Inflammatory pseudotumor of the liver complicated with recurrent gouty arthritis

Inflammatory pseudotumor (IPT) of the liver is a rare benign lesion of unknown etiology and is often accompanied by fever. Unexplained persistent fever unresponsive to antibiotics developed in a 70-year-old man suffering from intractable recurrent gouty arthritis. 67Ga-scintigraphy disclosed intense focal uptake in the upper abdomen. The lesion in the left lobe of the liver was an ill-defined hypodensity mass on computed tomographic scan and was enhanced on dynamic magnetic resonance imaging. The tumor was surgically removed and a diagnosis of IPT was made. Fever and arthritis resolved completely after surgery. Possible interaction between IPT of the liver and gouty arthritis was suggested.

Synthesis of branched cyclomaltooligosaccharide carboxylic acids (cyclodextrin carboxylic acids) by microbial oxidation

Novel branched cyclomaltooligosaccharide carboxylic acid (cyclodextrin carboxylic acid) derivatives were synthesized by microbial oxidation using Pseudogluconobacter saccharoketogenes to oxidize five types of branched cyclodextrins, including maltosyl beta-cyclodextrin (maltosyl-beta-CyD). For each novel cyclodextrin carboxylic acid derivative synthesized, the hydroxymethyl group of the terminal glucose residue in the branched part of the molecule was regiospecifically oxidized to a carboxyl group to give the corresponding uronic acid. In addition, the physicochemical properties of cyclomaltoheptaosyl-(6-->1)-alpha-D-glucopyranosyl-(4-->1)-alpha-D-glucopyranosiduronic acid (GUG-beta-CyD) (1) and its sodium salt were studied more extensively, as these compounds are most likely to have a practical application.

Anisotropy of magnetothermal conductivity in Sr2RuO4

The dependence of in-plane and interplane thermal conductivities of Sr2RuO4 on temperature, as well as magnetic field strength and orientation, is reported. We found no notable anisotropy in the thermal conductivity for the magnetic field rotation parallel to the conducting plane in the whole range of experimental temperatures and fields, except in the vicinity of the upper critical field H(c2), where the anisotropy of the H(c2) itself plays a dominant role. This finding imposes strong constraints on the possible models of superconductivity in Sr2RuO4 and supports the existence of a superconducting gap with a line of nodes running orthogonal to the Fermi surface cylinder.

Directly linked soluble IL-6 receptor-IL-6 fusion protein induces astrocyte differentiation from neuroepithelial cells via activation of STAT3

Signals of interleukin 6 (IL-6) are transduced by binding of IL-6 to its cell surface receptor (IL-6R) and subsequent association of the resultant IL-6/IL-6R complex with gp130, the signal transducing receptor component utilized in common by all the IL-6 family of cytokines. A soluble form of IL-6R (sIL-6R), which lacks transmembrane and cytoplasmic regions, retains the ability to bind IL-6 and signal through gp130. We show here that a fusion protein of sIL-6R and IL-6 without a polypeptide linker, termed FP6, induces differentiation of astrocytes from fetal mouse neuroepithelial cells as potently as a representative IL-6 family cytokine, leukaemia inhibitory factor (LIF). FP6 has a potential to activate a transcription factor, signal transducer and activator of transcription 3 (STAT3), and mitogen-activated protein kinases, ERK1 and ERK2, in these cells as does LIF. FP6 activates a promoter of the gene for an astrocytic marker, glial fibrillary acidic protein (GFAP), in neuroepithelial cells. This activation is virtually abolished by ectopic expression of a dominant-negative form of STAT3, or by introducing a point mutation into the STAT3 response element located in the GFAP promoter. These results suggest that FP6 induces astrocyte differentiation from neuroepithelial cells through STAT3 activation and that FP6 could be of use as a substitute for natural IL-6 family cytokines.

[Home drug therapy for a patient who rejected use of morphine--management of dyspnea and pain by codeine phosphate]

We encountered a terminal lung cancer patient with severe back pain and dyspnea who refused the use of morphine, and succeeded in home palliative care with the use of an original prescription (CA), the main ingredient of which was codeine phosphate.

[Death at home and hospital of home terminal cancer patients]

We think that death at home has increased among patients from our hospital due to following factors: 1) solid cooperation with visiting nurse stations, 2) progress in judgments of care ability, 3) changes in family consciousness, 4) enrichment of other support systems for home care.

Studies of amphetamine or methamphetamine psychosis in Japan: relation of methamphetamine psychosis to schizophrenia

There exist clinical characteristics of methamphetamine (MAP) psychosis in the Japanese population. MAP psychosis involves paranoid-hallucinatory states indistinguishable from paranoid schizophrenia, with residual volitional disturbances (e.g., loss of spontaneity and idleness). Paranoid-hallucinatory states persist after the pharmacological effects of MAP have worn off and readily reappear upon a reinjection of MAP. Individuals with a history of MAP psychosis further undergo spontaneous recurrence of their paranoid-hallucinatory states in response to stress. The development of MAP psychosis might therefore be related to persisting brain damage or changes in brain metabolism induced by repeated MAP use, and thus studies of the clinical course and neurological basis of MAP psychosis could provide insights into the pathophysiology of schizophrenia. Accordingly, psychiatrists have studied the clinical characteristics of MAP psychosis and examined the neurobiological basis of MAP-induced behavioral sensitization, using animals. MAP-induced behavioral sensitization might well be related to dopamine supersensitivity; however, the contribution of presynaptic autoreceptors remains controversial, and other hypotheses should be considered. Recently, the process that triggers spontaneous recurrence of MAP psychosis (flashbacks) and corresponding peripheral neurotransmitter functions has been studied. Stress sensitization associated with noradrenergic hyperactivity, involving increased dopamine release, appears to be crucial in the development of flashbacks. Overall, MAP-induced susceptibility to paranoid-hallucinatory states and to abnormal behavior (e.g., stereotyped behavior) in animals is examined as a model for predicting relapses of paranoid schizophrenia. Further extensive studies on the neurobiological and molecular mechanisms of this susceptibility are required.

Susceptibility to subsequent episodes in spontaneous recurrence of methamphetamine psychosis

The relation is examined between increased sensitivity to stress associated with noradrenergic hyperactivity and dopaminergic changes, and susceptibility to subsequent spontaneous recurrences of methamphetamine (MAP) psychosis (i.e., flashbacks). Plasma monoamine metabolite levels were assayed in 23 flashbackers, 19 nonflashbackers with a history of MAP psychosis, 10 subjects with persistent MAP psychosis, and 21 MAP user and 9 nonuser controls. All 23 flashbackers had undergone frightening stressful experiences during previous MAP use. Mild psychosocial stressors then triggered flashbacks. The 12 flashbackers with further episodes had markedly increased norepinephrine levels and slightly increased plasma levels of 3-methoxytyramine, an index of dopamine release. While the 11 flashbackers with a single episode displayed small increases in norepinephrine and 3-methoxytyramine levels. Thus, robust noradrenergic hyperreactivity, involving increased dopamine release in response to mild stress may predispose to further episodes of flashbacks.

Inhibitory effect of ATF3 antisense oligonucleotide on ectopic growth of HT29 human colon cancer cells

ATF3 is a transcription factor belonging to the Jun / Fos family whose mouse homologue (TI-241) was isolated, using the differential screening method, from B16 mouse melanoma cells as a blood-borne metastasis-associated gene. Here we show the tumorigenicity-inhibiting effect of an antisense oligonucleotide designed to reduce the expression of ATF3 in HT29 colon cancer cells. HT29 cells were reported to metastasize to the skin after intravenous inoculation. The antisense oligonucleotide inhibited cell attachment to the collagen-coated floor of the plates and invasion of HT29 cells in vitro, which are thought to be two important factors in the process of cancer metastasis and ectopic tumor growth. While the antisense oligonucleotide had no effect on cell growth of HT29 cells in vitro, mice that were inoculated subcutaneously with HT29 cells and treated with the antisense oligonucleotide survived longer than the control mice due to the inhibition of tumor growth in vivo. These show that ATF3 plays an important role in the ectopic growth / metastasis of HT29 colon cancer cells.

Homogeneous detection of a target nucleic acid sequence by combination of the intercalation activating fluorescence DNA probe and the isothermal sequence amplification

We demonstrated the homogeneous real-time detection of RNA produced during isothermal TRC amplification by INAF probe.

Increased sensitivity to stress associated with noradrenergic hyperactivity, involving dopaminergic hyperactivity in spontaneous recurrences in methamphetamine psychosis

Abstract The study examined the significance of increased sensitivity to stress associated with noradrenergic hyperactivity and dopaminergic changes in spontaneous recurrences of methamphetamine (MAP) psychosis (flashbacks). Plasma monoamine metabolite levels were assayed in the subjects: 19 flashbackers, 18 non-flashbackers with a history of MAP psychosis and 37 controls. Monoaminergic values underwent a square-root transformation. All flashbackers had been exposed to stressful events plus MAP-induced fear-related psychotic symptoms (n = 11) or fear-related symptoms alone (n = 8). Factors triggering flashbacks met the DSM-III-R criteria for mild psychosocial stressors. During flashbacks norepinephrine levels increased markedly and 3-methoxytyramine, which is indicative of dopaminergic activity, increased to a lesser extent. Among the flashbackers, 11 with a history of stressful events plus fear-related symptoms displayed further a small increase in 3-methoxytyramine levels. Thus, stressful events plus fear-related symptoms, together with MAP use, may induce noradrenergic hyperactivity and some degree of dopaminergic hyperactivity in response to mild stressors. Increased sensitivity to stress associated with a predominance of noradrenergic over dopaminergic hyperactivity may be a precipitating factor in flashbacks.

[A multicenter study of cardiac events and anesthetic management of patients with ischemic heart diseases for noncardiac surgery--a follow-up report]

We have conducted a joint research project to investigate the incidence of ischemic heart disease in patients for noncardiac surgery and to define the risk of perioperative cardiac complications in these patients. From September to November 1997 we had 7288 patients scheduled to undergo noncardiac surgery in the 8 departments of anesthesiology. Of these patients, 228 (3.1%) patients had ischemic heart disease, and 30 of them (13.2%) developed perioperative cardiac events. Critical cardiac events, including perioperative myocardial ischemia and lethal arrhythmia, occurred in 7 of these patients. In our region of Japan, 3-4% of surgical patients tend to develop ischemic heart disease and 3.1% of them demonstrated severe cardiac complications perioperatively. Compared with United States we encounter fewer surgical patients with ischemic heart disease, but the risk of developing perioperative cardiac complications in such patients is almost the same for both countries.

[Multicenter study of cardiac events and anesthetic management of patients with ischemic heart diseases undergoing noncardiac surgery]

We designed a joint research project to investigate the incidence of ischemic heart diseases in patients undergoing noncardiac surgery and to define the risk of perioperative cardiac complications in these patients. Of the 8358 surgical patients in the 8 departments of anesthesiology between March 1997 and June 1997, 328 (3.9%) had ischemic heart diseases. Among the 328 patients, 54 (16.4%) developed perioperative cardiac events, including myocardial infarction (3 patients) and either lethal or potentially dangerous dysrhythmias (51 patients). Preoperative cardiac assessments were performed while the anesthetic techniques including intensive monitoring and perioperative prophylactic therapy were also employed. Patients with ischemic heart diseases received various types of preoperative evaluation to identify the degree of coronary artery disease and to assess the overall cardiac function. The patients were monitored using a multilead electrocardiogram, an arterial line, a central venous catheter, a pulmonary artery catheter, and by transesophageal echocardiography intraoperatively. Therapeutically, isosorbide, nitroglycerin, beta-blockers, calcium channel blockers, and/or nicorandil were administered to prevent perioperative ischemia. So far, no generally accepted management strategies have been established in patients with cardiovascular disorders based on large-scale outcome trials in Japan. Therefore, nationwide large multicenter trials are awaited with interest in order to establish helpful guidelines to improve the perioperative management and to reduce ischemia in cardiac patients undergoing noncardiac surgery.

Risperidone counteracts lethality in an animal model of the serotonin syndrome

RATIONALE

The serotonin (5-HT) syndrome is the most serious side effect of antidepressants, and pharmacologic treatment should be offered in severe cases.

OBJECTIVE

In the present study, the effects of risperidone, ketanserin, and haloperidol on an animal model of the serotonin (5-HT) syndrome were evaluated.

METHODS

Intraperitoneal administration of 100 mg/kg 5-hydroxy-L-tryptophan (5-HTP) (a precursor of 5-HT) and 2 mg/kg clorgyline (a monoamine oxidase type-A inhibiting antidepressant) induced the 5-HT syndrome in rats. The rectal temperature of the rats was measured, and the microdialysis method was used to measure noradrenaline (NA) levels in the anterior hypothalamus.

RESULTS

In the group pre-treated with saline, the NA concentration increased to 13 times the pre-administration level, rectal temperature increased to more than 40 degrees C, and all of the animals died 75 min later. In the group pre-treated with risperidone (0.5 mg/kg), the 5-HT syndrome was completely inhibited, and the NA level increased to 6.5 times the pre-administration level. Ketanserin, a selective 5-HT2A antagonist (5 mg/kg) also inhibited the 5-HT syndrome. In contrast, all of the rats in the group pre-treated with haloperidol (0.5 mg/kg) died earlier than in the saline group.

CONCLUSIONS

These results suggest that strong 5-HT2A antagonists such as risperidone, but not dopamine D2 antagonists, counteract lethality due to 5-HT syndrome, and that not only does enhancement of 5-HT activity occur in the 5-HT syndrome, but NA activity also increases.

Utility of blasts with a clear halo around the nucleolus as a predictive indicator for disease progression in patients with myelodysplastic syndromes and aplastic anemia

This study was designed to evaluate the utility of blasts with a clear halo around their nucleoli (BCHN) as a predictive indicator of disease progression in myelodysplastic syndromes (MDSs) and aplastic anemia (AA). Bone marrow aspirates from 75 patients with MDSs and 18 with AA were fixed in 95% ethanol solution or 10% neutral formalin and stained with the Papanicolaou method. BCHNs were detected in 57 of 75 patients with MDSs and in 10 of 18 AA patients. Disease progression was restrictedly observed in 17 patients with MDSs who had BCHNs at onset and in 1 patient with AA. The proportion of BCHNs increased with disease progression in these 16 of 17 patients with MDSs. The presence of BCHNs at onset and the increase in proportion of BCHNs during the clinical course of MDSs were significant indications for predicting disease progression.

Analysis of novel metastasis-associated gene TI-227

TI-227 is a cancer metastasis-associated gene isolated from the B16-F10 mouse melanoma subline that preferentially metastasizes to the lung following intravenous injection. TI-227 is more highly expressed in the B16-F10 and colon26-nl17 sublines, which preferentially metastasize to the lung following intravenous injection, than in the B16-BL6 and colon26-nl22 sublines, which preferentially metastasize to the lung following subcutaneous injection. Since TI-227 could not be detected in normal tissues, there is a possibility that it is expressed specifically in tumors that preferentially metastasize to the lung following intravenous inoculation. Although the 5' end of TI-227 was analyzed, its total sequence contained no obvious open reading frame. However comparison with the isolated human counterpart, TI-227H gene, revealed a highly homologous region near the 3' end, which was expected to contain a very short open reading frame.

Increased sensitivity to stress in spontaneous recurrence of methamphetamine psychosis: noradrenergic hyperactivity with contribution from dopaminergic hyperactivity

The significance of increased sensitivity to stress associated with noradrenergic hyperactivity involving dopaminergic change in spontaneous recurrences of methamphetamine (MAP) psychosis (flashbacks) was examined. Plasma monoamine metabolite levels were assayed in 18 subjects with flashbacks who had been exposed to stressful events plus MAP-induced frightening psychotic symptoms (N = 11) or frightening psychotic symptoms alone (N = 7) during previous MAP use, in 15 nonflashbackers with a history of MAP psychosis, in 8 subjects with persistent MAP psychosis, and in 27 control subjects. Monoaminergic values were subjected to a square-root transformation, rendering the distribution normal. The numbers of stressful events (mostly threatening events) and frightening psychotic symptoms were significantly higher in the flashbackers than in the nonflashbackers. Factors triggering flashbacks were mild psychosocial stressors (mostly a mild fear of other people). During flashbacks, plasma norepinephrine levels increased, and the flashbackers, 11 of whom had experienced stressful events plus frightening psychotic symptoms, had an additional small increase in plasma levels of 3-methoxytyramine, which is indicative of dopamine release. Thus, threatening stressful events, together with MAP use, may induce noradrenergic hyperreactivity to subsequent mild stressors. Threatening, stressful events plus frightening psychotic symptoms may further induce increased dopamine release in response to mild stressors. Increased sensitivity to stress associated with noradrenergic hyperactivity involving increased dopamine release may have elicited memories of MAP psychosis related to frightening, stressful experiences. The increased sensitivity may be critical for the development of flashbacks.