Presence of Vicia graminea or Vicia unijuga lectin-binding (Vgu) glycoproteins with and without Thomsen-Friedenreich (T) antigen in normal human seminal plasma

Vgu glycoprotein (Vicia graminea lectin- or Vicia unijuga lectin-binding glycoprotein) has been reported as oncofetal antigen, which is found in many kind of tumor tissues, amniotic fluid and fetal membranes. In autoradiography with an 125I-labeled Vicia unijuga lectin (VUA) probe and an 125I-labeled Arachis hypogaea lectin (PNA, anti-T lectin) probe, seminal plasma samples of eight healthy men gave 2-7 Vgu glycoproteins without T antigen, 1-2 Vgu glycoproteins with Thomsen-Friedenreich antigen (T antigen) and 1-8 T-antigen glycoproteins, respectively. These results show that in addition to T-antigen glycoproteins, normal human seminal plasma contains Vgu glycoproteins and Vgu glycoproteins with T antigen as seminal plasma components as well as other tumor markers such as CA19-9, CA-125 and CEA.

Quantitative assessment of cerebral neocapillary network and its remodeling in mice using intravital fluorescence videomicroscopy

To assess the responses of different growth factors on cerebral neocapillary density (NCD), cerebral angiogenesis was induced in mice using growth factors, basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) at a concentration of 6 ng/ml each. Intravital fluorescence videomicroscopy was used to quantitatively evaluate microhemodynamic parameters such as diameter and red cell velocity. The gel-nylon mesh-sandwich system was implanted over the exposed cortex. After incubation for different periods of time (days 7, 14 or 28), fluorescein isothiocyanate (FITC)-labeled red cells were injected through a carotid artery and the neocapillaries on the upper surface of the nylon mesh were observed under a fluorescence videomicroscope. Based on the recorded videoimages, we evaluated the density, diameter and red cell velocity of the neocapillaries. The NCD in the bFGF group on day 7 was significantly higher than that in the PDGF group on day 7 (P < 0.01). The NCD (index) reached 100% on day 14, while it reduced significantly in both the groups on day 28. The neocapillary diameter was greater than that of the pre-existing capillaries on day 7. On day 14, a clear difference appeared in the capillary density between large and small vessels. The red cell velocity increased with the number of days after incubation. The response of cerebral neocapillaries to acetylcholine was measured after 28 days of incubation with growth factor bFGF and with PDGF. The red cell velocity increased significantly from its basal value in the PDGF group. These results suggest that the neocapillaries in the PDGF group matured earlier than those in the bFGF group.

Pitavastatin inhibits vascular smooth muscle cell proliferation by inactivating extracellular signal-regulated kinases 1/2

We recently reported that lysophosphatidylcholine (lysoPC) acts on vascular smooth muscle cells ( VSMCs ) to produce a mitogenic response through the activation of extracellular signal-regulated kinases 1/2 (ERK1/2). In this study, we examined the role of HMG-CoA reductase inhibitors on lysoPC-induced VSMC proliferation. Pitavastatin, a new HMG-CoA reductase inhibitor, suppressed lysoPC-induced DNA synthesis in primary cultured rat VSMCs. Since lysoPC-induced ERK1/2 activation contributes to smooth muscle cell proliferation, we explored the effect of pitavastatin on ERK1/2 activation. Pitavastatin inhibited lysoPC-induced ERK1/2 phosphorylation and ERK1/2 activation. The other HMG-CoA reductase inhibitors, atrovastatin and fluvastatin, also inhibited lysoPC-induced ERK1/2 phosphorylation. Pitavastatin also inhibited lysoPC-induced c-fos mRNA expression. To gain insight into the mechanism of the inhibitory effect of pitavastatin on ERK1/2 activation by lysoPC, we examined the role of the mevalonate pathways. Mevalonate and farnesylpyrophosphate reduced the inhibition of ERK1/2 phosphorylation by pitavastatin. These studies demonstrate that pitavastatin may inhibit lysoPC-induced VSMC proliferation, at least in part, by inactivating ERK1/2, which is linked to mevalonate metabolism.

Comparison of bone mineral density among residents of a mountain village and a fishing village in Japan

OBJECTIVE

To compare the bone mineral density of residents of a mountain village with that of residents of a fishing village in Mie Prefecture, Japan.

METHODS

Microdensitometry was used to measure bone mineral density of the second metacarpal bone of 202 participants living in a mountain village and of 852 participants living in a fishing village to identify contributory factors for osteoporosis. The participants were interviewed using a questionnaire on alcohol consumption, fish intake, milk intake, and daily activity.

RESULTS

Analysis of covariance revealed that bone mineral density was significantly higher among the participants living in a fishing village than among those living in a mountain village (2.5-2.9 versus 2.1-2.7 mmAl; p<0.001). A higher proportion of women in the fishing village than of those in the mountain village consumed alcohol (17% versus 10%; p<0.05).

CONCLUSION

Nutrition may be a contributory factor to the lower incidence of osteoporosis among residents of the fishing village compared with those of the mountain village.

Absorption of short wavelengths of endoillumination in indocyanine green solution: implications for internal limiting membrane removal

PURPOSE

To measure the absorption coefficients of short wavelengths, irradiated by a light source used for vitreous surgery, in indocyanine green (ICG) solution and balanced salt solution (BSS), and to determine the implications of these absorption coefficients on retinal phototoxicity caused by ICG-assisted internal limiting membrane removal.

METHODS

The absorption coefficients of short wavelengths irradiated by a commercially available light source used for vitreous surgery were measured in ICG solution and BSS using a dual-beam spectroradiometer.

RESULTS

The absorption coefficient of wavelengths irradiated by the endoillumination light source in ICG solution was almost the same as that obtained in BSS. The absorbance coefficients of the ICG solutions were 0.18 cm(-1) at 400 nm and 0.03 cm(-1) at 450 nm. In BSS, the absorption coefficients were 0.17 cm(-1) at 400 nm and 0.015 cm(-1) at 450 nm. No significant difference in absorbance was seen between 400 nm and 450 nm ( P>0.05).

CONCLUSIONS

The absorption of wavelengths is not greater in ICG solution than in BSS. ICG solution during intravitreal use probably does not enhance retinal photochemical injury during ICG-assisted internal limiting membrane removal.

Lysophosphatidylcholine activates extracellular signal-regulated kinases 1/2 through reactive oxygen species in rat vascular smooth muscle cells

Lysophosphatidylcholine (lysoPC) acts on vascular smooth muscle cells (VSMCs) to produce a mitogenic response through the activation of extracellular signal-regulated kinases 1/2 (ERK1/2). In the present study, we examined the importance of reactive oxygen species (ROS) in lysoPC-stimulated ERK1/2 activation in cultured rat VSMCs. Treatment with lysoPC for 3 minutes caused a 2-fold increase in intracellular ROS that was blocked by the NADH/NADPH oxidase inhibitor, diphenylene iodonium (DPI). Antioxidants, N-acetyl-L-cysteine, glutathione monoester, or alpha -tocopherol, inhibited ERK1/2 activation by lysoPC. Almost identical results were obtained in the VSMC line A10. Pretreatment of VSMCs with DPI but not allopurinol or potassium cyanide (KCN) abrogated the activation of ERK1/2. The Flag-tagged p47phox expressed in A10 cells was translocated from the cytosol to the membrane after 2 minutes of stimulation with lysoPC. The overexpression of dominant-negative p47phox in A10 cells suppressed lysoPC-induced ERK activation. The ROS-dependent ERK activation by lysoPC seems to involve protein kinase C- and Ras-dependent raf-1 activation. Induction of c-fos expression and enhanced AP-1 binding activity by lysoPC were also inhibited by DPI and NAC. Taken together, these data suggest that ROS generated by NADH/NADPH oxidase contribute to lysoPC-induced activation of ERK1/2 and subsequent growth promotion in VSMCs.

Lysophosphatidylcholine inhibits insulin-induced Akt activation through protein kinase C-alpha in vascular smooth muscle cells

To better understand the intracellular signaling mechanism that causes the association of insulin resistance and hyperlipidemia with cardiovascular diseases, we specifically looked at the ability of lysophosphatidylcholine (lysoPC) to inhibit the Akt activation induced by insulin in cultured rat aortic vascular smooth muscle cells. LysoPC inhibited the insulin-induced phosphorylation of Akt at Ser473, and the inhibition was concentration dependent. Phorbol 12-myristate 13-acetate (PMA), a protein kinase C (PKC) activator, inhibited the insulin-induced phosphorylation of Akt. LysoPC stimulated PKC phosphorylation at Ser660, which was inhibited by the PKC inhibitor GF109203X. The PKC-alpha/beta-selective inhibitor Go6976 also blocked the PMA- and lysoPC-induced inhibition of Akt phosphorylation by insulin. PKC-alpha, but not PKC-beta, is expressed in vascular smooth muscle cells, and overexpression of PKC-alpha, but not PKC-beta or PKC-delta, inhibited insulin-induced Akt activation. LysoPC rapidly stimulated PKC-alpha translocation to the membrane. In contrast, pretreatment with the p42/44 mitogen-activated protein kinase kinase inhibitor PD98059 or the p38 mitogen-activated protein kinase inhibitor SB203580 did not block the lysoPC-induced inhibition of Akt phosphorylation by insulin. In addition, lysoPC inhibited the insulin-induced tyrosine phosphorylation of insulin receptor substrate (IRS)-1 but not that of the insulin receptor beta subunit or insulin binding. PMA treatment or PKC-alpha overexpression also inhibited the tyrosine phosphorylation of IRS-1. From these data, we conclude that lysoPC negatively regulates the insulin signal at the point of IRS-1 through PKC-alpha in the vasculature, which may explain the association of hyperlipidemia with hyperinsulinemia in cardiovascular diseases.

Progressive apoptosis in chorion laeve trophoblast cells of human fetal membrane tissues during in vitro incubation is suppressed by antioxidative reagents

Previously, we demonstrated apoptotic cell death in the chorion laeve trophoblast layer of human fetal membrane tissues during the late stages of pregnancy, the progression of apoptosis during incubation in vitro, and its suppression by a low concentration of glucocorticoid hormones. We now report examination of mRNA expression of inflammatory cytokines [interleukin (IL)-1beta, IL-6, tumor necrosis factor-alpha] and antioxidative enzyme genes [heme oxygenase 1, catalase, Mn-superoxide dismutase (SOD), Cu/Zn-SOD, glutathione S-transferase, glutathione reductase and glutathione peroxidase] and apoptosis-related genes during in vitro progression of apoptosis with or without glucocorticoid by a reverse transcription/PCR method. It was shown that the mRNA levels increased in chorion laeve tissue for each cytokine examined and for catalase, heme oxygenase 1 and Mn-SOD in direct correlation with the in vitro incubation period. By Western blotting the existence of Mn-SOD protein, and its slight increase with incubation time, was also shown. The investigation of the influence of antioxidative reagents [pyrrolidine dithiocarbamate (PDTC), N-acetyl-l-cysteine (NAC) and nordihydroguaiaretic acid (NDGA)] on DNA fragmentation showed that DNA fragmentation in chorion laeve tissues was inhibited by approximately 50% in the presence of 1 mm PDTC, 30 mm NAC and 1 mm NDGA. These results suggest that apoptotic cell death of the trophoblast layer of chorion tissues may be induced through intracellular oxidative stress at the stage of parturition.

Sentinel lymph node biopsy in patients with papillary thyroid carcinoma

BACKGROUND

It remains controversial whether modified radical neck dissection (MRND) for patients with papillary thyroid carcinoma improves prognosis. However, it is highly probable that the incidence of local recurrence is reduced by lymph node dissection. Sentinel lymph node (SLN) biopsy (SLNB) for patients with melanoma and breast carcinoma has been validated as an accurate method for assessing lymph node status. The objective of this study was to determine the feasibility of SLNB for the evaluation of cervical lymph node status in patients with papillary thyroid carcinoma.

METHODS

After injection of methylene blue around the tumor in 22 patients with papillary thyroid carcinoma, blue-stained lymph nodes were dissected as SLNs. After the SLNB, all patients also underwent subtotal thyroidectomy and MRND. SLNs and other lymph nodes were investigated with regard to their number, distribution, size, lymph node status, and ratio of metastatic area.

RESULTS

There was concordance between the SLN findings and the regional lymph node status in 19 of 21 patients (90.5%; 7 patients had both positive SLN and regional lymph node results, and 12 patients had both negative SLN and regional lymph node results). Two patients had negative SLN results but, in the end, had positive nonsentinel lymph nodes (NSLNs). The overall reliability rate of SLNB was 86.3% (19 of 22 patients). The authors experienced no complications with the use of methylene blue for the detection of SLNs.

CONCLUSIONS

SLNB using methylene blue is feasible technically and is safe, and the findings correlate with cervical lymph node status. Therefore, SLNB is a good technique for estimating the status of cervical lymph nodes in patients with papillary thyroid carcinoma.

Recurrent hepatic portal venous gas in a patient with hemodialysis- dependent chronic renal failure

We report a case of recurrent hepatic portal venous gas (HPVG). A 51-year-old woman who had been undergoing hemodialysis for 19 years was admitted with abdominal pain. Computed tomography (CT) scans revealed the presence of HPVG, and bowel necrosis was confirmed at operation. After 1 year, the abdominal pain recurred. CT scans on the second admission also revealed HPVG; however, an exploratory laparotomy was negative. Recurring presentation of HPVG in the same patient has not been described previously.

[Is the bronchoscopic criteria of early lung cancer valid?]

We studied the validity of the bronchoscopic criteria of the early lung cancer using the surgical specimen excised between 1980 and 1999. Twenty-four cases with squamous cell carcinoma of the lung of clinical stage I were located subsegmental or more proximal bronchi and trachea, and the size less than 20 mm in greatest dimension. We histopathologically investigated the endoscopic features in relation to the width of superficial extent, the depth of cancer invasion, and lymph node metastasis. Tumors of the thickened type lesions less than 20 mm in greatest dimension showed no invasion into the cartilaginous layer and no lymph node metastasis. On the other hand, in the nodular and polypoid types, invasion beyond the cartilaginous layer was observed more or less, and lymph node metastasis was observed in 1 case. These cases would not be suitable for bronchoscopic (photodynamic) therapy. In conclusion, the bronchoscopic criteria of early lung cancer is valid in the thickened type, but not in the nodular type or polypoid type.

Changes in body fat mass in male hemodialysis patients: a comparison between diabetics and nondiabetics

Nutritional status is an important factor that affects morbidity and mortality of hemodialysis patients. We investigated 1-year changes in body fat mass of male patients undergoing hemodialysis (duration, 4.9 +/- 2.5 years). Fat mass of 217 male patients (age 60 +/- 13 years) was measured by dual x-ray absorptiometry twice in a 1-year interval. The patients consisted of 70 with diabetes mellitus and 147 without diabetes. At the second measurement compared with the first, a significant decrease in fat mass was observed in diabetic patients (12.1 +/- 4.4 kg versus 11.0 +/- 4.7 kg; P < 0.01); there were no significant changes in fat mass in nondiabetic patients (12.2 +/- 5.0 kg versus 11.9 +/- 4.9 kg; P = 0.15). Significant differences in percent fat mass changes per year were seen between diabetic and nondiabetic patients (P < 0.05). Protein catabolic rates of diabetic patients were significantly lower than those of nondiabetic patients (0.86 +/- 0.18 g/kg/d versus 0.93 +/- 0.19 g/kg/d; P < 0.05). In all patients, there was a significant correlation between protein catabolic rates and percent fat mass changes per year (r = 0.15; P < 0.05). These results showed that body fat mass was decreased significantly in 1 year in male diabetic patients with maintenance hemodialysis, suggesting poorer nutritional status in these patients. Poor protein intake may be one of the risk factors for the decrease in fat mass. Dual x-ray absorptiometry assessment of fat mass changes is suggested as a useful method to examine clinically the nutritional status of hemodialysis patients.

Microcirculatory characterization of cerebral angiogenesis in mice using intravital videomicroscopy

The present study investigated microcirculatory characteristics of the cerebral neovasculature induced in mice, using basic fibroblast growth factor (bFGF) and platelet derived growth factor (PDGF). The nylon-mesh sandwich (collagen gel/growth factor in bovine serum albumin embedded in between two nylon-mesh pieces) was used to induce angiogenesis. After different days of incubation, the observations of neocapillaries were done on the upper surface of the nylon-mesh, using fluorescence video-microscopy. The neocapillary diameter, red cell velocity, and the neocapillary density were evaluated based on the video-image. The neocapillaries were visible on the upper surface of the mesh on the 6th day after the incubation, and red cells started to flow from the day 7. The neocapillary red cell velocity increased with days after incubation, but its level was less than that of the pre-existing capillaries. The neocapillary diameter decreased as the neocapillaries got matured. The neocapillary density was dependent on the doses of bFGF and PDGF. The neocapillary diameter did not alter with the higher concentration as well as with different growth factors. Both bFGF and PDGF showed an increase in red cell velocity at high concentration.

Microcirculatory responses to repeated embolism-reperfusion in cerebral microvessels of cat: a fluorescence videomicroscopic study

Intra-carotid injections of degradable starch microspheres (DSMs) can induce DSM embolism-reperfusion in the level of cerebral arterioles. Vascular responses of cerebral arterioles to repeated DSM embolism (ischemia)-reperfusion were examined when DSMs were injected twice through a carotid artery with a time interval of 30 min. Arteriolar diameter was measured from images of arterioles filled with rhodamine-B isothiocyanate dextran and red cell velocity was measured with a dual window technique using FITC-labeled red cells as a flow tracer. DSM embolization induced ischemia (flow reduction including stasis) for approximately 10 min in the level of microvessels (arterioles). Cerebral arterioles began to dilate immediately after embolism induced by the DSM injection and vasodilation was sustained until reperfusion. After reperfusion the arteriole began to constrict and the arteriolar diameter returned to the initial diameter level at approximately 20 min after the DSM injection. The arteriolar diameters for the second DSM embolism showed a similar response to those for the first embolism in 7 out of 8 cats. It can be concluded that the vascular response of cerebral arterioles to the second embolism-reperfusion could not be affected by the first embolism-reperfusion.

Identification of a landmark in a roentgenographic cephalogram by employing the wavelet neurons

This paper describes an identification method of a landmark in a roentgenographic cephalogram by employing the input-correlated wavelet neurons. For the purpose of improvement of identification precision, a novel pattern matching method, named "wavelet neuron matching (WNM)," is proposed in this paper. Furthermore, the "weighted window", which is proposed in this paper, enables us to consider the orthodontists' knowledge on local information as precisely as possible. The effectiveness and the validity of the proposed method have been verified by the experiments to identify a landmark called Menton.

The role of nitric oxide in the gastric acid secretion induced by ischemia-reperfusion in the pylorus-ligated rat

In a rat model of the ischemia-reperfusion with pylorus ligation, gastric ulcer was formed, although gastric acid secretion was reduced. When the polymorphonuclear leukocytes were inactivated in advance, gastric ulcer was not formed, but acid secretion was increased, indicating that gastric acid is not a cause of the ulcer formation in this model. The mechanism of gastric acid suppression accompanied by ischemia-reperfusion was examined in relation to the role of oxygen-free radicals in this rat model. Prior administration of superoxide dismutase did not modulate acid secretion, but N-nitro-L-arginine methyl ester (L-NAME) increased acid secretion. The action of L-NAME was antagonized specifically by L-arginine, but not by D-arginine. S-nitroso-N-acetylpenicillamine did not inhibit basal acid secretion but antagonized the action of L-NAME. Aminoguanidine increased significantly the gastric acid output that was suppressed by ischemia-reperfusion. When polymorphonuclear leukocytes were inactivated by treatment with their antibody, the gastric acid output recovered to the level in the pylorus-ligated rat without ischemia-reperfusion. These results suggested that nitric oxide (NO) produced by the infiltrated polymorphonuclear leukocytes plays an important role in the suppression of acid secretion induced by ischemia-reperfusion.

Protective immunity against influenza A virus induced by immunization with DNA plasmid containing influenza M gene

DNA vaccination is characterized by its preferential induction of the cytotoxic T cell lymphocyte (CTL) response and is expected to be a useful means of protection against viral infection. We examined the protective effect of an expression plasmid (pME18S-M) containing M1 and M2 genes of influenza A/PR/8/34. We detected the CTL activity by introducing these plasmids into BALB/c mice by either the intramuscular or the intranasal route. The influenza-specific antibody response was also induced, although its neutralizing effect against influenza virus was not observed. From 70 to 80% protection was observed in the mice immunized with the pME18S-M plasmid followed by lethal infection with influenza viruses of the A/WSN/33 and A/PR/8/34 strains, whereas all mice without the plasmid vaccination failed to survive. This protective activity was significantly weakened when the CD8(+) cells of these immunized mice were eliminated by several injections of anti-CD8 antibody. The protective activity was also weakened when anti-CD4 antibody was injected in the early phase of DNA vaccination. These data suggest that the pME18S-M plasmid is useful as a DNA vaccine for overcoming highly mutational influenza viruses.

Improvement of separation method of fragmented DNA from an apoptotic cell DNA sample for the quantitation using agarose gel electrophoresis

In order to quantify fragmented DNA extracted from apoptotic cells, we devised a separation method which condenses fragmented DNA into a small band, separating it from larger-size DNA with agarose gel electrophoresis. Calf thymus DNA and standard fragmented DNA were loaded onto 1.0% gel for 0.5, 1.0, 1.5 and 2.0 cm length, and onto 0.7, 1.0, 1.5 and 2.0% of gels for 1 cm length. DNA was then extracted from gel slices with the UltraClean 15 DNA Purification Kit, and estimated by measuring fluorescence intensity using Hoechst No.33258 dye. DNA recovery from the gel showed constant values regardless of the amount of loaded DNA up to 1 microg/assay, and a plot of loaded DNA amounts vs. the DNA amount yielded resulted in a strait line in any gel concentration used. Our results show the best conditions to estimate DNA fragmentation rates in apoptotic cells in which fragmented DNA was separated from thymus DNA by loading on 1.0% gel for 1.0 cm length. We used our method to estimate fragmentation rates in DNA fractions extracted from apoptotic human cervical fibroblast, amnion epithelial and chorion laeve trophoblast cells by stimulation with actinomycin D. The results show that DNA fragmentation rates in these cells were consistent with the electrophoretic patterns of the DNA samples shown by their photographs.

T lymphopaenia in relation to body mass index and TNF-alpha in human obesity: adequate weight reduction can be corrective

OBJECTIVE

Although individuals with obesity are susceptible to infection, the underlying causes have not been fully identified. To investigate whether obesity affects immunity, we studied subjects with isolated obesity.

DESIGN AND SUBJECTS

Thirty-four obese persons from our outpatient obesity clinic and 50 nonobese healthy control subjects were studied. The effects of weight reduction were evaluated in obese subjects on a very-low-energy diet. We examined blastogenic response, lymphocyte subsets, circulatory TNF-alpha, soluble TNF-alpha receptor 1, soluble TNF-alpha receptor 2, and in vitro TNF-alpha production in obesity.

MEASUREMENTS

Lymphocyte subsets were analysed with flowcytometry. TNF-alpha and soluble TNF receptors levels were assayed using commercially available enzyme-linked immunosorbent assay kits.

RESULTS

Blastogenic responses to phytohemagglutinin or concanavalin A of T cells, CD3(+), CD4(+), CD8(+), CD4(+)CD45RO(+), and TCR alpha beta T cells were significantly diminished in obese subjects. Strong negative correlations were observed between TCR alpha beta and body weight and BMI in obese subjects. Circulatory levels of TNF-alpha, soluble TNF-alpha receptors, and in vitro TNF-alpha production were significantly increased compared to nonobese subjects. In obese subjects, there were significant positive correlations between serum levels of TNF-alpha and waist-hip ratio, serum levels of soluble TNF-alpha receptor 1 and body weight, soluble TNF-alpha receptor 2 and BMI, and soluble TNF-alpha receptor 2 and waist-hip ratio. The T cell responses and previously reduced non-CD8 T cell subsets were increased significantly following weight reduction.

CONCLUSIONS

Our results suggest that subsets of T cell populations and their function may be reduced in human obesity, and that this may be related, at least in part, to the elevated TNF-alpha production. Furthermore, this T cell dysfunction can be recovered by adequate weight reduction.

Glomerulocystic kidney associated with subacute necrotizing-encephalomyelopathy

A 22-year-old man with subacute necrotizing-encephalomyelopathy (SNE; Leigh's disease) was diagnosed as having progressive renal dysfunction. The clinical diagnosis of Leigh's disease was obtained by the typical central nervous lesions, abnormalities in other organs, and increased lactate concentrations in blood and cerebrospinal fluid. We performed an open biopsy of the right kidney. Light microscopic studies of the renal specimen showed diffuse glomerulocystic kidney (GCK) with tubulointerstitial damage. Electron microscopic examination showed marked swelling and increase in the number of mitochondria of the renal tubular epithelial cells. Therefore, it is suggested that mitochondrial disease seems to play an important role in developing GCK.

Mechanism of superoxide generation system in indomethacin-induced gastric mucosal injury in rats

We studied the mechanism of the superoxide generation system in indomethacin-induced gastric mucosal injury. First, 10 mM indomethacin had no direct effect on xanthine oxidase (XOD) activity. Next, we found that NADPH oxidase activity in polymorphonuclear leukocytes (PMN) of peripheral blood was significantly increased 6 h after administration of indomethacin. This phenomenon was inhibited by the injection of the NADPH oxidase inhibitor, diphenylene iodonium chloride (DIC). Activation of NADPH oxidase caused the component, p47phox to be translocated to the plasma membrane. Since indomethacin did not directly activate NADPH oxidase, we sought another route of activation of PMN. As IL-1 and TNF alpha play in the inflammation, we examined these cytokines in this study. TNF alpha was not detected but IL-1 was increased significantly 30 min after administration of indomethacin.

[A case of lung cancer underwent carinal resection with right upper lobectomy and carinal reconstruction with double-barreled anastomosis]

A 70-year-old male complaining cough was admitted to our hospital. Bronchoscopic examination revealed a tumor mass which occluded the orifice of the right upper lobe. Chest computed tomographic (CT) scans gave the image of tumor invasion at the carina. The pathological diagnosis of the tumor was squamous cell carcinoma. Operation was accomplished by right posterolateral thoracotomy approach through the fifth rib bed. The carinal resection with right upper lobectomy was followed by a double-barreled anastomosis of the right intermediate trunk and left main-stem bronchus into the carina. The operation was successfully performed and was considered curative. The length of resected airway measured 4.0 cm from tracheal line of resection to the divided the right intermediate trunk. Reinforcement of the anastomosis was not performed in this case. No postoperative complication occurred but mild ischemia of the anastomosis. The patient died of recurrent tumor in a year and 2 months after operation.

[History of surgery for cholelithiasis: from the era of cholecystostomy to laparoscopic surgery]

Since Stalpert von der Wiel first incised the abdominal wall for bile drainage in a patient with an intraabdominal abscess due to gangrenous cholecystitis with calculi in 1684, the problems inherent in the treatment of cholelithisiasis have received attention from surgeons working in this field. However, the major event was the development of the technique of cholecystectomy by Langenbuch in 1882 opening a new era in surgery for cholelithiasis. Subsequently numerous advances were made in cholecystectomy, choledochotomy, choledochoenterostomy, and sphincteroplasty associated with progress in the diagnostic techniques and instrumentation necessary to perform surgery for cholelithiasis. However, the outcomes of these methods were criticized, and they were gradually abandoned due to development of minimally invasive endoscopic or laparoscopic surgery. The development of laparoscopic cholecystectomy revolutionized the history of biliary surgery. In the 21st century, the best treatment will be available to all patients with the use of ultramodern technologies such as telesurgery and robotic surgery.