Pathological changes of finger and toe in patients with vibration syndrome

Pathological findings of the fingers and toes were studied in finger and toe skin specimens from 21 male patients with vibration syndrome and 13 referent male cadavers. Thickening of the medial muscle layer of small arteries or arterioles, and increase of collagen fibers in the connective tissues, especially in perivascular regions, were noted in not only the finger but also the toe in patients with vibration syndrome. The ratio of the media/external diameter in the finger and toe was significantly greater in the patients than in the referents, even in the patients who had operated chain saws, bush cutters or grinders and had not been exposed to vibration of the foot directly. And the ratio in the finger was approximately parallel with that in the toe in the same subject. The present findings pathohistologically confirmed the existence of circulatory disturbances in the feet as well as the hands. The medial thickening of arteries and perivascular fibrosis in the toe can result from not only direct vibration exposure of the foot, but also long-term repeated vasoconstriction and circulatory disturbances in the foot through the activation of the sympathetic nerve system caused by hand-arm vibration.

Growth in methylcellulose of human mast cells in hematopoietic colonies stimulated by steel factor, a c-kit ligand

We examined the effect of Steel factor (SLF) on the development of human mast cells in hematopoietic colonies from cord blood mononuclear cells in methylcellulose culture. When cord blood cells were cultured for 3 weeks, SLF increased the cellular tryptase levels detected in total cultured cells. It also stimulated the formation of small-cell colonies consisting mainly of polymorphonuclear granulocytes and immature blastoid cells in a concentration-dependent manner but not the formation of colonies consisting of large macrophagic cells. A low percentage of tryptase-positive mast-cell-like cells was found in 39 out of 100 granulocyte/blastoid cell colonies. Four of the 100 colonies contained 10-20% tryptase-positive cells, but we failed to observe colonies consisting of > 20% of tryptase-positive cells. These results suggest that the effect of SLF on mast cell growth is brought on by stimulating the growth of primitive hematopoietic progenitors.

Left ventricular volume and mass: Comparative study of two-dimensional echocardiography and ultrafast computed tomography

This study was undertaken to define the accuracy of two-dimensional echocardiography in the determination of left ventricular end-diastolic and end-systolic volumes, stroke volume, ejection fraction, and mass when compared to ultrafast cine computed tomography in the same 56 patients. Single-plane and biplane modified Simpson's rule, single-plane and biplane ellipsoidal formula, bullet formula (biplane only), and biapical Simpson's rule methods were utilized. Linear regression analysis showed the strongest correlation with the modified biplane Simpson's rule (mean r = 0.897). In valvular heart disease (n = 12) and dilated cardiomyopathy (n = 6), the mean correlation coefficients for all methods were high (r = 0.894 and 0.911, respectively). The mean correlation coefficient for all methods in patients with prior myocardial infarction (n = 25) was relatively poor (r = 0.643). Intraobserver and interobserver variabilities for all methods were low (r = 0.980 and 0.965, respectively). It is concluded that calculations of left ventricular volumes and mass by two-dimensional echocardiography are accurate and reproducible in patients with a global effect on the left ventricle and were less acceptable in patients with segmental (ischemic) left ventricular involvement. The best measurement technique is a modified biplane Simpson's rule.

Frequent occurrence of familial aggregations of high lipoprotein(a) levels associated with small apolipoprotein(a) isoforms

School-age children with high lipoprotein(a) [Lp(a)] levels were screened and family studies were conducted to examine the relationship between high Lp(a) levels and apolipoprotein(a) [apo(a)] isoforms in families. All the probands from 17 families had one of the A2 to A12 apo(a) isoforms, which are the smaller apo(a) isoforms of the 25 different isoforms thus far detected. The ratio of subjects with high plasma Lp(a) levels was 0.47 among the first-degree relatives. All 15 relatives with high plasma Lp(a) levels shared one of the small apo(a) isoforms with the proband in each family, while 16 of 17 relatives with normal Lp(a) levels did not. These data indicate the frequent occurrence of familial aggregations of high Lp(a) levels associated with one of the small apo(a) isoforms.

[Cardiovascular risk factors among Japanese school-age children: a screening system for children with high risk for atherosclerosis in Ibaraki, Japan]

Total cholesterol levels, obesity index and blood pressure were measured in 6,278 school-age children living in Ibaraki Prefecture in 1991, and children with high risk for atherosclerosis were identified. The frequencies of the school-age children with hypercholesterolemia (total cholesterol > or = 200 mg/dl), obesity (obesity index > or = 40%) or hypertension were 7%, 5%, 1%, respectively. In half of the area where the children lived, lipid measurements were also obtained in the parents of hypercholesterolemic children. Twenty-nine out of ninety fathers (32%) and 22 out of 140 mothers (16%) were hypercholesterolemia (total cholesterol > or = 240 mg/dl). Among them five families of familial hypercholesterolemia were diagnosed. Seventy children with hypercholesterolemia and 81 obese children, who were screened and received health counseling, were re-examined after one year. The levels of LDL-cholesterol, triglyceride and atherogenic index were significantly decreased and HDL cholesterol level was significantly increased in the children with hypercholesterolemia. Obesity index, triglyceride level and atherogenic index were significantly decreased and HDL cholesterol level was significantly increased in the children with obesity. In addition, the frequencies of the children with dyslipidemia or liver dysfunction were significantly decreased in the obese children after one year. These data suggested that the screening system and the plans after the examinations described here were effective in reducing risk factors for atherosclerosis in children.

High degree of genetic polymorphism in apolipoprotein(a) associated with plasma lipoprotein(a) levels in Japanese and Chinese populations

We have developed a sensitive, high-resolutin method for the analysis of the apolipoprotein(a) [apo(a)] isoforms using sodium dodecyl sulfate (SDS)-agarose/gradient polyacrylamide gel electrophoresis. In an analysis of the genetic polymorphism of apo(a) isoforms and their relationship with plasma lipoprotein(a) [Lp(a)] levels in Japanese and Chinese, this method identified 25 different apo(a) isoforms and detected one or two apo(a) isoforms in more than 99.5% of the individuals tested. The apparent molecular weights of the apo(a) isoforms ranged from 370 kDa to 950 kDa, and 22 of the 25 different apo(a) isoforms had a higher molecular weight than of apo B-100. Studies on Japanese families confirmed the autosomal codominant segregation of apo(a) isoforms and the existence of a null allele at the apo(a) locus. The observed frequency distribution of apo(a) isoform phenotypes fit the expectations of the Hardy-Weinberg equilibrium in both the Japanese and Chinese populations. Our data indicate the existence of at least 26 alleles, including a null allele, at the apo(a) locus. The frequency distribution patterns of the apo(a) isoform alleles in Japanese and Chinese were similar to each other and also similar to that of apo(a) gene sizes reported in Caucasian American individuals. The average heterozygosity at the apo(a) locus was 92% in Japanese and 93% in Chinese. A highly significant inverse correlation was observed between plasma Lp(a) levels and the size of apo(a) isoforms in both the Japanese (r = 0.677, P = 0.0001) and the Chinese (r = -0.703, P = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Data on the CGG repeat at the fragile X site in the non-retarded Japanese population and family suggest the presence of a subgroup of normal alleles predisposing to mutate

The fragile X mutation is the result of amplification in the repeat number of p(CGG)n in FMR-1; alleles with more than 52 repeats have been shown to be so unstable as to mutate in the repeat number in almost every transmission. To improve our understanding of mutations in normal alleles of FMR-1, the following studies were carried out in the Japanese population: a study on length variation in the repeat to determine the allele distribution of the repeat length in a non-retarded population, family studies to observe new mutations in normal allele, and haplotype analyses with microsatellite markers flanking the repeat to confirm estimated mutation rates and founder chromosomes in the fragile X syndrome. Analysis of the p(CGG)n in 370 unrelated males detected 24 distinct alleles with repeats of 18-44. A comparison with previously reported data suggests the presence of racial/ethnic differences in the allele distribution. No premutation allele was found in 824 unrelated X chromosomes examined by the polymerase chain reaction and Southern blot analysis. Family studies detected one new mutation in a total of 303 meioses. However, the mutation rate was not in accordance with the expected or observed heterozygosities in the population or with linkage disequilibrium observed between the repeat numbers and the haplotypes of the markers flanking the CGG. The haplotype in the chromosome in which the new mutation was found was the same as that frequently found in the Japanese fragile X chromosomes, and the variance in the CGG repeat number was wider in chromosomes with the haplotypes frequently found in the fragile X chromosome than in those with the other haplotypes. These observations suggest that a subgroup is present in normal alleles and that this subgroup is more liable to mutate than others.

[Hyperlipidemia, hypoalphalipoproteinemia and liver dysfunction in Japanese school-age children with obesity]

Three hundred and twenty nine obese children (206 boys, 123 girls) whose obesity index were above 40% were screened among 6,278 school-age children living in Ibaraki Prefecture. Six hundred and fifty-eight school-age children without obesity were used as controls. The mean levels of total cholesterol and triglyceride of obese boys were significantly higher than those of control boys. The mean levels of HDL-cholesterol of both boys and girls with obesity were significantly lower than those of controls. Hypercholesterolemia, hypertriglyceridemia and hypoalphalipoproteinemia in the boys with obesity were significantly more frequent than those in control boys. In the girls with obesity, hypoalphalipoproteinemia was significantly more frequent than that in control girls. Liver dysfunction (GPT > or = 40 IU/l) in obese children was significantly more frequent than in controls: Although none of controls had liver dysfunction, 24.8% of obese boys and 11.4% of obese girls had liver dysfunction. These findings indicated that atherogenic dyslipidemias and liver dysfunction were common in Japanese school-age children with obesity, especially in boys.

Autosomal dominant hypoalphalipoproteinemia due to a completely defective apolipoprotein A-I gene

Primary hypoalphalipoproteinemia is associated with atherosclerosis and exhibits significant familial aggregation. To reveal the presence of autosomal dominant hypoalphalipoproteinemia due to a completely defective apolipoprotein A-I gene, the apolipoprotein A-I gene was analyzed in a Japanese family with low levels of HDL cholesterol and apolipoprotein A-I. An insertion of a C in the region of the seven C run between codons 3 and 5 was detected in the apolipoprotein A-I gene. The heterozygous state for the mutation was associated with approximately 50% of the normal HDL cholesterol levels and of the normal apolipoprotein A-I levels. The data suggest that a part of familial hypoalphalipoproteinemia might be an autosomal dominant trait due to a completely defective apolipoprotein A-I gene.

Anorectal function after preoperative intraluminal brachytherapy and colonic J pouch-anal anastomosis for rectal carcinoma

The effects of preoperative intraluminal brachytherapy on bowel function after anoabdominal rectal resection and colonic J pouch-anal anastomosis were studied. The patients included eight not receiving irradiation (group 1), eight who received 30 Gy (group 2) and eight who received 80 Gy (group 3). Stool frequency and the incidence of soiling were significantly greater in group 3 than in the other groups. Anal resting pressure was lower in group 3 during the study period but J pouch distensibility was not reduced. The maximum tolerated volume, threshold volume and squeeze pressure were significantly lower in group 3 than in the other groups in the early postoperative period. These results suggest that high-dose brachytherapy affects the anal sphincters and colonic J pouch. A moderate dose of 30 Gy may be more suitable before restorative anorectal surgery.

Effects of sodium valproate on various intestinal motor functions after ileal J pouch-anal anastomosis

BACKGROUND

We investigate the effects of sodium valproate, a gamma-aminobutyric acid transaminase inhibitor, on the clinico-physiologic state after ileoanal anastomosis.

METHODS

Twelve patients (five with ulcerative colitis and seven with familial adenomatous polyposis coli) were studied in a placebo-controlled trial.

RESULTS

Placebo had no effect, but valproate increased the resting anal pressure by 22.4% and the maximum tolerable pouch volume by 20.7%. It also prolonged pouch emptying by 47.3%, with an associated improvement in stool frequency and incontinence. These results suggested that valproate improved both reservoir continence and sphincter continence.

CONCLUSIONS

Only minimal side effects were noted, so the administration of sodium valproate appears to be a safe and useful adjunct for patients with ileoanal anastomosis in the early postoperative period.

Intraoperative colonoscopy

From 1987 to 1991, we performed intraoperative colonoscopy on 66 patients as a result of the following indications: the air leakage test (53%), detection of a previous malignant polypectomy site (20%), inability to complete preoperative colonoscopy (17%), detection of the source of intestinal bleeding (4%), and detection of impalpable colonic lesions (4%). Intraoperative colonoscopy was successful in 61/66 patients and provided information that altered the planned operation in 10 of 61 completely examined patients. The air leakage test proved useful in detecting subclinical anastomotic leaks. The indications for intraoperative colonoscopy have been expanded, and this procedure is often useful when one is attempting to decide on the appropriate surgical strategy for patients.

Protein tyrosine kinase in colorectal adenoma

To determine whether protein tyrosine kinase (PTK) could be utilized as a biological indicator of colonic tumorigenesis, we examined the PTK activity in the cytosolic and particulate fractions of homogenates from 25 adenomas (polyps) and from adjacent normal mucosa. The particulate fraction PTK activity in the colorectal adenomas was significantly higher than in the normal mucosa. The adenomas were then analyzed according to size, histological type (tubular and tubulovillous), and degree of dysplasia (mild, moderate and severe). The average particulate fraction PTK activity ratio (adenoma/normal mucosa) of tubulovillous adenomas or adenomas with moderate to severe dysplasia was significantly elevated in comparison with that of tubular adenomas or adenomas with mild dysplasia. The particulate PTK activity ratio increased significantly with increasing adenoma size, while the cytosolic ratio did not. The cytosolic PTK activity ratio in tubulovillous adenomas or adenomas with severe dysplasia decreased significantly with increasing size. These findings suggest that colonic carcinogenesis might be associated with alterations in the cellular level of PTK activity and that the PTK activity ratio (adenoma/normal mucosa) in the particulate and/or cytosolic fractions may possibly correlate with the risk of malignant transformation.

Molecular dynamics simulation of winter flounder antifreeze protein variants in solution: correlation between side chain spacing and ice lattice

The solution structure of the 38 amino acid C-terminal region of the precursor for the HPLC-6 antifreeze protein from winter flounder has been investigated with molecular dynamics using the AMBER software. The simulation for the peptide in aqueous solution was carried out at a constant temperature of 0 degree C and at atmospheric pressure. The simulation covered 120 ps and the results were analyzed based on data sampled upon reaching a stable equilibrium phase. Information has been obtained on the quality of constant temperature and pressure simulations, the solution structure and dynamics, the hydrogen bonding network, the helix stabilizing role of terminal charges and the interaction with the surrounding water molecules. The Lys18-Glu22 interactions and the terminal charged residues are found to stabilize a helical structure with the side chains of Thr2, Thr13, Thr24 and Thr35 equally spaced on one side of the helix. The spacing between oxygen atoms in the hydroxyl group of the threonine side chains exhibits fluctuations of the order of 2-3 A during the 120 ps of simulation, but values simultaneously close to the repeat distance of 16.6 A between oxygen atoms along the [0112] direction in ice are observed. Furthermore, two engineered variants were studied using the same simulation protocol.

Transitory elevation of serum amylase levels after restorative proctocolectomy

The incidence of postoperative hyperamylasaemia was evaluated in 70 patients who underwent staged restorative proctocolectomy. On the 14th postoperative day, 27 of 70 patients after total colectomy showed hyperamylasaemia, and the serum amylase returned to normal on the 30th postoperative day. Three out of 37 after ileoanal anastomosis and 8 out of 70 after stoma closure showed elevation of serum amylase postoperatively. Total colectomy might have a possible role in the postoperative increase of serum amylase. None of these patients had any obvious clinical evidence of postoperative pancreatitis. In 7 patients showing significant elevation of serum amylase levels (over 1000 IU), this was due predominantly to the pancreatic isoenzyme. This transitory elevation of serum amylase did not seem to be altered by the administration of therapeutic agents for pancreatitis. These observations suggest that postoperative hyperamylasaemia without clinical evidence of pancreatitis is very common after total colectomy, and that postoperative hyperamylasaemia itself does not necessarily require treatment.

Modified anoabdominal rectal resection and colonic J-pouch anal anastomosis for lower rectal carcinoma: preliminary report

BACKGROUND

There has recently been increasing interest in coloanal reconstruction after proctectomy for low rectal carcinoma. We describe here our pilot experience with seven patients undergoing modified anoabdominal resection of the rectum and a colonic J-pouch anal anastomosis.

METHODS

The procedure varied according to the extent of internal anal sphincter (IAS) resection (type a, partial resection of the upper IAS; type b, circumferential resection of the upper IAS; type c, partial preservation of the lower IAS; and type d, total resection of the IAS).

RESULTS

None of the patients had incontinence, but preservation of the lower half of the IAS (types a and b) showed functional superiority over more extensive IAS resection (types c and d). Only patients who underwent types c and d resection needed medications to reduce stool frequency.

CONCLUSIONS

Our results suggest that the lower half of the IAS has a more important role than the upper half in the control of defecation. Total resection of the IAS did not sacrifice continence, but preservation of at least the lower IAS resulted in a better quality of life. Careful patient selection is needed when considering the use of these procedures for tumors in the lowest part of the rectum.

Steroid complications in patients with ulcerative colitis

Physicians treating patients with ulcerative colitis are confronted with the difficult task of deciding whether medical or surgical treatment is best for their patients. There are no definitive criteria to indicate when medical therapy should be exchanged for definitive surgery. Even in patients who respond well to glucocorticoid treatment, the side effects of these drugs may necessitate surgery. We reviewed the steroid complications of our operative cases retrospectively. Although ulcerative colitis was usually in remission, severe steroid complications were no longer tolerable and definitive surgery was required. We also reviewed the literature regarding the adverse effects of steroid. Because of advances in sphincter-preserving surgery, re-evaluation of the treatment of ulcerative colitis is necessary. Although conservative treatment remains the first choice, tolerance of irreversible side effects (especially in children) no longer seems to be justified. In such patients, early definitive surgery may offer more than it appears to sacrifice.

Correlation between protein kinase C activity and histopathological criteria in human colorectal adenoma

We examined protein kinase C (PKC) activity in the cytosolic and particulate fractions of homogenates obtained from 25 colorectal adenomas and adjacent normal mucosa in patients with colorectal carcinoma. The total PKC activity of colorectal adenomas was significantly reduced compared with that of normal mucosa in all cases (122 +/- 45.8 vs 174 +/- 50.5 pmol min-1 mg-1) (means +/- s.d.) (P less than 0.001). The particulate fraction PKC activity of adenomas was also significantly lower than in normal mucosa (71.4 +/- 31.3 vs 115 +/- 39.6 pmol min-1 mg-1) (P less than 0.001). Adenomas were classified by size, histological type and degree of dysplasia. The average particulate PKC activity ratio (adenoma/normal mucosa) of tubulovillous adenomas or those with severe dysplasia was significantly reduced compared with that of tubular adenomas or tumours with mild and moderate dysplasia (both P less than 0.001), while there were no significant differences in the cytosolic PKC activity ratio. The particulate PKC activity ratio decreased significantly with increasing adenoma size (P less than 0.001), while the cytosolic ratio again showed no difference. These findings suggested that the particulate PKC activity ratio had a possible correlation with the malignant potential of colorectal adenomas and that this ratio may be a useful biological indicator of colorectal carcinogenesis.

Occult cancer in localized giant pseudopolyposis

Localized giant pseudopolyposis is a rare complication in patients with ulcerative colitis which progresses to a huge intramural polypoid mass. Our case described here is a 30-yr-old female with chronic ulcerative colitis who developed localized giant pseudopolyposis with unexpected infiltrating adenocarcinoma. This case is one of an unusual form of cancer presentation in ulcerative colitis, and it indicates that we should be aware of the possibility of occult adenocarcinoma inside a large pseudopolyposis with no superficial dysplasia.

Malignant histiocytosis of the intestine simulating Crohn's disease. Report of a case

We report a case of malignant histiocytosis of the intestine (MHI) in which clinical and small bowel barium examination led to an initial diagnosis of Crohn's disease. The patient's symptoms and radiologic features improved dramatically with steroid therapy, and the patient remained free of severe symptoms for five years; at this stage, massive rectal bleeding occurred and segmental ileal resection was performed. Pathology findings of the resected specimen revealed nonspecific ulceration of the ileum. The correct diagnosis, MHI, became apparent six months after surgical intervention, on the appearance of multiple lymphadenopathy.

Protein kinase C activity in human colonic adenoma and colorectal carcinoma

To additionally understand the molecular mechanisms and biologic indicators of colonic tumorigenesis through the adenoma-carcinoma sequence, protein kinase C (PKC) activity was examined in the cytosol and particulate fraction of specimen homogenates from 18 human colonic carcinomas and seven coexisting colonic adenomas and was compared with the adjacent normal mucosal tissues. This study showed that PKC activity could be detected precisely using mini DEAE-Sephacel column purification and histone III-S as a substrate. The PKC activity in both colonic adenoma and carcinoma progressively was reduced in the particulate fraction compared with that of the adjacent normal mucosa from each patient (74.9 +/- 11.3 and 42.4 +/- 9.37 versus 112 +/- 16.8 pmol/min/mg, P less than 0.001), although PKC activity in the cytosolic fraction was not significantly different (62.6 +/- 17.7 and 63.1 +/- 8.08 versus 56.4 +/- 7.32 pmol/min/mg) with respect to protein concentration. Both colonic adenomas and carcinomas showed a significant progressive decrease in total particulate PKC activity compared with the adjacent normal mucosa of each patient (13.5 +/- 2.18 and 7.64 +/- 1.35 versus 19.8 +/- 2.74 pmol/min/g tissue, P less than 0.001) and no difference in total cytosolic PKC activity (15.2 +/- 3.80 and 16.5 +/- 2.02 versus 14.6 +/- 1.81 pmol/min/g tissue). Among PKC activities in carcinomas, there was no difference related to histologic type, Dukes' staging, or carcinoembryonic antigen values. Among PKC activities in colonic adenomas, a significant decrease in particulate PKC correlated with size. The specific PKC activity in the particulate fraction decreased with advancing adenoma size (P less than 0.05). This study showed that colonic carcinogenesis might be associated with alterations in cellular levels of PKC activity and that the decrease in particulate PKC activity in the adenoma had a possible correlation with adenoma size.

The application of a thread holding ring for ileoanal and coloanal anastomosis

A thread holding ring, originally developed for valve replacement surgery and now commercially available, was successfully employed when performing ileoanal or coloanal anastomosis in 34 patients. The use of this instrument for ileoanal or coloanal anastomosis shortened the operation time and resulted in a decreased rate of complications related to the anastomosis.

Function after anoabdominal rectal resection and colonic J pouch--anal anastomosis

Twenty-eight patients undergoing anoabdominal resection of the rectum with construction of a colonic J reservoir and eight patients without a reservoir were studied 2 years after surgery. Frequency of defaecation and daytime soiling were inversely correlated with the maximum tolerable volume of the colonic J pouch. The distensibility and threshold volume of those with a pouch were significantly greater than in those without a pouch 6 months or more after stoma closure. Anal resting pressure, squeeze pressure, anal canal length and a positive inhibitory reflex were similar in both groups. Anal resting pressure, squeeze pressure and pouch distensibility correlated with frequency of defaecation in the stable phase. Pouch construction may improve the patient's quality of life in the adaptation phase.

Production of tissue collagenase (matrix metalloproteinase 1) by human aortic smooth muscle cells in response to platelet-derived growth factor

The production of the precursor of tissue collagenase/matrix metalloproteinase 1 (proMMP-1) by cultured human aortic medial smooth muscle cells (SMCs) was significantly enhanced by the treatment of the cells with platelet-derived growth factor (PDGF), interleukin 1 or 12-O-tetradecanoylphorbol-13-acetate (TPA). The response to PDGF of SMCs exhibited a tendency to be age-dependent: only SMCs obtained from older individuals (age: 54, 56, 72 and 74 years) responded to PDGF and synthesized proMMP-1, but not SMCs from young individuals (age: 10, 16 and 41 years), and weak responsiveness with a 19-year-old individual. On the other hand, induction of proMMP-1 synthesis in SMCs by TPA was not discriminated by age. The synthesis of two other related matrix metalloproteinases was also examined. Matrix metalloproteinase 2 was found to be constitutively expressed in zymogen form in SMCs and its synthesis was not affected by the treatments with PDGF, interleukin 1 or TPA. The synthesis of matrix metalloproteinase 3 (stromelysin) was not detected in SMCs from both young and old individuals even after the treatment with PDGF, interleukin-1, prostaglandin E2 or TPA. The ability of SMCs to synthesize and secrete proMMP-1 in response to PDGF suggests that this enzyme plays an important role in the migration of PDGF-stimulated SMCs from the media into the intima of aorta and the eventual formation of atherosclerotic plaques.

Collagenase production by immortalized human aortic endothelial cells infected with simian virus 40

Human aortic endothelial cells, isolated at autopsy from a 52-year-old male dying from lung cancer, were treated with simian virus 40 (SV40). One colony was isolated from the infected endothelial cell culture 4 weeks after infection. The cells expressed SV40 large T antigen and p53 protein (p53) in their nuclei but lacted the characteristics of a transformed phenotype. The cells grew well in a monolayer over the 97th passage and exhibited Factor VIII-related antigen, Ulex europaeus 1 agglutinin (UEA-1) as endothelial cell markers, and a well-developed fibronectin network. The amount of prostacyclin synthesized by the cells was less than the amount synthesized by normal aortic or umbilical cord vein endothelial cells. The cells produced relatively large amounts of procollagenase, and 12-o-tetradecanoyl-phorbol-13-acetate (TPA) augmented the ability of the cells to produce this enzyme. These immortalized human aortic endothelial cells, which have some characteristics of normal endothelial cells and, like capillary endothelial cells, have the ability to produce collagenase, will probably prove useful for studies of atherosclerosis and angiogenesis.

Stapled anastomosis for trans-sphincteric resection of the rectum

We have found that in all patients who have undergone this procedure, normal defecation and complete continence are maintained. The surgical wound heals well and functional results have been uniformly good, even in instances in which only 1 centimeter of the rectum remains. This procedure may be useful for patients who are carefully diagnosed by preoperative transrectal ultrasonography in which the lower edge of the rectal tumor is within 8 centimeters of the anal verge, the tumors do not extend into the muscularis propria and there is no lymph node metastasis. Use of the CEEA stapling device can shorten the time of operation and is particularly beneficial for elderly patients and those who are at poor risk.

gamma-Aminobutyric acid enhances the tone of human internal anal sphincter

The effect of gamma-aminobutyric acid (GABA) on the human internal anal sphincter was investigated. Cumulative applications of GABA produced concentration-dependent contractions (10(-8)-10(-5) M) of the isolated human sphincter. Pretreatment with bicuculline (GABAA antagonist) turned them to relaxation. Muscimol, a GABAA agonist, induced concentration-dependent contractions (10(-8)-10(-5) M); however, baclofen (GABAB agonist, 10(-8)-10(-5) M) promoted concentration-dependent relaxation of the strips. These results suggested that both excitatory GABAA receptors and inhibitory GABAB receptors exist in the internal anal sphincter. Oral administration of sodium valproate (1600 mg/day), a GABA transaminase inhibitor, enhanced the anal canal resting pressure in 10 normal volunteers. Anal manometry showed a significant elevation in tonus without affecting amplitudes or frequencies. These results indicated that endogenous GABA, which was increased by sodium valproate, produced elevations in the anal canal resting pressure through its specific receptors in the human internal anal sphincter.

Disappearance of hyperplastic polyposis after resection of rectal cancer. Report of two cases

Since 1980, when the first description of hyperplastic polyposis of the colon appeared, 18 cases of hyperplastic polyposis have been reported in the literature. Only two of them bore colonic cancer. Here we add two cases of hyperplastic polyposis accompanying rectal carcinoma following cancer resection, in which residual hyperplastic polyps disappeared after resection.

Accuracy of three-dimensional volume measurement using biplane transesophageal echocardiographic probe: in vitro experiment

Two phased-array scanning methods can be used for volumetric transesophageal echocardiographic imaging: (1) pull-back "breadloaf" reconstruction, and (2) rotation "fan-like" reconstruction. The purpose of this study was to (1) test accuracy and precision of pull-back versus rotational geometries for three-dimensional volume determination, and (2) test accuracy of the resulting surface/volume rendered images. The endoscope shaft was inserted into a tube with the handle connected to a stepper device. Seventeen balloons (61 to 471 ml) were put into a water bath consecutively. Two scans were performed: (1) pull-back: the probe was withdraw in 1 mm steps to obtain parallel "breadloaf" slices, and (2) rotational: the probe was rotated in increments of 1.8 degrees, 3.6 degrees, or 5.4 degrees to obtain "fan-like" slices. Each image was digitized for computer analysis. The data were interpolated into 128 x 128 x 128 voxels for three-dimensional reconstruction. Volume measurement was done using a stereometric random marking method. Volumes obtained from the reconstructed images were compared with the true volume (weight) by linear regression analysis. Excellent correlation between measured and actual volumes was obtained from rotation scans as follows: for 1.8 degrees steps (r = 0.9987, SEE = 6.5 ml), for 3.6 degrees steps (r = 0.9959, SEE = 11.5 ml), and for 5.4 degrees steps (r = 0.9943, SEE = 13.5 ml). The pull-back scans showed r = 0.9990, SEE = 5.8 ml. Three-dimensional surface/volume rendered images of the balloons indicate that 1.8 degrees rotation scans are almost as good as 1 mm pull-back scans. We conclude that volume measurements from rotation scans in vivo will not be hindered by scan geometry or software interpolation.

Vipoma of the pancreas complicating ulcerative colitis

We report a case of vipoma of the pancreas in conjunction with ulcerative colitis in a 20-yr-old woman. Twenty months after the onset of ulcerative colitis, the patient complained of watery diarrhea and was found to have an electrolyte disorder. A pancreatic tumor was detected by ultrasonography and computed tomography, along with an elevation of serum vasoactive intestinal polypeptide (VIP). The secretory diarrhea diminished dramatically, and the serum VIP level decreased into the normal range immediately after resection of the pancreatic tumor. Immunohistochemical staining revealed a pancreatic vipoma. Despite removal of the vipoma, she underwent restorative proctocolectomy and ileal J-pouch anal anastomosis 2 yr later due to progression of the ulcerative colitis. Postoperative course was uneventful, with excellent functional results. Knowledge of this rare condition accompanying ulcerative colitis may help in the management of the patient with an atypical clinical course.

Effect of linoleic acid hydroperoxide on replication of adenovirus DNA in endothelial cells of bovine aorta

The effect of linoleic acid hydroperoxide on replication of adenovirus type 2 DNA in cultured endothelial cells of bovine aorta was studied to elucidate the deleterious effect of lipid peroxides on replication of DNA in the arterial endothelial cells. When, just after the infection, the cells were incubated with 1 nmol (measured by the thiobarbituric acid reaction and expressed in terms of malondialdehyde) of the hydroperoxide, the replication of adenovirus type 2 DNA was markedly reduced. The level of the messenger RNA for adenovirus type 2 DNA polymerase was also reduced. In accordance with the reduction of the messenger RNA, the synthesis of the polymerase in the cells was reduced. The inhibition of DNA replication in the arterial endothelial cells by lipid peroxides was discussed in relation to atherogenesis.

Giant hypertrophied anal papilla. Case report

Anal papillae, polypoid lesions formed by hyperplasia of connective tissue in the vicinity of the anal columns, are usually small and asymptomatic. A rare case of giant hypertrophied anal papilla complicated by massive anal bleeding and prolapse is reported.

Protein kinase C activity as marker for colorectal cancer

Protein kinase C (PKC) activity was measured in normal-appearing colonic mucosa from patients undergoing colonic resection. Comparisons were made between cases with and without colorectal cancers. PKC activity in cytosolic and particulate fractions was significantly reduced in patients with colorectal cancer: 40 +/- 9 and 114 +/- 29 (pmol/min/mg) respectively, compared with patients without cancer; 129 +/- 11 and 250 +/- 38 (pmol/min/mg) (p less than 0.05). Normal-appearing colonic mucosa in patients with cancer showed significantly decreased total PKC activities in the cytosolic and particulate fractions compared with those in patients without cancer (10 +/- 1 and 20 +/- 3 vs. 30 +/- 2 and 33 +/- 6) (pmol/min/g tissue) (p less than 0.05). The cellular distribution (% particulate fraction) of PKC activity in normal-appearing mucosa in patients with cancer (64%) was higher than in patients without cancer (49%) (p less than 0.05). OUr data suggest that PKC activity may be used as a biological marker of risk of developing colorectal cancer or risk of bearing an asymptomatic tumor.

Purification and characterization of three forms of differently glycosylated recombinant human granulocyte-macrophage colony-stimulating factor

We have purified recombinant human granulocyte-macrophage colony-stimulating factor (hGM-CSF) produced in human lymphoblastoid Namalwa cells. From the results of tunicamycin treatment and N-glycosidase F digestion, it was demonstrated that Namalwa-derived hGM-CSF was highly glycosylated at two potential N-glycosylation sites and several O-glycosylation sites as previously shown for naturally occurring hGM-CSF. We classified the hGM-CSF molecules into three groups according to the molecular weight corresponding to the degree of N-glycosylation: the molecules with two N-glycosylation sites occupied (designated 2N), the molecules with either site glycosylated (1N), and the molecules lacking N-glycosylation (0N). Despite such varied degrees of N-glycosylation, almost all molecules were O-glycosylated. To investigate the role of carbohydrate moieties of hGM-CSF, we isolated each form of hGM-CSF and examined its biological properties. The 2N-type showed 200-fold less in vitro specific activity compared with unglycosylated Escherichia coli-derived hGM-CSF, although the activity of the 0N-type was equivalent to that of the E. coli-derived material. The 1N-type showed an intermediate level of activity. However, in terms of clearance from blood circulation in the rat, the 2N-type showed a half-life five times longer than that of the 0N-type and E. coli-derived hGM-CSF. From these findings, we concluded that N-linked carbohydrate moieties of hGM-CSF play conflicting physiological roles in the efficacy of the protein in vivo but that O-linked carbohydrate moieties do not have such effects.

Apolipoprotein A-I deficiency due to a codon 84 nonsense mutation of the apolipoprotein A-I gene

The molecular genetic defect of a female patient with apolipoprotein A-I (apoA-I) deficiency and premature atherosclerosis was examined. Her parents were first cousins. Her plasma density fraction from 1.063 to 1.21 g/ml contained no apoA-I on SDS/PAGE and no measurable high density lipoprotein cholesterol. Southern blot hybridization showed no gross abnormality to be present in the patient's apoA-I gene and homozygosity for a haplotype of restriction fragment length polymorphisms in the apoA-I gene region. Sequencing after amplification by PCR revealed a codon 84 nonsense mutation (CAG----TAG, Gln----stop) of exon 4 and a codon 67 missense mutation (GCC----ACC, Ala----Thr) of exon 3 in the patient's apoA-I gene. The data from dot-blot hybridization with allele-specific oligonucleotide probes indicated that she was homozygous for the apoA-I gene with regard to the two mutations. The codon 37 missense mutation was also detected in the apoA-I gene of 6 out of 60 controls, who all had normal levels of apoA-I and high density lipoprotein cholesterol, suggesting that the missense mutation is polymorphic and not associated with apoA-I deficiency. These findings indicate that homozygosity for the apoA-I gene with codon 84 nonsense mutation causes the deficiency of apoA-I and of high density lipoprotein cholesterol in the patient.

Recurrent rectal carcinoma treated with high-dose-rate intraluminal brachytherapy

A 63-year-old man with recurrent rectal carcinoma was treated with high-dose-rate intraluminal brachytherapy (6 Gy x 4). After treatment, anal pain and bleeding were greatly improved. He died as a result of liver metastasis, but he was able to evacuate the bowels until death. bowels until death.

Family studies of the LDL receptor gene of relatively severe hereditary hypercholesterolemia associated with Achilles tendon xanthomas

To assess the relationship between relatively severe hereditary hypercholesterolemia with Achilles tendon xanthomas and the defect of the low density lipoprotein (LDL) receptor gene, family studies were carried out in 17 hypercholesterolemic families. In 16 out of the 17 families, hypercholesterolemia co-segregated with four different gross rearrangements, six different restriction fragment length polymorphism (RFLP) haplotypes, or an abnormal TaqI band of the LDL receptor gene. These findings are compatible with the interpretation that hypercholesterolemia is caused by defective LDL receptor genes, and that the origin of the mutant LDL receptor genes in Japanese generally differs among different pedigrees. In the remaining family, the proband and his sibling, both having relatively severe hypercholesterolemia and Achilles tendon xanthomas, shared an RFLP haplotype, although the proband's other sibling with moderate hypercholesterolemia but without Achilles tendon xanthomas did not. The mutant gene for familial defective apolipoprotein B-100 was not detected in the 17 probands. These data suggest that most, if not all, of the relatively severe hereditary hypercholesterolemia associated with Achilles tendon xanthomas is caused by a defect of the LDL receptor gene.

[Effect of inclusion complexation of decanoic acid with alpha-cyclodextrin on rectal absorption of cefmetazole sodium suppository in rabbits]

Inclusion complex of decanoic acid (DA) with alpha-cyclodextrin (alpha-CyD) was prepared as an additive of cefmetazole sodium (CMZ) suppository and rectally administered to rabbits. The resulting complexation was examined by the phase solubility method, differential scanning calorimetry (DSC) and X-ray diffractometry. Plasma concentration and AUC of CMZ after rectal administration of a suppository containing DA/alpha-CyD complex to rabbits increased more significantly than those with none additive.

Amplification and high-level expression of a cDNA for human granulocyte-macrophage colony-stimulating factor in human lymphoblastoid Namalwa cells

We have achieved high-level expression of human granulocyte-macrophage colony-stimulating factor (GM-CSF) in human lymphoblastoid Namalwa cells by introducing and subsequently amplifying an expression vector encoding human GM-CSF and mouse dihydrofolate reductase (DHFR). Transformants expressing elevated levels of both GM-CSF and DHFR were selected by a step-wise increase in the concentration of methotrexate (MTX). Several cell lines resistant in 800 nM MTX have been established that express GM-CSF at a rate of 10-20 micrograms/10(6) cells/day. The amplified genes are integrated and stably maintained in the chromosomes of these cell lines. Analysis of the GM-CSF produced in the amplified Namalwa cells revealed that the molecular-size distribution due to varied degrees of glycosylation was similar to that observed in the naturally-occurring molecules.

Association of hypercholesterolemia and apolipoprotein E4 in school children

To investigate the association of apolipoprotein (APO) E4 and hypercholesterolemia in children, we studied the APOE phenotypes of 51 school-age children with hypercholesterolemia and of 51 age, sex and obesity index-matched controls with normocholesterolemia by two-dimensional gel electrophoresis APOE4 was present in 21 of 51 hypercholesterolemic children (41.2%), and in nine of 51 control subjects (17.6%). The difference was significant (p less than 0.01). This finding indicates that APOE4 is associated with hypercholesterolemia in children.