Effect of dietary linoleic, alpha-linolenic and arachidonic acids on lipid metabolism, tissue fatty acid composition and eicosanoid production in rats

Rats were fed semipurified diets containing 10% fat with a constant polyunsaturated/monounsaturated/saturated fatty acid ratio of 1:1:1. This was performed by mixing vegetable oils. Linoleic acid was the sole polyunsaturated fatty acid in the linoleic acid group. The alpha-linolenic and arachidonic acids were contained at the 1% level in the diet at the expense of linoleic acid in the alpha-linolenic acid and arachidonic acid groups, respectively. The concentration of serum triglyceride, phospholipid and liver triglyceride were significantly lower in the alpha-linolenic acid and arachidonic acid groups than in the linoleic acid group. Hepatic phospholipids were significantly higher in the alpha-linolenic acid and arachidonic acid group as compared to the linoleic acid group. Compared to the linoleic acid group, the percentages of arachidonic acid in the phosphatidylcholine (PC) and phosphatidylethanolamine (PE) in the liver and heart were significantly lower in the alpha-linolenic acid group; in contrast, they were significantly higher in the arachidonic acid group. Dietary arachidonic acid, but not alpha-linolenic acid, resulted in a marked reduction of linoleic acid and increased arachidonic and n-6 docosapentaenoic acids in heart cardiolipin. Platelet thromboxane (TX) A2 production tended to be lower in the alpha-linolenic acid group as compared to the linoleic acid and arachidonic acid groups. There was no difference in TXA2 production between the linoleic acid and arachidonic acid groups. The aortic production of prostacyclin (PGI2) was the same among the three groups. The ratios of TXA2 and PGI2 in the linoleic acid and arachidonic acid groups were comparable, whereas they were significantly higher than that in the alpha-linolenic acid group. The results demonstrate that dietary arachidonic acid enriches the arachidonic acid content in tissue phospholipids more effectively than linoleic acid, whereas the effect on the production of TXA2 and PGI2 was comparable under these experimental conditions.

[Squamous cell carcinoma of unknown origin affecting mediastinal lymph nodes]

A 65-year-old woman was admitted to the hospital because of an abnormal shadow on a chest X-ray film. Chest CT scans showed enlargement of the right mediastinal lymph nodes. However, no primary lesion was detected despite thorough examination. Mediastinoscopic biopsy revealed that the tumor was a lymph-node metastatic lesion of a squamous cell carcinoma of unknown origin. A thoracotomy was done and the mass was completely resected. Radiotherapy was given after the operation. We have followed the patient for 1 year since the operation, but no primary lesion has yet been detected. Metastasis of cancer of unknown origin to hilar or mediastinal lymph nodes is extremely rare, and only 6 cases have been reported previously in the Japanese medical literature.

Preoperative radiotherapy and surgery for advanced thymoma with invasion to the great vessels

From 1983 to 1994, 12 advanced thymomas with invasion to the great vessels were initially treated by irradiation (mean dose, 18.3 Gy) and subsequent surgical resection. In nine patients, complete resection was possible by concomitant resection of the surrounding tissues, mainly pericardium and/or brachiocephalic vein. Histologically, all tumors showed prominent fibrosis. Ten patients also received postoperative radiotherapy (mean dose, 42.3 Gy). Tumor-related deaths occurred in only two patients; one who did not receive postoperative irradiation 21 months and one who had viable cells at the surgical margin 10 months after operation. However, there were also 2 patients who died of respiratory failure due to operation and/or irradiation, one 45 days and the other 7 years after the treatment. Preoperative radiotherapy could facilitate complete resection of the advanced thymomas. The prognosis of the patients treated with preoperative radiotherapy seemed fair if followed by adequate resection and subsequent irradiation.

[A case of bronchial neurinoma]

Neurinoma of the bronchial tree is extremely rare. We report a case of bronchial neurinoma involving a 21-year-old woman. The patient was admitted due to an abnormal shadow on chest X-ray, with cough and sputum production. Chest CT and MRI showed that the tumor arose from the left lower bronchus and bronchofiberscopic examination revealed complete obstruction of the lower bronchus by a polypoid tumor. A left lower lobectomy was performed based on the histological diagnosis of benign neurinoma and the postoperative course was uneventful. The tumor was 7.0 x 6.0 x 5.0 cm in size and had grown endobronchially without penetrating the bronchial wall. Pathological diagnosis was Antoni A type benign neurinoma. Since malignant or metastasized tumors have been reported in cases of tracheobronchial or intrapulmonary neurinoma, complete surgical resection of bronchial neurinomas should be performed.

Cherubism: diagnostic imaging and review of the literature in Japan

Cherubism is a nonneoplastic disease of bone characterized by clinical, bilateral, painless enlargements of the jaws that are said to give the patient a cherubic appearance. Cherubism may appear in solitary cases or in many members of the family, often in multiple generations. On radiography the lesions have the appearance of bilateral multilocular radiolucent areas. On histopathologic evaluation the lesions show proliferating fibrous connective tissue containing numerous multinucleated giant cells. Since it was first described by Jones in 1933, many cases have been documented without restriction to any one country or ethnic group, but only a few cases have been reported in Japan, apparently because it is rare here. We report a case of cherubism in a 15-year-old boy and review the Japanese literature.

Changes in diastolic regional stiffness of the left ventricle before and after coronary artery bypass grafting

To evaluate the effect of coronary artery bypass grafting (CABG) on regional diastolic function of the left ventricular wall, we applied the concept of the stiffness constant to the diastolic sigma-ln (1/H) relation, where sigma is the mean wall stress, and H is the wall thickness of the region of concern, and ln (1/H) is the natural logarithm of the reciprocal of wall thickness. We assessed 12 cardiac regions in six patients with coronary artery disease who underwent CABG at the Cardiovascular Hospital of Central Japan between May 1994 and January 1995. Left ventricular pressure and regional wall thickness were measured simultaneously, with a micromanometer-tipped catheter and by two-dimensional echocardiography, respectively, before and after CABG. The stiffness constant (K) was obtained by fitting the diastolic sigma-ln (1/H) data points to an exponential curve with zero asymptote: sigma = Cexp[Kln (1/H)]. Preoperatively, the stiffness constant in the affected region (CABG region) was greater than that in the unaffected region (non-CABG region) (4.79 +/- 2.56 vs 2.95 +/- 0.72). Postoperatively, the stiffness constant in the CABG region was significantly decreased, to 3.21 +/- 1.22. The stiffness constant, which is derived from the sigma-ln (1/H) relation, is useful for the assessment of LV regional diastolic function.

Renal oncocytoma treated by surgical enucleation: a case report

We experienced a case of renal oncocytoma, in a 46-year-old woman. At a health examination, ultrasonography revealed a right renal tumor, and she was admitted to our hospital for evaluation. From the ultrasonogram, computerized tomography (CT) and angiography, we suspected a renal oncocytoma, but renal cell carcinoma was not completely ruled out. Since the location of the tumor seemed suitable for a local resection, we scheduled a surgical enucleation, but we intended to switch to a radical nephrectomy if examination of a frozen-section suggested renal cancer. Because the frozen findings were suggestive of an oncocytoma without malignancy, the surgical enucleation procedure was completed as scheduled. Pathological findings of the resected specimens were characterized by granular eosinophilic cytoplasm, and rounded nuclei without nuclear pleomorphism or mitotic figures. Electron microscopic studies revealed an increased number of mitochondria. The patient was accordingly diagnosed as having renal oncocytoma. We also reviewed the literature to elaborate procedures for a preoperative diagnosis and therapy for renal oncocytoma.

Mechanical unfolding of alpha2-macroglobulin molecules with atomic force microscope

alpha2-Macroglobulin was derivatized with a sulfhydryl cross-linker and sandwiched between a mica substrate and a silicon nitride tip, both coated with gold, of an atomic force microscope and force curve measurement was carried out. An extensive downward deflection of the cantilever was observed in the retracting realm of the curve, when and only when the substrate was covered with the derivatized protein. The result was interpreted in terms of the mechanical stretching and unfolding of a single or a few protein molecules.

[A case of resected lung cancer associated with bullous pemphigoid]

The relationship between bullous pemphigoid and malignancies of visceral organs is still controversial. A case of lung cancer associated with bullous pemphigoid is reported. A 63-year-old man admitted hospital because of multiple bullae of the whole body skin and continuous fever. The skin lesions were diagnosed as bullous pemphigoid by the skin biopsy. However, the chest x-ray on admission revealed a large tumor in the left upper lung field. The tumor was diagnosed as a lung cancer by trans-bronchial lung biopsy. The fever withdrew with the administration of prednisolone. The left upper lobectomy of the lung and mediastinal lymph node dissection were performed. The skin lesion disappeared 5 days after the surgery. This clinical course is thought to indicate the relationship of both diseases. Bullous pemphigoid is thought to have many problems during perioperative period, such as hypoproteinemia and delayed wound healing due to administration of the steroid, therefore intensive care is necessary in the perioperative care.

Hepatic HCV-RNA as a predictor of outcome after interferon therapy in patients with chronic hepatitis C

Measurement of serum HCV-RNA is a useful index for evaluating the antiviral effect of interferon therapy in chronic hepatitis C. In the present study, we investigated whether the detection of hepatic HCV-RNA after interferon treatment, using a polymerase chain reaction assay, predicted long-term response to therapy in patients with chronic hepatitis C. Thirty-three patients underwent liver biopsies before and after interferon therapy. Histology and clinical courses were compared after treatment. Before therapy, serum and hepatic HCV-RNA was detected in specimens from 32 (97%) and 33 (100%) patients, respectively. Serum HCV-RNA became undetectable in samples from 22 (67%) patients; however, in 10 of these patients (45%), serum HCV-RNA levels relapsed after therapy. Hepatic HCV-RNA became undetectable in 14 patients after therapy and the serum aminotransferase concentration remained within normal limits during and following (24-92 weeks) therapy in 12 of these patients (86%). All 11 patients with detectable hepatic HCV-RNA also had serum HCV-RNA and elevated aminotransferase concentrations refractory to therapy. The absence of hepatic HCV-RNA at the end of interferon treatment thus predicted a long-term complete response to therapy with a sensitivity of 100%, a specificity of 90% and an accuracy of 94%. We conclude that hepatic rather than serum HCV-RNA is a more useful index for the prediction of the long-term efficacy of interferon therapy.

Thoracoscopic repair of diaphragmatic hernia

A 22-year-old woman presented with left subcostal pain and nausea. A radiograph and a computed tomographic scan of the chest revealed diaphragmatic hernia. Thoracoscopic surgery was performed. The herniated organs were put back into the peritoneal cavity and the hernial hilum was closed with interrupted silk suturing.

The pleiotropic effect of the GTS1 gene product on heat tolerance, sporulation and the life span of Saccharomyces cerevisiae

We investigated whether or not the potential clock gene, GTS1, of the yeast Saccharomyces cerevisiae, shows pleiotropic effects on the yeast cellular processes. We tested the efect of the Gts1 protein on heat tolerance, sporulation and life-span, by characterizing the phenotypes of transformants with different copy numbers of the gene. We found that the Gts1 protein affects the capacity of heat tolerance in the stationary phase and the speed leading to sporulation in a gene-dose dependent manner, and that both inactivation and overexpression of the gene shortened the life-span of yeast. These results supported the notion that GTS1 affects the biological clock of the yeast S. cerevisiae, although this cannot be definitively concluded because the strain cannot be synchronized with circadian or ultradian rhythms.

Dystrophin localization at presynapse in rat retina revealed by immunoelectron microscopy

PURPOSE

It has been accepted that retinal dystrophin is localized in the outer plexiform layer (OPL) of the retina, but no electron microscopic evidence has been reported until now. Using immunoelectron microscopy, the authors investigate whether retinal dystrophin localizes at the presynaptic or postsynaptic membrane of synaptic regions.

METHODS

Monoclonal antibody raised against human dystrophin C-terminus was used. Immunoblotting analysis was used for testing dystrophin protein in retinal tissues. Tissue preparations were stained with the immunofluorescence or immunoperoxidase method and were observed with light and electron microscopy.

RESULTS

Immunoblotting analysis showed a molecular weight of band 420 kDa in the sodium dodecyl sulfate--polyacrylamide gel electrophoresis of the retinal tissues. Immunoelectron microscopy disclosed that retinal dystrophin was localized at the presynaptic membrane of synaptic regions in the OPL.

CONCLUSIONS

Rat retinal dystrophin localizes at the presynaptic membrane in the OPL, suggesting that it may play some role in the neurotransmitter release of the photoreceptor cell.

Successful treatment of invasive thoracopulmonary mucormycosis in a patient with acute lymphoblastic leukemia

BACKGROUND

Pulmonary mucormycosis associated with hematologic malignancy is an uncommon, but important opportunistic fungal pneumonia that is usually a fatal infection. Only a few survivors of pulmonary mucormycosis have been reported.

METHODS

A case report of invasive thoracopulmonary mucormycosis during remission-induction therapy for acute lymphoblastic leukemia and a review of the literature are presented.

RESULTS

The fungal lesions extended to both lungs, the left ribs, and intercostal muscles. Percutaneous needle biopsy and immunostaining of the fungal hyphae established the diagnosis of thoracopulmonary mucormycosis. The patient was treated with granulocyte-colony stimulating factor (G-CSF) and intravenous amphotericin B for 9 weeks and the lesions in the right lung disappeared. Left pneumonectomy and partial resection of the chest wall were later performed. The left lung was grossly necrotic and contained a large cavity and bronchopulmonary fistula. Thereafter, antileukemic therapy was resumed and completed without recurrence of mucormycosis or leukemia.

CONCLUSIONS

In the management of mucormycosis, the addition of G-CSF to the conventional treatment may substantially improve outcome.

[Clinical study on stage PT1 and grade 3 transitional cell carcinoma of the urinary bladder]

Thirty-three patients who had transitional cell carcinoma of the bladder with stage PT1 and grade 3 components were treated between January 1980 and December 1992. Clinical study was done for these 33 patients on treatment modalities and it's problem, intravesical recurrence, disease progression and prognosis. Twenty-five of 33 patients underwent bladder-sparing surgeries and total cystectomy was performed for another 8 patients as initial treatment. Intravesical recurrence was observed in 18 (72%) of 25 patients who underwent initial bladder-sparing surgeries. Recurrence-free rate was 44% for 1 year and mean period to recurrence from initial therapy was 13.1 months. Although some adjuvant therapy after initial treatment was performed for 20 patients, it's efficacy in preventing intravesical recurrence could not be confirmed. Disease progression was recognized in 10 (40%) of 25 patients initially treated by bladder-sparing surgeries after median latent period of 33.7 months, whereas only one (12.5%) of another 8 patients who underwent total cystectomy showed progression, and 5-year progression-free rate after initial bladder-sparing surgeries was 55.6%. Three and five-year actural survival rate in all cases were 81.5% and 65.1%, respectively. According to initial treatment, 5-year survival rate was 62.2% for the patients treated by bladder-sparing surgeries, whereas it was 83.3% for the cases who underwent total cystectomy. However statistical significant difference was not recognized. In view of disease progression after initial bladder-sparing surgeries, patients with progression yealed a 45.7% 5-year survival rate compared to 81.5% for the patients without progression, and significant difference was demonstrated between them.(ABSTRACT TRUNCATED AT 250 WORDS)

Scintigraphic detection of xenografted renal tumor by anti-renal cancer monoclonal antibody radiolabeled with technetium-99m

Accumulation in the tumor of the RCS-1 monoclonal antibody, which recognizes the cell surface antigen of renal cancer cells was examined. The antibody purified by affinity chromatography (protein-A column) and gel fractionation was labeled with technetium-99m (99mTc) by a direct method. High labeling efficiency (> 98%) could be routinely obtained. However, the 99mTc labeling of the antibody did not reduce the reactivity of the RCS-1 antibody. The labeled antibody was injected into nude mice transplanted with human renal and gastric tumors, and the accumulation of the antibody in each tumor and various tissues was compared at 48 hours after injection. The highest accumulation of radiolabeled RCS-1 antibody was observed in the AM-RC-3 renal tumors; at 8.0% of the injected dose per gram and a tumor-to-blood ratio of 1.05, respectively. However, the radiolabeled RCS-1, did not show specific accumulation in the gastric tumor nor in any tissues tested. The xenografted tumor, AM-RC-3 was successfully visualized with the radiolabeled RCS-1 antibody by scintigraphy.

[Transpericardial completion pneumonectomy with omental pedicle flap for chronic empyema caused by bronchiectasis]

A 61-year-old man received right middle and lower lobectomies for lung abscess caused by bronchiectasis in 1957. Since the right upper lobe was destroyed and multiple peripheral bronchopleural fistulae developed later, open thoracostomy was done in 1990. For this patient we performed transpericardial completion pneumonectomy with omental pedicle flap in 1993. He was complicated in a transient thoracic empyema. But he recovered by open drainage followed by surgical closure using Clagett's method and remains well 2 years after the radical operation. Transpericardial approach with omental pedicle flap though a median sternotomy seemed useful to prevent the postpneumonectomy bronchopleural fistula in this patient with thoracic empyema. But the primary closure of the empyema cavity should not be done, if dead space remains in the pleural cavity.

[Two cases of priapism cured by transcatheter embolization of internal pudendal arteries]

We report here two cases of priapism. One of these cases was suspected to be drug induced and high and low flow mixed type. The patient had taken the drugs, alpha-blocker for hypertension and dysuria by BPH for a long time. He was treated by a caveno-glandular shunt. After surgery, detumescence was obtained for some time, but erection appeared again soon. Transcatheter embolization of the internal pudendal arteries was then performed, and detumescence became permanent. The other case was an idiopathic and high flow type. Detumescence was achieved soon by transcatheter embolization of the internal pudendal arteries only, then he experienced morning erection imperfectly on the 9th day after this treatment. The management of priapism as reported to date is also reviewed.

Inhibitory effect of ethanolamine plasmalogen on iron- and copper-dependent lipid peroxidation

The effect of ethanolamine plasmalogen (EtnPm) on lipid peroxidation was investigated in liposomal suspension of egg yolk phosphatidylcholine. EtnPm inhibited iron- and copper-dependent peroxidation in the presence of preformed hydroperoxides, although it was not effective for radical initiator mediated lipid peroxidation. EtnPm resulted in complete binding of iron to liposomal lipids, suggesting that EtnPm exerts its inhibitory effect on lipid peroxidation through inhibiting preformed peroxide decomposition by trapping transition metal ions.

[Criteria of limited operation for bronchial carcinoid]

The purpose of this study is to establish criteria of limited operation for bronchial carcinoid. Ten cases surgically treated in our hospital and 47 cases reported in Japan from 1981 to 1992 were examined. Thirty-nine cases had typical carcinoid tumor and 18 had atypical. Limited operation, such as pulmonary segmentectomy, wedge resection or partial resection, was performed in 12 cases. In these, all patients of typical type were alive except for a case died of other disease. However, two patients of atypical type died of distant metastasis of the tumor. No lymph node metastasis was revealed in all cases of typical type. On the contrary, in cases of atypical type, six had n1 and two had n2 disease. Moreover, two cases with n1 disease had pulmonary metastasis. Therefore, patients with typical bronchial carcinoid can be cured by limited operation, but radical operation should be indicated for atypical bronchial carcinoid.

Purification and characterization of cycloinulooligosaccharide fructanotransferase (CFTase) from Bacillus circulans MCI-2554

Cycloinulooligosaccharide fructanotransferase (CFTase) that produces cyclofructan from inulin was purified about 69-fold from a culture broth of Bacillus circulans MCI-2554 by column chromatographies on DEAE-Toyopearl, QAE-Toyopearl, hydroxyapatite, and phenyl-Sepharose. The molecular mass of the enzyme was estimated to be 115 kDa by SDS-polyacrylamide gel electrophoresis and gel filtration, indicating a monomer structure. Maximal activity was observed at pH 7.5 and 45 degrees C. The enzyme was active from pH 5.5 to pH 9.5, and at temperatures up to 45 degrees C. The enzyme activity was inhibited by Fe2+ and Cu2+. A part of the amino acid sequence was identical with that of beta-fructofuranosidases of Zymomonas mobilis, carrot, Salmonella typhimurium, and mung bean.