Current clinical results of the Tsukuba BNCT trial

Nine high grade gliomas (5 glioblastomas and 4 anaplastic astrocytomas) were treated with BSH-based intaoperative boron neutron capture therapy (IOBNCT). BSH (100 mg/kg body weight) was intravenously injected, followed by single fraction irradiation using the mixed thermal/epithermal beam of Japan Research Reactor 4. The blood boron level at the time of irradiation averaged 29.9 (18.8-39.5)microg/g. The peak thermal neutron flux as determined by post-irradiation measurements varied from 1.99 to 2.77x10(9) n cm(-2)s(-1). No serious BSH-related toxicity was observed in this series. The interim survival data in this study showed median survival times of 23.2 months for glioblastoma and 25.9 months for anaplastic astrocytoma, results which are consistent with the current conventional radiotherapy with/without boost radiation. Of the 4 residual tumors, 2 showed complete response (CR) and 2 showed partial response (PR) within 6 months following BNCT. No linear correlation was proved between the dose and the occurrence of early neurological events. The maximum boron dose of 11.7-12.2 Gy in the brain related to the occurrence of radiation necrosis. The clinical application of a mixed thermal/epithermal beam and JRR-4 facilities on BSH-based IOBNCT proved to be safe and effective in this series.

Radiographic examination of mesiodens and their associated complications

OBJECTIVES

To examine mesiodens with regard to their status, their influence on adjacent teeth and their alteration during the follow-up period.

METHODS

From retrospective reviews of all patients who visited our institution from 1990-2001, we identified 200 patients (256 mesiodentes) who were shown to have mesiodentes on the basis of a periapical radiograph, a panoramic radiograph or an axial radiograph.

RESULTS

The number of supernumerary teeth was one in 146 cases (73%), two in 52 cases (26%) and three in 2 cases (1%). Of 256 mesiodentes, the direction of the crown of the mesiodens was inverted in 172 (67%), in a normal direction in 69 (27%) and in a horizontal direction with regard to the tooth axis in 15 (6%). Of the 147 mesiodentes for which axial radiography was performed, 131 (89%) were located at a palatal site against the dental arch, 16 (11%) overlapped the dental arch and none were at a labial site. Of our 200 cases, a delay of eruption of the permanent central incisor was seen in 12 (6%), malposition or rotation of the central incisor in 5 (2.5%) and dentigerous cyst formation arising from mesiodens in 22 (11%). Marked movement of the mesiodens was seen in 10 cases during the follow-up period of 5-7 years. Some complication arising from mesiodens was seen in 19.5% of all cases in our research.

CONCLUSION

Although mesiodentes are not caused by malocclusion, they may cause it. A long period of impaction of mesiodentes may bring about dentigerous cyst formation or movement of the mesiodentes.

Increased adrenomedullin immunoreactivity and mRNA expression in coronary plaques obtained from patients with unstable angina

OBJECTIVE

To examine the expression and localisation of adrenomedullin in human coronary atherosclerotic lesions from patients with unstable angina (UAP) and stable angina (SAP), and to study the relation between adrenomedullin expression and plaque instability.

DESIGN

A retrospective observational study.

PATIENTS

Directional coronary atherectomy samples were obtained from 15 patients with UAP and 12 with SAP.

METHODS

The localisation of adrenomedullin was examined by immunohistochemistry, and adreno-medullin mRNA expression was measured by quantitative polymerase chain reaction.

RESULTS

Adrenomedullin immunoreactivity was preferentially localised in macrophages, intimal smooth muscle cells, and proliferated microvessels. The mean number of adrenomedullin positive cells in five high power fields (x 400) per specimen was higher in patients with UAP than in those with SAP (mean (SEM), 110 (13) v 76 (7); p < 0.05); and the ratio of adrenomedullin positive to total cells was higher in patients with UAP (43.0 (2.2)% v 34.2 (2.0)%; p < 0.01). More adrenomedullin mRNA was expressed in the plaque of patients with UAP than in those with SAP (60.4 (16.9)% v 9.7 (3.3)%; p < 0.01).

CONCLUSIONS

The findings suggest that adrenomedullin is involved in the development of atherosclerosis and plaque instability in human coronary arteries, in an autocrine or paracrine manner.

Evidence for nucleosome depletion at active regulatory regions genome-wide

The identification of nuclease-hypersensitive sites in an active globin gene and in the 5' regions of fruit fly heat shock genes first suggested that chromatin changes accompany gene regulation in vivo. Here we present evidence that the basic repeating units of eukaryotic chromatin, nucleosomes, are depleted from active regulatory elements throughout the Saccharomyces cerevisiae genome in vivo. We found that during rapid mitotic growth, the level of nucleosome occupancy is inversely proportional to the transcriptional initiation rate at the promoter. We also observed a partial loss of histone H3 and H4 tetramers from the coding regions of the most heavily transcribed genes. Alterations in the global transcriptional program caused by heat shock or a change in carbon source resulted in an increased nucleosome occupancy at repressed promoters, and a decreased nucleosome occupancy at promoters that became active. Nuclease-hypersensitive sites occur in species from yeast to humans and result from chromatin perturbation. Given the conservation of sequence and function among components of both chromatin and the transcriptional machinery, nucleosome depletion at promoters may be a fundamental feature of eukaryotic transcriptional regulation.

Isolation and characterization of a mesenchymal cell line that differentiates into osteoblasts in response to BMP-2 from calvariae of GFP transgenic mice

We established the clonal mesenchymal cell line, GFP-C3 (C3), which differentiates into osteoblasts in response to BMP-2 from calvariae of newborn green fluorescence protein (GFP) transgenic mice. This cell line cultured with control medium expressed low levels of alkaline phosphatase (ALP) activity and osterix mRNA and undetectable ALP and osteocalcin mRNA. Incubation of these cells with rhBMP-2 increased ALP activity dose-dependently and induced substantial levels of ALP, osteocalcin and osterix mRNA expression. C3 cells infected with adenovirus vector encoding BMP-2 (AdBMP-2) or Runx2 (AdRunx2) showed greatly increased ALP mRNA expression in a time-dependent fashion. Transduction with AdRunx2-induced expression of ALP and osteocalcin mRNA, but not osterix mRNA by day 3. Transduction with AdBMP-2 induced apparent expression of ALP and osterix mRNA by day 1 after transduction, but induced only weak expression of osteocalcin mRNA day 3 after transduction. Transplantation of C3 cells transduced with AdBMP-2 into back subfascia in wild-type mice with a complex of poly-d,l-lactic-co-glycolic acid/gelatin sponge (PGS) generated ectopic bone formation involving GFP-positive osteoblasts and osteocytes 2 weeks after transplantation. C3 cells transduced with AdRunx2 or AdLacZ failed to induce ectopic bone formation. Transplantation of C3 cells transduced with AdBMP-2 into craniotomy defects in wild-type mice using PGS as a carrier induced bone formation 2 weeks after transplantation, and replaced defects 4 weeks after transplantation. C3 cells transduced with AdRunx2 failed to induce bone repair after transplantation into craniotomy defects. These results indicate that C3 cells retain differentiation potential into osteoblasts in response to BMP-2. They are useful tools for analyzing the process of osteoblast differentiation in vivo after transplantation.

Observation of millimeter-wave radiation generated by the interaction between an electron beam and a photonic crystal

We observed directional light emission in the millimeter-wave region when a high-energy (150 MeV) electron beam passes just above a photonic crystal made of polytetrafluoroethylene beads ( approximately 3.2 mm in diameter). The relation between the momentum and the energy of the emitted photons strongly suggests that the observed light is generated by the umklapp scattering process that changes the evanescent waves emitted by the electron beam into observable ones. By comparing the observed spectra with calculated ones based on the photonic band structure, we found that generated photons excite the photonic band modes making them observable as enhanced fine structures in the emission spectra.

Radiographic examination of dentigerous cysts in the transitional dentition

OBJECTIVES

To examine radiographically the relationship between the deciduous tooth and dentigerous cyst of the permanent successor during the transitional dentition.

METHODS

From a retrospective review of all patients who visited our institution from April 1988 to August 2001, 70 patients under 16 years of age who had histologically confirmed dentigerous cysts that had developed from the central incisor to the second premolar were identified. These 70 patients were investigated using panoramic and periapical radiographs.

RESULTS

In most cases (54 cases; 77.1%) the cyst was in the premolar region. Of the 54 premolars with dentigerous cysts, the overlying deciduous tooth had already been lost in 7 cases. Of the 47 remaining premolars with associated deciduous tooth, 35 (74.5%) had bone resorption of the periapical or bifurcation region, or irregular resorption of the associated deciduous tooth. Of the remaining 12 deciduous teeth with no periapical lesions, 9 had been treated with root canal therapy. Thus, 44 of these 47 cases (93.6%) had the possibility of inflammation at the deciduous tooth associated with the dentigerous cyst. Evidence from one case in the present study suggesting the process by which cyst development occurs is also given.

CONCLUSION

Inflammatory change at the apex of the deciduous tooth may bring on a dentigerous cyst of the permanent successor.

Construction of 144, 565 keV and 5.0 MeV monoenergetic neutron calibration fields at JAERI

Monoenergetic neutron calibration fields of 144, 565 keV and 5.0 MeV have been developed at the Facility of Radiation Standards of JAERI using a 4 MV Pelletron accelerator. The 7Li(p,n)7Be and 2H(d,n)3He reactions are employed for neutron production. The neutron energy was measured by the time-of-flight method with a liquid scintillation detector and calculated with the MCNP-ANT code. A long counter is employed as a neutron monitor because of the flat response. The monitor is set up where the influence of inscattered neutrons from devices and their supporting materials at a calibration point is as small as possible. The calibration coefficients from the monitor counts to the neutron fluence at a calibration point were obtained from the reference fluence measured with the transfer instrument of the primary standard laboratory (AIST), a 24.13 cm phi Bonner sphere counter. The traceability of the fields to AIST was established through the calibration.

Purification and partial characterization of a dipeptidyl peptidase from Prevotella intermedia

A peptidase hydrolyzed X-Pro-p-nitroanilide was purified from the cell extract of Prevotella intermedia ATCC 25611 by ion-exchange chromatography and hydrophobic interaction chromatography. The purified enzyme exhibited a molecular size of 74 kDa from sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the maximum enzyme activity was found between pH 7.0 and pH 7.5. This peptidase was a serine enzyme and hydrolyzed Lys-Pro-p-nitroanilide, Arg-Pro-p-nitroanilide, and Ala-Pro-p-nitroanilide, but Lys-Ala-p-nitroanilide was not split. The enzyme may be classified as a dipeptidyl peptidase IV.

Comparison of ability of apoptosis induction by lipopolysaccharide of Porphyromonas gingivalis with Escherichia coli

We compared effects of Porphyromonas gingivalis LPS with Escherichia coli LPS to the murine peritoneal macrophage. E. coli LPS possessed a threshold dose between 100 micro g and 10 micro g, the higher dose induced apoptosis at the murine peritoneal macrophage while the lower dose did not. The ability of apoptosis induction at the murine peritoneal macrophage of P. gingivalis LPS was weaker than E. coli LPS. P. gingivalis LPS did not induce significant apoptosis in all tested dose. However, the morphology of the peritoneal macrophage treated by P. gingivalis LPS was obviously different from that of the unstimulated cells.

Transplantation of skin fibroblasts expressing BMP-2 promotes bone repair more effectively than those expressing Runx2

We investigated the osteogenic potential of skin fibroblasts that overexpressed BMP-2 or Runx2 by using adenoviral vectors. In in vitro experiments, skin fibroblasts infected with adenovirus vector encoding BMP-2 (AdBMP-2) released substantial levels of BMP-2 proteins into culture media, and those infected with adenovirus vector encoding Runx2 (AdRunx2) produced its protein. Transduction of BMP-2 or Runx2, respectively, increased alkaline phosphatase (ALP) activity and induced expression of mRNAs of ALP, osteocalcin, and osterix in skin fibroblasts. In in vivo experiments, we investigated the bone induction activity by transplantation of a complex composed of carrier [poly-D,L-lactic-co-glycolic acid/gelatin sponge (PGS)] and skin fibroblasts (PGS/SF complex). Transplantation of PGS/SF complexes composed of skin fibroblasts transduced with AdBMP-2-induced ectopic bone formation when transplanted into the subfascia of back muscle, unlike those infected with AdRunx2. Transplantation of PGS/SF complexes composed of skin fibroblasts transduced with AdBMP-2 into craniotomy defects induced bone formation from 2 weeks after transplantation, and almost all PGS was replaced by newly synthesized bone at 6 weeks. To investigate the fate of the transplanted cells, we transplanted skin fibroblasts isolated from green fluorescence protein transgenic mice into craniotomy defects. Transplantation of these skin fibroblasts transfected with AdBMP-2 generated green fluorescence protein-positive osteoblasts and osteocytes, indicating that the transplanted skin fibroblasts differentiated into osteoblastic lineage cells during bone repair. In contrast, transplantation of PGS/SF complexes composed of skin fibroblasts transduced with AdRunx2 induced a few ALP-positive cells at 1 week after transplantation, but their number decreased depending on time after transplantation. In addition, transplantation of these complexes was insufficient to induce bone repair. Taken together, our results suggest that skin fibroblasts expressing BMP-2 are more suitable for cell-mediated therapy of bone repair than those expressing Runx2.

Phosphorylation of RNA polymerase II CTD regulates H3 methylation in yeast

Histone methylation is now realized to be a pivotal regulator of gene transcription. Although recent studies have shed light on a trans-histone regulatory pathway that controls H3 Lys 4 and H3 Lys 79 methylation in Saccharomyces cerevisiae, the regulatory pathway that affects Set2-mediated H3 Lys 36 methylation is unknown. To determine the functions of Set2, and identify factors that regulate its site of methylation, we genomically tagged Set2 and identified its associated proteins. Here, we show that Set2 is associated with Rbp1 and Rbp2, the two largest subunits of RNA polymerase II (RNA pol II). Moreover, we find that this association is specific for the interaction of Set2 with the hyperphosphorylated form of RNA pol II. We further show that deletion of the RNA pol II C-terminal domain (CTD) kinase Ctk1, or partial deletion of the CTD, results in a selective abolishment of H3 Lys 36 methylation, implying a pathway of Set2 recruitment to chromatin and a role for H3 Lys 36 methylation in transcription elongation. In support, chromatin immunoprecipitation assays demonstrate the presence of Set2 methylation in the coding regions, as well as promoters, of genes regulated by Ctk1 or Set2. These data document a new link between histone methylation and the transcription apparatus and uncover a regulatory pathway that is selective for H3 Lys 36 methylation.

Quasi-solid dye sensitised solar cells filled with ionic liquid—increase in efficiencies by specific interaction between conductive polymers and gelators

Photo-energy conversions for quasi-solid dye sensitised solar cells increased when gel electrolytes were combined with conductive polymers as counter electrodes and the conversion surpassed that for DSSCs equipped with conventional Pt counter electrodes.

Cell cycle dependence of boron uptake from two boron compounds used for clinical neutron capture therapy

In neutron capture therapy, it is important that the boron is selectively uptaken by tumor cells. In the present study, we used flow cytometry to sort the cells in the G0/G1 phase and those in the G2/M phase, and the boron concentration in each fraction was measured with inductively coupled plasma atomic emission spectroscopy. The results revealed that sodium borocaptate and boronophenylalanine (BPA), were associated with higher rates of boron uptake in the G2/M than in the G0/G1 phase. However, the difference was more prominent in the case of BPA. The G2/M:G0/G1 ratio decreased as a function of exposure time in BPA containing culture medium, thereby indicating the cell cycle dependency of BPA uptake. Such heterogeneity of boron uptake by tumor cells should be considered for microdosimetry.

Anode glow discharge plasma treatment enhances calcium phosphate adsorption onto titanium plates

Glow discharge plasma (GDP) supplied to a cathode (GDP-) has been applied for cleaning, surface activating, and sterilizing biomaterials, because the kinetic energy in the case of the GDP- is larger than that supplied to the anode (GDP+). However, no comparison between GDP+ and GDP- has been reported. In this study, a titanium surface pre-treated with GDP+ and GDP- was characterized by x-ray photoelectron spectroscopy (XPS). In addition, the wettability of the titanium surface was measured with and without GDP. Furthermore, XPS characterized the adsorption of inorganic ions on titanium surfaces with and without GDP and immersed in an electrolyte solution. The findings suggested that GDP+ enhances calcium phosphate nucleation, due to the accumulation of electrons. In addition, calcium phosphate was not nucleated on the specimen with GDP-. We conclude that GDP+ is more suitable for biomineralization on titanium.

Influence of alcohol consumption on the association between serum lipids and colorectal adenomas

BACKGROUND

There have been no reports that low serum cholesterol levels increase the risk of colorectal adenoma, although many studies have shown that they do increase the risk of colorectal cancer. Alcohol intake, which is associated with a risk of colorectal adenomas, and serum cholesterol levels are closely related. The purpose of this study was to evaluate the influence of alcohol consumption on the association between serum cholesterol levels and colorectal adenoma.

METHODS

The subjects were 1,349 male patients who underwent both barium enema examination and total colonoscopy. They answered a questionnaire regarding their alcohol consumption history, and their blood samples were analysed. The subjects were divided into three groups: those with no tumour (with neither adenoma nor adenocarcinoma), those with adenoma and those with adenocarcinoma. Among the groups, the serum total cholesterol and triglyceride levels were compared in all the patients, in the patients who did not drink daily and in the patients who did.

RESULTS

In all the patients, the serum cholesterol and triglyceride levels did not differ between the patients with and those without adenoma. In the daily drinkers, the serum cholesterol and triglyceride levels were significantly lower in patients with adenoma than in those without.

CONCLUSIONS

Significantly lower levels of serum cholesterol and triglycerides were found in daily drinkers with adenoma than in those without.

Spontaneous esophageal perforation related to a duodenal ulcer with pyloric stenosis: report of a case

This report describes a case of spontaneous esophageal perforation that was considered to be etiologically related to a duodenal ulcer with pyloric stenosis. The patient was a 54-year-old Japanese man who presented following the sudden onset of severe abdominal pain and dyspnea after an episode of vomiting. He had a history of duodenal ulcer. Computed tomography revealed an extremely dilated stomach containing abundant food residue, intraabdominal effusion, bilateral pleural effusion, and mediastinal emphysema, findings that strongly suggested esophageal perforation. Esophagoscopy confirmed perforation of the lower esophagus. Laparotomy revealed marked contamination, including food residue in the abdominal cavity, and a severely dilated stomach attributed to pyloric stenosis caused by a duodenal ulcer. A 2-cm longitudinal perforation was found on the right side of the lower esophagus. Because the patient's general condition was too poor to tolerate a one-stage operation (primary closure of the perforation, gastrectomy, and reconstruction), we initially performed decompression gastrostomy and control of the esophageal leakage with T-tube placement. Following the T-tube was removed 1 month later, distal gastrectomy and reconstruction of the gastrojejunostomy (Billroth II method) could be safely performed.

In-phantom two-dimensional thermal neutron distribution for intraoperative boron neutron capture therapy of brain tumours

The aim of this study was to determine the in-phantom thermal neutron distribution derived from neutron beams for intraoperative boron neutron capture therapy (IOBNCT). Gold activation wires arranged in a cylindrical water phantom with (void-in-phantom) or without (standard phantom) a cylinder styrene form placed inside were irradiated by using the epithermal beam (ENB) and the mixed thermal-epithermal beam (TNB-1) at the Japan Research Reactor No 4. With ENB, we observed a flattened distribution of thermal neutron flux and a significantly enhanced thermal flux delivery at a depth compared with the results of using TNB-1. The thermal neutron distribution derived from both the ENB and TNB-1 was significantly improved in the void-in-phantom, and a double high dose area was formed lateral to the void. The flattened distribution in the circumference of the void was observed with the combination of ENB and the void-in-phantom. The measurement data suggest that the ENB may provide a clinical advantage in the form of an enhanced and flattened dose delivery to the marginal tissue of a post-operative cavity in which a residual and/or microscopically infiltrating tumour often occurs. The combination of the epithermal neutron beam and IOBNCT will improve the clinical results of BNCT for brain tumours.

Immunocytochemical studies of major gap junction proteins in rat salivary glands

We examined protein components of the gap junctions between acinar cells of the parotid, sublingual and submandibular glands of the rat, using type-specific antibodies directed against major gap junction proteins, connexin32 (Cx32) and connexin26 (Cx26). Double-immunofluorescence microscopy revealed that fluorescent spots of both connexins in the parotid and sublingual glands were distributed between the apposed regions of acinar cells. They appeared together, or were co-localized. The intensity of the Cx26-associated fluorescent signals was relatively weak in the submandibular glands compared with the other glands and was absent from some acini. When present, these spots were always co-localized with Cx32 immunoreactive positive spots. The results suggest that Cx32 and Cx26 in rat salivary glands are colocalized within the same gap junctional plaques when simultaneously expressed by the same acinar cells.

Ragweed-induced expression of GATA-3, IL-4, and IL-5 by eosinophils in the lungs of allergic C57BL/6J mice

Allergen-induced recruitment of T lymphocytes and eosinophils to the airways is associated with increased expression of the transcription factor GATA-3. In this study, the relationship between airway inflammation and GATA-3 expression in the lungs was investigated using ragweed-sensitized C57BL/6J mice. Intratracheal ragweed challenge increased both the number of GATA-3-expressing cells in the perivascular and peribronchial regions and the amount of expression per cell. Interleukin (IL)-4 and IL-5 levels in bronchoalveolar lavage fluid were upregulated in parallel with GATA-3 expression. GATA-3 mRNA and protein colocalized to eosinophils. Eosinophils isolated from the lungs and stimulated with phorbol 12-myristate 13-acetate and/or A-23187 released IL-5. The release was inhibited by actinomycin D, which indicates that de novo synthesis of the cytokine was involved. Western blot analysis of proteins from isolated eosinophils demonstrated expression of the p50 subunit of nuclear factor-kappaB, a transcription factor that is implicated in control of GATA-3 expression. These data provide evidence that allergen challenge increases GATA-3 and proinflammatory cytokine expression by pulmonary eosinophils, which could provide positive feedback for the inflammatory response.

Evaluation of a telemedicine system for supporting thyroid disease diagnosis

A telemedicine system connecting Japan and Belarus via a communication satellite and the international ISDN has been in use since February, 1999. Two relational databases, which are essentially the same, are set respectively at Nagasaki University School of Medicine and Gomel Regional Specialized Dispensary in Belarus for management of patients' data and for research including epidemiologic studies. The thyroid ultrasonographic images, microscopic images of cytological findings and other information on patients are sent from Gomel to Nagasaki once a week with diagnoses and comments by physicians at Gomel Regional Specialized Dispensary for cases whom they found difficult to diagnose. Thyroid specialists at Nagasaki University School of Medicine correct the diagnoses, if necessary, on the basis of information from Gomel and send their comments and instructions to Gomel for improving diagnosis skills of physicians at Gomel. The findings of 330 cases have been sent from Gomel to Nagasaki by September, 2000 since the commencement of the system in February, 1999. Of the 329 cases, thyroid diagnosis was made at Gomel for 261 cases in whom two or more diagnoses were made for 35 cases. As of the end of October, 2000, the Gomel diagnoses have been reviewed for 217 cases and the remaining 112 cases are under review at Gomel. The diagnoses made at Gomel and Nagasaki were in agreement for 110 (50.7%) of 217 cases. Thyroid cancer was diagnosed in 8 cases in whom 6 had been diagnosed at Gomel while the other 2 were diagnosed anew at Nagasaki. The usefulness of the system for improving thyroid diagnosis in Belarus was indicated.

Striped iron zoning of olivine induced by dislocation creep in deformed peridotites

Deformation of solid materials affects not only their microstructures, but also their microchemistries. Although chemical unmixing of initially homogeneous multicomponent solids is known to occur during deformation by diffusion creep, there has been no report on their chemical zoning due to deformation by dislocation creep, in either natural samples or laboratory experiments. Here we report striped iron zoning of olivine ((Mg,Fe)2SiO4) in deformed peridotites, where the iron concentration increases at subgrain boundaries composed of edge dislocations. We infer that this zoning is probably formed by alignment of edge dislocations dragging a so-called Cottrell 'atmosphere' of solute atoms (iron in this case) into subgrain boundaries during deformation of the olivine by dislocation creep. We have found that the iron zoning does not develop in laboratory experiments of high strain rates where dislocations move too fast to drag the Cottrell atmosphere. This phenomenon might have important implications for the generation of deep-focus earthquakes, as transformation of olivine to high-pressure phases preferentially occurs in high-iron regions, and therefore along subgrain boundaries which would be preferentially aligned in plastically deformed mantle peridotites.

15 years after Chernobyl: new evidence of thyroid cancer

The Chernobyl nuclear power plant accident happened on April 26, 1986. We investigated the cause of the striking increase in frequency of thyroid cancer in children who lived within a 150 km radius of Chernobyl and who were born before and after the accident. No thyroid cancer was seen in 9472 children born in 1987-89, whereas one and 31 thyroid cancers were recorded in 2409 children born April 27, 1986, to Dec 31, 1986, and 9720 born Jan 1, 1983, to April 26, 1986, respectively. Short-lived radioactive fallout caused by the Chernobyl accident probably induced thyroid cancer in children living near Chernobyl.

Chondrolysis of the glenohumeral joint following a color test using gentian violet

Two patients developed chondrolysis following injection of 0.4% aqueous gentian violet into the glenohumeral joint to visualize a rotator cuff tear during surgery. In both cases, conventional radiographs revealed joint space narrowing 10-12 months after surgery. Histological examination of the humeral heads revealed loss of the articular cartilage.

Phenotypic and suppressor analysis of defecation in clk-1 mutants reveals that reaction to changes in temperature is an active process in Caenorhabditis elegans

Mutations in the Caenorhabditis elegans maternal-effect gene clk-1 affect cellular, developmental, and behavioral timing. They result in a slowing of the cell cycle, embryonic and postembryonic development, reproduction, and aging, as well as of the defecation, swimming, and pharyngeal pumping cycles. Here, we analyze the defecation behavior in clk-1 mutants, phenotypically and genetically. When wild-type worms are grown at 20 degrees and shifted to a new temperature, the defecation cycle length is significantly affected by that new temperature. In contrast, we find that when clk-1 mutants are shifted, the defecation cycle length is unaffected by that new temperature. We carried out a screen for mutations that suppress the slow defecation phenotype at 20 degrees and identified two distinct classes of genes, which we call dsc for defecation suppressor of clk-1. Mutations in one class also restore the ability to react normally to changes in temperature, while mutations in the other class do not. Together, these results suggest that clk-1 is necessary for readjusting the defecation cycle length in response to changes in temperature. On the other hand, in the absence of clk-1 activity, we observe temperature compensation, a mechanism that maintains a constant defecation period in the face of changes in temperature.

Intracranial hypotension

The authors present the case of a 55-year-old man suffering from intractable spontaneous intracranial hypotension, in whom conservative treatment with 19 weeks of bed rest was not effective. In this period the patient twice underwent surgery for bilateral chronic subdural hematoma, a complication of spontaneous intracranial hypotension. Conventional radionuclide cisternography, magnetic resonance imaging, and computerized tomography myelography did not demonstrate cerebrospinal fluid (CSF) leakage. Repeated radionuclide cisternography with the patient in an upright position revealed leakage of the tracer at upper cervical levels. Computerized tomography myelography with breath holding also showed CSF leakage of the contrast medium bilaterally at upper cervical levels. The patient underwent surgery, and bilateral C-2 and C-3 spinal nerve root pouches were sealed off from the subarachnoid space with oxidized cellulose cotton and fibrin glue. Epiarachnoid spaces around the root sleeves were also sealed to ensure complete resolution of the CSF leakage. After the surgery, the patient was completely free of the disease. In the case of intractable persistent spontaneous intracranial hypotension, surgical treatment is preferable to long-term conservative management. To identify CSF leakage, radionuclide cisternography with the patient in the upright position is useful. When obvious leakage is encountered, surgical sealing of the lesion should be performed via a subarachnoid approach.

Implications of excessive fibrinolysis and alpha(2)-plasmin inhibitor deficiency in patients with severe head injury

OBJECTIVE

To evaluate the involvement of the fibrinolytic system, especially focused on alpha(2)-plasmin inhibitor, in patients with head injury.

METHODS

This study consisted of 47 patients with isolated blunt head trauma in whom blood sampling could be initiated within 3 hours after injury. Patients were divided into two groups according to Glasgow Outcome Scale score status at 3 months after injury. In Group 1 patients (n = 26), the outcome was characterized as good recovery or moderate disability; in Group 2 patients (n = 21), the outcome was characterized as severe disability, vegetative state, or death.

RESULTS

Concentrations of thrombin-antithrombin III complex were greater than 100 microg/L in 39 of 47 patients, and concentrations in Group 2 patients were elevated significantly beyond the concentrations in Group 1 patients. Activities of alpha(2)-plasmin inhibitor in Group 2 were significantly lower than in Group 1 (P < 0.0001). In Group 1 patients, alpha(2)-plasmin inhibitor activity was greater than 60%, while in all but four Group 2 patients, the inhibitor was reduced to less than 60% of normal activity within 3 hours of injury. All patients with alpha(2)-plasmin inhibitor activity less than 60% showed a marked bleeding tendency and/or severe brain edema. Using sandwich enzyme-linked immunosorbent assay, fibrinogen degradation product and fibrin degradation product were measured separately. A significant correlation was apparent between thrombin-antithrombin III complex and fibrinogen degradation product, as well as between the complex and fibrin degradation product. Marked decreases in alpha(2)-plasmin inhibitor were noted only in patients with thrombin-antithrombin III complex concentrations exceeding 500 microg/L.

CONCLUSION

Fibrinolysis and fibrinogenolysis may be involved according to the degree of coagulation activation in the pathophysiology of severe head injury. Decreased activity of alpha(2)-plasmin inhibitor indicated poor prognosis and may be an exacerbating factor in the acute phase of head trauma.

Removal of polyA tails from full-length cDNA libraries for high-efficiency sequencing

We have developed a method to overcome sequencing problems caused by the presence of homopolymer stretches, such as polyA/T, in cDNA libraries. PolyA tails are shortened by cleaving before cDNA cloning with type IIS restriction enzymes, such as GsuI, placed next to the oligo-dT used to prime the polyA tails of mRNAs. We constructed four rice Cap-Trapper-selected, full-length normalized cDNA libraries, of which the average residual polyA tail was 4 bases or shorter in most of the clones analyzed Because of the removal of homopolymeric stretches, libraries prepared with this method can be used for direct sequencing and transcriptional sequencing without the slippage observed for libraries prepared with currently available methods, thus improving sequencing accuracy, operations, and throughput.

Alveolar macrophage deficiency in osteopetrotic mice deficient in macrophage colony-stimulating factor is spontaneously corrected with age and associated with matrix metalloproteinase expression and emphysema

Macrophage colony-stimulating factor (M-CSF) is one of several hematologic growth factors capable of regulating the survival, proliferation, and differentiation of macrophages, but its role in modulation of the accumulation and function of alveolar macrophages (AMs) in vivo is not well defined. Osteopetrotic (Op/Op) mice have no detectable M-CSF and show variable tissue-specific reductions in macrophage numbers. It was hypothesized that AMs would be decreased in number and have altered function in Op/Op mice because of the absence of M-CSF. Lung macrophages identified by Mac-3 staining in lung sections were decreased in number in 20-day-old Op/Op mice (P <.001) but not Op/Op mice older than 4 months (P =.68) compared with findings in age-matched littermate controls. The numbers of AMs recovered by bronchoalveolar lavage (BAL) were also reduced in young but not adult Op/Op mice compared with controls. Expression of interleukin-3 (IL-3) was increased in the lungs of Op/Op mice compared with controls as determined by quantification of IL-3 cytokine levels (P =.04), bioactivity (P =.02), and messenger RNA transcript levels. AMs of Op/Op mice spontaneously released higher levels of matrix metalloproteinases (MMPs) than AMs of controls as determined by immunohistochemical staining of AMs and zymographic assessment of BAL fluid and AM lysates. Consistent with an increased release of MMP, Op/Op mice had abnormal elastin deposition and spontaneously developed emphysema in the absence of molecular or cellular evidence of lung inflammation. These data show that the AM deficiency observed in young Op/Op mice is spontaneously corrected with age and is associated with increased lung levels of IL-3, spontaneous MMP expression by AMs, and destruction of lung tissue.

Peripheral blood dendritic cells, but not monocyte-derived dendritic cells, can augment human NK cell function

Dendritic cells (DCs) are essential antigen-presenting cells with a wide variety of functions relating to both adaptive and innate immunity. Recently, interactions of DCs with natural killer (NK) cells and NK1.1-positive T cells have been reported in mice. However, in humans, this interaction is not well understood. Here we report the use of a coculture method to analyze the modulation of NK cell function in antitumor immunity by DCs. We found that peripheral blood DCs (PDCs) enhanced NK cell activity in cytotoxicity assay, even without direct contact between DC and NK cells. In contrast, neither monocyte-derived DCs (MoDCs), nor TNF-alpha-treated MoDCs, stimulated NK lytic activity. Secretion of IL-12 and TNF-alpha into the PDC-NK coculture supernatant was increased. However, blocking antibodies against these cytokines could not completely abolish the upregulation of NK activity, suggesting the presence of other soluble factor(s) that affect DC-NK cell interaction. To summarize, this study demonstrates for the first time the direct activation of human NK cells by DC-NK cell interaction in vitro, suggesting that DCs may have a central role linking the innate and adaptive immune responses. Moreover, in stimulating NK cell function, PDCs appear to have a different potential from MoDCs.

Th1 adjuvant N-acetyl-D-glucosamine polymer up-regulates Th1 immunity but down-regulates Th2 immunity against a mycobacterial protein (MPB-59) in interleukin-10-knockout and wild-type mice

Treatment of mice with heat-killed (HK) Mycobacterium bovis BCG or 1- to 10-microm chitin particles (nonantigenic N-acetyl-D-glucosamine polymers) is known to induce innate immune responses, including gamma interferon (IFN-gamma) production, which plays a Th1 adjuvant role. However, HK BCG further induces prostaglandin E2-releasing spleen macrophages (Mphi) (PGE2-Mphi), which potentially inhibit Th1 adjuvant activities. We found that chitin particles did not induce PGE2-Mphi formation. To further assess whether chitin has Th1 adjuvant effects, interleukin-10 (IL-10)-knockout (KO) mice and their wild-type (WT, C57BL/6) controls were immunized with a 30-kDa MPB-59 mycobacterial protein mixed with chitin. Immunization with MPB-59 alone induced Th2 responses, characterized by increases in total serum immunoglobulin E (IgE) and specific serum IgG1 levels and spleen Th2 cells producing IL-4, IL-5, and IL-10. No IFN-gamma-producing spleen Th1 cells, specific serum IgG2a, or delayed-type hypersensitivity (DTH) footpad reactions were detected. On the other hand, chitin-MPB-59 immunization significantly increased spleen Th1 responses, DTH reaction, and serum IgG2a levels along with decreases of Th2 responses. The magnitude of these Th1 adjuvant effects was greater in IL-10-KO mice than in WT mice. In contrast, immunization with HK BCG-MPB-59 showed little or no Th1 adjuvant effect. These data indicate that chitin has a unique Th1 adjuvant effect on the development of Th1 immunity against a mycobacterial antigen. IL-10 down-regulates the adjuvant effect of chitin.

GM-CSF regulates alveolar macrophage differentiation and innate immunity in the lung through PU.1

GM-CSF gene targeted (GM(-/-)) mice are susceptible to respiratory infections and develop alveolar proteinosis due to defects in innate immune function and surfactant catabolism in alveolar macrophages (AMs), respectively. Reduced cell adhesion, phagocytosis, pathogen killing, mannose- and Toll-like receptor expression, and LPS- or peptidoglycan-stimulated TNFalpha release were observed in AMs from GM(-/-) mice. The transcription factor PU.1 was markedly reduced in AMs of GM(-/-) mice in vivo and was restored by selective expression of GM-CSF in the lungs of SPC-GM/GM(-/-) transgenic mice. Retrovirus-mediated expression of PU.1 in AMs from GM(-/-) mice rescued host defense functions and surfactant catabolism by AMs. We conclude that PU.1 mediates GM-CSF-dependent effects on terminal differentiation of AMs regulating innate immune functions and surfactant catabolism by AMs.

Effects of recombinant human erythropoietin therapy on blood coagulation and fibrinolysis system

This study was designed to examine the effects of recombinant human erythropoietin (rHuEPO) therapy on blood coagulation and fibrinolysis in patients scheduled for elective heart surgery and undergoing preoperative autologous blood donation. Twenty-seven patients were studied, of whom 16 patients received rHuEPO (group E) and 11 patients no rHuEPO therapy (group N). The patients in group E were given 6000 units of rHuEPO intravenously every other day, three times a week, beginning from two weeks prior to the operation. In both groups, 400 ml of blood was collected preoperatively for predeposit once a week for two weeks, and the self-donated blood was returned to the patient intra- and postoperatively. Blood samples were drawn at the beginning of the study, immediately before the operation and two weeks after the operation. They were analyzed to assess blood coagulation, fibrinolysis, platelet function and vascular endothelial cell function, in order to examine the effects of the administration of rHuEPO. No significant difference was observed between the two groups in the degree of changes in these parameters following the operation. As enhancement of blood coagulability and fibrinolytic activity was evident postoperatively in both groups, changes in these parameters during the preoperative autologous blood donation period were also assessed excluding the postoperative data. Again, there was no significant intergroup difference in any of the markers evaluated. It was concluded that the administration of rHuEPO during preoperative autologous blood donation is unlikely to affect coagulation and fibrinolysis.

Release of IL-4 and IL-5 from human peripheral blood mononuclear cells co-cultured with Japanese cedar pollen antigen in vitro

The Japanese cedar pollen (JCP) is a major allergen with respect to pollinosis in Japan. It is believed that interleukin-4 (IL-4) and interleukin-5 (IL-5) derived from lymphocytes and other cells play a pivotal role in allergic reactions. We investigated whether the JCP antigen stimulates the release of these cytokines by peripheral blood mononuclear cells (PBMCs). PBMCs from eight adults (five adults with JCP pollinosis and three adults without JCP pollinosis) were co-incubated with purified JCP antigens. IL-4 was released in response to JCP antigens in six of the eight subjects at 24 h and in three subjects at 48 h. IL-4 release at 24 h occurred in all five subjects with JCP pollinosis but in only one of the three subjects without pollinosis. IL-5 was released in response to the JCP antigen in five of the eight subjects at 24 h and 48 h, including four of the five subjects with JCP pollinosis and one of the three subjects without pollinosis. These results suggest that PBMCs were more likely to release IL-4 and IL-5 in the presence of JCP pollinosis.

Balanced-size and long-size cloning of full-length, cap-trapped cDNAs into vectors of the novel lambda-FLC family allows enhanced gene discovery rate and functional analysis

We have developed a new class of cloning vectors: lambda-full-length cDNA (lambda-FLC) cloning vectors. These vectors can be bulk-excised for preparing full-length cDNA libraries in which a high proportion of the plasmids carry large inserts that can be transferred into other (for example, functional) vectors. Unlike other cloning vectors, lambda-FLC vectors accommodate a broad range of sizes of eukaryotic cDNA inserts because they contain "size balancers." Further, the main protocol we use for direct bulk excision of plasmids is mediated by a Cre-lox system and is apparently free of size bias. The average size of the inserts from excised plasmid cDNA libraries was 2.9 kb for standard and 6.9 kb for size-selected cDNA. The average insert size of the full-length cDNA libraries was correlated to the rate of new gene discovery, suggesting that effectively cloning rarely expressed mRNAs requires vectors that can accommodate large inserts from a variety of sources. Part of the vectors are also suitable for bulk transfer of inserts into various functional vectors.

Arthroscopic debridement for dialysis shoulders

PURPOSE

To arthroscopically treat "dialysis shoulder," severe shoulder pain in patients on long-term hemodialysis. This pain occurs only at rest such as during hemodialysis or while sleeping and is temporarily alleviated by assuming the sitting position or moving the shoulder joint. Limitations in range of motion and pain with overhead activity or the arm in the forward flexed position are not the patient's chief complaints. Although frozen shoulder and impingement syndrome may be observed as complications, pain at rest is the most characteristic.

TYPE OF STUDY

Clinical research on arthroscopic debridement to treat dialysis shoulder.

METHODS

We performed arthroscopic debridement of 36 dialysis shoulders in 29 patients. Only complete debridement in the glenohumeral joint and subacromial bursa was performed, without invasion to the bone and ligaments.

RESULTS

The pain improved in 34 shoulders in 27 patients (94%) a mean of 29.8 months after surgery, showing satisfactory results. In this group, the mean Japan Orthopaedic Surgery Association shoulder score (maximum 100 points) was 66.4 points before surgery but increased to 86.6 points postoperatively, statistically significant by 2-group t test.

CONCLUSIONS

We decided before beginning the study that no postoperative rehabilitation would be necessary. There were no complications and no need for further surgery, with all but 2 of the patients being satisfied with their postoperative condition.

Diversity and molecular anatomy of gap junctions

In animal tissues, most cells are connected via intercellular cytoplasmic channels called gap junctions. Various electron microscopy techniques have made a crucial contribution to our understanding of the function and structure of gap junction channels. Tracer studies and freeze-fracture replica observations indicate that the connexon, the unit gap junction channel, is a pair of hemichannels apposed in the narrow intercellular gap between neighboring cell membranes. Recent advances in cellular biology have shown that connexon hemichannels are composed of hexamers of connexin proteins. Purification of the gap junction membrane and cDNA cloning analysis indicate the diversity of the connexin protein family, which contains more than 18 members, and their tissue- and cell type-specific distributions. Defects in some connexin genes may cause various hereditary diseases, such as X-linked Charcot-Marie-Tooth disease (Cx32), nonsyndromic autosomal deafness (Cx26), and cataract (Cx50). Analysis of gene knockout mice indicates that certain types of connexin play important roles in differentiation and development at crucial times in specific tissues and cell types.

Solitary thyroid metastasis of renal clear cell carcinoma: report of a case

A case of solitary thyroid metastasis of renal clear cell carcinoma is described. The patient was a 77-year-old Japanese woman, who was referred to our department after a thyroid tumor was identified in May 1999. She had a history of renal clear cell carcinoma of the left kidney, which had been partially resected 3 years previously. Ultrasound sonography demonstrated that a well-demarcated hypoechoic mass containing high-echo spots representing small calcifications, which measured 45 x 34 x 31 mm in size, occupied the left lobe. Computed tomography revealed a low-density mass containing small calcifications. The results of preoperative fine-needle aspiration cytology strongly suggested a clear cell carcinoma metastasizing to the thyroid. A left hemithyroidectomy was performed on July 27, 1999. A histological examination revealed that the neoplasm was composed of tumor cells with abundant clear cytoplasm and round nuclei. The histological characteristics of this thyroid tumor were virtually identical to the renal cell carcinoma resected 3 years previously. Thyroglobulin stained negatively in the clear cells of the resected thyroid tumor in an immunohistochemical analysis. Clinically, the thyroid gland is a rare site of tumor metastasis; however, we should also consider the possibility of metastasis in the case of thyroid tumor patients with a history of renal cell carcinoma.

Regulation of the epithelial-mesenchymal transformation through gap junction channels in heart development

Analyses of mice lacking the gap junction protein, connexin45 (Cx45), have provided new insights into the essential roles of gap junction channels in early embryogenesis. Of great surprise is the function of Cx45 in the endothelium, where it is essential for synchronized activation of the transcription factor Nfatc1. This laterally synchronized regulation model extends the generally accepted vertical model, in which interactions between the endocardium and the myocardium induce endocardial cushion formation through the epithelial-mesenchymal transformation.

Dendritic cells activate antitumor immunity for malignant intracranial germ cell tumor: a case report

We report a 22-year-old male patient with a history of intracranial malignant germ cell tumor (GCT) who had undergone tumor resection twice, followed by radiation and chemotherapy. The tumor had rapidly recurred along the entire ventricular wall with extensive invasion into the brain parenchyma. The serum level of human beta-chorionic gonadotropin (beta-hCG) was 232.3 ng/ml on admission. Although tissue samples of the recurrent tumor could not be obtained, the previous histological diagnosis of germinoma and elevated serum beta-hCG levels suggested recurrence of malignant GCT. The patient declined chemotherapy but accepted dendritic cell (DC)-based immunotherapy. DC inoculation five times resulted in rapid tumor shrinkage and a significant decrease in the serum level of beta-hCG. Here we discuss the effectiveness of immunotherapy using DCs for recurrent intracranial malignant GCTs.

Identification of coding single-nucleotide polymorphisms in human taste receptor genes involving bitter tasting

T2Rs comprise a G-protein-coupled receptor superfamily that contains functionally defined bitter taste receptors. Here we report the tissue expressions and coding single-nucleotide polymorphisms (cSNPs) in human T2R genes (hT2R3, hT2R4, and hT2R5) on chromosome 7q31. We first demonstrated that hT2R3, hT2R4, and hT2R5 are actually expressed in the circumvallate papillae of the human tongue by reverse transcription-polymerase chain reaction (RT-PCR). We identified six cSNPs within the T2R receptor genes. The hT2R4 and hT2R5 contained four and one cSNPs that cause missense mutations, respectively, while hT2R3 included one silent nucleotide mutation. However, we could not find any nonsense mutations that resulted in a frameshift or a premature stop codon within the open reading frames. Genotype frequencies of each cSNP were in Hardy-Weinberg equilibrium. The identification of nucleotide diversity and amino acid polymorphisms in human T2R receptors could help clarify individual differences in the acceptability and sensitivity to bitter compounds.