[Bowel anastomosis using valtrac in urologic surgery]

Valtrac, a biofragmentable anastomosis ring, was used in 10 patients who underwent total cystectomy and urinary tract reconstruction. The primary disease was bladder tumor, neurogenic bladder, and sigmoid colon cancer invading the bladder in 8, 1, and 1 of the patients, respectively. There were 8 ileo-ileostomies and 2 ileo-colostomies. No patient developed anastomotic leakage or insufficiency. Symptoms of mild bowel obstruction were observed in 3 patients, but they improved with conservative management. The outcome was good in all the patients without further ileus during a follow-up period of 1 to 12 months (median: 7.3 months). The most important advantage of this device is that precise bowel anastomosis is standardized and can be achieved safely and quickly. Our findings indicate that the Valtrac system offers a reliable and reproducible alternative to conventional anastomotic techniques in urologic surgery.

Occupation of the QB-binding pocket by a photosystem II inhibitor triggers dark cleavage of the D1 protein subjected to brief preillumination

The D1 protein of the photosystem (PS) II reaction center turns over very rapidly in a light-dependent manner initiated by its selective and specific cleavage. The cleavage of D1 was studied by using a PS II inhibitor, N-octyl-3-nitro-2,4,6-trihydroxybenzamide (PNO8), as a molecular probe. The following results were obtained. (i) D1 was selectively cleaved into 23-kDa N-terminal and 9-kDa C-terminal fragments in complete darkness by PNO8 at a single site in a D-E loop connecting membrane-spanning helices D and E. (ii) The cleavage was markedly enhanced when PS II was illuminated for a brief period before the addition of PNO8 in darkness. (iii) The effect of preillumination was slowly lost during incubation in the dark, with a decay half-time of approximately 1 h at 25 degrees C. (iv) The light intensity of preillumination required for the cleavage was much lower than that required for O2 evolution. (v) The light-triggered cleavage of D1 was observed in thylakoids, PS II membranes, and PS II core particles, but not in purified PS II reaction centers. More than 60% of D1 was cleaved into the two fragments with no other by-products. (vi) The cleavage reaction revealed a marked pH dependence that was considerably different from that for inhibition of PS II activity. The results are interpreted as indicating that the binding of PNO8 to the QB-binding pocket triggers proteolytic cleavage of D1 that has been previously modified during illumination.

[A case report--congenital esophago-bronchial fistula with esophageal diverticulum]

Congenital esophago-bronchial fistula with diverticulum is rare, and in Japan only 29 cases have been reported. A 59-year-old man had suffered from recurrent pulmonary infections and often complained of coughing while drinking water during the previous two years. An UGI series for follow-up of gastric ulcer revealed an esophago-bronchial fistula, located between the mid-esophagus and B10 of the right lung. We resected the diverticulum and the fistulous tract with a partial excision of S10. Histological examination revealed that the squamous epithelium with the muscularis mucosa of the esophagus was smoothly connected to the columnar epithelium of the bronchus. Thus, we diagnosed this fistula as congenital, not acquired. Comparison of the previous UGI series before presenting symptoms with that performed at this admission showed the lengthening and thickening of this congenital fistula during the three-years period. We suspected that the influence of acquired factors may cause a congenital fistula to manifest various clinical symptoms.

Acellular human dermal matrix as a small vessel substitute

In both vascular and microvascular surgery, there is a need for a non-thrombogenic, small-caliber, arterial substitute. Clinically, most vessel substitutes with diameters under 4 mm have low patency rates. An arterial conduit made from a biocompatible human acellular dermis may be useful as a small vessel conduit. The purpose of this study was to evaluate and compare the patency rates of a vascular conduit made from rolled human acellular dermal (ACD) matrix and a similar-sized polytetrafluoroethylene (PTFE) tube, using the rat femoral artery interposition model. Twenty-eight days after implantation, 9 or 10 (90 percent) ACD grafts and 5 of 8 (62.5 percent) PTFE grafts were patent. False aneurysms formed in 6 ACD conduits along the longitudinal suture line. The three patent non-aneurysmal ACD conduits developed an endothelial luminal lining. While further studies are needed, acellular dermis appears to be a promising material for use as a vessel substitute.

Regional variation in expression of calbindin and inositol 1,4,5-trisphosphate receptor type 1 mRNAs in the cerebellum of the staggerer mutant mouse

The Purkinje cells in the staggerer mutant mouse have various cellular abnormalities, including reduced cell number, ectopia, smaller size and absence of dendritic spines. It is also know that some of these abnormalities exhibit regional variations in the cerebellum. In this paper we have investigated expression in the staggerer Purkinje cells of the calbindin and inositol 1,4, 5-trisphosphate receptor type 1 mRNAs by in situ hybridization. Although the transcription levels of both mRNAs were significantly reduced compared with the wild-type cells, the reduction among the Purkinje cell populations was not even, varying greatly from region to region. Purkinje cells with different transcription levels were distributed in discrete regions and arranged alternately in the mediolateral direction. Moreover, the cell bodies with higher transcription levels were larger in size and aligned in a monolayer between the granular and molecular layers, whereas those with lower levels were smaller in size, fewer in number and dispersed throughout the granular layer. These findings suggest that there is a distinct mediolateral heterogeneity in the staggerer cerebellum with respect to transcription levels of these Purkinje cell-specific molecules, which might correlate with some cytological phenotypes.

Adsorption kinetics of bacterial PHB depolymerase on the surface of polyhydroxyalkanoate films

The kinetics of adsorption and hydrolysis by an extracellular PHB depolymerase from Alcaligenes faecalis were studied at 37 degrees C on the surface of five types of polyhydroxyalkanoate (PHA) films. The films of poly[(R)-3-hydroxybutyrate] (P(3HP)), poly(3-hydroxypropionate) (P(3HP)), and poly(4-hydroxybutyrate)(P(4HB)) were hydrolyzed by the enzyme, while the films of poly[(S)-2-hydroxypropionate)(P(2HP)) and poly(6-hydroxyhexanoate)(P(6HH)) were not eroded. The PHB depolymerase with binding and catalytic domains adsorbed on the surface of all PHA films used, and the adsorption kinetics were found to obey the Langmuir isotherm. The cross-area per one molecule of enzyme binding to the surface of PHA film was estimated to be 17 +/- 8 (nm2/molecule). It has been concluded that the binding domain of enzyme is non-specific for the binding to the surface of PHA film, while the active site in a catalytic domain is specific for the hydrolysis of PHA molecules.

Oxidative stress response in yeast: purification and characterization of glutathione reductase from Hansenula mrakii

Glutathione reductase was purified from a yeast. Hansenula mrakii IFO 0895, to approximately 3500-fold with 59% activity yield. The enzyme was homogeneous on polyacrylamide gel electrophoresis. The molecular weight of the enzyme was estimated to be 56 kDa by SDS-polyacrylamide gel electrophoresis, and 123 kDa by gel filtration using a calibrated Sephadex G-150 column. The Km values for glutathione disulfide and NADPH were 21.3 microM and 14.3 microM, respectively. The enzyme was most active at pH 7.5, 55 degrees C. The enzyme was stable up to 40 degrees C, and between pHs 4 and 10. The enzyme was inhibited by p-chloromercuribenzoate and metal ions such as Fe3+, Cd2+, Cu2+, and Zn2+.

[Clinical evaluation of grade 3 superficial bladder cancer]

PURPOSE

To evaluate the treatment of grade 3 superficial bladder tumor, retrospective analysis of superficial bladder tumors was performed with special references to tumor progression and prognostic factors.

MATERIALS AND METHODS

From 1976 to 1994, 247 cases with pTa-pT1 superficial bladder tumor were treated. Mean duration of follow up 77.3 months. These patients were divided into pTa (196), pT1 (52), grade 1 (61), grade 2 (196) and grade 3 (62). The prognostic factors were calculated with multivariate and univariate analysis. Tumor progression was defined as muscle invasion or distant metastasis.

RESULTS

G3 tumor showed poor prognosis and was more frequent in tumor progression compared with G1 and G2 tumors (19.4% vs 0% and 1.6%). According to multivariate analysis, significant variables for actual survival rate were patient age and tumor grade. Tumor grade, recurrence and tumor configuration were also significant risk factor for cause-specific survival rate. By univariate analysis, patient age, tumor configuration, tumor size, multiplicity and concomitant CIS in G3 group were different from the other two G groups. In the G3 group, only recurrence was the predictable factor for progression. Analysis of prognosis and therapeutic modality revealed that G1 and G2 tumors were sufficiently controlled by endoscopic treatment. On the other hand, 21 cases (33.9%) of G3 tumor required total cystectomy after all. 11 cases of G3 group died of bladder cancer. Lymphatic involvement was detected in some cases of G3 tumor even if superficial. This factor showed a little relevance to poor prognosis of G3 tumor.

CONCLUSION

Tumor grade was thought to be the most important risk factor of superficial bladder tumor. These results suggested that total cystectomy should be considered for the treatment of superficial G3 bladder cancer when recurrence occurs or conservative treatment is though to be failed.

Isolation and identification of novel sulfated and nonsulfated oligosialyl glycosphingolipids from sea urchin sperm

Novel sulfated and nonsulfated oligosialylglycosphingolipids were isolated from sperm of the sea urchin, Hemicentrotus pulcherrimus, and their structures were established as follows: [formula: see text] This provides the first evidence for the natural occurrence of a tetrasialic acid structure in glycosphingolipids. The finding of sulfated oligosialyl chains is especially noteworthy in that the sulfate group exclusively resides on the C-8 of the nonreducing terminal residues of oligo/polysialyl chains and that sulfation appears to be a termination signal for elongation of oligosialyl chains. Sulfation at the nonreducing terminal Neu5Ac residues of oligosialyl chains was also found to facilitate the formation of an inter-residue lactone between the carboxyl group at the nonreducing terminal sulfated Neu5Ac and the hydroxyl group at C-9 of the penultimate Neu5Ac residue. The long chain base was 4-hydroxysphinganine (t18:0) and the major fatty acid species were identified as C20:1, C21:1, and C22:1.

Cell death of oligodendrocytes or demyelination induced by overexpression of proteolipid protein depending on expressed gene dosage

The transgenic mice, which were produced by introducing the wild type proteolipid protein (PLP) gene, revealed different neurological symptoms depending on expressed gene dosage. Homozygotes, which bore four more copies of the extra PLP gene, died before 4 weeks old with severe tremors and convulsions, while histologically hypomyelination and death of the oligodendrocytes were particularly noticeable. Heterozygotes, which bore two more copies and survived nearly 1 year, suffered from severe hindlimb palsy and bladder-rectal disturbances before death. These symptoms probably resulted from striking demyelination which occurred abruptly at a later stage of life. The heterozygous PLP-transgenic mice are thus available for a model of demyelination diseases.

Occurrence and structural analysis of highly sulfated multiantennary N-linked glycan chains derived from a fertilization-associated carbohydrate-rich glycoprotein in unfertilized eggs of Tribolodon hakonensis

This study represents the first detailed investigation of the nature of highly sulfated (keratan-sulfate-like) complex-type asparagine-linked glycans having a tetraantennary core structure and shows the effectiveness of fast-atom-bombardment mass spectrometric (FAB-MS) methods incorporating derivatization and mild methanolysis for analyzing such complex types of sulfated glycans. The structure of the N-glycan chains was unambiguously established by a combination of compositional analysis, methylation analysis, mild methanolysis for desulfation, hydrazinolysis/nitrous acid deamination, enzymatic (endo-beta-galactosidase and peptide:N-glycosidase F) digestions, and instrumental analyses (1H-NMR spectroscopy and FAB-MS) which revealed the novel repeating sulfated carbohydrate sequences, +/- Gal beta 1-->4Gal beta 1[-->(HSO3-->6)GlcNAc beta 1-->3(+/- Gal beta 1-->4)Gal beta 1]n--> (see Structure I; p + q + r + s approximately 14). This sequence is unique in: (a) the skeletal structure is similar to that of keratan sulfate but is completely devoid of 6-O-sulfated Gal residues and (b) the presence of branched Gal residues in the sequence -->4GlcNAc beta 1-->3(Gal beta 1-->4)Gal beta 1-->. [formula: see text]

Sleep apnea syndrome. Examination of pharyngeal obstruction with high-speed MR and polysomnography

PURPOSE

We attempted to determine the usefulness of high-speed MR imaging for evaluating the severity of sleep apnea syndrome (SAS) by comparing findings of pharyngeal obstruction obtained with high-speed MR with those of all-night polysomnography (PSG).

SUBJECTS AND METHODS

A total of 33 patients with SAS underwent turbo-FLASH MR examination, while awake and after i.v. injection of hydroxyzine hydrochloride. Serial images were examined by cinemode. Pharyngeal findings on MR were divided into single-site obstruction (SO) at the velopharynx, multiple-site obstruction (MO), and no obstruction (NO). PSG findings were analyzed to determine the predominant type of apnea, severity as evaluated by an apnea index (AI), and the lowest SaO2 value during sleep.

RESULTS

Seventy-five percent of the central apnea group had SO, and 70% of the mixed apneas had MO, while only 15% of the obstructed apneas had MO. The percentage of patients with severe SAS (AI of 20% or higher) was 48% for the SO, and 70% for the MO. The lowest SaO2 value tended to be low in the mixed apnea in the case of PSG, and tended to be low in the MO at MR examination.

CONCLUSION

Analysis of pharyngeal dynamics using high-speed MR may provide some useful information for evaluating the severity of SAS.

Production of recombinant human monoclonal antibody using ras-amplified BHK-21 cells in a protein-free medium

A ras oncogene-amplified recombinant BHK-21 cell line (ras-rBHK-IgG) has been established, and was shown to hyperproduce the recombinant IgG chimeric human monoclonal antibody (hMAb) AE6F4, which recognizes lung cancer cells. We found that the ras-rBHK-IgG cell could be easily cultured in a protein-free ERDF medium supplemented with iron(III) nitrate, hydroxyethyliminodiacetic acid, and non-protein synthetic attachment factor as well as in a serum-free ERDF medium supplemented with insulin, transferrin, ethanolamine, and sodium selenite. The productivity of recombinant hMAb from the cells cultured in dishes at high cell densities was higher in protein-free medium than in serum-containing medium. True high density culture of the ras-rBHK-IgG cells was done in protein-free medium using the Tecnomouse, which is a novel hollow fiber bioreactor system. After culture for 30 days in protein-free culture, a total amount of about 14 mg of the recombinant hMAb AE6F4 was obtained, and was shown to be reactive against lung cancer cells in tissues.

Ocular and orbital imaging

The development of magnetic resonance imaging technology has proven to be a great breakthrough in diagnostic medical imaging, ophthalmologic imaging, and biomedical research. The anatomic detail demonstrated by an magnetic resonance image is a representation of at least three physical properties of static tissue: photon density and T1 and T2 relaxation times. Intrinsic differences in proton density and proton relaxation times of tissues allow excellent image contrast between various normal structures and high sensitivity for detecting pathologic states. This article discusses magnetic resonance imaging features of common ocular and orbital lesions, with emphasis on the potential of magnetic resonance imaging in ophthalmology.

Developmental changes in expression and distribution of the glutamate receptor channel delta 2 subunit according to the Purkinje cell maturation

The glutamate receptor (GluR) channel delta 2 subunit is considered to be a functional molecule involved in motor coordination, Purkinje cell synapse formation and cerebellar long-term depression. We examined developmental changes in expression and distribution of the GluR delta 2 in the mouse cerebellum by in situ hybridization and immunohistochemistry. The GluR delta 2 mRNA was detected as early as embryonic day 15 (E15) in a cell mass consisting of Purkinje neuroblasts in the posterior cerebellum. During late embryonic and postnatal periods, the GluR delta 2 mRNA was expressed abundantly and specifically in Purkinje cells. By immunohistochemistry, immunoreactivity of the GluR delta 2 was found in both shafts and spines of Purkinje dendrites at early postnatal period. By P21, however, the intense immunoreactivity became restricted to the dendritic spines, especially along the postsynaptic membrane in contact with parallel fiber terminals. These findings suggested that the transcription of the GluR delta 2 subunit occurs in the Purkinje cells from fetal through adult stage, but the intracellular localization of the protein products undergoes an alteration from non-synaptic to synaptic site when active synaptogenesis takes place.

Location of the non-heme iron center on the alpha subunit of photoreactive nitrile hydratase from Rhodococcus sp. N-771

Nitrile hydratase (NHase) from Rhodococcus sp. N-771, which possesses a non-heme iron center binding nitric oxide (NO), is activated by light irradiation. To localize the iron center in the protein, we quantified Fe atoms and performed FTIR measurements of the isolated alpha and beta subunits. The native NHase and the isolated alpha subunit contained about 1.0 and 0.8 mol Fe per mol protein, respectively, whereas the beta subunit contained only a trace of Fe. An NO stretching band was observed at 1852 cm-1 in the FTIR spectrum of the alpha subunit, but not in that of the beta subunit. Upon light irradiation of the alpha subunit, the affinity of the Fe atom decreased and the NO band disappeared from the FTIR spectrum. These observations indicate that the non-heme iron center, which is responsible for the photoreaction, is present in the alpha subunit.

Occurrence of poly(alpha2,8-deaminoneuraminic acid) in mammalian tissues: widespread and developmentally regulated but highly selective expression on glycoproteins

In tissues of higher organisms homopolymers of alpha2,8-linked N-acetylneuraminic acid can be found as a posttranslational modification on selected proteins. We report here the discovery of homopolymers of alpha2,8-linked deaminoneuraminic acid [poly(alpha2,8-KDN)] in various tissues derived from all three germ layers in vertebrates including mammals. The monoclonal antibody kdn8kdn in conjunction with a bacterial KDNase permitted the detection of poly(alpha2,8-KDN) by immunohistochemistry and immunoblotting. Further evidence for the existence of poly(alpha2,8-KDN) was obtained by gas/liquid chromatography. The poly(alpha2,8-KDN) glycan was detectable in all tissues studied with the exception of mucus-producing cells present in various organs, the extracellular matrix, and basement membranes. However, in certain organs such as muscle, kidney, lung, and brain its expression was developmentally regulated. Despite its widespread tissue distribution, the poly(alpha2,8-KDN) glycan was detected on a single 150-kDa glycoprotein except for a single >350-kDa glycoprotein in kidney, which makes it most distinctive among polysialic acids. The ubiquitous yet selective expression may be indicative of a general function of the poly(alpha2,8-KDN)-bearing glycoproteins.

The influence of work loads on regional differences in sweating rates

The influence of work loads (20, 40 and 60% VO2max) on regional differences in sweating rates was investigated in six healthy male students. The ratios of local sweating rate (msw) on the chest and back to estimated total sweating rate (mean msw of four sites examined x body surface area) at 20% work load were significantly greater than those on the forearm and forehead, whereas the ratio on the forehead at 60% work load was greater than at the other sites. The ratios on the forearm at 40 and 60% work loads were significantly greater than at 20% work load. The regional differences in sweating rates change with the increase in work load as seen by the greater variation in the ratios of msw on each site at 20% work load compared with 40 and 60% work loads. The results indicate that redistribution of this sweat activity to whole body or head with the rise in work load induces favorable conditions for evaporation and controlling brain temperature.

Atherosclerotic abdominal aorta saccular protrusion

Fourteen saccular abdominal aortic protrusion patients (ages ranged from 55 to 84, mean age 69.1 years) were reported. Their lesions were pathologically or bacteriologically suggested to be of atherosclerotic origin. Other origins were eliminated by using the patients past history or physical and diagnostic examination. All patients were classified into 1 of 3 types; solitary, adjacent to fusiform AAA, and independent of fusiform AAA. Diagnosis and surgical techniques were complicated when coexisting with a fusiform abdominal aortic aneurysm (AAA) and located in the AAA neck. The treatment of choice for 13 patients was surgery. Postoperatively two patients died of hepatic failure at 5 weeks, and from apoplexia at four months, after surgery, respectively. The remaining patients' prognosis is good after a 3-month to 6-year follow-up with a mean period of 2.9 years except 1 medically treated patient. Accordingly, atherosclerotic abdominal aorta saccular protrusion should be carefully diagnosed and be surgically treated in the usual AAA manner. Only juxtarenal saccular protrusions require careful reconstruction, preserving the renal or visceral function.

[Application of laser spectroscopy for 13C-breath tests]

A new device Tunable Diode Laser Spectroscopy (LS) was developed for the analysis of isotope ratios of 13CO2/12CO2. Its applicability for breath tests was validated. The exhaled breath is collected in a 2 l aluminum bag, of which CO2 is separated by cryogenic system and introduced into LS. Repeat measurements (8 times) of two kinds of gases (delta 13C:-2.62 and - 1.14%) revealed 0.045% and 0.065% variation (IS.D.), from which precision of measurement was estimated as 0.2% (3S.D.). Seven healthy volunteers were given orally different dose of 13C-glycine (50 mg-200 mg in 5 subjects) and 13C-methacetin (30 mg and 150 mg in 2 subjects). One patient with gastric ulcer with helicobacter pylori (HP) infection was given 100 mg of 13C-urea. Serial breath samples (9-15) were taken and measured both by LS and mass spectrometer (MS) thereafter. Appreciable peaks were obtained at 30-50 min. after glycine and methacetin ingestions. The height of the peaks were dose dependent. Increased excretion of 13CO2 characteristics to HP infection was obtained in 13C-urea breath test. Measured values with LS were identical with those measured with MS (60 samples) with the range of difference within 0.2% (3S.D.). [Y (LS) = 1.02X (MS) + 0.55, r = 0.996] We conclude the LS is suitable for various 13C-breath tests.

Structure-activity relationships of dermorphin analogues containing chiral piperazin-2-one and piperazine derivatives

The amide and ester carbonyl groups of four piperazin-2-one derivatives (N,N'-ethylene-bridged dipeptide ethyl esters) constructed from (R)- or (S)-phenylalanine and glycine were reduced with borane-tetrahydrofuran complex to produce the corresponding piperazine derivatives in 70-80% yields. These piperazin-2-one or piperazine derivatives were used as the carboxyl-terminal residues of eight dermorphin analogues (H-tyrosyl-D-alanyl-piperazine derivatives were used as the carboxyl-terminal residues of eight dermorphin analogues (H-tyrosyl-D-alanyl-piperazin-2-one or piperazine derivatives) whose opiate activities were examined in vitro by use of the guinea pig ileum and the mouse vas deferens assays. It was found in the guinea pig ileum assay that the configuration of pheylalanine and the replacement of the piperazin-2-one ring with a piperazine ring are important for enhancing or reducing the opiate activities of these analogues.