A nonpathogenic GAAGGA repeat in the Friedreich gene: implications for pathogenesis

An individual with late-onset ataxia was found to be heterozygous for an unusual (GAAGGA)65 sequence and a normal GAA repeat in the frataxin gene. No frataxin point mutation was present, excluding a form of Friedreich ataxia. (GAAGGA)65 did not have the inhibitory effect on gene expression in transfected cells shown by pathogenic GAA repeats of similar length. GAA repeats, but not (GAAGGA)65, adopt a triple helical conformation in vitro. We suggest that such a triplex structure is essential for suppression of gene expression.

Electropharmacological effects of UK-1745, a novel cardiotonic drug, in guinea-pig ventricular myocytes

Effects of (2RS, 3SR)-2-aminomethyl-2,3,7,8-tetrahydro-2,3,5,8, 8-pentamethyl-6H-furo-[2,3-e] indol-7-one hydrochloride (UK-1745), a novel cardiotonic drug with beta-adrenoceptor blocking property and antiarrhythmic activity, on the action potentials of isolated papillary muscles and the membrane currents of single ventricular myocytes of guinea pigs were examined and compared with those of milrinone using conventional microelectrode and patch-clamp techniques. In papillary muscles, UK-1745 (3-100 microM) produced a mild positive inotropic response and depressed the maximum upstroke velocity of the action potential (V(max)) at 100 microM. Milrinone, a phosphodiesterase III inhibitor, markedly shortened the action potential duration with a significant increase in developed tension. In enzymatically-dissociated ventricular myocytes, UK-1745 failed to increase the L-type Ca(2+) current (I(Ca)) at 10 and 30 microM and rather decreased I(Ca) at 100 microM. The high concentration of UK-1745 slightly inhibited the delayed rectifier K(+) current (I(K)). Although UK-1745 antagonized the isoproterenol-induced increase in I(Ca), it potentiated the histamine-induced increase in I(Ca). On the other hand, milrinone per se significantly increased I(Ca) and markedly enhanced the isoproterenol-induced increase in I(Ca). It can be concluded that UK-1745 is a unique cardiotonic drug possessing beta-adrenoceptor blocking and weak phosphodiesterase-inhibitory actions in addition to direct inhibitory actions on the Na(+), Ca(2+) and K(+) channels with its high concentrations.

Characteristics of intracardiac potentials at successful ablation sites in concealed Wolff-Parkinson-White syndrome

The authors investigated bipolar electrograms recorded from the catheter tip at the actual successful ablation sites in 22 consecutive patients with concealed Wolff-Parkinson-White syndrome to clarify the characteristics of the potentials indicating the optimal site for catheter ablation. In all patients the retrograde transaortic approach to their left-sided accessory pathways, and a temperature-controlled (60 degrees C) energy delivery, were performed. The authors assumed that a shorter dissociation time (time from energy delivery to ventriculoatrial conduction dissociation) indicated more accurate catheter mapping. A significant negative correlation (r = 0.527, p < 0.05) between the AV ratio (ratio of the amplitudes of the atrial to ventricular potentials) recorded at the ablation catheter tip and the dissociation time was observed. When the AV ratio and the dissociation time were compared among the groups classified according to the corresponding Npeak (the number of positive potential peaks in the electrogram obtained from the ablation catheter tip during right ventricular apical pacing) value, they differed significantly (p < 0.05 and p < 0.01, respectively), ie, a higher AV ratio and a shorter dissociation time related to a multipeak electrogram from the ablation catheter tip. The authors conclude that the atrial insertion site of the accessory pathway, exhibiting a multipeak complex electrogram that may represent nonuniform anisotropic characteristics, is an adequate ablation site.

Presence of ganglia within the prostatic capsule: ganglion involvement in prostatic cancer

BACKGROUND

The presence of ganglia within the prostatic capsule (capsular ganglia) is a poorly understood phenomenon. If cancer invasion into or around ganglia is identified in a needle biopsy specimen, such a finding may be diagnosed as an extraprostatic extension. In this study, the presence of capsular ganglia was clarified. Furthermore, we discuss the significance of these ganglia in prostatic cancer patients.

METHODS

The study group comprised a total of 42 patients, who had all undergone a radical prostatectomy for prostate adenocarcinoma with a relatively small volume. After surgery, the step-sectioned radical prostatectomy specimens were histologically evaluated.

RESULTS

In 22 of 42 cases, capsular ganglia were recognized. With respect to the distribution of the capsular ganglia, the ganglia were most frequently observed at the posteriolateral aspect of the prostatic base. Morphologically there were no obvious differences between the capsular and periprostatic ganglia. Moreover, in 3 of 5 cases with cancer involvement into the capsular ganglia, such involvement was not predictive of extraprostatic extension.

CONCLUSIONS

The presence of capsular ganglia needs to be clarified in prostatic cancer patients. Our findings therefore suggest that cancer involvement either in or around the ganglia should not be immediately interpreted as indicating an extraprostatic extension, if such a finding is recognized in a needle biopsy specimen.

[Clinicopathological analysis of transition zone cancer of the prostate: the clinical significance of coexistent non-transition zone cancer foci]

BACKGROUND

Dominant cancer of transition zone origin of the prostate (TZ cancer) has been frequently detected, because ultrasound-guided systematic biopsies have been generalized. In cases of TZ cancer, we attempted to determine clinical significance of coexistent non-TZ cancer foci.

MATERIALS AND METHODS

Twenty cases with TZ cancer who underwent radical prostatectomy or cystoprostatectomy were clinicopathologically evaluated using step-sectioned specimens.

RESULTS

In TZ cancer foci, there were extraprostatic extension in 5 cases (25%), seminal vesicle invasion in 2 cases (10%), positive surgical margin in 6 cases (30%) and bladder neck invasion in 4 cases (20%). The extraprostatic extension and the positive surgical margin occurred at the anterior or anterioapical portion of the prostate in all the cases. On the other hand, 17 (85%) had coexistent non-TZ cancer foci. In non-TZ cancer foci, there were extraprostatic extension in 3 cases (15%), seminal vesicle invasion in 1 case (5%) and positive surgical margin in 1 case (5%). The extraprostatic extension and the positive surgical margin occurred at the posteriolateral portion of the prostate in all the cases. In 3 cases a coexistent non-TZ cancer focus showed the extraprostatic extension, the seminal vesicle invasion or the positive surgical margin, although a TZ cancer focus were organ-confined.

CONCLUSION

We should add attention to coexistent non-TZ cancer foci in TZ cancer cases. Particularly, we believe that pre-operative evaluation of non-TZ cancer foci is needed in TZ cancer cases of the candidates for nerve-sparing radical prostatectomy.

Localization effects of acetylcholine release from a synaptic vesicle at the neuromuscular junction

A two-dimensional compartment model devised for the appropriate representation of the transient process of the spontaneous generation of miniature endplate current (MEPC) at the neuromuscular junction is applied for clarifying the biochemical significance of the quantal release mechanism of acetylcholine (ACh), a typical neurotransmitter, in the synaptic chemical transmission process. The simulation analysis with the model demonstrates that the localization of the ACh release due to the fusion of a synaptic vesicle with the presynaptic membrane has significant effects on the amplitude of MEPC and that the stronger effects are caused with the smaller diffusion coefficients of ACh in the cleft. The sharpest and highest response of MEPC is achieved when the release area is about 4 times to the natural release through the narrow pore. On the other hand, the actual localization corresponding to the natural release of ACh makes the amplitude of MEPC higher by a factor about 2.5 compared with that in the most extended release of ACh examined, implying that the natural release mechanism works as an amplifier of the MEPC with the fixed amount of ACh available.

A practical object-oriented approach to a development of a next generation hospital information system

KIND (stands for Kyushu university hospital Information Network Database) is a five years project, which aims to provide integrated services for patients, physicians, researchers and other hospital staffs. The final product of KIND is a next generation hospital information system. A physicians' clinical workstation, for example, integrated into a secured medical information network, can electronically develop a longitudinal medical record and interface with pharmacies, laboratories, medical specialists, and radiologists, as well as develop patient census and demographic profiles, in addition to doing electronic claims. Since clinical requirements on those medical records may vary for each case, we would like to have an essential data model under the hood. We decided to introduce domain analysis method to produce a relevant domain model. A domain analysis method captures the nature of business and helps us have an essential and extensible data model. Although there are several ways to describe a domain model, we chose an object-oriented description and consequently implementation using an object-oriented database system. Once we could have a decent domain model and implemented it as an object-oriented data model, application programs can utilize those data very easy without worrying extra efforts like finding complex queries including multiple joins. More over, if an application uses decent object-oriented technologies, it allows a user to access whole aspects of data transparently. This paper describes the architecture of KIND (the system) and outlines our domain model. In this paper, we also describe a practical application of several object-oriented technologies to develop a next generation hospital information system.

Direct observation of fibrinogen-heparinoid complexes formation using surface plasmon resonance

We analyzed the binding of heparinoid or heparin with fibrinogen by real-time measurement using surface plasmon resonance technology. Poly(glucosyloxyethyl methacrylate) sulfate [poly(GEMA) sulfate] and dextran sulfate were used as heparinoids. The binding ability of each sulfated polymer was estimated by having each polymer-containing buffer interact with the sensor chip surfaces that had immobilized fibrinogen. Dextran sulfate and poly(GEMA) sulfate showed high affinity to the fibrinogen in this experiment, while the heparin did not. All of the dextran sulfates were desorbed from its surface, while about 30% of the poly(GEMA) sulfate remained on the immobilized fibrinogen upon the addition of NaCl to the buffer which was done in order to analyze the desorption of poly(GEMA) sulfate or dextran sulfate from the surface of the fibrinogen. These data show that the type of binding between fibrinogen-poly(GEMA) sulfate was different from that of dextran sulfate, indicating that the interaction between fibrinogen and poly(GEMA) sulfate was caused not only by an electrostatic but also by a hydrophobic force. These results suggest that the interaction mechanism of heparinoids with fibrinogen was different from that of heparin.

Sticky DNA: self-association properties of long GAA.TTC repeats in R.R.Y triplex structures from Friedreich's ataxia

A novel DNA structure, sticky DNA, is described for lengths of (GAA.TTC)n found in intron 1 of the frataxin gene of Friedreich's ataxia patients. Sticky DNA is formed by the association of two purine.purine.pyrimidine (R.R.Y) triplexes in negatively supercoiled plasmids at neutral pH. An excellent correlation was found between the lengths of (GAA.TTC) (> 59 repeats): first, in FRDA patients, second, required to inhibit transcription in vivo and in vitro, and third, required to adopt the sticky conformation. Fourth, (GAAGGA.TCCTTC)65, also found in intron 1, does not form sticky DNA, inhibit transcription, or associate with the disease. Hence, R.R.Y triplexes and/or sticky DNA may be involved in the etiology of FRDA.

Use of bone turnover marker, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), in the assessment and monitoring of bone metastasis in prostate cancer

BACKGROUND

We investigated whether a new marker of bone turnover, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), could be useful in the assessment of bone metastasis and in monitoring of the response to treatment in patients with prostate cancer with bone metastasis.

METHODS

In all, 58 patients with prostate cancer (25 with bone metastasis and 33 without bone metastasis) and 52 patients with benign prostate hypertrophy who were treated between June 1994-August 1997 were included in this study. All patients were newly diagnosed.

RESULTS

Serum ICTP levels in patients with prostate cancer with bone metastasis were significantly higher than those in patients with prostate cancer without bone metastasis (P<0.0001) or with benign prostate hypertrophy (P<0.0001). No significant differences were observed in serum ICTP levels between patients with prostate cancer without bone metastasis and those with benign prostate hypertrophy. Serum ICTP levels correlated significantly with Soloway's grading system for bone scans. Serum ICTP levels in patients with bone metastasis showed a significant downward trend in response to hormonal treatment.

CONCLUSIONS

The determination of serum ICTP levels is useful in the assessment of bone metastasis and in monitoring the response of bone metastasis to treatment to prostate cancer.

Neural response of mechanoreceptors to acute inflammation in the rotator cuff of the shoulder joint in rabbits

We examined with electrophysiological techniques the effects of experimentally induced inflammation on the mechanosensitive afferent units in the rotator cuff of the shoulder joint of 21 rabbits. We identified 21 mechanosensitive units belonging to group III. 12 units had mechanical thresholds of > 7.0 g and 9 units had thresholds of < 7.0 g. After injection of inflammatory agents, kaolin and carrageenan, into the joint space, ongoing afferent discharge rates increased in all units. The average discharge rate increased significantly from 7 imp/s to 15 imp/s after injection. 5 units had a decreased mechanical threshold after the injection. Acute inflammation seems to have an excitatory and sensitizing effect on the high- and low-threshold units in the rotator cuff.

Relationship between acute insulin response and vitamin K intake in healthy young male volunteers

To evaluate the effects of vitamin K (VK) on pancreatic function, especially on acute insulin response, 25 healthy young male volunteers were given an oral load of 75 g of glucose, and their mean daily VK intake was estimated by a one-week food check list. After excluding low (<20) and high (> or =25) body mass index (BMI) subjects, the remaining 16 participants were divided into three semi-equal groups according to VK intake. Blood VK status of the low VK intake group tended to be poorer than that of the high intake group (median of 5 samples: prothrombin time; 12.5 vs 12.2s and protein-induced VK absence-factor-II; 23 vs 15 mAU/ml), but fasting plasma glucose status was not markedly different between both groups: [plasma glucose (PG); 87 vs 86 mg/dl, immunoreactive insulin (IRI); 6.7 vs 5.3 microU/ml, HbA1c; 4.8 vs 4.9%]. However, at 30 min after glucose loading, PG of the low VK intake group tended to be higher than those of the high intake group (160 vs 145 mg/dl) and IRI was lower (36.1 vs 52.3 microU/ml). Insulinogenic index (incremental IRI/incremental PG, 0-30 min) of the low VK intake group was significantly lower than that of the high intake group (0.4 vs 0.9). These results suggested that VK may play an important role on the acute insulin response in glucose tolerance.

Fusion variations of pancreatic ducts in patients with anomalous arrangement of pancreaticobiliary ductal system

Fusion variations of the pancreatic ducts were studied to elucidate the significance of such variations. We classified structural fusion anomalies of the main and accessory pancreatic ducts on endoscopic retrograde cholangio-pancreatography (ERCP) in 37 patients with anomalous arrangement of the pancreaticobiliary ductal system (AAPB). The fusion variations of the pancreatic ducts were classified into five types: common, ansa pancreatica, branch fusion, looped, and separated. These fusion variations, except for common type, were found in 68% of the 37 patients with AAPB on ERCP. Fusion variations of the pancreatic ducts were very frequent (93%) in the 30 patients with congenital cystic dilatation of the common bile duct (CCD). The branch confluence fashion, in which the terminal bile duct communicated with a pancreatic duct branch, was found only in patients with cystic dilatation cyst of the CCD, and it appeared that cystic dilatation cyst of CCD might differ from spindle or cylindrical cyst originating from embryonic formation of an anomalous confluence. It was also suggested that in patients with fusion variations of the pancreatic ducts, the flow of pancreatic juice might be disordered, leading to the development of acute pancreatitis or pancreatic dysfunction. Consequently, it appears to be necessary to carefully examine patients with AAPB for the presence or absence of any fusion variations of the pancreatic ducts and to observe such patients with long-term monitoring by ERCP, and computed temography, and with pancreatic function tests.

The effect of diet on blood vitamin K status and urinary mineral excretion assessed by a food questionnaire

To assess Vitamin K (VK) status by food questionnaire, healthy young males (32) and females (9) were given a food list of 50 VK rich foods (identified in the 4th edition standard tables of food composition in Japan). After checking the food names and approximate amount eaten for 7 days, early morning blood and urine samples were collected. Prothrombin and hepaplastin was tested and plasma protein induced by VK absence factor II (PIVKA-II), osteocalcin, and calcium, phosphorous and magnesium in plasma and urine were determined. Participants who have a habit of eating natto, a traditional Japanese food very rich in Vitamin K, VK were excluded, and lowest and highest VK consumers were compared (males; lowest 7 vs. highest 7, females; 3 vs. 3). Plasma PIVKA-II levels, and urinary calcium and magnesium excretion of the lowest was significantly higher, but urinary phosphorus was lower, than that of the highest in females. In the natto eaters, daily mean VK intakes and hepaplastin test results of natto eaters were significantly higher, but urinary calcium excretions were lower than that of non natto eaters in males. These results suggest that Daily VK intake estimated from a questionnaire, is well related to real VK status, and also that natto is a good dietary source of vitamin K.

Low vitamin K intake effects on glucose tolerance in rats

To investigate the effects of vitamin K (VK) on pancreatic function, intravenous glucose tolerance tests were performed in rats fed with and without low VK diet (including less than 20% required vitamin K1). Plasma glucose and immuno-reactive insulin (IRI) were determined. It was found that at 0 min., plasma glucose and IRI levels in low VK group were slightly less than in the control (glucose, 204.5 +/- 21.7 vs. 229 +/- 19.6 mg/dl, IRI, 6.6 +/- 1.3 vs. 9.3 +/- 1.8 ng/ml mean +/- SEM). At 3 min. after glucose administration, plasma glucose was higher (391.8 +/- 25.6 vs. 371.8 +/- 18.7 mg/dl) and IRI, lower (11.8 +/- 2.1 vs. 18.2 +/- 3.6 ng/ml) in the low VK group. The disappearance rate of plasma glucose in the low VK group at 5-10 min. was significantly less than in the control (6.7 +/- 2.2 vs. 11.9 +/- 1.8 mg/dl/min.). Incremental IRI area at 0 to 5 min. in the low VK group is less than in the control (15.2 +/- 4.4 vs. 25.0 +/- 9.1 ng/ml/min.), but at 5-60 min. and 0-60 min., it was found to be significantly higher compared to the control (210.3 +/- 55.2 vs. 32.5 +/- 47.1 ng/ml/min. at 5-60 min.). Dietary low VK intake would thus appear to induce a tendency of poor early insulin response, and late hyperinsulinemia to the glucose load in rats.

Surgical excision of a metastatic adrenal lesion in a patient with prostatic cancer

BACKGROUND

A 64-year-old Japanese man with stage D2 prostatic cancer, after having responded dramatically to androgen ablation, demonstrated a solitary adrenal metastasis without disease progression to any other site.

METHODS

A surgical excision of the lesion and adjuvant systemic chemotherapy was performed.

RESULTS/CONCLUSIONS

The patient has since remained alive without any evidence of recurrence 21 months after surgery.

Effect of aldose reductase inhibitors on glucose-induced changes in sorbitol and myo-inositol metabolism in human neutrophils

AIM

To investigate the influence of glucose and the efficacy of two different aldose reductase (AR) inhibitors, epalrestat and SNK-860, on the polyol pathway and myo-inositol metabolism in human neutrophils.

METHODS

We incubated neutrophils with various concentrations of glucose and AR inhibitors. The neutrophils from healthy volunteers were incubated in the media containing 5-40 mmol/l glucose with or without an AR inhibitor. The sorbitol and myo-inositol contents, and myo-inositol uptake were measured by high performance liquid chromatography and radio isotope technique with 2-[3H]-myo-inositol.

RESULTS

After 2 h incubation, the sorbitol content increased with rising extracellular glucose concentrations, while the myo-inositol content decreased. Both AR inhibitors reduced the sorbitol content in neutrophils exposed to 40 mmol/l glucose medium. A 70% fall in the myo-inositol content in neutrophils exposed to 40mmol/glucose medium was attenuated approximately 40% by the addition of AR inhibitors. myo-Inositol uptake into neutrophils was inhibited by high glucose. AR inhibitors significantly ameliorated the decrease in myo-inositol uptake, but did not completely normalize it.

CONCLUSIONS

Our present in vitro studies showed that the glucose-induced metabolic alterations in human neutrophils were similar to those in tissues prone to diabetic complications, and that AR inhibitors effectively corrected glucose-induced imbalances of the polyol pathway and myo-inositol uptake in neutrophils. In addition, our study suggests that glucose-induced metabolic alterations may result in the neutrophil dysfunction and that an AR inhibitor may be capable ameliorating it.

Aromatic L-amino acid decarboxylase- and tyrosine hydroxylase-immunohistochemistry in the adult human hypothalamus

The distribution of cell bodies immunoreactive for tyrosine hydroxylase and aromatic L-amino acid decarboxylase was studied in the adult human hypothalamus. Many neurons in the posterior (A11) and caudal dorsal hypothalamic areas (A13) as well as in the arcuate (A12) and periventricular (A14) zone were immunoreactive for the two enzymes, suggesting that they were dopaminergic. Numerous tyrosine hydroxylase-immunoreactive neurons, which were not immunoreactive for aromatic L-amino acid decarboxylase, could be seen in the paraventricular, supraoptic and accessory nuclei (A15) as well as in the rostral dorsal hypothalamic area. These were considered to be non-dopaminergic. Conversely, large numbers of small neurons immunoreactive for aromatic L-amino acid decarboxylase but not for tyrosine hydroxylase, were identified in the premammillary nucleus (D8), zona incerta (D10), lateral hypothalamic area (D11), anterior portion of the dorsomedial nucleus (D12), suprachiasmatic nucleus (D13), medial preoptic area and bed nucleus of the stria terminalis (D14). In the human hypothalamus, besides dopaminergic cell bodies, there exists a large number of tyrosine hydroxylase-only and aromatic L-amino acid decarboxylase-only neurons, whose physiological roles remain to be determined.

[Reproducibility and validity of a semi-quantitative food frequency questionnaire]

The reproducibility and relative validity of a semi-quantitative food frequency questionnaire (FFQ) were evaluated. Subjects were 72 (36 men and 36 women) residents of N island, Shimane Prefecture in Japan, aged 50-76 years. The questionnaire was administered twice at an interval of one week (FFQ1, FFQ2), and 7-day weighing diet records were collected during that period. This protocol was conducted in summer and winter. The mean intakes for 11 nutrients calculated from the FFQ1 and FFQ2 were similar and, those from the FFQ1 were smaller than those from the diet records for all but fat and vitamin C. Pearson correlation coefficients assessing reproducibility between nutrient intakes from FFQ1 and FFQ2 ranged from 0.59 for vitamin C to 0.90 for carbohydrate. Validity was measured by comparing nutrient intakes from FFQ1 with those from the 7-day diet record, and Pearson correlation coefficients ranged from 0.15 for iron to more than 0.35 for total energy and macronutrients. These correlation coefficients showed slight difference by gender or age group, but did not vary materially between seasons. These data indicate that this questionnaire is reproducible but has some problems in validity.

Mineral concentrations in the blood of male smokers and non-smoking males and females measured with fluoro-X-ray analyzer

For clarification of the effects of smoking on mineral absorption in red blood cells (RBC) and serum, their concentrations at these sites were examined in ten male smokers and 12 male and 10 female non-smokers by fluoro-X-ray analysis. K in serum was high, and P, Ca and Fe low, compared to RBC. Mg and S in serum and RBC were essentially the same. S, Mg, P and K in RBC of smokers were higher than in male non-smokers, and Ca was lower. S and Ca in serum of smokers were significantly lower than in male non-smokers. P in smokers was higher than in non-smokers. P in RBC may possibly activate the reflux of Mg into RBC and may suppress that of Ca. In smokers, the correlation coefficient (gamma) between Fe and Ca was r = -0.68 in RBC, and r = 0.76 in serum. Also gamma between P and Mg was r = 0.4 in RBC and r = -0.48 in serum. Thus Fe in RBC may suppress the reflux of Ca. Mg and Ca in serum of females were significantly higher than in male non-smokers. Ca in RBC of females was significantly higher than in male non-smokers, and P, K and Fe were significantly lower. The product of Ca and P in RBC of females was lower than in male non-smokers, while in serum it was higher. gamma between P and Ca, and between Fe and Ca in RBC of females were negative, while they were positive in male non-smokers. The correlations in female RBC had the same pattern as in male smokers.

Effects of platelet release products on neutrophilic Fc gamma receptors

Large and small macromolecular activators of phagocytosis from platelets (I-MAPP and s-MAPP, respectively), which function via the neutrophilic Fc gamma receptors (Fc gammaR) were refined from platelet release products by gel filtration and affinity chromatography with the use of an anti transferrin antibody column and the mechanism of phagocytosis activation was investigated. Flow cytometry revealed that 1-MAPP and s-MAPP did not increase the expression of neutrophilic Fc gammaRII (CD32) and Fc gammaRIII (CD16) antigens, whereas rosette formation of neutrophils with rabbit IgG-sensitized sheep erythrocytes (EA) in the presence of anti Fc gammaR antibodies suggested that both MAPPs increase the binding ability of Fc gammaRII. On the other hand, the enhancing effect of I-MAPP and s-MAPP on neutrophilic phagocytosis disappeared with the increase in phagocytosis by the phosphate-buffered saline control neutrophils when they were centrifuged with EA before incubation for phagocytosis. The enhanced phagocytosis, both by the two MAPPs and centrifugation, was canceled by treatment of the neutrophils with anti-CD32 Fab. The phagocytosis activatory effects of MAPP on neutrophils were canceled by anti-CD71 monoclonal antibody but not by transferrin.

Anticoagulant and antiprotease activities of a heparinoid sulfated glucoside-bearing polymer

We studied anticoagulant and antiprotease activities of the poly(glucosyloxyethyl methacrylate) sulfate [poly(GEMA)-sulfate] in plasma and purified enzyme systems in order to evaluate the anticoagulant behavior of a heparin-like sulfated glucoside-bearing polymer. As a result, we found that poly(GEMA)-sulfate can inhibit some coagulation proteases, although its antiprotease behavior differed from those of heparin and dextran sulfate. Poly(GEMA)-sulfate could not enhance antithrombin activity; therefore, we did not observe any significant inhibition of Factor Xa via antithrombin. However, we found that poly(GEMA)-sulfate was able to inhibit thrombin through the activation of heparin cofactor II. In addition, poly(GEMA)-sulfate was able to inhibit Tenase. In our previous research. we found that the anticoagulant activity of poly(GEMA)-sulfate is due primarily to the formation of an insoluble complex with fibrinogen. This paper showed that the antiprotease activities of poly(GEMA)-sulfate contribute to some extent to its anticoagulant activity.

Analysis of temporal expression pattern and cis-regulatory sequences of chicken pepsinogen A and C

Three groups of pepsinogens exist in vertebrates, namely, pepsinogen A, pepsinogen C, and prochymosin, which are produced at different developmental stages. In the chicken, prochymosin is expressed only in the embryonic stage, while pepsinogens A and C are secreted from adult chicken proventricular (glandular stomach) mucosa. In order to understand the mechanism of transcriptional regulation of these genes, we have cloned the genes encoding chicken pepsinogens A and C and analyzed the sequences possibly involved in their regulation. 5'-Upstream sequences of both genes contain putative binding motifs for transcription factors such as GATA, Sox, and HNF-3 beta, which are expressed in the chicken gut epithelium. Moreover, we found seven putative binding motifs for human MZF-1 in intron 8 of pepsinogen A gene. These transcription factors may act as regulators of expression of chicken pepsinogen genes.

Preparation of a novel functional hydrogel consisting of sulfated glucoside-bearing polymer: activation of basic fibroblast growth factor

Sulfated poly(glucosyloxyethyl methacrylate) [poly(GEMA)-sulfate] and its hydrogel were synthesized and evaluated to develop novel tissue regeneration assist devices. The poly(GEMA)-sulfate hydrogel was obtained by gamma-ray irradiation. Basic fibroblast growth factor (bFGF) was expected to be subsequently incorporated with hydrogel matrices and activated or released from the matrices. A sustained release of bFGF from the poly(GEMA)-sulfate hydrogel was not realized; however, bFGF from poly(GEMA)-sulfate hydrogel was effectively activated. Poly(GEMA)-sulfate hydrogels are thought to be potential component materials for a tissue engineering matrix.

Bradykinin B2-receptor-mediated modulation of membrane currents in guinea-pig cardiomyocytes

1. In order to define the electrophysiological mechanism(s) responsible for bradykinin (BK)-induced positive inotropic and chronotropic responses in isolated guinea-pig atria, effects of BK on the membrane currents were examined in isolated atrial cells using patch clamp techniques. 2. BK (0.1-1000 nM) increased the L-type Ca2+ current (I(Ca)), which was recorded from enzymatically-dissociated atrial myocytes by the nystatin-perforated patch method, in a concentration-dependent fashion, and the calculated EC50 value for increasing I(Ca) was 5.2 nM. In conventional ruptured patch experiments, BK inhibited the muscarinic acetylcholine receptor-operated K+ current (I(K.ACh)) that was activated by the muscarinic agonist carbachol (1 microM) with an EC50 value of 0.57 nM. Both the increase in I(Ca) and the decrease in I(K.ACh) were blocked by HOE140, a selective bradykinin B2 receptor antagonist. 3. The BK-induced inhibition of I(K.ACh) was significantly attenuated by staurosporine and calphostin C, protein kinase C inhibitors. In addition, the I(K.ACh) inhibition by BK was also attenuated by the tyrosine kinase inhibitor genistein or tyrphostin but not by daidzein, an inactive analogue of genistein. However, neither protein kinase C inhibitor nor tyrosine kinase inhibitor affected the BK-induced increase in I(Ca). 4. In the presence and absence of muscarinic stimulation, BK prolonged the action potential recorded from the atrial cells in the current clamp mode. 5. We conclude that BK increases I(Ca) and decreases I(K.ACh) in atrial cells, resulting in positive inotropic and chronotropic responses in atrial preparations. Protein kinase C activation, and possibly tyrosine kinase activation, may be involved in the B2-receptor-mediated I(K.ACh) inhibition.

The incidence and characteristics of silent cerebral infarction in elderly diabetic patients: association with serum-soluble adhesion molecules

The purpose of this study was to investigate the relationship between complications arising from silent cerebral infarction (SCI) and changes in the levels of serum-soluble adhesion molecules in 82 elderly diabetic patients aged 60 years and older. SCI was found in 43 % of the 82 patients, with incidence increasing in relation to age. The prevalence of SCI was higher in subjects with hypertension, poor metabolic control and increased fibrinolysis. The levels of soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin (sE-selectin) were higher in diabetic patients than in non-diabetic subjects (p < 0.05, p < 0.001, and p < 0.05, respectively). Also, sICAM-1 and sVCAM-1 were found at increased levels in diabetic patients with SCI compared to those without SCI (p < 0.01 and p < 0.05, respectively). In particular, the level of sICAM-1 was increased in patients with SCI due to perforating arterial occlusion, while the level of sVCAM-1 was increased in patients with SCI due to cortical arterial occlusion. However, no significant difference was found in sE-selectin levels. Overall average of the intima and media thickness (IMT) of the common carotid arteries increased with age. IMT proved to be greater in patients with SCI than in patients without SCI (p < 0.05), and showed a weak but significant positive correlation with sVCAM-1, while no correlation was found with either sICAM-1 or sE-selectin levels. In conclusion, measurement of serum adhesion molecules may be useful for diagnosing the early stages of brain damage and for prophylactic treatment which may prevent the onset or progression of SCI.

[Antitumor effect of human lactoferrin against newly established human pancreatic cancer cell line SPA]

This paper describes the antitumor effect of human lactoferrin against the human pancreatic cancer cell line SPA, which was newly established in our laboratory from a metastatic liver tumor of pancreatic origin. In tissue culture, the cancer cells proliferated rapidly at 16 hours of doubling time, and produced tumor markers into the culture medium at a high concentration. Subcutaneous and intraperitoneal transplantation of these neoplastic cells into nude mice resulted in tumor formation and carcinomatous peritonitis. The inhibitory effect of human lactoferrin on the cell growth of SPA was found both in vivo and in vitro. There was significant inhibition of cell growth in vivo at the concentration of 1 microgram/ml of hLf in the culture medium. And in the in vivo assay, hLf delayed the growth of subcutaneously transplanted tumors into BALB/c nude mice, and the effect was retained for two weeks. These results indicate the possibility that hLf will become one of the new drugs for adjuvant therapy against pancreatic cancer.

Immune responses of adenoidal lymphocytes specific to Haemophilus influenzae in the nasopharynx

OBJECTIVES

Investigate immune responses of adenoidal lymphocytes against outer-membrane protein P6 purified from nontypeable Haemophilus influenzae (HI). Clarify the role of adenoids in regulating the colonization of HI in the nasopharynx.

STUDY DESIGN

Microbiological and immunological examinations of adenoids obtained from 21 children, 15 boys and five girls, from 1 to 13 years of age (median, 5 y), suffering from adenoidal hypertrophy complicated by otitis media with effusion (OME).

METHODS

The incidence of HI in adenoids was compared with the number of P6-specific immunoglobulin (Ig) A-secreting cells in adenoids, determined by enzyme-linked immunoassay.

RESULTS

Quantitative culture assay showed significant correlation between the numbers of HI in adenoids and those in nasopharyngeal secretions (NS). In children aged 5 years and younger, the numbers of P6-specific IgA-secreting cells in adenoids were significantly correlated with IgA antibody titers in NS (r = 0.68, P < .05). The numbers of P6-specific IgG- and IgA-secreting cells were lower in children aged 6 years and older than in children aged 5 years and younger. Furthermore, the number of P6-specific IgA-secreting cells was significantly increased in HI-negative subjects when compared with HI-positive subjects (P < .05).

CONCLUSIONS

Adenoids play an important role as an effector site of the mucosal immune system in the upper respiratory tract. IgA immune responses in adenoids are responsible for the clearance of HI from the nasopharynx.

Differential expression of sea urchin Otx isoform (hpOtxE and HpOtxL) mRNAs during early development

Two distinct types of orthodenticle-related proteins (early type: HpOtxE, late type: HpOtxL) of the sea urchin, Hemicentrotus pulcherrimus, have been implicated as enhancer element binding factors of the aboral ectoderm-specific arylsulfatase (HpArs) gene. In order to understand the role of these isoforms during sea urchin development, we have isolated and characterized HpOtx gene. Here we describe the spatial expression patterns of HpOtxE and HpOtxL mRNAs and effects of overexpression of these mRNAs on embryogenesis. Whole-mount in situ hybridization using each isoform-specific probe reveals the complex and dynamic change of expression patterns among three germ layers. HpOtxE mRNA is maternally stored and exists apparently in a nonlocalized manner by the blastula stage. After hatching, HpOtxE transcripts are expressed predominantly in presumptive endoderm cells and gradually decrease during gastrulation. Signals for HpOtxL mRNA are intense at the vegetal half after hatching and subsequently, its expression is restricted to the micromere-derived cells. After primary mesenchyme cell (PMC) ingression, HpOtxL transcripts are localized at the vegetal plate and thereafter, concentrated primarily in ectoderm. Eggs injected with HpOtxE or HpOtxL mRNA develop into similar radialized structures without PMC ingression and gut invagination, whose oral-aboral axes are disrupted. Overexpression of HpOtxE induces accumulation of HpOtxL mRNA at the significantly earlier stages, though HpOtxL overexpression inhibits the accumulation of HpOtxE transcripts. Expression patterns of HpOtxE and HpOtxL in all three germ layers and dramatic morphological changes observed in the mRNA-injected embryos suggest that each HpOtx isoform has an important role in sea urchin embryogenesis.

Identification of a point mutation associated with a silent phenotype of human serum butyrylcholinesterase--a case of familial cholinesterasemia

A point mutation which caused a silent phenotype of human serum butyrylcholinesterase (BChE) was identified in the DNA of a 47-year-old Japanese woman who visited our hospital complaining of hypertension. The propositus exhibited an unusually low level of BChE activity, whereas her younger sister and her daughter had intermediate levels of BChE activity and her elder sister a normal level. Immunologically, the amount of BChE protein in the serum of the propositus was normal. DNA sequence analysis of the propositus identified a point mutation at codon 199 (GCA --> GTA), resulting in a Ala --> Val substitution. This alteration is one downstream codon from the catalytic active site (Ser, 198). A family study showed her younger sister and her daughter to have the same mutation.

[Clinical features and characteristics of paranasal sinus effusion in allergic sinusitis]

Plain paranasal sinus radiographs including occipitofrontal and occipitomental views often show abnormal shadows in patients with allergic rhinitis. For that reason, the relationship between chronic sinusitis and allergy has been discussed for many years. Type I allergy is thought to be involved in the sinusitis which is called allergic sinusitis. However, there is not enough information pertaining to this disorder. In order to determine the clinical feature and the characteristics of paranasal sinus effusion in allergic sinusitis, we investigated the differences between 20 patients with allergic sinusitis and 20 with non-allergic chronic sinusitis used as controls. Clinical symptoms (nasal discharge, nasal obstruction, headache, postnasal discharge) and anterior rhinoscopic findings (nasal discharge, nasal edema), clinical examinations (type of x ray maxillary sinus shadow, bacteriology of nasal discharge), and pathological features of the paranasal sinus effusion were examined and compared in the two kind of sinusitis. Pathological findings of the effusion sampled from 14 patients with allergic sinusitis and 15 with non-allergic sinusitis included the number of eosinophils, activated eosinophils and neutrophils, concentrations of interleukin (IL)-1 beta, IL-4, IL-5, IL-8, and concentrations of leukotriene C4/D4/E4 and prostaglandin E2. The incidence and degree of postnasal discharge as a symptom and a nasal finding were lower in allergic sinusitis patients than in the controls. Microorganisms were detected less frequently in the allergic group. The number of eosinophils, activated eosinophils and neutrophils was higher in the paranasal sinus effusion of the patients with allergic sinusitis. The concentrations (ng/mg of protein) of IL-1 beta and IL-8 showed no difference between the two groups, but IL-4, and IL-5 were more prevalent per mg of protein in the effusion of allergic sinusitis patients. These findings suggest that the clinical features of allergic sinusitis include a low incidence and degree of postnasal discharge and a low rate of detection of bacteria, and that the sinus effusion is characterized by the presence of more eosinophils, activated eosinophils, and IL-5 than in those of chronic sinusitis.

[A case of spastic paraparesis with mental deterioration and markedly thin corpus callosum--callosal dysfunction demonstrated by magnetic stimulation]

We have studied function of the corpus callosum in a patient with spastic paraparesis with mental deterioration and markedly thin corpus callosum using magnetic stimulation methods. In a 21-year-old woman with slowly progressive gait disturbance, neurological examination showed mental deterioration, euphoria, spastic paraparesis, bilateral Babinski's sign, and hyperesthesia caudal to the eighth thoracic level. No abnormalities were observed in electroencephalograms. Magnetic resonance imaging (MRI) studies of the brain showed cerebral cortical atrophy, markedly thin corpus callosum, and dilated cavum septum pellucidum and cavum Vergae, but spinal cord MRIs showed no abnormalities. The lysosomal enzyme activities, whose reduction was known to cause leukodystrophy, were all normal. Very long chain fatty acid was not increased in her blood, which is against adrenoleukodystrophy. She had no anti-HTLV-1 virus antibody. Based on these clinical features and the results of biochemical analyses, we diagnosed this patient as having spastic paraplegia associated with hypoplasia of the corpus callosum (Nojima and Iwabuchi). We performed three studies on the central motor pathways in this patient. The latencies of responses recorded from upper or lower limb muscles were all within the normal range, despite that the thresholds were slightly increased. This suggests that axonal degeneration occurs in the central motor pathways, which is consistent with the autopsy findings of a patient with hereditary spastic paraplegia associated with hypoplasia of the corpus callosum. Connection between the bilateral motor cortices was investigated by magnetic stimulation of both motor cortices. The suppression of the motor cortex evoked by stimulation of the contralateral motor cortex through the corpus callosum was absent in this patient. Intracortical inhibition within the motor cortex was demonstrated to be normal by a paired-magnetic stimulation technique. Based on the results of these results of these two experiments, we conclude that the function of the corpus callosum was disturbed in the present patient. This report first shows the functional abnormality of the extremely thin corpus callosum in a patient with hereditary spastic paraplegia associated with hypoplasia of the corpus callosum.

Availability of software services for a hospital information system

Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability of computers, in which all that matters is that the computer is functioning. It means the provision of necessary information for hospital operations by the computer software, and we will call it the availability of software services. HISs these days are mostly client-server systems. To increase availability of software services in these systems, it is not enough to just use system structures that are highly reliable in existing host-centred systems. Four main components which support availability of software services are network systems, client computers, server computers, and application software. In this paper, we suggest how to structure these four components to provide the minimum requested software services even if a part of the system stops to function. The network system should be double-protected in stratus using Asynchronous Transfer Mode (ATM) as its base network. Client computers should be fat clients with as much application logic as possible, and reference information which do not require frequent updates (master files, for example) should be replicated in clients. It would be best if all server computers could be double-protected. However, if that is physically impossible, one database file should be made accessible by several server computers. Still, at least the basic patients' information and the latest clinical records should be double-protected physically. Application software should be tested carefully before introduction. Different versions of the application software should always be kept and managed in case the new version has problems. If a hospital information system is designed and developed with these points in mind, it's availability of software services should increase greatly.

Effects of feedback inhibition on transit time in a linear pathway of Michaelis-Menten-type reactions

An analysis of the effects of external and internal metabolites on the steady-state behavior of linear pathways comprising a sequence of three Michaelis-Menten-type reactions with and without a simple feedback inhibition (i.e. an interaction of an internal metabolite with the pathway) is performed with respect to the transit time tau by its formulation as rectangular-hyperbolic functions of the flux J, instead of direct expressions in terms of the external metabolite concentrations. For a given concentration of the external metabolite M1 (substrate of the pathway) or M4 (product of the pathway), the flux J has a lower value in the pathway with feedback inhibition than in the pathway without feedback inhibition. With variation in the M1 concentration the transit time tau shows a concave relationship with the flux J which is virtually identical for both pathways, yielding a minimum at a certain value of J. With variation in the M4 concentration the transit time tau monotonously decreases with higher value of J, and for a given value of J the feedback inhibition allows a lower transit time. This effect is enhanced with stronger feedback inhibition, and is in turn greatly reduced with higher values of total concentration and rate constants for the first enzyme in the pathway.

Comparison of diets among elderly female residents in two suburban districts in Chiang Mai Province, Thailand, in dry season--survey on high- and low-risk districts of lung cancer incidence

By means of duplicate meals, we collected food samples of general female residents, aged 50 to 74 years at two suburban districts in Chiang Mai Province, which are distinguished by very high and low incidence rates of lung cancer. Then, on the basis of analyses of their consumption of foods by food groups, we compared their dietary habits in the dry season of northern Thailand with special reference to the difference in lung cancer incidence. In brief, the following features and difference in their dietary habits were found; 1) Rice, vegetables, and pork were most frequently eaten in both the districts. 2) Consumption of fruits, in both quantity and variety, at a high-risk district was much less than that at a low-risk district. 3) Female residents at a low-risk district consumed more variety of green and yellow vegetables than those at a high-risk district. 4). Potato was not found in food samples of a high-risk district. 5) confectionery was more prevalent in a low-risk district than at a high-risk district.

[A guide for the timing of peripheral blood stem cell harvest in patients with lung cancer]

Harvest of peripheral blood stem cells (PBSC) was performed 57 times in 17 lung cancer patients after standard-dose chemotherapy (cisplatin, etoposide) supplemented with granulocyte-colony stimulating factor (G-CSF). In every case, more than 1.5 x 10(6)/kg CD 34+ cells were collected by 2-5 apheresis. Statistical significance was noted between peripheral leukocyte counts (WBC) and collected CD 34+ cell counts (p = 0.0298), between peripheral platelet counts and collected CD 34+ cell counts (p = 0.0009), and between the peripheral immature granulocyte ratio and collected CD 34+ cell counts (p < 0.0001). Because of the remarkable relationship between collected CD 34+ cell counts and peripheral WBC counts, peripheral platelet counts and the peripheral immature granulocyte ratio, these parameters were useful for determining the correct timing of PBSC harvest.

[Immunohistochemical study on pulmonary neuroendocrine cells containing calcitonin gene-related peptide in sudden infant death syndrome]

To examine whether pulmonary neuroendocrine cells (PNEC) is associated with sudden infant death syndrome (SIDS), distribution and function of PNEC were investigated in infants from one to twelve months of age, including 19 cases with SIDS and 18 control cases without congenital heart disease and premature birth. In this study, lung tissue sections were immunostained with antibodies against chromogranin A (CGA) and calcitonin gene-related peptide (CGRP). Although the positivity of CGA in SIDS cases was not significantly different from that in control, the positivity of CGRP in SIDS cases was lower than that in control cases among one to four months old (p < 0.05). Our results suggest that respiratory and/or circulatory regulation of cases with SIDS is disturbed by reduction of CGRP expression, because CGRP is well known to be a vasodilator, a neurotransmitter and a promoter for proliferation of epithelium in airways.

Structure and function of a sea urchin orthodenticle-related gene (HpOtx)

Two distinct types of orthodenticle-related proteins (HpOtxE/L) have been implicated as transcription activators of the aboral ectoderm-specific arylsulfatase (Ars) gene. Here, we describe the structure of HpOtx gene and present evidence that mRNAs of HpOtxE/L are transcribed from a single HpOtx gene by altering the transcription start site and by alternative splicing. By transactivation experiments, we have also demonstrated that HpOtxL activates the Ars promoter in the gastrula-stage embryo.

Intra-articular osteochondroma of the ankle joint

Intra-articular osteochondroma is a rare entity that appears as a single giant osteocartilaginous loose body in a joint cavity. The few reported cases of intra-articular osteochondroma have occurred in the knee joint. We report the case of a large osteochondral loose body in the ankle joint of a 10-year old girl and discuss the origin of the osteochondral tumor.

Immunohistochemical detection of human milk components aspirated in lungs of an infant

We examined an autopsy case of an infant whose cause of death was suspected to be asphyxia due to human breast milk aspiration. In order to demonstrate aspirated milk in the lungs, we conducted immunohistochemical staining using eight antibodies against the components of human milk. Seven of the eight antibodies reacted positively with the substances suspected to be aspirated milk. We concluded that immunohistochemical staining with these antibodies is useful to demonstrate human milk aspiration and provide some keys for detecting the causes of unexpected infant deaths.

[Regional cerebral hypoperfusion reduces the effect of rectal midazolam in children with Moyamoya disease]

To investigate the effect of regional cerebral blood flow on the effect of midazolam, we evaluated 99mTc-hexamethylpropylene-amine-oxime-single photon emission computed tomography (SPECT) in 37 cases of childhood moyamoya disease. They were divided into two groups according to the findings of SPECT; one group showed hypoperfusion in the bifrontal regions (n = 20), and the other did not (n = 17). Both groups received 1 mg.kg-1 of midazolam transrectally 30 min before the anesthesia induction and level of sedation was measured with six point scales. Significantly lower level of sedation score was recognized in the group that showed hypoperfusion in bifrontal regions (P < 0.05). Our finding may suggest that regional cerebral hypoperfusion may modify the sedative effect of midazolam in children with moyamoya disease.