Atherosclerosis-associated changes in the carbohydrate-binding capacities of smooth muscle cells of various human arteries

A set of labelled neoglycoproteins and sulfated polysaccharides, recognizing carbohydrate receptors specific for glucose (glu), mannose (man), lactose (lac), fucose (fuc), fucoidan (fud), dextran sulfate (dex), and heparin (hep), as well as polyclonal antibodies specific for an endogenous beta-galactoside-specific lectin of molecular weight 14kD (A14kD) and a heparin-binding lectin (AHL) have been applied to the main arteries of 10 autopsy cases. Slides of the following types of vessels were incubated with solutions of the biotinylated probes or antibodies at room temperature for 60 min: right and left coronary artery, carotid artery, abdominal and thoracic aorta, pulmonal artery, and the left femoral artery. Atherosclerotic lesions and non-atherosclerotic areas were analyzed for each individual type of vessel. The percentage of the determined expression of the presence of specific binding sites for the various probes was the lowest in the carotid and cardiac arteries, and the highest in the pulmonal artery. Pronounced quantitative differences between the normal and atherosclerotic arterial walls were noted for binding of fuc-, man-, and lac-exposing neoglyco-proteins of the right coronary artery and the carotid artery. Pulmonal and femoral arteries differed with respect to fucoidan or dextran sulfate binding. The heparin-specific lectin and the 14kD-lectin were found to be present in nearly all arterial walls, independent from the localization and the presence of an atherosclerotic lesion. The findings suggest that the expression of sugar receptors, as assessed by labelled neoglycoproteins or sulfated polysaccharides, may be of importance in the development of atherosclerotic lesions in the coronary and carotid arteries.

[Hemophilia A complicated with hepatocellular carcinoma]

A 60-year-old hemophiliac man complaining of abdominal discomfort was admitted on suspicion of hepatocellular carcinoma (HCC) by ultrasonography (US). When he was 22-year-old, blood transfusion was given for intra-abdominal hematoma due to an external wound and a diagnosis of moderate hemophilia A and non-A non-B type chronic hepatitis (later, C type chronic hepatitis) was made at the age of 40. After admission, HCC in the S6 segment of the liver was diagnosed by US, computerized tomography, magnetic resonance imaging and angiography. He was treated with transcatheter arterial embolization (TAE) and partial resection of the liver. Later, percutaneous ethanol injection therapy and TAE was performed because of the recurrence of HCC. He is now alive with no evidence of recurrence. The rate of infection with hepatitis C virus (HCV) is significantly high in hemophiliacs but, because of the replacement therapy, their life expectation has dramatically improved in last two decades. Therefore, it is speculated that the incidence of HCC in hemophiliacs will increase. We emphasize that regular US examination for HCV-positive hemophiliacs is important for the early detection of HCC.

Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) after chemotherapy in patients with non-Hodgkin's lymphoma; a placebo-controlled double blind phase III trial

To assess the clinical and hematopoietic effects of rhGM-CSF, a placebo-controlled double blind multicenter phase III study was undertaken in patients with non-Hodgkin's lymphoma receiving cytotoxic chemotherapy. Sixty-two patients who had granulocytopenia (< 1 x 10(3)/microliters) after the first cycle of chemotherapy with cyclophosphamide, adriamycin, vincristine, and prednisolone were enrolled. After the second cycle of chemotherapy with the same regimen, patients randomly received either rhGM-CSF (125 micrograms/m2/day) or placebo for 14 days (rhGM-CSF; 31 patients and placebo; 31 patients). Administration of rhGM-CSF induced a significant increase in granulocytes mainly with neutrophils, eosinophils and monocytes, but elevation of lymphocytes, platelets, and reticulocytes was not induced. Median days of granulocytes less than 1 x 10(3)/microliters in patients receiving rhGM-CSF were significantly shorter than in patients receiving placebo (p = 0.001). Adverse reactions encountered with rhGM-CSF, and observed in 58% of the patients were never life-threatening and always rapidly reversible. They included fever, nausea and vomiting, diarrhea, skin eruption, and malaise. These results suggest that rhGM-CSF can be safely administered to prevent neutropenia after chemotherapy in patients with non-Hodgkin's lymphoma.

CGRP-immunoreactive cells supplying laryngeal sensory nerve fibres in the cat's nodose ganglion

Through a combination of retrograde staining by wheat germ agglutinin (WGA) and immunohistochemistry, calcitonin gene-related peptide (CGRP)-reactive sensory neurons projecting from the laryngeal mucosa were detected in the feline nodose ganglion. The size of the CGRP-immunoreactive cell which was regarded as a laryngeal sensory neuron, was about 60 microns in diameter: the shape of the immunoreactive laryngeal sensory neuron was unipolar. CGRP-reacted laryngeal sensory cells were found in the rostral part of the nodose ganglion extending to the middle part. They aggregated in the most rostral part, were sparse in other parts and were approximately 50 per cent of WGA-reactive laryngeal sensory neurons in number. Our results suggest that this neurotransmitter might play an important role in laryngeal peripheral sensory innervation.

pH profile of esophagus in patients with inlet patch of heterotopic gastric mucosa after tetragastrin stimulation. An endoscopic approach

In a series of 1771 endoscopic examinations from 1988 to 1990, we observed 62 cases (3.3%) of inlet patch of heterotopic gastric mucosa (IPHGM) in the upper esophagus. Ten of the IPHGM patients complained of throat discomfort or globus sensation, and these symptoms were relieved by histamine H2-antagonists, suggesting that these symptoms could be caused by acid secretion from IPHGM. Acidity under tetragastrin stimulation was measured in the esophagus and compared with the pool of gastric juice and saliva under direct vision by a newly devised endoscopic method. Congo red staining was also carried out after pH measurement. Significant pH reduction at IPHGM was observed in three cases, and black coloration with Congo red staining in the IPHGM was observed in four cases. These findings suggest that IPHGM is a mucosal change with latent acid secretion.

Three cases of juvenile onset HTLV-I-associated myelopathy with pseudohypoparathyroidism

Among 201 patients diagnosed with HAM/TSP at Kagoshima University, 21 juvenile onset patients had manifested clinical signs and symptoms at less than 15 years of age. They appeared to have common characteristics such as short stature and slight mental retardation. These signs prompted us to investigate five of them endocrinologically; and three patients with pseudohypoparathyroidism (PHP) were confirmed. Serum calcium levels were low, and human parathyroid hormone (PTH) infusion (Ellsworth-Howard test) caused low response in urinary cyclic AMP and phosphorus excretion. The first case had IgA nephropathy, which is generally associated with infectious diseases, while the second case had muscular lymphocytic infiltration. The mothers of cases 1 and 2, who were both seropositive for HTLV-I, were suspected to have abnormal calcium metabolism based on Ellsworth-Howard test. A brother of case 1 and two sisters of case 3 had also HAM/TSP and short stature. The early clinical onset of HAM/TSP may be due to PTH receptor anomaly and a low level of 1,25-dihydroxyvitamin D, which is deficient in PHP and is involved in the regulation of the immune response. The association with IgA nephropathy or myositis may result from progressive HTLV-I infection.

Mutational analysis of the amino acid residues essential for the cis and trans cleavage activity of the potato virus Y 50-kDa protease

To examine the proteolytic activities of various truncated derivatives of the potato virus Y (PVY) 50-kDa protease, the derivatives were expressed in Escherichia coli in polyprotein forms fused with coat protein (CP). For the intermolecular cleavage reaction, the truncated proteases were expressed together with the substrate protein containing the polymerase-CP junction. The activity was evaluated by the amount of the mature CP released from the precursor by the intra- and intermolecular cleavage occurring in E. coli. By this experiment, we identified the moiety responsible for the proteolytic activity of the 50-kDa protease to be a 26-kDa polypeptide mapped to the C-terminal half of the protease. Introduction of His234-->Tyr, Asp269-->Asn, or Cys339-->Gly substitution in the putative catalytic triad of the protease abolished its activity. However, the mutated protease with Cys339-->Ser replacement retained a reduced proteolytic activity.

Target organ specificity of cell proliferation induced by various carcinogens

The target organ specificities of cell proliferation and histopathological lesion induction by 5 carcinogens having different target organs were evaluated using a multiorgan carcinogenesis bioassay. In Group 1, male F-344 rats aged 6 wk were sequentially treated with N-diethylnitrosamine (DEN, single 100-mg/kg ip injection, week 0), N-methyl-N-nitrosourea (MNU, 4 20-mg/kg ip injections, weeks 0-2), N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN, 0.05% in drinking water, weeks 0-2), N,N'-dimethylhydrazine (DMH, 4 40-mg/kg sc injections, weeks 2-4), and dihydroxy-di-N-propylnitrosamine (DHPN, 0.1% in drinking water, weeks 2-4) during the first 4 wk. In Groups 2-6, rats were treated with only one of the above initiators, applied as in Group 1. Group 7 served as the no-treatment control. Bromouracil deoxyriboside (BUdR) labeling indices (LI) were counted in various organs at weeks 2 and 4. Numbers and areas of glutathione S-transferase placental form positive (GST-P+) liver foci were measured at weeks 2, 4, and 28. Preneoplastic or neoplastic lesion development was assessed at week 28. With regard to specific elevation of cell proliferation in target organs, BUdR LIs in the urinary bladder, liver, and colon were, respectively, increased in the BBN alone, DEN alone, and DMH alone treated groups as well as in Group 1. However, LIs of thyroid, lung, and kidney were also elevated by several carcinogens not including these organs in their carcinogenic target specificity. On the other hand, morphological lesions and GST-P+ foci were limited to Group 1 and the target organs of the corresponding carcinogen-treated groups.(ABSTRACT TRUNCATED AT 250 WORDS)

An immunohistochemical study of helix pomatia agglutinin binding on carcinomas of the esophagus

In many factors affecting the biologic behavior of malignant cells, alterations in the carbohydrate composition of cell membrane glycoproteins and glycolipids are considered to underlie the changes in cell adhesion that accompany malignant transformation and the development of invasive and metastatic properties. We investigated the alterations of the cell surface glycoproteins structure of carcinoma of the esophagus cells by HPA staining. The rate of patients with positive HPA staining increases with progression of depth of carcinoma invasion and venous invasion, and the survival in patients with positive HPA was poorer than in those with negative HPA. HPA-positive cells of carcinoma of the esophagus represent high malignant potentials. The HPA staining method is available to predict the prognosis of patients with carcinoma of the esophagus.

Cloning of a cDNA which encodes a novel ubiquitin-like protein

The cloning of a mouse cDNA, Nedd-8, which encodes a small novel protein of 81 amino acid residues with a relative molecular mass of 9 kDa, is described. The putative Nedd-8 product is approximately 60% identical to ubiquitin protein. The 0.6 kb mRNA for Nedd-8 gene can be detected in various mouse tissues and cell lines derived from various sources. Nedd-8 probe hybridizes to genomic DNA from various vertebrate species as well as yeast, indicating high degree of interspecies conservation. These data suggest that like ubiquitin, the product of this gene may play some essential role in eukaryotic cellular metabolism.

[A case of pulmonary thromboembolism associated with heparin-induced thrombocytopenia]

A 41-year-old man was admitted to our hospital for dyspnea on exertion and chest oppression. He was diagnosed as having pulmonary thromboembolism by pulmonary perfusion scan and angiography. An anticoagulant (heparin) and fibrinolytic (urokinase) therapy were administered to him as standard therapy. Six days after continuous infusion of heparin, however, he complained of worsening of dyspnea associated with severe hypoxemia and thrombocytopenia. Because heparin-induced thrombocytopenia was suspected, heparin administration was discontinued. Shortly after switching anticoagulant therapy from heparin to warfarin, the patient's symptom improved and his platelet count returned to the pretreatment value. In this case, it was thought that an immune-mediated response contributed to this heparin-induced thrombo-cytopenia. Moreover, we revealed platelet aggregating factor in the patient's plasma. This case illustrates that caution must be taken in the use of heparin for anticoagulant therapy in patients with pulmonary thromboembolism.

[Detection of minimal residual clone after sex-mismatched bone marrow transplantation by fluorescent in situ hybridization]

In our previous paper we reported that fluorescent in situ hybridization (FISH) using DYZ1 and DXZ1 was a highly reproducible technique and cellular chimerism consisting of cells of male and female origins could be detected in the order of 0.1%. In the present study FISH was applied to detect minimal residual clones (MRC) in 10 patients with a variety of leukemias who received sex-mismatched bone marrow transplantation (BMT). In 9 patients who had no signs of recurrence, serial FISHs performed on each patient revealed the presence of 0.1 to 3.2% recipient residual clone. On the other hand, in the remaining one patient 10.6% and 16.9% of MRC were found by FISH performed 6 and 10 months after BMT. Immediately thereafter, this patient was diagnosed as in relapse by bone marrow examination.

[Autonomic innervation of feline laryngeal glands: an immuno-electronmicroscopic study]

Autonomic innervation of feline laryngeal glands was investigated immunoelectronmicroscopically using antisera for vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY), and tyrosine hydroxylase (TH). A relatively dense population of immunoreactive (ir) VIP fibers was found in the vicinity of the basement membranes of glandular and myoepithelial cells. Some VIP -ir fibers contacted the basement membrane and some of the fibers penetrated the adjoining glandular cells intercellularly without making synaptic contacts with them. Ir-NPY and -TH fibers were less abundant than VIP-fibers and were distributed beneath the basement membranes of myoepithelial cells. These fibers were not encountered between glandular cells. The estimated ratio of ir-VIP, -TH and -NPY fibers was 20:4:1, based on the density of fibers in glandular tissues. Because this value was equal between serous and mucous glandular cell, these two tissues may receive the same pattern of autonomic innervation.

[Newly developed ultrasonic micro-probe (15MHz), basic and clinical study for gastrointestinal lesions]

The authors evaluated a new device the ultrasonic micro-probe (2.4mm in the outer diameter, radial scanning system, 15MHz, Toshiba Co.) from both its basic and clinical aspects using resected gastric specimens and clinical subjects. The ultrasonic resolution of this new ultrasound imaging catheter was demonstrated to be best the probe-object distance was 1.0-3.0mm and angle of inclination was 0-20. On clinical use of the probe, the above-mentioned basic evaluation is important to achieve high resolution ultrasonic image. For attenuation of ultrasound due to the high-frequency (15MHz), the main subjects of this probe for evaluation of gastrointestinal tract are small lesions of mucosal-submucosal layers. Because of its small caliber (2.4mm), the micro-probe can be passed through the biopsy channel of common used endoscope, and permits the intra-luminal ultrasound examination at routine endoscopy, if necessary. This new device the ultrasonic micro-probe will develop the ability of endoscopic ultrasound in diagnosing gastrointestinal disorders.

Improved leader and putative terminator sequences for high-level production of Streptomyces subtilisin inhibitor in Escherichia coli

A high-level production system in Escherichia coli for an alkaline serine protease inhibitor, termed Streptomyces subtilisin inhibitor (SSI), from S. albogriseolus S-3253 was established by replacing the SSI signal sequence with the OmpA signal sequence using the inducible pIN-III-ompA vector. Significant amounts of recombinant SSI, resulting from accurate cleavage of the OmpA signal peptide, were accumulated in the periplasmic space or excreted into the culture medium. The inhibitory activity of the processed protein against subtilisin BPN' was identical with that of authentic SSI. Furthermore, deletion of one of the putative dual terminators (terminator 1) resulted in a 1.9-fold increase in production. This effect on SSI gene expression efficiency was found to be governed mainly at the transcription level.

Reconstitution of the RB gene suppresses the growth of small-cell lung carcinoma cells carrying multiple genetic alterations

Multiple genetic alterations, including inactivation of the RB gene, occur commonly in small-cell lung carcinoma (SCLC). To assess a functional role of RB inactivation in the development of SCLC, an RB expression plasmid was introduced by stable transfection into SCLC cell lines, Lu-135 and N417, in which the RB gene was inactivated. Lu-135 and N417 cells transfected with the wild-type RB gene formed G418-resistant colonies twofold less efficiently than those with a mutated RB gene or with the control vector. Intact exogenous wild-type RB genes were detected only in approximately 20% of G418-resistant clones; three of 14 in Lu-135 and three of 16 in N417, respectively. Transcripts from the transfected RB gene were also detected in two of these three clones from Lu-135 and two of three from N417 but the amount of RB mRNA and protein was less than one fifth of that in normal fibroblast cells WI-38. Furthermore, clones with exogenous wild-type RB expression showed either reduced growth rates in culture or suppressed tumorigenicity in nude mice. These findings suggest that functional correction of the RB gene is sufficient to suppress the growth of SCLC cells, even though several other genetic alterations in the cells remain uncorrected.

[Pathology of arteriosclerosis--an overview]

Arteriosclerosis is vascular disease characterized by thickening, hardening and remodelling of the arterial wall and classified into following three categories: atherosclerosis, Mönckeberg's medial calcific sclerosis, and arteriolosclerosis. Fibromuscular intimal thickening starts its development in the fetal age of the 6th month and continues to grow with aging. The specific topography of early atherosclerotic lesions is primarily attributed to wall shear stress, one of hemodynamic forces. The lesion will proliferate to form atherosclerosis when complicated by hyperlipidemia, hypertension, and/or other clinical risk factors. The major complications of atherosclerosis, stenosis of the arterial lumen and thrombus formation at ulcerated arterial walls, frequently cause such lethal diseases as ischemia of various pivotal organs or rupture of aneurysms.

Gastric non-Hodgkin's lymphoma associated with Behçet's disease

The first case of primary gastric lymphoma associated with Behçet's disease is reported. A 43-year-old woman, who had been treated for Behçet's disease for 15 years, was diagnosed as low-grade and small lymphocytic malignant lymphoma of the stomach. Although the patient had been treated for Behçet's disease, chemotherapy was performed and a complete remission of gastric lymphoma was achieved. The literature regarding the association of malignant diseases with Behçet's disease is briefly reviewed.

Clinical and cytogenetic findings of myelodysplastic syndromes showing hypocellular bone marrow or minimal dysplasia, in comparison with typical myelodysplastic syndromes

Hematologic and cytogenetic data were collected on 401 myelodysplastic syndromes (MDS) patients in Japan and their clinical relevance was analyzed. More than 50% of the MDS patients with hypocellular bone marrow had > 5% marrow blasts at the time of MDS diagnosis and frequently had complex aberrations (chromosome changes at three or more regions). They showed peripheral blood findings resembling those of aplastic anemia, but progression into leukemic phase and the prognosis tended to mimic typical MDS. In MDS patients with minimal dysplasia, hematologic parameters were different from those of aplastic anemia. However, the low incidence of leukemic transformation and the favorable prognosis was similar to that of aplastic anemia. More than 90% of the patients in this group had refractory anemia and had normal karyotypes. Thus differential diagnosis from a low grade aplastic anemia is important, since this type of MDS might have a clonal nature as well. In conclusion, although some hematologic and clinical deviations are noticed in MDS with hypocellular marrow or minimal dysplasia, these MDS subtypes might constitute marginal forms of MDS.

[Clinical usefulness of measurement of erythropoietin in blood]

Blood erythropoietin (EPO) concentration was measured by radioimmunoassay in 513 patients with various diseases. Untreated polycythemia vera showed lower EPO concentration than normal. Aplastic anemia (AA) revealed the highest EPO level among all anemic diseases in relation to hematocrit value. EPO level of AA patients who underwent bone marrow transplantation was as low as normal subjects even when the anemia has not fully recovered. Paroxysmal nocturnal hemoglobinuria (PNH) showed unusually high EPO concentration among hemolytic anemias. In normal subjects, blood EPO concentration showed a diurnal rhythm that was higher at night than during the daytime. These findings suggest the diagnostic usefulness of measurement of EPO in blood diseases.

[Lipoprotein (a) and sclerotic changes in retinal arterioles]

Lipoprotein (a) (Lp(a)) has been considered an independent risk factor for arteriosclerotic disease and its role in retinal vascular changes was studied in this report. The study was made on 160 patients of age 54 and above. They were divided into four groups depending upon their clinical background with or without the presence of diabetes mellitus (DM) and cerebral infarction (CI). The retinal vascular status of the patients was studied by ophthalmoscopic examination and the findings were graded according to Scheie's classification. We found that all the patients with retinal arterial hypertension and arteriosclerosis had a significant by high level of serum Lp (a). Similarly, serum Lp (a) level was higher in the patients with DM and CI than in the control subjects. These findings suggested that Lp (a) might influence the pathological changes of senile retinal arterioles. Moreover, we found a positive linear correlation between Lp (a) and plasminogen in patients with CI.

[A case of sporadic and transient bradyarrhythmias in a patient with a glioma in the medulla oblongata]

In a 20-year-old female patient with a brain stem glioma in the medulla oblongata in association with paraplegia and respiratory paralysis, bradyarrhythmias such as sinus bradycardia and sinus arrest repeated sporadically and transiently, but soon subsided as radiotherapy was being delivered to the glioma in the medulla oblongata. The bradyarrhythmias were differentiated from sick sinus syndrome in their sporadic and transient character. The patient responded normally to atropine, isoproterenol, and phenylephrine. Parasympathetic nerve reflexes induced by Aschner's, Czermak's, and Valsalva's maneuvers and sympathetic nerve reflex induced by change of body position were within normal limits. Although EKG abnormalities associated with diseases of the central nervous system are frequently due to intracranial hypertension and/or irritation of the hypothalamus, the bradyarrhythmias in this patient were possibly due to vagus stimulation caused by the glioma in the medulla.