YM617. The drug seems to be useful in the treatment of patients with benign prostatic hypertrophy.

Study of enzyme inhibitory activities by dipyridamole

Inhibitory activities of Dipyridamole (DPM, 2,6-bis(diethanolamino)-4,8-dipiperidinopyrimido(5,4-d)py rim idine) against xanthine oxidase (XO), carbonic anhydorase (CA) and monoamine oxidase (MAO) were studied, in vitro. DPM did not inhibit XO and CA, but it strongly inhibited MAO. The type of inhibition by DPM against MAO with respect to benzylamine as a substrate was uncompetitive.

Possible role of endogenous prostaglandins against ethanol injury in rat stomach

Exposure of the gastric mucosa for 3 min to 30% intragastric ethanol induced mucosal injury that appeared dark red in anesthetized rats. Microscopic observation of the microvasculature in the injured area after exsanguination of rats and in living rats confirmed that there was congestion of the blood flow in the collecting venules and capillaries. Hemorrhage was observed about 30 min after application of ethanol. Monastral blue dye was deposited along the postcapillary venules only at the border of the congestion area. A selective 5-lipoxygenase inhibitor, AA-861, inhibited the gastric lesion, and immunoreactive leukotriene C4 (LTC4) was detected in the gastric wall. Previous exposure of the gastric mucosa to 1.0 M NaCl solution inhibited the ethanol-induced mucosal injury markedly. NaCl solutions (0.5-1.0 M) also suppressed the electrical activity of smooth muscle and the suppression was released by indomethacin. Having observed that PGE2 generation in the stomach was induced dose-dependently by intragastric NaCl solutions (0.5-1.0 M), we propose the hypothesis that peptide LTs released by intragastric ethanol constrict the collecting venules or lamina muscularis mucosae and induce congestion of these venules, whereas the PGE2 released by intragastric NaCl solution releases the congestion of the collecting venules directly or through suppression of contraction of the lamina muscularis.