Angiotropic B-cell lymphoma with hemophagocytic syndrome

A unique autopsy case of angiotropic lymphoma, which is a rare lymphoma characterized by the lymphoma cells confined in blood vessels and with a minimal involvement of lymph nodes, is presented. The clinical diagnosis was a malignant histiocytosis (histiocytic medullary reticulosis), since clinical manifestations were muscle weakness of the extremities, pancytopenia, fever and hepatosplenonephromegaly, and biopsy exhibited infiltration by histiocytic cells showing hemophagocytosis in the liver sinusoids and the bone marrow, the latter with myelofibrosis. Postmortem examination revealed lymphoma cell proliferation within small blood vessels of the kidneys, perineural tissue of extremities and lungs. Lymph nodes were not involved. In the liver, spleen and bone marrow, prominent infiltration of benign histiocytic cells with active hemophagocytosis was evident but there was no lymphoma cell infiltration. No viral infection, including Epstein-Barr (EBV), was demonstrable either serologically or immunohistochemically. Autopsy diagnosis was angiotropic lymphoma of B-cell origin (immunophenotypically CD 45+, CD 20-related+, CD 45R+, CD 45 RO-, CD 43-, CD 57-, CD 30-, CD 68-) accompanied by hemophagocytic syndrome clinicopathologically simulating malignant histiocytosis.

Effect of aging on urinary excretion of 18-hydroxycortisol

The secretion of aldosterone declines with age. We reported that sodium depletion increased urinary excretion of 18-hydroxycortisol (18-OH-F). To elucidate the effect of aging on urinary excretion of 18-OH-F, we measured urinary 18-OH-F in 30 normotensive subjects aged 20-70 yr. There were significant negative correlations between age and urinary excretion of 18-OH-F or of aldosterone (r = -0.49, r = -0.58, P < 0.05, respectively) but not of urinary free cortisol. These results suggest that angiotensin may contribute to chronic regulation of 18-OH-F.

Angiotensin II up-regulates the expression of type A endothelin receptor in human vascular smooth muscle cells

Using vascular smooth muscle cells, the effect of angiotensin II on endothelin receptor regulation was examined. Vascular smooth muscle cells cultivated from human pulmonary artery exhibited high affinity receptors for endothelin-1. When the cells were exposed to angiotensin II, the number of receptors was found to be increased without any change in their affinity. The ligand binding was effectively displaced by BQ123, a selective antagonist for type A endothelin receptor, but not by S6c, a selective ligand for type B receptor, in both control and angiotensin II-treated cells. The level of mRNA coding for the type A receptor was elevated in the latter. These results indicate that angiotensin II up-regulates type A endothelin receptors in human vascular smooth muscle cells through an increase in their corresponding mRNA, suggesting a link between the renin-angiotensin and the endothelin systems.

Induction of the renal pelvic and ureteral carcinomas by N-butyl-N-(4-hydroxybutyl)nitrosamine in SD/cShi rats with spontaneous hydronephrosis

We attempted to establish an animal model for renal pelvic and ureteral carcinomas. In Experiment 1, Sprague-Dawley (SD)/cShi and SD/gShi strains of male and female rats and Fischer-344 (F-344)/DuCrj and LEW/Crj strains of male rats, 6 wk old, were given 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) for 12 wk and then treated without chemical for 10 wk. Only the SD/cShi strain, which has spontaneous hydronephrosis and hydroureter, showed high incidences of carcinomas in the renal pelvises and ureters, whereas the other strains did not. In Experiment 2, SD/cShi and Crj:CD strains of male and female rats, 6 wk old, were exposed to 0.05% BBN for 20 wk. Both sexes of SD/cShi rats had high incidences of bilateral carcinomas in renal pelvises and/or ureters associated with urinary bladder carcinomas, whereas both sexes of Crj:CD rats had urinary bladder tumors only. These results indicate that the SD/cShi strain may be a suitable animal for the induction of renal pelvic and ureteral carcinomas that appear to depend on urine stagnation secondary to hydronephrosis and hydroureter.

Biosynthetic pathway of 19-noraldosterone in isolated rat glomerulosa cells

The biosynthetic pathway of 19-noraldosterone (19-noraldo) in isolated rat glomerulosa cells (GC) and fasciculata-reticular cells (FC) was studied by analyzing [14C]pregnenolone metabolism using HPLC and quantification by specific RIA. In GCs, 18,19-dihydroxycorticosterone was detected after 15 min incubation with [14C]pregnenolone, 18-hydroxy-19-norcorticosterone was detected after 30 min and 19-noraldo was detected after 45 min before the appearance of an aldosterone peak. These three mineralocorticoids were not detected in FCs. The results demonstrate that 19-noraldo is synthesized in GCs and then undergoes further metabolism.

Gene expression of 11 beta-hydroxysteroid dehydrogenase in the mesenteric arteries of genetically hypertensive rats

11 beta-Hydroxysteroid dehydrogenase (11 beta-HSD) modulates the access of corticosteroids to their receptors and plays an important role in controlling blood pressure. We determined 11 beta-HSD activity and mRNA levels in the mesenteric arteries of genetically hypertensive rats, the Dahl salt-sensitive hypertensive rat, and compared them with Dahl salt-resistant and Sprague-Dawley rats. 11 beta-HSD activity was expressed as the percent conversion of [3H]corticosterone to [3H]11-dehydrocorticosterone. 11 beta-HSD activity was significantly decreased in the mesenteric arteries of 8-week-old Dahl salt-sensitive hypertensive rats (11.4 +/- 1.4%) compared with Dahl salt-resistant rats (17.4 +/- 1.4%) or Sprague-Dawley rats (18.0 +/- 1.5%) of the same age (P < .05). There were no significant differences in 11 beta-HSD activity between 4-week-old Dahl salt-sensitive hypertensive and Dahl salt-resistant rats of the same age (15.3 +/- 1.3% and 15.1 +/- 1.9%, respectively). The concentration of 11 beta-HSD mRNA in the mesenteric arteries of 8-week-old Dahl salt-sensitive hypertensive rats was significantly lower than in Dahl salt-resistant or Sprague-Dawley rats of the same age (P < .05). There were no significant differences in the concentration of 11 beta-HSD mRNA in the mesenteric arteries of 4-week-old Dahl salt-sensitive hypertensive rats, Dahl salt-resistant rats, and Sprague-Dawley rats. These results indicate that 11 beta-HSD in the vascular wall may play a role in the pathogenesis of hypertension in this rat model.

Type IV collagen in hypertrophic cardiomyopathy

Basement membrane of myocytes from patients with hypertrophic cardiomyopathy who died suddenly, seemed to be discontinuous by immunohistochemical methods. With the use of the sandwich immunoassay technique, we determined the frequency of type IV collagen and its influence on functional abnormality in 31 patients with hypertrophic cardiomyopathy and controls. Hypertrophic cardiomyopathy exhibited significantly increased serum type IV collagen compared with controls. A significant correlation was observed between serum type IV collagen and fractional shortening (r = -0.42 p < 0.05), and end-diastolic volume (r = 0.40 p < 0.05), DT (r = -0.50 p < 0.05). These data suggest that serum type IV collagen enhances clusters of cell-surface type IV collagen, including an alteration of the cytoskeleton, which may account for functional abnormalities in hypertrophic cardiomyopathy. Considering the fact that microscopic examination is unable to resolve the structure of the myocardial basement membrane, measurement of serum type IV collagen is thought to be useful in the diagnosis of myocardial basement membrane injury and the progression of hypertrophic cardiomyopathy.

Detection of anomalous origin of the left coronary artery by transesophageal echocardiography and magnetic resonance imaging

Anomalous origin of the left coronary artery can lead to angina pectoris, acute myocardial infarction or even sudden death, especially during exercise. We present a patient in whom the anomalous origin of the left coronary artery from the posterior aortic (non-coronary) sinus produced ischemic chest pain. The anomaly was identified by transesophageal echocardiography (TEE) and magnetic resonance imaging (MRI) as well as by coronary angiography. TEE and MRI are useful for detecting anomalies of the coronary artery both clearly and noninvasively and for evaluating the mechanism of ischemia.

Expression of PC2 and PC1/PC3 in human pheochromocytomas

Expressions of two Kex2-related proteases, Pc2 and PC1/PC3, and of one of their possible substrates, proenkephalin, were examined in normal (n = 7) and various pathological (n = 48) human adrenal tissues. Northern blot analysis detected the expression of these genes in pheochromocytomas only. In the 20 pheochromocytomas studied with this technique, PC2, PC1/PC3 and proenkephalin were expressed in 85%, 50% and 90%, respectively. The presence of PC2 and PC1/PC3 was further confirmed using the sensitive RT/PCR techniques. Other evidence of human tumoral adrenal medullary PC2 expression was provided by in situ hybridization and immunohistochemistry. In addition, proenkephalin was expressed only in the pheochromocytomas expressing PC2 and/or PC1/PC3. These results demonstrate that functional Kex2-related endoproteases are expressed in human pheochromocytomas and may be involved in the processing of proenkephalin.

Increased feline cerebral blood flow induced by dehydroevodiamine hydrochloride from Evodia rutaecarpa

Dehydroevodiamine hydrochloride (0.1-0.3 mg/kg iv), which was isolated from the leaves of Evodia rutaecarpa, increased the cerebral blood flow recorded from the surface of the supra-sylvian gyrus in anesthetized cats. This action reached a maximum 1-4 min after injection and continued for 10 min. However, the compound had negligible effects on other cardiorespiratory functions at the doses examined. These results suggest that the compound selectively increases cerebral blood flow.

Effect of glycyrrhizin on cortisol metabolism in humans

Urinary cortisol and cortisone excretion were measured after glycyrrhizin administration (225 mg/day, per os) for seven consecutive days in five healthy volunteers. The ratio of plasma cortisol and cortisone during hydrocortisone (0.6 mg/kg i.v.) infusion was also examined. After glycyrrhizin administration, the urinary cortisone to cortisol ratio was significantly decreased, but the ratio of plasma cortisol to cortisone was not significantly altered. Glycyrrhizin inhibited 11 beta-hydroxysteroid dehydrogenase in the kidney and so inhibited the conversion of cortisol to cortisone. The increased cortisol in the kidney could be the cause of the apparent mineralocorticoid excess syndrome induced by glycyrrhizin.

[Analysis of synthetic corticoids by high performance liquid chromatography]

High performance liquid chromatography (HPLC) has been developed to analyze the synthetic corticoids (SCS) in human biological fluids. First, steroid moiety was extracted with a chemical solvent and/or an octadecylsilan (or diatomaceous earth) column, then the extracts were separated on the ordinary or reversed phase HPLC column with ultraviolet detection, at 254 nm. The total automatic system for the HPLC method has improved the accuracy and precision of SCS measurement for clinical use. Protein binding and free steroids, assayed by HPLC in plasma and saliva of the subjects treated with SCS may relate to steroid sensitivity. On the other hand, the simultaneous analysis of the metabolites of SCS in urine and other fluids reveals the clinical activity of the given SCS. HPLC analysis can therefore be utilized for evaluation of SCS pharmacodynamics.

Influences of aging and sex on renal pelvic carcinogenesis by N-butyl-N-(4-hydroxybutyl)nitrosamine in NON/Shi mice

Influences of aging and sex on renal pelvic carcinogenesis induced by N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) were examined in 6-, 15 -and 45-week-old male and female NON/Shi mice. Histopathological examination revealed an age-related shortening of induction time for renal pelvic carcinomas in males, although actual incidences did not increase. The histological patterns of carcinomas induced in both renal pelvis and urinary bladder demonstrated male mice to be more prone to develop transitional cell carcinomas, while squamous cell carcinomas were more likely to arise in females. Moreover, the sex factor appeared to influence the progression of both renal pelvic and urinary bladder carcinomas.

[Pre-clinical Cushing's syndrome: report of a case and the review of the literature]

Among 838 consecutive patients who underwent abdominal CT scan, adrenal incidentalloma was detected in 41 cases (4.7%). We performed high (8 mg/day) and low dose (2 mg/day) dexamethasone (DXM) suppression test and diurnal rhythm of plasma cortisol in these patients. Autonomic cortisol production was observed in one hypertensive patient in whom Cushigoid appearance was absent, suggesting pre-clinical Cushing's syndrome. We reviewed the endocrine results of the 65 reported cases of pre-clinical or non-Cushigoid Cushing's syndrome in world and Japanese literature. Urinary cortisol excretion was normal in 77%, plasma cortisol rhythm was absent in 70%, and high dose DXM failed to suppress plasma cortisol in 95% of cases. Plasma ACTH and cortisol showed subnormal to low responses to CRF administration similar to overt Cushing's syndrome. Therefore, CRF-test alone was considered insufficient to differentiate the two disorders. Hypertension and glucose intolerance were present in approximately 50% of cases in otherwise asymptomatic patients. Post-surgical steroid replacement was required in 55% of cases in Japan and in 75% of the cases world-wide. Women were affected more with pre-Cushing's syndrome than men. Peak incidence of the pre-Cushing's syndrome in women was in the forties which was older than that of overt Cushing's syndrome, suggesting that pre-Cushing's syndrome is not the predisposing condition to clinically symptomatic Cushing's syndrome. We consider that endocrine test is necessary in incidentally discovered adrenal tumors to exclude the presence of pre-clinical Cushing's syndrome.

Effect of phenacetin pretreatment on renal pelvic carcinogenesis by N-butyl-N-(4-hydroxybutyl)nitrosamine in NON/Shi mice of both sexes

Influences of phenacetin (PH) pretreatment on renal pelvic carcinogenesis induced by N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) were examined in NON/Shi mice of both sexes. Histopathological examination revealed that PH pretreatment enhanced not only the induction of urinary tract carcinoma but also distant metastasis of renal pelvic carcinoma by BBN in male mice. The high incidence of urinary tract carcinoma by PH pretreatment might be due to hydronephrosis and epithelial proliferative lesions enhanced by PH, since a single treatment of PH induced hydronephrosis in all mice and simple hyperplasia in 70-80% of mice used.

Tissue-specific expression of isoaspartyl protein carboxyl methyltransferase gene in rat brain and testis

Isoaspartyl protein carboxyl methyltransferase (PIMT) is widely distributed in mammalian tissues. Using a polymerase chain reaction-generated 124-bp DNA fragment from brain cDNA as a probe, four different sizes (approximately 4.0, 2.5, 1.7, and 1.1 kb) of transcripts were detected with northern blot analysis. They were expressed predominantly in rat brain and testis. The major transcripts were 2.5 and 1.7 kb in the brain and 2.5 and 1.1 kb in the testis. One of the major transcripts specific to the testis (1.1 kb) was determined to study the structural difference of major transcripts in the two tissues. This testicular cDNA had neither the 5' (94 nucleotides) nor the 3' (594 nucleotides) end of previously reported brain cDNA corresponding to 1.7 kb. The mRNA levels and enzyme activities of different regions and developmental changes were examined in the brain. The mRNA levels and enzyme activities were concomitantly high in cerebral cortex and hippocampus. Although they increased rapidly approximately 30 days after birth in the testis and decreased in aged rats, they increased gradually after birth and remained high during the aging of the brain. Both structural and developmental studies show that the expression of the PIMT gene in brain and testis is regulated in a tissue-specific manner.

Decreased activity of 11 beta-hydroxysteroid dehydrogenase in mesenteric arteries of Dahl salt-sensitive rats

11 beta-Hydroxysteroid dehydrogenase (11 beta-HSD) activity in mesenteric arteries of 4-week- and 8-week-old Dahl rats was determined to evaluate the relationship between glucocorticoids and norepinephrine in hypertension, 11 beta-HSD activity (expressed as the percentage conversion of 3H-corticosterone (B) to 3H-11-dehydrocorticosterone (A)) significantly decreased in 8-week-old Dahl salt-sensitive (DS) rats (11.4 +/- 1.4%) compared with Dahl salt-resistant (DR) rats (15.3 +/- 0.3%) (p < 0.05) when each group was fed a high-sodium chow (7%) for 4 weeks. There were no significant differences in 11 beta-HSD activity in the 4-week-old DS and DR rats. The enhanced response of mesenteric arteries to norepinephrine was observed only in 8-week-old DS rats. Our results suggest that a decreased 11 beta-HSD activity in the vascular walls contributes to the increased response of norepinephrine by local increment of glucocorticoids in DS hypertensive rats.

Frequency of renin gene restriction fragment length polymorphism in hypertensives with a genetic predisposition to hypertension

The genetic basis of essential hypertension is still uncertain. Because renin is thought to be a candidate gene for essential hypertension, a prospective study was conducted to compare the frequency of renin gene HindIII restriction fragment length polymorphism (RFLP) in normotensive and hypertensive subjects without (HTG-) and with a genetic predisposition to essential hypertension (HTG+). The frequency of the 9.0-kb fragment was significantly (p < 0.05) higher in the HTG+ group than in the normotensive and HTG- groups. An association between renin RFLP and hypertension in man was shown for the first time. It is suggested that a gene for blood pressure regulation has been localized to a part of the genome close to, or identical to, the renin locus.

Expression of 11 beta-hydroxysteroid dehydrogenase mRNA in rat vascular smooth muscle cells

The enzyme 11 beta-hydroxysteroid dehydrogenase (11-HSD) converts corticosterone to the inactive 11-dehydrocorticosterone in the rat. The bioactivity of 11-HSD, expressed as the percentage conversion of 3H-corticosterone to 3H-11-dehydrocorticosterone, was 13.7 +/- 0.4% in rat vascular smooth muscle cells (rVSMC). Cells treated with 100 nM dexamethasone (Dex) showed a 1.4-fold (p < 0.05) increase in 11-HSD activity. Insulin (100 microM) decreased 11-HSD activity by 0.8-fold (p < 0.05). Expression of 11-HSD mRNA was also confirmed in rVSMC by Northern blot analysis. Dexamethasone increased and insulin decreased the levels of 11-HSD mRNA in parallel with the increase in bioactivity. Vascular smooth muscle cells express 11-HSD activity; the access of corticosterone to vascular smooth muscle receptors may be modulated by the enzyme.