Divergent trophic actions of glioma conditioned media on cultured rat hippocampal neurons

Neuron-glia interaction is considered to be important for the establishment and maintenance of neuronal shape and polarity during development. Glial cells release a number of trophic factors, many of which have not been fully characterized. In the present study, the trophic influences of conditioned media (CMs) of four glioma cell lines (T98G, Hs683, AC, C6) were tested on cultured hippocampal neurons dissociated from fetal rat brain. The survival of hippocampal neurons was enhanced by C6-CM, but inhibited by T98G-CM. The elongation of neurites was remarkably potentiated by C6-CM and T98G-CM. The other two CMs had little effect on neuronal survival and neurite elongation. These results suggest that different glioma cell lines produce and release different kinds and/or amounts of neurotrophic factors. Our experimental method may provide a suitable assay system for the identification of unknown trophic factors.

Clinicopathological study of poststreptococcal glomerulonephritis in the elderly

In order to characterize the clinical features in elderly patients with poststreptococcal glomerulonephritis (PSGN), 31 patients, who were both histologically and immunologically proven to be PSGN, were divided up into 3 groups according to age; elderly patients being 55 years or older (n = 7), middle-aged patients being 40 to 54 years old (n = 7) and younger patients being 20 to 39 years old (n = 17). Renal functional impairment as indicated by serum creatinine levels of over 2.0 mg/dl, developed in 4 of the elderly patients and later completely improved at the end of the follow-up period (178.9 +/- 150.7 days). On the other hand, none of the middle-aged and younger patients revealed any renal function impairment. Hypertension was observed more frequently in elderly patients than in younger patients, and was 86% and 6% at the time of admission, respectively. In addition, 43% of elderly patients remained hypertensive at the time of discharge. There was no difference in total protein, ASO, CH50, the degree of proteinuria or proliferative and exudative features in renal histology among the three groups. None of the elderly patients with PSGN died or developed persistent renal failure. In conclusion, elderly patients with PSGN had a high incidence of renal functional impairment and hypertension compared to the younger patients on admission, however, their short-term prognosis seems to be favorable.

Case report: Wegener's granulomatosis accompanied by communicating hydrocephalus

A case of Wegener's granulomatosis (WG) accompanied by communicating hydrocephalus is described. An elderly woman with rapidly progressive renal failure was referred to the authors' hospital. Renal histologic study showed necrotizing granulomatous glomerulonephritis with some multinucleated giant cells, which suggested a diagnosis of WG. After admission, a gait disturbance, incontinence, and dementia developed in the patient. Diagnostic procedures including lumbar puncture, computed tomography (CT), and scintigraphy showed findings compatible with communicating hydrocephalus with a normal cerebrospinal fluid (CSF) pressure. Removal of 20 mL of CSF led to a marked improvement in symptoms. Because the presence of subarachnoid hemorrhage, meningitis, and brain tumor was excluded, the final diagnosis was communicating hydrocephalus secondary to WG.

Tandem mass spectrometry for characterization of unsaturated disaccharides from chondroitin sulfate, dermatan sulfate and hyaluronan

Fast atom bombardment tandem mass spectrometry has been used in the characterization of non-, mono-, di- and trisulfated disaccharides from chondroitin sulfate, dermatan sulfate and hyaluronan. The positional isomers of the sulfate group of mono- and disulfated disaccharides were distinguished from each other by both positive- and negative-ion fast atom bombardment tandem mass spectra, which gave sufficient information characteristic of the isomers. The anomeric isomers of nonsulfated disaccharides were characterized by the technique in the positive-ion mode. This fast atom bombardment collision induced dissociation mass spectrometry/mass spectrometry technique was also applied successfully to the characterization of trisulfated disaccharide.

TGF-beta 1 in glomerulosclerosis and interstitial fibrosis of adriamycin nephropathy

The role of transforming growth factor-beta 1 (TGF-beta 1) for renal injury was investigated in the chronic model of progressive renal disease in rats induced by the injection of adriamycin. The renal cortical tissues were sampled at weeks 4, 8 and 16 for histological examination, either cortical or glomerular cell culture, and RNA extraction. A progressive increase in fibronectin synthesis was found in metabolically labeled cortical or glomerular culture at week 8 or 16, correlating with the degree of glomerulosclerosis and interstitial fibrosis. TGF-beta bioassay (mink lung epithelial cell assay) showed a progressive increase in latent TGF-beta secretion from cortex and glomeruli, while the amount of active TGF-beta was small. The peak of latent TGF-beta levels at week 16 coincided with the intense TGF-beta 1 staining of inflammatory cells dispersed in the interstitium and glomeruli. Northern blotting demonstrated the difference in the mRNA expression patterns of TGF-beta 1 and latent TGF-beta 1 binding protein (LTBP) in the cortex. TGF-beta 1 mRNA was constantly high throughout the experiment, while LTBP mRNA increased progressively and reached a peak at week 16. Furthermore, mRNA levels of fibronectin, procollagen alpha 2(I), and TGF-beta type II and type III receptors increased progressively in a similar pattern to the renal histological changes. These temporal and spacial relationships between the renal histological changes and the increased expression of TGF-beta 1 and TGF-beta receptors may thus suggest that TGF-beta 1 plays an important role in the process of the renal fibrosis and sclerosis.

Inhibitory effects of antihypertensive drugs on mesangial cell proliferation after anti-thymocyte serum (ATS)-induced mesangiolysis in spontaneously hypertensive rats

The effects of antihypertensive drugs on mesangial cell proliferation were studied in spontaneously hypertensive rats (SHR) with anti-thymocyte serum (ATS)-induced glomerulo-nephritis. Rats were treated with either enalapril (Group 1), nifedipine (Group 2), or reserpine + hydrochlorothiazide + hydralazine (Group 3), or were untreated (Group 4). The animals were sacrificed 2, 4 and 7 days after ATS injection and the glomerular cell number and degree of mesangial area expansion were examined. A marked, similar decrease in glomerular nuclear cell number (NC) due to severe mesangiolysis was observed in all of the groups on day 2. Thereafter, an increase in NC reflecting mesangial cell proliferation after mesangiolysis occurred in Group 4 on days 4 and 7. In Group 1 and 2, the NC was significantly smaller than that in Group 4 on days 4 and 7, indicating suppression of mesangial cell proliferation. In Group 3, however, the number of NCs did not differ from that in Group 4 on days 4 and 7, indicating a lack of such suppression by conventional antihypertensive drugs. The degree of mesangial area expansion (MS) showed the same pattern as mesangial cell proliferation. That is, the rapid increases in MS seen in Group 4 on days 4 and 7 were apparently suppressed in Groups 1 and 2, but not in Group 3. Our in vivo observations that both an angiotensin converting enzyme (ACE) inhibitor and a calcium channel blocker suppress mesangial cell proliferation and mesangial area expansion suggest that these agents have practical implications in the treatment of mesangial proliferative glomerular diseases through the suppression of excess mesangial cell proliferation.

Alpha tocopherol improves focal glomerulosclerosis in rats with adriamycin-induced progressive renal failure

The effect of d-alpha-tocopherol on the progression of renal dysfunction was investigated in rats injected with adriamycin (ADR), a model of progressive glomerulosclerosis associated with the nephrotic syndrome. Treatment with d-alpha-tocopherol was started 1 day before or 1 day after ADR injections (BE-TOC or AF-TOC rats). When compared to rats without d-alpha-tocopherol treatment (ADR-CON rats), the serum total cholesterol and triglyceride levels were significantly lower in the BE-TOC and AF-TOC groups. In week 16, the LDL cholesterol level and the atherogenic index were both significantly lower in BE-TOC and AF-TOC rats than in ADR-CON rats. The urinary protein, serum creatinine, blood urea nitrogen, malondialdehyde, and systolic blood pressure levels as well as the glomerulosclerosis score were high in ADR-CON rats, and reduced in BE-TOC or AF-TOC rats. There were no significant differences in body weight and serum albumin between the three groups in week 16. It is concluded that d-alpha-tocopherol can improve hyperlipidemia and ameliorate glomerulosclerosis in rats with ADR-induced progressive renal failure. Thus, d-alpha-tocopherol may have the potential for clinical application to treat focal glomerulosclerosis.

The association of Helicobacter pylori with differentiated-type early gastric cancer

BACKGROUND

Recent studies have indicated that infection with Helicobacter pylori is closely associated with increased risk for gastric cancer. Previous studies, however, usually have been made on cases of advanced gastric cancer.

METHODS

The Congo red-methylene blue test was performed on 19 healthy subjects, 24 patients with early gastric cancer of differentiated type, and 17 patients with early cancer of undifferentiated type. H. pylori infection was examined by culture of biopsy specimens obtained from noncancerous antral mucosa.

RESULTS

H. pylori was detected in 19 (79%) of 24 patients with differentiated-type early gastric cancer, but in only 5 (29%) of 17 patients with undifferentiated-type early gastric cancer; this difference was statistically significant. It also was detected significantly more frequently in patients with differentiated cancers than in healthy subjects.

CONCLUSIONS

H. pylori infection was closely associated with differentiated-type gastric cancers, but not with undifferentiated types.

[A case of tuberculous meningitis with abnormal contrast enhancement of choroid plexus on CT and MRI]

A 55-year-old man first noted a swelling on his back in September 1990, when CT scan of his chest suggested a pleural fistula and a cold abscess. In the following month, he became pyrexial and felt nauseated with headache. Subsequently he was transferred to our hospital. Results of neurological examination were abnormal only in that he had neck stiffness and bilateral nystagmus with drowsiness. Cerebrospinal fluid (CSF) showed turbid yellowish fluid with an opening pressure of 360 mmH2O, a protein content of 173 mg/dl, a glucose level of 19 mg/dl, and a white blood cell count of 3,024/ml (75% polymorphs, 25% lymphocytes). Tryptophane test was positive. No bacteria, fungi or acid-fast bacilli were seen on direct smear. Adenosine deaminase activity in CSF was 13.9 IU/l. Antibiotics, antituberculous drugs, corticosteroids and glycerol were administered. The clinical course in the hospital was satisfactory for the next two months, but a contrast enhanced CT scan showed prominent enhancement in the left choroid plexus, and MRI revealed another mass in the subarachnoidal space under the right frontal lobe. An open biopsy was done on the massive lesion in the frontal lobe. Macroscopically, this lesion was an encapsulated granulomatous one. On the other hand, there were groups of epitheloid cells with micronecrosis in their centers microscopically. These findings were compatible with tuberculoma, in spite of the absence of acid-fast bacilli or caseous necrosis. Medication was intensively continued: a follow-up CT showed gradual reduction of the choroid plexus lesion and shrinkage of the left lateral ventricle.

The association of Helicobacter pylori with differentiated-type early gastric cancer

BACKGROUND

Recent studies have indicated that infection with Helicobacter pylori is closely associated with increased risk for gastric cancer. Previous studies, however, usually have been made on cases of advanced gastric cancer.

METHODS

The Congo red-methylene blue test was performed on 19 healthy subjects, 24 patients with early gastric cancer of differentiated type, and 17 patients with early cancer of undifferentiated type. H. pylori infection was examined by culture of biopsy specimens obtained from noncancerous antral mucosa.

RESULTS

H. pylori was detected in 19 (79%) of 24 patients with differentiated-type early gastric cancer, but in only 5 (29%) of 17 patients with undifferentiated-type early gastric cancer; this difference was statistically significant. It also was detected significantly more frequently in patients with differentiated cancers than in healthy subjects.

CONCLUSIONS

H. pylori infection was closely associated with differentiated-type gastric cancers, but not with undifferentiated types.

Clival chordoma associated with pathological laughter. Case report

The case of a 40-year-old man with a clival chordoma who presented with symptoms of pathological laughter and left sixth cranial nerve paresis is reported. Laughing and talking during sleep were noted on polygraphic and videotape recordings of nocturnal sleep. Selective disorganization of sleep was observed, with laughing facial expressions and a lack of muscular atonia. The tumor developed in the prepontine cistern, compressing the pontomesencephalic structures backward and involving the upper clivus and the left cavernous sinus. No recurrence of laughter attacks were noted after total removal of the tumor. The sleep patterns observed were similar to those of experimental animals with lesions of the peri-alpha locus ceruleus. The importance of uncontrolled laughter as a sign of a ventral brain-stem mass is emphasized.

Prognostic value of periodic Acid-schiff (pas) staining of fine-needle aspirates from patients with primary hepatocellular-carcinoma

The relationships of cytological findings on periodic acid-Schiff (PAS) staining of fine-needle aspirates of hepatocellular carcinomas (HCC) with the length of survival of patients, their therapeutic response after transcatheter arterial embolization (TAE), and the tumor volume doubling time (TVDT) before chemoembolization were investigated in 74 patients with primary HCC. On the basis of cytologic findings on PAS-staining, HCC was classified into PAS-positive, mixed, and PAS-negative types. The two-year survival (70%) of patients with PAS-positive HCC was significantly longer than those of patients with the mixed or PAS-negative type of HCC. The TVDT of PAS-positive HCC was also significantly longer than that of the mixed type of HCC. These findings indicate that cytological findings on PAS-staining of HCC are useful in assessing the prognosis of patients with HCC.

Clinicopathological features and endoscopic diagnosis of superficial early adenocarcinomas of the large intestine

From October 1987 to March 1991, 21 (8%) superficial early cancers were found among 256 early colorectal cancers (Dukes A and B1). Superficial early cancers were defined as early cancers less than 3 mm in height. These tumors were found scattered throughout the large intestine and were often observed as reddish spots, which were easily overlooked without careful observation. Histologically, 19 (90%) of them were well-differentiated adenocarcinomas, and five (24%) of them reached the submucosal layer. Eighteen (86%) of them were not associated with adenoma.

Possibility of hepatic resection in patients on maintenance hemodialysis

A review of seven hepatic resections in six patients undergoing maintenance hemodialysis is presented. These cases consisted of hepatocellular carcinoma in four, and cholangiocellular carcinoma, myelolipoma and focal nodular hyperplasia in one each. The last preoperative hemodialysis was undertaken within 24 h prior to the operation with heparin. Intraoperatively, infused solutions containing no potassium, along with strict attention to preventing overhydration, allowed us to manage the patients without hemodialysis on the day of the operation. No specific intra-operative complications related to hemodialysis were noted. Postoperative hemodialysis was performed on the first or second day after operation, using nafamstat mesilate, a synthetic protease-inhibiting agent. The morbidity rate in the hemodialyzed patients was 85.7% (6/7), which was significantly higher than that in the non-hemodialyzed patients who underwent hepatic resections in our hospital. Fluid collection in the pleural and/or peritoneal cavities was frequent and difficult to control, but transient. Our experience suggests that hepatic resection is an acceptable procedure for hemodialyzed patients, when used in conjunction with careful perioperative management.

Hookwire localizer as an aid for ultrasonic detection of small liver nodules

We applied a V-shaped localizer and evaluated its clinical usefulness in nine patients with small hepatic nodules less than 2 cm in diameter. A small hepatic nodule was punctured with a 21-gauge localization needle under ultrasonic guidance, and the V-shaped localizer was pushed into the nodule with a wire. The localizer could be observed as a strong echo line by ultrasonography and as a high-density bar by computed tomography (CT). By this method, it was possible to precisely localize the nodule. Intraoperative ultrasonography became less time-consuming, and resection of the nodules could be confirmed with low-kilovoltage radiography.

Effect of side-chain structure on inhibition of yeast fatty-acid synthase by cerulenin analogues

Yeast fatty-acid synthase (FAS) inhibition by cerulenin analogs with varying side-chain lengths was compared with that of cerulenin, tetrahydrocerulenin and iodoacetamide. Although inhibition by cerulenin was the highest, the analogs having (E,E)-delta 7,10 double bonds showed high inhibition. This strongly suggests that the (E,E)-delta 7,10 double bonds play an important role in the interaction of the inhibitors with the enzyme. It was suggested that the size of the hydrophobic cavity in the condensing enzyme terminates fatty-acid chain elongation by decreasing inhibition by the C18 analog. Like cerulenin itself, the shortest analog (C6) did not induce malonyl-CoA decarboxylase activity.

Fundal atrophic gastritis as a risk factor for gastric cancer

The role of atrophic gastritis of the gastric corpus (fundal atrophic gastritis) as a high-risk factor was investigated by studying operative findings and follow-up data on 690 patients with benign gastric diseases recorded at the Osaka Cancer Registry. The extent of fundal atrophic gastritis was determined by the endoscopic Congo red test. The patients were followed-up from the time of endoscopic examination (1968 to 1976) to December 31, 1987. The vital status of 654 patients (94.8%) at the end of the observation period was determined. During the follow-up period, 22 patients were found to have gastric cancer. The extent of fundal atrophic gastritis was shown to be closely related with the risk of developing gastric cancer. Patients who had been diagnosed as having severe fundal atrophic gastritis showed significantly higher risk of gastric cancer than patients who had been diagnosed as having little or no fundal atrophic gastritis (5.76-fold, calculated with adjustments for age, sex and the follow-up period). A positive linear relationship was found between the risk of developing gastric cancer and the extent of fundal atrophic gastritis. The observed number of gastric cancers was compared with the expected number calculated from the incidence in Osaka Prefecture. Analysis of the results showed that the observed and expected numbers of gastric cancers in patients with severe fundal atrophic gastritis were 11 and 4.8, respectively, the ratio of observed to expected numbers being 2.3 (p < 0.05). These findings indicate that severe fundal atrophic gastritis is a major risk factor for gastric cancer.

Effects of endothelin and angiotensin II on renal hemodynamics in experimental mesangial proliferative nephritis

The renal hemodynamic response to pressor substances in the diseased kidney has been suggested to be different from that in the normal kidney. The aim of this study was to investigate the effects of endothelin and angiotensin II on renal hemodynamics in experimental nephritis induced by the administration of antithymocyte serum in Wistar rats. This model showed mesangiolytic lesions in the glomeruli on day 2 and hypercellular lesions on day 8. Prior to the injection of either endothelin or angiotensin II, the glomerular filtration rate and renal plasma flow were significantly lower in model rats on day 2 or day 8 than in the control rats. The basal glomerular filtration rate and renal plasma flow on day 8 were negatively correlated with the mesangium cell number. The injection of endothelin (0.5 ng/kg BW) led to a decrease in both renal plasma flow and glomerular filtration rate in rats on day 8 which was significantly greater than that in the control rats. Similarly, angiotensin II infusion (0.2 micrograms/kg BW) reduced both renal plasma flow and glomerular filtration rate in the rats on day 8 and the reductions were significantly greater than those in the control rats. In conclusion, renal hemodynamics in rats with mesangial proliferation of the kidney were more sensitive to both endothelin and angiotensin II than those in the normal kidney.

Cytologic examination of pure pancreatic juice in the diagnosis of pancreatic carcinoma. The endoscopic retrograde intraductal catheter aspiration cytologic technique

BACKGROUND

Although cytologic examination of pure pancreatic juice obtained with a duodenofiberscope has been useful for the diagnosis of pancreatic carcinoma, the rate of false-negative results is reported to be high. To eliminate these false-negative results, the authors developed a new technique, endoscopic retrograde intraductal catheter aspiration cytology, especially for an accurate cytologic diagnosis of carcinoma of the body or tail of the pancreas.

METHODS

The accuracy of conventional cytologic examination of pure pancreatic juice was assessed in 25 patients with pancreatic carcinoma, 29 patients with pancreatitis, and 52 control subjects. Pure pancreatic juice was collected from the pancreatic duct by endoscopic cannulation using a videoimaging duodenoscope after intravenous administration of secretin. The new endoscopic retrograde intraductal catheter aspiration technique was used in four patients with carcinoma of the body or tail of the pancreas and five patients with localized pancreatitis in whom a correct diagnosis was not made by previous cytologic examination of pure pancreatic juice.

RESULTS

Positive cytologic findings were obtained in 76% of the patients with pancreatic carcinoma. Positive cytologic results were more frequent in patients with carcinoma of the head of the pancreas than in those with carcinoma of the body or tail. By the new technique, positive cytologic results were obtained in all of the patients with pancreatic carcinoma. This technique caused no severe complications.

CONCLUSIONS

This procedure of endoscopic retrograde intraductal catheter aspiration cytology seems useful for diagnosis of pancreatic carcinoma.

[Role of TGF-beta in glomerular diseases]

Accumulation of extracellular matrix (ECM) is a major histological change in glomerular diseases that progress to chronic renal failure. Such accumulation can be mediated by increased production of molecular signal such as cytokines. Transforming growth factor beta 1 (TGF-beta 1) has a combined effect of enhancing the synthesis of ECM, while inhibiting the proteolytic degradation of newly formed matrix proteins. TG1-F beta 1 has stimulative effects on the production of ECM by cultured rat mesangial cells. In an experimental glomerulonephritis, there was a close association between elevated expression of the TGF-beta 1 mRNA and development of glomerulonephritis. Treatment of glomerulonephritic rats with antiserum directed to a synthetic peptide from mature TGF-beta 1 prevented the histological accumulation of ECM in glomeruli. These results suggest that TGF-beta 1 may participate in glomerular matrix expansion.

Cytologic examination of pure pancreatic juice in the diagnosis of pancreatic carcinoma. The endoscopic retrograde intraductal catheter aspiration cytologic technique

BACKGROUND

Although cytologic examination of pure pancreatic juice obtained with a duodenofiberscope has been useful for the diagnosis of pancreatic carcinoma, the rate of false-negative results is reported to be high. To eliminate these false-negative results, the authors developed a new technique, endoscopic retrograde intraductal catheter aspiration cytology, especially for an accurate cytologic diagnosis of carcinoma of the body or tail of the pancreas.

METHODS

The accuracy of conventional cytologic examination of pure pancreatic juice was assessed in 25 patients with pancreatic carcinoma, 29 patients with pancreatitis, and 52 control subjects. Pure pancreatic juice was collected from the pancreatic duct by endoscopic cannulation using a videoimaging duodenoscope after intravenous administration of secretin. The new endoscopic retrograde intraductal catheter aspiration technique was used in four patients with carcinoma of the body or tail of the pancreas and five patients with localized pancreatitis in whom a correct diagnosis was not made by previous cytologic examination of pure pancreatic juice.

RESULTS

Positive cytologic findings were obtained in 76% of the patients with pancreatic carcinoma. Positive cytologic results were more frequent in patients with carcinoma of the head of the pancreas than in those with carcinoma of the body or tail. By the new technique, positive cytologic results were obtained in all of the patients with pancreatic carcinoma. This technique caused no severe complications.

CONCLUSIONS

This procedure of endoscopic retrograde intraductal catheter aspiration cytology seems useful for diagnosis of pancreatic carcinoma.

Measurement of glycated albumin by the nitroblue tetrazolium colorimetric method

A method has been developed for the measurement of glycated albumin (albumin-fructosamine) by the nitroblue tetrazolium (NBT) colorimetric method. In this method, polyethylene glycol was added to the serum and then the mixture was centrifuged to separate globulin proteins from albumin proteins. This made it possible to measure the glycated albumin in the supernatant by the NBT colorimetric method, without the interference of globulin proteins. This measurement method correlated with the measurement of glycated albumin using boronate affinity chromatography with an r value of 0.942 (P < 0.001). Our method using polyethylene glycol permits easy measurement of albumin fructosamine and is therefore useful as an index of diabetic control and for diabetic screening.

[Newly developed MRSA medium]

We have developed a new selective medium, tentatively named MR(SA)2, for rapid identification of methicillin-resistant Staphylococcus aureus (MRSA) from clinical specimens. MR(SA)2 medium contained modified Müller-Hinton agar supplemented with 75 g of NaCl, 10 g of mannit, 20 mg of bromcresol purple, 20 g of egg-yolk, 4 mg of oxacillin, and 12.5 mg of ceftisoxime per 1,000 ml. There were no differences between the growth of MRSA strains on this medium at 30 C and that of 37 C. This medium can detect the egg-yolk reaction instead of the coagulase reaction. By single streaking of a test material on the surfaces of MR(SA)2 agar, MRSAs can easily be distinguished from methicillin-resistant coagulase-negative staphylococci (MR-CNS), other bacteria and fungi from their colony morphologies in a quantitative manner. A few MRSA strains would not form colonies on this medium because of their susceptibilities to ceftisoxime, but this may not inpede its use, since most MRSA strains isolated from clinical materials showed resistance to ceftisoxime. From the above results, the MR(SA)2 medium may be suitable for rapid detection of MRSA and MR-CNS.

Regional intraarterial infusion chemotherapy without laparotomy for hepatic metastases of pancreatic-cancer

The therapeutic effectiveness of regional infusional chemotherapy for treatment of hepatic metastases of pancreatic cancers was compared with systemic chemotherapy. Studies were made on 17 patients with unresectable pancreatic cancer with hepatic metastases. Regional infusion chemotherapy was performed after the insertion of an angiocatheter into the hepatic artery without laparotomy. This treatment significantly increased the rate of the partial response (40%) of the hepatic metastases, prolonged the survival and reduced the duration of the hospital stay. As hepatic infusion chemotherapy without laparotomy is also simple and inexpensive, it should be useful for treatment of hepatic metastases of pancreatic cancer.

[Proposal for the nosocomial infection control of methicillin-resistant Staphylococcus aureus (MRSA)]

To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in hospital environments, quantitative isolation of MRSA from environmental and human specimens was performed. It was found that as many as 6 x 10(4) colony forming units (CFU)/100cm2 of MRSA and also methicillin-resistant coagulase-negative Staphylococcus (MRCNS) were isolated from 1) 25-100% of the bed-mattresses tested in 10 out of 11 (90%) hospitals, and also 2) bed sheets for patients, floors of patient wards, laundry, bath-room, toilet and laundry storage-room. And seven and eight palms of 20 patients were contaminated with MRCNS and MRSA, respectively, and MRCNS contamination was revealed in six of medical staffs. These results indicate that hospital environments, especially the mattresses and hospital floors are highly contaminated with MRCNS and MRSA, and sanitation and cleanliness of mattresses and floors are necessary to prevent the dissemination of both MRCNS and MRSA in hospital.

Inhibition of acyl-CoA: cholesterol acyltransferase activity by cyclodepsipeptide antibiotics

The effect was studied of the fungal cyclodepsipeptide antibiotics beauvericin and seven distinct enniatins on acyl-CoA: cholesterol acyltransferase (ACAT) activity. In an enzyme assay using rat liver microsomes, all the compounds were found to inhibit ACAT activity. The drug concentration that caused 50% inhibition (IC50 value) of the enzyme activity was determined to be 3.0 microM for beauvericin, indicating that the compound is one of the most potent ACAT inhibitors of microbial origin. Enniatins exhibited much higher IC50 values of 22 to 110 microM. More hydrophobic enniatins showed more potent inhibitory activity. Furthermore, the ACAT inhibitory activity was evaluated as inhibition of cholesteryl ester formation in a cell assay using J774 macrophages. Calculation of the ratio, CD50 value (the drug concentration causing 50% cell damage)/IC50 value of cholesteryl ester formation, indicated that beauvericin shows the highest specificity. These data indicate that beauvericin is one of the most potent and specific ACAT inhibitors of microbial origin.

Early depressed adenocarcinomas of the large intestine

From January 1987 to December 1990, five cases of early depressed cancer of the large intestine were seen. Endoscopically, almost all of these tumors were located in the proximal colon and looked like a reddish depression (similar to the sucker of an octopus). Histologically, all of these cancers were well differentiated and tended to reach deeper layers at an early stage. Four (80%) of these cancers were not associated with adenoma and were thought to have arisen de novo.

Enhancement by thyroxine of experimental carcinogenesis induced in rat colon by azoxymethane

The effect of thyroxine (T4) on the incidence, number and histology of colon tumors induced by azoxymethane (AOM), and on the labeling index of colon mucosa were investigated in Wistar rats. Rats were given AOM by injection once a week for 10 weeks, together with T4 in depot form until the end of the experiment. Administration of T4 resulted in a significant increase in the incidence of colon tumors in week 35. However, it did not influence the histological appearance of the colon tumors or the histological types and depths of involvement of colon adenocarcinomas. Furthermore, it caused a significant increase in the labeling index of the colon during, but not after, AOM treatment. Our findings indicate that T4 enhances the development of colon tumors, which may be related to its effect in increasing proliferation of epithelial cells in the colon mucosa during administration of the carcinogen.

Effect of treatment with cisapride alone or in combination with domperidone on gastric emptying and gastrointestinal symptoms in dyspeptic patients

The effects on gastric emptying and gastrointestinal symptoms of treatment with cisapride alone and in combination with domperidone were investigated in 25 patients with chronic idiopathic dyspepsia. In a double-blind study, 9 patients were randomly assigned to receive cisapride 2.5 mg three times daily, and 8 patients to receive placebo. After 7 days of treatment, gastric emptying was significantly accelerated and the score of gastrointestinal symptoms was significantly reduced in patients treated with cisapride. Placebo treatment had no significant effect. A randomized, double-blind crossover study of 8 patients compared the effects of combined treatment with cisapride 2.5 mg plus domperidone 10 mg three times daily for 7 days against the effects of cisapride plus placebo. Administration of cisapride plus domperidone gave significantly higher gastric emptying and lower gastrointestinal symptoms than cisapride plus placebo.

Albuminuria is not an aggravating factor in experimental focal glomerulosclerosis and hyalinosis

It is widely known that the severity of glomerular sclerosis is proportional to the degree and chronicity of proteinuria and that the degenerative changes of glomerular epithelial cells that are associated with overflow albuminuria can be experimentally induced by the injection of large quantities of heterologous albumin. Such evidence suggests that autologous albuminuria per se may have a harmful effect on the kidneys. To examine the cause and effect relationship between renal lesions and albuminuria, we produced Adriamycin-induced experimental focal glomerular sclerosis in Nagase analbuminemic (NA) rats and control Sprague-Dawley (SD) rats and observed both the renal functional and histologic changes for 20 weeks. At week 4 after injection of Adriamycin glomerular epithelial lesions including foot process fusion were similarly revealed by an electron microscopic study in both groups in spite of the presence of a large difference in the amount of proteinuria (SD rats: 491 +/- 84 mg/day, NA rats: 43 +/- 30 mg/day) and albuminuria (SD rats: 383 +/- 73 mg/day, NA rats: 2 +/- 1 mg/day). At week 20, a light microscopic study showed the same degree of glomerular sclerosis and hyalinosis and tubulointerstitial changes associated with a decrease in inulin clearance in both groups. The increased glomerular accumulation of immunoglobulin M or complement 3 and glomerular trapping of aggregated human immunoglobulin G were also similar between the SD and NA groups. In summary, renal destruction of Adriamycin-nephropathy was not dependent on the degree of albuminuria. These results suggest that albuminuria is not an aggravating factor in focal glomerulosclerosis.

Enhancement of dopaminergic agonist bromocriptine of gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine in Wistar rats

The effects of the dopamine agonist 2-bromo-alpha-ergocryptine methanesulfonate (bromocriptine) on the incidence, number and histology of gastric cancer induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) were investigated in Wistar rats. Rats were given 1 or 2 mg kg-1 body weight of bromocriptine subcutaneously every other day in depot form after 25 weeks of oral treatment with MNNG. Prolonged administration of bromocriptine at both dosages every other day resulted in a significant increase in the incidence and number of gastric cancers of the glandular stomach by week 52. Bromocriptine treatment did not influence the histological type of gastric cancer, but caused a significant increase in the labelling index of epithelial cells of the antrum. These findings indicate that the dopamine agonist bromocriptine promotes gastric carcinogenesis, and that this effect may be related to its effect in increasing proliferation of epithelial cells in the antral mucosa.

Enhancement by vaso-active intestinal peptide of gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine in rats

The effects of vaso-active intestinal peptide (VIP) on gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) were investigated in Wistar rats given VIP every other day for 27 weeks after oral administration of MNNG for 25 weeks. In week 52, administration of VIP caused a significant increase in the incidence of gastric cancers, but did not influence their histological appearance. VIP significantly increased the labeling indices of the antral mucosa. Our findings indicate that VIP enhances gastric carcinogenesis, and that this effect may be related to its effect in increasing cell proliferation of the antral epithelial cells.

A prospective trial of early detection of pancreatic cancer by ultrasonographic examination combined with measurement of serum elastase 1

The accuracy of ultrasonographic examination combined with measurement of elastase 1 levels for early detection of pancreatic cancer was evaluated prospectively. Abdominal ultrasonographic examination and measurement of serum elastase 1 levels were done within 2 weeks after the initial visit to the clinic in a total of 2098 patients older than 35 years of age with symptoms suggesting pancreatic disease. Those in which one or both of these examinations had abnormal results underwent additional tests such as endoscopic retrograde cholangiopancreatography and computed tomography. Of those with pancreatosonograms with abnormal results with or without abnormally high serum elastase 1 levels, 19 patients eventually were found to have pancreatic cancer. No patients with pancreatic cancer, a normal level of serum elastase 1, and a pancreatosonogram with normal results were found, but follow-up studies revealed one pancreatic cancer in 189 patients after technically unsatisfactory ultrasonographic examination. In 9 (45%) of the 20 cases detected in this study, the pancreatic cancers were resectable, and two (10%) were less than 2.0 cm in longest diameter. These findings indicate that this combined examination is useful for early detection of pancreatic cancer. However, no pancreatic cancer was found in patients with abnormally high serum elastase 1 levels without a pancreatosonogram with abnormal results. Moreover, a combination of ultrasonographic examination and measurement of the elastase 1 level did not raise the diagnostic accuracy over that of ultrasonographic examination alone. These findings indicate that ultrasonographic examination alone is useful in screening for early pancreatic cancer.

Attenuating effect of ornithine decarboxylase inhibitor (1,3-diaminopropane) on bombesin enhancement of gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine

The effects of combined administration of bombesin and the ornithine decarboxylase (ODC) inhibitor 1,3-diaminopropane (DAP) on the incidence and number of gastric tumors induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), the ODC activity of the gastric wall and the labelling index of the gastric mucosa were investigated in inbred Wistar rats. Rats were given drinking water containing MNNG (50 micrograms/ml) for 25 weeks and then drinking water containing DAP (2.5 g/l) and/or injections of 40 micrograms/kg body weight of bombesin in depot form every other day. Administration of bombesin alone resulted in significant increases in the incidence of gastric cancers, the ODC activity of the antral portion of the gastric wall and the labelling index of the antral mucosa. Administration of DAP with bombesin significantly reduced enhancement by the latter of gastric carcinogenesis, ODC activity of the antral portion of the gastric wall and the labelling index of the antral mucosa. Our results suggest that ODC inhibition attenuated the enhancement of gastric carcinogenesis by bombesin, and that this enhancement by bombesin was mediated by polyamine biosynthesis.

Synthesis of fibronectin by isolated glomeruli from nephrectomized hypertensive rats

The accumulation of extracellular matrix (ECM) is an important feature of most forms of progressive glomerular diseases. In order to examine the relationship between ECM synthesis and glomerulosclerosis, we evaluated fibronectin synthesis by glomeruli with the immunoprecipitation of conditioned media from isolated glomeruli in 5/6 nephrectomized spontaneously hypertensive rats (5/6N-SHR). There was no difference in blood pressure between 5/6N-SHR and control SHR throughout the experiment. Two weeks after the nephrectomy, most of the glomeruli were intact and no difference in the synthesis of fibronectin was observed between either groups. Twenty weeks after the nephrectomy, marked glomerulosclerosis associated with an increase in urinary protein was revealed in 5/6N-SHR but no glomerular lesions in control SHR. The synthesis of fibronectin by isolated glomeruli increased in 5/6N-SHR compared to control SHR. The administration of enalapril or hydralazine + reserpine + hydrochlorothiazide markedly attenuated the glomerular sclerosis and urinary protein excretion to a comparable degree, although the later therapy reduced blood pressure more effectively. These antihypertensive therapies also suppressed fibronectin synthesis in the 5/6N-SHR group at week 20. In conclusion, increased synthesis of glomerular fibronectin appeared to contribute to the glomerulosclerosis caused by subtotal nephrectomy and hypertension.

Enhancement by methionine- and leucine-enkephalin of gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine in Wistar rats

The effects of the opioid receptor agonists methionine-enkephalin (Met-ENK) and leucine-enkephalin (Leu-ENK) on gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine were investigated in Wistar rats. After 25 weeks of oral treatment with the carcinogen, the rats received subcutaneous injections of Met-ENK (20 micrograms/kg) or Leu-ENK (20 micrograms/kg) once every 2 days. The prolonged administrations of Met-ENK and Leu-ENK significantly increased the incidence of gastric cancers in week 52. Treatments with these opioid receptor agonists significantly increased the labeling index of the antral mucosa. These findings indicate that opioids enhance gastric carcinogenesis and suggest that their effects may be related to their influence on increasing proliferation of the antral epithelial cells.

Inhibition by the dopamine antagonist haloperidol of experimental carcinogenesis induced by azoxymethane in rat colon

The effects of the dopamine agonist bromocriptine and antagonist haloperidol on the incidence and histology of colon tumors induced by azoxymethane and on the labeling index of colon mucosa were investigated in Wistar rats. Rats received weekly s.c. injections of 7.4 mg/kg of body weight azoxymethane for 10 weeks and s.c. injections of 2 mg/kg of body weight bromocriptine or 2 mg/kg of body weight haloperidol, in depot form, every other day until the end of the experiment in week 30. Administration of haloperidol resulted in a significant decrease in the incidence of colon tumors. It also caused a significant decrease in the incidence of adenocarcinomas, with 75% of the tumors being adenomas, and in the labeling index of the colon epithelial cells. In contrast, bromocriptine had no influence on the incidence or histology of colon tumors or the labeling index of the colon mucosa. These findings indicate that the dopamine antagonist haloperidol inhibits colon carcinogenesis and that this effect may be related to its effect in decreasing the proliferation of colon epithelial cells.

Chronic tubulointerstitial changes induced by germanium dioxide in comparison with carboxyethylgermanium sesquioxide

Chronic nephrotoxicity was investigated in rats orally administered germanium dioxide (GeO2) and carboxyethylgermanium sesquioxide (Ge-132) for 24 weeks. Increased BUN and serum phosphate as well as decreased creatinine clearance, weight loss, anemia and liver dysfunction were apparent at week 24 only in the GeO2 treated group. Vacuolar degeneration and granular depositions were observed by light microscope in the degenerated renal distal tubules in the rats of this group, with the semiquantitative scores of tubular degeneration being 95 +/- 9% in the GeO2 group, 3 +/- 1% in the Ge-132 group and 1 +/- 1% in the control group, respectively. Electron microscopy revealed electron-dense inclusions in the swollen mitochondrial matrix of the distal tubular epithelium in the GeO2 group. Although systemic toxicities were reduced after GeO2 was discontinued at week 24, renal tubulointerstitial fibrosis became prominent even at week 40 (16 weeks after discontinuation). A Ge.K alpha X-ray spectrum was clearly demonstrated in the mitochondrial matrix of the distal tubular epithelium in the GeO2 group with the help of electron probe X-ray microanalysis. On the other hand, neither toxic effects nor renal histological abnormalities were manifested in either the Ge-132 or the control group. The renal tissue content of germanium was high at weeks 24 and 40 in the GeO2 group. From these results, it is concluded that GeO2 causes characteristic nephropathy while Ge-132 does not. In addition, it appears that residual GeO2 remains for a considerably long time even after the cessation of GeO2 intake.

Dietary protein restriction rapidly reduces transforming growth factor beta 1 expression in experimental glomerulonephritis

Dietary protein restriction has been shown to slow the rate of loss of kidney function in humans with progressive glomerulosclerosis due to glomerulonephritis or diabetes mellitus. A central feature of glomerulosclerosis is the pathological accumulation of extracellular matrix within the diseased glomeruli. Transforming growth factor beta 1 (TGF-beta 1) is known to have widespread regulatory effects on extracellular matrix and has been implicated as a major cause of increased extracellular matrix synthesis and buildup of pathological matrix within glomeruli in experimental glomerulonephritis. In the present study, it is shown that administration of a low protein diet to rats rapidly reduces the elevated expression of TGF-beta 1 mRNA and TGF-beta 1 protein that is known to occur within glomeruli after induction of glomerulonephritis. Compared to a normal protein diet, glomerulonephritic rats receiving the low protein diet did not develop an increase in glomerular extracellular matrix and showed significantly less proteinuria. Glomeruli isolated from glomerulonephritic rats fed the normal protein diet showed a marked increase in proteoglycan synthesis on day 7 of disease and were demonstrated to be secreting increased amounts of TGF-beta 1 into the medium, whereas glomeruli at the same point in time isolated from rats on a low protein diet showed no increase in proteoglycan production or TGF-beta 1 secretion. These results suggest that a mechanism of the rapid therapeutic effect of a low protein diet on experimental glomerulonephritis is through suppression of TGF-beta 1 expression and prevention of the induction of extracellular matrix synthesis within the injured glomeruli.

[Topographic correlation between basilar artery occlusion and cerebellar involvement--a clinicopathological study]

Nineteen patients (15 men, 4 women) with occlusion of the vertebrobasilar artery were studied in order to identify possible pathomechanism and to define the site of arterial occlusion and the topography of ischemic lesion of the cerebellum. Their mean age at onset was 66.7 years and the final clinicopathological diagnosis were thrombosis of the basilar artery (BA) in 15 patients and embolism in 4. The occlusion of the BA was contiguous to that of the vertebral artery in ten patients. Of these, the occlusion was localized to the caudal portion of the BA in two, to the middle portion in six, and extended to the rostral portion in two. In eight patients, the arterial occlusion was restricted to the BA. Occlusions of the middle portion were observed in four and that of rostral portion in two; in the other two patients, the whole BA was occluded. In one patient, there was no occlusion in the vertebro-basilar artery at the postmortem examination, but infarctions of the base of pons, bilateral cerebellar hemispheres and occipital lobes were confirmed, suggesting recanalization of the occluded BA. Cerebellar lesions were observed in all nineteen patients. Involvements of the area supplied by the superior cerebellar artery (SCA) were found in seventeen, while that of the posterior inferior cerebellar artery (PICA) only in ten. Eight patients had cerebellar lesions supplied by both SCA and PICA. These facts suggest that cerebellar lesions are rather frequent and the SCA areas are more involved than those of the PICA in fatal patients with occlusion of the BA.(ABSTRACT TRUNCATED AT 250 WORDS)

Purpactins, new inhibitors of acyl-CoA:cholesterol acyltransferase produced by Penicillium purpurogenum. III. Chemical modification of purpactin A

Acylated derivatives of the C-1' and/or C-11 hydroxy group(s) of penicillide were synthesized and their inhibitory activity against acyl-CoA:cholesterol acyltransferase (ACAT) was studied. Introduction of long acyl group into either or both hydroxy residue(s) decreased the inhibitory activity. A small acyl moiety such as acetyl or n-butyryl at the C-1' hydroxy group is responsible for potent inhibitory activity against ACAT. The 1'-O-acetyl-11-O-tetrahydropyranyl derivative (11-O-2''-tetrahydropyranylpurpactin A) showed high selectivity (cytotoxic dose vs. effective dose) in a cell assay using J774 macrophages.