Patients' reactions to angioplasty: realistic or not?

BACKGROUND

A major problem limiting the success of angioplasty is the high restenosis rate. In addition, coronary artery disease is an ongoing process requiring lifestyle changes to prevent disease progression.

OBJECTIVE

To examine patient concerns and risk factor modification behaviors during early recovery from angioplasty. Specific attention was directed to: (1) expectation of restenosis, (2) occurrence of angina, (3) achievement of expected benefits, (4) tension/anxiety levels, (5) self-efficacy for and actual performance of needed lifestyle changes.

METHODS

For this descriptive study the Self-Report of Recovery (a project-derived questionnaire) and the Profile of Mood States were mailed to 54 patients at 1, 6, and 12 weeks of recovery. The study group comprised 37 men and 17 women (mean age, 57 years) who had undergone first-time successful angioplasty at a midwestern medical center. At 12 weeks 78% remained.

RESULTS

A majority of patients did not expect restenosis to occur. At 3 months 83% reported that they were angina-free, 90% reported that they would repeat the procedure if needed, all scores on the tension/anxiety scale were normal, and 86% had achieved some benefits they had expected. Most expressed high confidence in their ability to reduce risk factors, with 90% reporting initiation of at least one lifestyle change.

CONCLUSION

We concluded that patients had positive feelings about their angioplasty experience and were not overly concerned about restenosis.

Patients' reactions to angioplasty: realistic or not?

BACKGROUND: A major problem limiting the success of angioplasty is the high restenosis rate. In addition, coronary artery disease is an ongoing process requiring lifestyle changes to prevent disease progression. OBJECTIVE: To examine patient concerns and risk factor modification behaviors during early recovery from angioplasty. Specific attention was directed to: (1) expectation of restenosis, (2) occurrence of angina, (3) achievement of expected benefits, (4) tension/anxiety levels, (5) self-efficacy for and actual performance of needed lifestyle changes. METHODS: For this descriptive study the Self-Report of Recovery (a project-derived questionnaire) and the Profile of Mood States were mailed to 54 patients at 1, 6, and 12 weeks of recovery. The study group comprised 37 men and 17 women (mean age, 57 years) who had undergone first-time successful angioplasty at a midwestern medical center. At 12 weeks 78% remained. RESULTS: A majority of patients did not expect restenosis to occur. At 3 months 83% reported that they were angina-free, 90% reported that they would repeat the procedure if needed, all scores on the tension/anxiety scale were normal, and 86% had achieved some benefits they had expected. Most expressed high confidence in their ability to reduce risk factors, with 90% reporting initiation of at least one lifestyle change. CONCLUSION: We concluded that patients had positive feelings about their angioplasty experience and were not overly concerned about restenosis.

A high-resolution 15N solid-state NMR study of collagen and related polypeptides. The effect of hydration on formation of interchain hydrogen bonds as the primary source of stability of the collagen-type triple helix

High-resolution solid-state 15N-NMR was used to clarify the effect of hydration on the stability of the coiled-coil triple-helix conformation of Gly-Xaa-Yaa repeating units in collagen and the collagen-like polypeptides, (Pro-Ala-Gly)n and (Pro-Pro-Gly)10, because the stability is thought to be related to the presence of (Gly)NH ... O = C(Xaa or Pro) hydrogen bonds. The 15N-NMR signals of these samples were narrowed upon hydration, mainly due to hydration-induced conformational change or rearrangement of the repeating units. In particular, the 15N chemical shifts of the Gly N-H group and the high-field (low-frequency) shoulder peak of Pro nitrogen signals in (Pro-Pro-Gly)10 were shifted downfield (4.9 ppm and 6.8 ppm, respectively) with increasing relative humidity, while the corresponding peaks for collagen and (Pro-Ala-Gly)n were unchanged and close to the 15N shift of (Pro-Pro-Gly)10 in the hydrated state. Such downfield shifts are consistent with the formation of N-H ... O = C hydrogen bonds. In agreement with the NMR results, it was found that the (Gly)NH ... O = C (Xaa or Pro) hydrogen bonds are retained in dehydrated collagen fibrils but not in partially dehydrated (Pro-Pro-Gly)10. No evidence was obtained for the partial formation of the 3(1) helix form (Pro)n or (Gly)n either under hydrated or dehydrated conditions. It is concluded that the Gly 15N chemical shift is a very sensitive probe for studying supercoiling in collagen and collagen-like polypeptides.

The cortico-pallidal projection in the rat: an anterograde tracing study with biotinylated dextran amine

The projections from the frontal cortex to the pallidum (e.g. the globus pallidus and the entopeduncular nucleus) were studied in the rat using the biotinylated dextran amine (BDA) anterograde tracing method. Injections of BDA into the precentral medial and precentral lateral cortices consistently yielded labeling of thin fibers with small boutons in the ipsilateral pallidum although not in the contralateral pallidum. Electron microscopic observation revealed that BDA-labeled boutons form asymmetric synapses mainly with small dendrites and dendritic spines. When the injection sites included the insular, orbital, and prelimbic cortices, the labeled fibers and boutons were also seen in the ventral pallidum, the basal nucleus of Meynert, and the substantia innominata. Injections of BDA in the parietal and occipital cortices resulted in either very few labeling or no labeled boutons in the pallidum. The cortico-pallidal projections were topographically organized. The density of labeled boutons in the globus pallidus was found to be approximately 10% of the density of cortical terminals in the neostriatum.

The gene responsible for LEC hepatitis, located on rat chromosome 16, is the homolog to the human Wilson disease gene

We identified the rat homolog to the human Wilson disease (WD) gene as the gene responsible for hepatitis (hts) in the Long Evans Cinnamon (LEC) rat. A genetic study using fifty-three backcross progenies showed that the rat WD gene detected by Southern blotting using the human WD gene as a probe was tightly linked to the hts phenotype of the LEC rat with no recombination. LEC is a transcriptionally deficient mutant because no transcript of the rat WD gene could be found in the LEC rat by Northern blotting. This rat WD gene was mapped to 16q12.23-12.3 by fluorescence in situ hybridization and mouse x rat somatic cell hybrid analysis.

Antioxidative action of the nitrovasodilator nicorandil: inhibition of oxidative activation of liver microsomal glutathione S-transferase and lipid peroxidation

Antioxidative effects of the nitrovasodilator nicorandil (SG-75) and denitrated SG-75 (SG-86) were examined in vivo and in vitro. When the isolated rat liver was reperfused with Krebs-Henseleit solution after a 90-min ischemia, microsomal GSH S-transferase activity was increased significantly by oxidative modification of the sulfhydryl group of the enzyme. The increase in the transferase activity after ischemia/reperfusion was depressed by SG-75 but not by SG-86. Furthermore, only SG-75 significantly inhibited lipid peroxidation and the activation of microsomal GSH S-transferase induced by hydrogen peroxide treatment of liver microsomes. These data indicate that SG-75 has an antioxidative action and the nitro group of SG-75 may play a critical role for this action.

Functional electrical stimulation (FES) to the biceps brachii for controlling forearm supination in the paralyzed upper extremity

Control of forearm supination using the functional electrical stimulation (FES) to the biceps brachii was studied in a C4 quadriplegic patient. As a result of FES to the biceps brachii, and the other elbow flexors and extensors, supination was induced in maintenance of the elbow in the maximum flexion and extension, respectively. Although a range of the movements was still small and limited, these findings indicated a possibility of FES to the biceps brachii for controlling supination in paralyzed upper extremities.

Electrophysiological studies of the biceps brachii activities in supination and flexion of the elbow joint

Activities of the biceps brachii (long head: BiL, short head: BiS) on the elbow joint were studied using an electrical neuromuscular stimulation (ENS) and an electromyography (EMG). In ENS study, ENS to BiL or BiS was performed in seven volunteers. Before ENS, the volunteer relaxed the upper extremity on a table with the elbow extended and the forearm pronated. Then ENS-induced movements of the upper extremity were examined. Movements of elbow flexion and forearm supination were induced simultaneously by ENS to BiS in all volunteer and by ENS to BiL in six volunteers. ENS to BiL of one volunteer resulted in only elbow flexion. In EMG study, averaged EMGs of BiL and BiS during a to-and-fro motion from prone to supine of the forearm with holding a load were analyzed in eight volunteers. The volunteer acted the movements with keeping the elbow joint in different angles. Although an increase and a decrease of EMG activities in BiL and BiS were observed accompanied by the degree of forearm supination, patterns of changes in quantities of EMG activities to changing elbow angles varied from individual to individual. These findings seem to indicate that each human subject has an individual use of the biceps brachii for supination movements, while the action of the muscle on the elbow joint is similar among the subjects.

[Catheter intervention to venous system using expandable metallic stents]

Superior vena cava syndrome mainly associated with malignant tumors, is usually resistant to any therapy. Although mechanical dilation of narrowed lumen is ideal for relief of symptoms, conventional balloon angioplasty has not been effective method. Surgical intervention is not a good choice in patients with advanced malignant tumors. Recently developed expandable metallic stents have been adopted to superior vena cava syndrome with good results. In this article, characteristics of expandable metallic stents is reviewed, and our experience of expandable metallic stents (Gianturco stent and Wallstent) in venous system is indicated. In addition, percutaneous insertion of inferior vena cava filter (Greenfield filter) is also mentioned.

The cortico-nigral projection in the rat: an anterograde tracing study with biotinylated dextran amine

The projection from the cortex to the substantia nigra (SN) in the rat was studied using the biotinylated dextran amine (BDA) anterograde tracing method. Injections of BDA into the prefrontal cortex consistently yielded labeling of the thin nerve fibers with small boutons in the SN pars compacta (SNc) and the pars reticulata (SNr). The cortico-nigral projection had a loose medio-lateral and rostro-caudal arrangement. Injections of BDA into the precentral lateral, the parietal, the temporal, and the occipital cortices resulted in sparse or no labeling of boutons in the SN. The density of boutons in the most heavily labeled region of the SN was 0.23/10(3) micron3. For comparison, similar measurement was performed in the cortico-striatal projection. The density of the boutons in the the neostriatum was 4.9/10(3) micron3. This study indicates that the entire prefrontal cortex projects to the SNc and SNr and that the terminal density of this projection is much less than the cortico-striatal projection.

Expression of cripto in human pancreatic tumors

The expression of cripto gene product was examined immunohistochemically in 45 surgically resected pancreatic tumors, including 32 invasive ductal carcinomas, 4 intraductal papillary adenocarcinomas, 4 intraductal papillary adenomas, 2 mucinous cystadenomas, 2 islet cell tumors, and one solid and cystic tumor, and compared with that in 32 areas of accompanying chronic pancreatitis present in the cases of invasive ductal carcinomas and 5 non-tumorous areas of pancreas without pancreatitis. All pancreatic ductal tumors including adenomas and carcinomas showed positive staining with no difference in terms of staining intensity among intraductal tumors and invasive carcinomas with or without mucin hypersecretion. Islet cell tumors were positively stained but the solid and cystic tumor was negative. Duct epithelial cells and acinar cells were negative but islet cells were positive in the pancreas tissues without pancreatitis. Cells arranged in duct-like structures in areas of accompanying chronic pancreatitis were positively stained. The results suggest that cripto expression might be associated with a growth advantage of tumor cells and also with differentiation to form duct-like structures.

A high-resolution solid-state 13C-NMR study on [1-13C]Ala and [3-13C]Ala and [1-13C]Leu and Val-labelled bacteriorhodopsin. Conformation and dynamics of transmembrane helices, loops and termini, and hydration-induced conformational change

We have recorded 100.7-MHz high-resolution solid-state 13C-NMR spectra of [3-13C]Ala, [1-13C]Ala-labelled, Leu-labelled and Val-labelled bacteriorhodopsin (bR), to analyze the conformation and dynamics of transmembrane alpha helices and hydration-induced conformational changes. We assigned the 13C-NMR signals of these 13C-labelled amino acid residues to portions of the transmembrane alpha helices, loops and N-terminus and C-terminus, based on the conformation-dependent 13C chemical shift. The assignment of peaks to the transmembrane alpha helices is straightforward in view of the characteristic 13C chemical shifts of the C beta and carbonyl carbons, referred to the data of the model system. The signals of the transmembrane alpha helices were further divided into three or four peaks which are ascribed to either a dispersion of torsion angles of the alpha helices or variation of environments around the helices. In addition, we found that conformation of the N-terminus and C-terminus of bR is virtually the random-coil form which undergoes rapid reorientational motion in the hydrated system. Further, we show that the higher-order (secondary and/or tertiary) structure of bR is influenced by the hydration/dehydration process of the purple membrane, as viewed from the peak profile of the Ala C beta 13C signals. This change of structure occurs between relative humidities of 2% and 4%, consistent with the shift of the absorption maxima of retinal, which arise from the protonation/deprotonation processes of the Schiff base. In contrast, no such change of the carbonyl signals occurs for the Leu, Val and Ala residues. For the latter two residues, some spectral changes were noted at the stage of full hydration.

Clinical value of enzyme immunoassay of epidermal growth factor receptor in human breast cancer

Epidermal growth factor receptor (EGFr) levels were analyzed in 140 primary breast cancer specimens by immunohistochemical assay (ICA), competitive binding assay (BA), or enzyme immunoassay (EIA). Thirty-nine of 118 specimens (33.1%) were scored as positive by ICA, 30 of 116 (25.9%; cut-off level 10 fmol/mg protein) by BA, and 31 of 80 (38.9%: cut-off level 5 fmol/mg protein) by EIA. Agreement on EGFr status was 72.3% (68/94) between ICA and BA, 77.0% (57/74) between BA and EIA, and 73.8% (59/80) between EIA and ICA. These discrepancies are based on assay differences and the heterogeneous distribution of cancer cells within specimens. Regardless of the assay method used, EGFr status had a significantly negative correlation with estrogen receptor status. Although EGFr-ICA and BA status had no relationship with prognosis, patients with medium and high EGFr-EIA level tumors (over 5 fmol/mg protein) had shorter relapse-free periods than those with low level tumors. However, the prognostic value of positive EGFr-EIA status was weaker than that of c-erbB-2 overexpression.

Increase in liver microsomal glutathione S-transferase activity by phenobarbital treatment of rats. Possible involvement of oxidative activation via cytochrome P450

The possible involvement of oxidative activation of liver microsomal glutathione (GSH) S-transferase by the cytochrome P450 system was investigated. When rats were given phenobarbital (PB) intraperitoneally for 3 days, liver microsomal GSH S-transferase activity was stimulated 1.3-1.4-fold and the effect of PB on the transferase was potentiated by combination with a catalase inhibitor, 3-amino-1,2,4-triazole. Immunoblotting of microsomal proteins from PB-treated rats with anti-microsomal GSH S-transferase antibody after SDS-PAGE showed the presence of a dimer of the transferase. When microsomal suspensions prepared from PB-treated rats were placed on ice without GSH, the microsomal GSH S-transferase activity gradually increased with time and reached 200% of the initial level at 3 hr when activation of the transferase by N-ethylmaleimide was lost. The time-dependent increase in GSH S-transferase activity in PB-treated microsomes was prevented by addition of 0.1 mM GSH. The increase in microsomal GSH S-transferase activity by NADPH was depressed by cytochrome P450 inhibitors such as SKF 525-A (2-diethylaminoethyl-2,2-diphenylvalerate), metyrapone or isoniazid in agreement with the concomitant decrease in generation of hydrogen peroxide in microsomes. These results indicate that the increase in GSH S-transferase activity in liver microsomes by PB treatment of rats is due to the oxidative modification of the enzyme by reactive oxygen species which are concomitantly increased following induction of cytochrome P450.

Analysis of oncogenes and tumor suppressor genes in human breast cancer

Oncogenes (c-erbB-2, c-myc, and some genes linked to the 11q13 lesion), tumor suppressor genes (retinoblastoma gene, p53) and an antimetastatic gene (nm23/nucleoside diphosphate kinase) play important roles in breast cancer progression. Amplification of c-erbB-2, c-myc, and int-2, and expression of RB, p53(mutant), and NDP kinase were determined in 77 primary breast cancer specimens. nm23-H1 allelic loss was also studied. c-erbB-2 and c-myc amplification, loss of RB expression, p53(mutant) expression, and nm23-H1 allelic loss were also found in non-invasive carcinoma. int-2 amplification was significantly correlated with lymph node status (P = 0.02) and a significant association was found between p53(mutant) expression and tumor size (P = 0.04). c-erbB-2 amplification was strongly associated with disease-free and overall survival in multivariate analysis (P = 0.002). All of the c-erbB-2 amplified cases and all but one of the int-2 amplified cases in node-positive patients had relapsed within 2 years post resection. The cancer cells may acquire new proliferative pathways sequentially as a result of multiple genetic alterations which enable them to bypass the estrogen-dependent proliferation.

A specific host factor binds at a cis-acting transcriptionally silent locus required for stability control of yeast plasmid pSR1

A cis-acting locus, Z, of plasmid pSR1 functions in stable maintenance of the plasmid in the native host, Zygosaccharomyces rouxii. The Z locus was shown to be located in a 482 bp sequence in the 5' upstream region of an open reading frame, P, by subcloning various DNA fragments in a plasmid replicating via the ARS1 sequence of the Saccharomyces cerevisiae chromosome. Northern analysis revealed that the Z region is not transcribed in either the native host Z. rouxii or the heterologous host S. cerevisiae. The Z region is protected from micrococcal nuclease attack in Z. rouxii but not in S. cerevisiae, its protection depending on the product of the S gene encoded by pSR1. Gel retardation assays suggested that a factor present in nuclear extracts of Z. rouxii cells, irrespective of the presence or absence of a resident pSR1 plasmid, binds to a 111 bp RsaI-SacII sequence in the Z region. These findings suggest that a host protein binds to the Z locus and that the S product interacts with this DNA-protein complex and stabilizes pSR1.

Oxidative stress-induced activation of microsomal glutathione S-transferase in isolated rat liver

The activation of microsomal glutathione (GSH) S-transferase in isolated rat liver by oxidative stress was investigated using both ischemia/reperfusion and perfusion with hydrogen peroxide. When the isolated liver was reperfused for 30 min and 60 min after 90 min ischemia, microsomal GSH S-transferase activity, but not cytosolic transferase activity, was increased 1.2-fold and 1.3-fold, respectively. In addition, microsomal GSH peroxidase activity was also significantly increased after 60 min reperfusion following ischemia. The increase in microsomal GSH S-transferase activity by ischemia/reperfusion was reversed by dithiothreitol. When N-ethylmaleimide, which activates microsomal GSH S-transferase by covalent binding to the cysteine residue of the enzyme, was incubated with microsomes, transferase activity was increased to 526% in control microsomes and to 399% in liver that underwent ischemia/reperfusion liver. These data indicate that microsomal GSH S-transferase is activated by ischemia/reperfusion of the liver by means of disulfide bond formation. When rats were pretreated with a catalase inhibitor 3-amino-1,2,4-triazole for 6 weeks, microsomal GSH S-transferase activity was increased 1.4-fold by ischemia/reperfusion, corresponding to a 1.8-fold increase as compared to the non-perfused liver of untreated rats. Perfusion of the isolated liver with hydrogen peroxide (1 mM, 15 min) also caused a significant increase in microsomal GSH S-transferase activity with a concomitant decrease in GSH content, confirming that liver microsomal GSH S-transferase in rats was activated in vivo by oxidative stress.

New HIV plaque titration; application to the assay of neutralizing antibody

A simple, sensitive and accurate plaque assay was developed using HPB-Ma, a variant of the human T-cell line HPB-ALL, which becomes adherent to the substratum after infection with an amphotropic murine sarcoma virus (MSVa). The simplicity of this novel plaque assay allowed us to examine a large number of serum samples from patients with HIV infection for neutralizing antibody activity against two human immunodeficiency virus type-1 (HIV-1) strains. During the progression of clinical disease, the neutralizing activity in the sera from two individual patients remained unchanged or increased. A patient with a known time of HIV infection produced cross-neutralizing antibody at 25-34 weeks. The neutralizing activity in the sera from 17 asymptomatic carriers, four patients with AIDS-related complex and four AIDS patients was also examined and was found to be unrelated to the clinical stage.

Automatic elimination of unnecessary bacterial sequences from yeast vectors

Most vectors for Saccharomyces cerevisiae are shuttle vectors which can be both propagated and selected in Escherichia coli. The DNA segments, however, which are required for propagation in E. coli are unnecessary and moreover toxic in S. cerevisiae. To delete these harmful DNA fragments from the vector after it is introduced into S. cerevisiae cells, we propose a specific gene conversion mechanism of a yeast plasmid, pSR1. Plasmid pSR1 has a pair of inverted repeats (IRs) that divides the plasmid molecule into two unique regions. Intramolecular recombination frequently occurs at a pair of specific recombination sites in IRs catalyzed by recombinase R, encoded by a pSR1 plasmid gene. This R-mediated recombination is often accompanied by gene conversion in IRs. Thus, a 2.1-kb pBR322 sequence for the E. coli host ligated into one of the IRs of a composite plasmid was automatically and effectively eliminated when the plasmid was introduced into S. cerevisiae cells.

A high-resolution solid-state 13C-NMR study on crystalline bovine heart cytochrome-c oxidase and lysozyme. Dynamic behavior of protein and detergent in the complex

We have recorded 100.6-MHz high-resolution solid-state 13C-NMR spectra of crystalline cytochrome-c oxidase from bovine heart muscle and hen egg-white lysozyme, to compare conformation and dynamics of a typical membrane-protein complex with those of lysozyme. The absence of severe interference with the solid-state 13C-NMR spectra, from both the line broadenings from paramagnetic centers and overlapping of intense detergent signals, provided spectral resolution of 13C-NMR feature of cytochrome-c oxidase crystals comparable to that of lysozyme crystal and better than that of dissolved or lyophilized samples. In fact, the observed peak intensities of the polar heads of the detergents BL8SY and Brij 35 were only about 10% and 3% of the anticipated values, respectively. The dynamic behavior of the backbone and side chains of cytochrome-c oxidase was compared with that of lysozyme on the basis of the 13C spin-lattice relaxation times (T1): the backbone of the cytochrome-c oxidase turned out to be more flexible than that of lysozyme. Molecular motions of the detergent molecules attached to the proteins are found to be highly heterogeneous. Detergent molecules undergo rapid tumbling motions in the crystals in about 10 ns as detected by T1. In addition to rapid motions, slow motions were detected by 1H spin-lattice relaxation time in the rotating frame (TH1 rho) and cross-polarization time (TCH), together with data from static spectra, indicating that the aliphatic portion of the detergent interacts more strongly with hydrophobic protein surfaces than do the polar heads.

[A case report of solitary bone cyst of rib detected from pathological fracture]

A case of solitary bone cyst of rib was reported. The patient was 28-year-old man who was admitted to our hospital complaining of chest pain caused by pathological fracture of the left 10th rib. Chest x-ray film revealed a solitary cystic lesion of the 10th rib. The tumor was removed by extrapleural rib partial resection and the histological examination confirmed the diagnosis of solitary bone cyst.

Similarity of the genomic structure between the two members in a new family of heparin-binding factors

By differential hybridization of cDNA libraries from Fv-1 restrictive and non-restrictive somatic mutant mouse cells, we isolated a cDNA clone specifically present in the Fv-1 restrictive cells. Its sequence was found identical to that of heparin-binding growth-associated molecule or pleiotrophin (HB-GAM/PTN). We report here its genomic organization which has not been yet reported. Although the exon organization was similar to that of midkine, another member of the same family of heparin-binding factors, the sizes of introns were much larger and occupied more than a three-fold larger chromosomal region than midkine. As its introduction into Fv-1 non-restrictive cells failed to confer the Fv-1 restrictive character, HB-GAM/PTN is probably unrelated to Fv-1 restriction.

Functional anatomical studies of the elbow movements. I. Electromyographic (EMG) analysis

Activities of the elbow flexors and extensors during the movement of the elbow flexion and extension were analyzed in six normal human volunteers by electromyography (EMG). In the flexors, the majority of the muscles showed EMG activities during both the flexion and extension phases, although patterns and amplitudes of EMG activities varied from individual to individual. The biceps brachii always became less active when the forearm was in pronation. In the extensors, increase of EMG activities was observed at the period of the maximum elbow extension in the majority of cases, while no EMG activity was shown throughout the movement in some cases. During the elbow movement except at the maximum extension, the triceps brachii was almost inactive and some of their three heads, in particular the long head, often showed no EMG activity. In contrast, the anconeus was usually active, sometimes showing strong EMG activity.

[Research and development of pravastatin]

The attempts to find a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase which catalyzes the rate limiting step of cholesterol biosynthesis were started from 1971. The first potent inhibitor, ML-236B (compactin), was found from the culture broth of Penicillium citrinum. Among many derivatives of ML-236B, pravastatin sodium (hereafter refer to pravastatin) was finally selected because of its potency and tissue selectivity. Since pravastatin has a hydroxyl group at 6 beta position in the skeleton of decaline of ML-236B, the microbial hydroxylation was adopted for the production of pravastatin. Streptomyces carbophilus was finally chosen as a potent converter with the formation of a lesser amount of by-products. For the sake of industrial production of pravastatin, many devices and improvements were performed for selecting high potent strains and for culturing conditions both with ML-236B and pravastatin. Pravastatin strongly inhibited the sterol synthesis in freshly isolated rat hepatocytes, but only weakly inhibited in the cells from nonhepatic tissues. This selective inhibition of pravastatin in sterol synthesis was further confirmed by ex vivo and in vivo experiments by using rats and mice. Pravastatin markedly reduced serum cholesterol levels in dogs, monkeys and rabbits, including Watanabe heritable hyperlipidemic (WHHL) rabbits, an animal model for familial hypercholesterolemia. Pravastatin showed the preventive effect on the development of coronary atherosclerosis and xanthoma in young WHHL rabbits in consequence of maintaining the serum cholesterol levels low. In the clinical trials, pravastatin significantly reduced serum cholesterol and low density lipoprotein cholesterol levels, whereas inversely increased high density lipoprotein cholesterol levels.

Illegitimate recombination in a bovine papillomavirus shuttle vector: a high level of site specificity

Recombination in a bovine papillomavirus shuttle vector carrying direct repeats of Moloney murine leukemia virus LTR sequence was examined. Differently from similar vectors carrying direct repeats of SV40 polyA addition signal or neomycin resistance gene, the vector exhibited no homologous recombination between the repeats. Instead, illegitimate recombination took place. There were two major types of recombination products from the restriction cleavage pattern. The plasmids in independent cellular clones belonging to the same recombination type shared the identical crossover point. Thus, in this plasmid, illegitimate recombination occurred at preferential sites involving exactly the same sequences.

Enhancement of antitumour activity of etoposide by dihydropyridines on drug-sensitive and drug-resistant leukaemia in mice

We recently reported that six 1,4-dihydropyridine derivatives out of 57 screened effectively over-came vincristine (VCR)-resistance in VCR-resistant (P388/VCR) leukaemia-bearing mice when the dihydropyridines and VCR were administered intraperitoneally (i.p.). Furthermore, among the six dihydropyridine derivatives, two compounds, NK-250 and NK-252, most effectively overcame VCR-resistance while exhibiting relatively low calcium antagonistic activity and toxicity. In this study, we examined whether NK-250 and NK-252 could potentiate the antitumour activities of etoposide in mice with drug-sensitive (P388/S) or VCR-resistant (P388/VCR) leukaemia cells when the anticancer agents and tumour cells were administered by various routes. In both groups of mice inoculated i.p. with P388/S- and P388/VCR-leukaemia cells, the oral (p.o.) administration of NK-250 combined with i.p. or intravenously (i.v.) administration of etoposide (ip-po-ip trials and ip-po-iv trials) dramatically potentiated the antitumour activity of etoposide. Although etoposide alone was less effective in treating mice inoculated i.v. with P388/S- and P388/VCR-leukaemia cells, p.o. administration of NK-250 combined with i.p. or i.v. administration of etoposide (iv-po-ip trials and iv-po-iv trials) potentiated the antitumour activity of etoposide to similar levels as in treating mice inoculated i.p. with leukaemia cells. These 1,4-dihydropyridines were therefore highly effective in potentiating anticancer drugs against both drug-sensitive and drug-resistant tumours.

In vitro "progression" of bovine papillomavirus-transformed cells: loss of contact sensitivity after multiple rounds of selection

The transformed phenotype of C127 cells harboring bovine papillomavirus shuttle vector pdBPVMMT neo(342-12) was suppressed by direct contact with untransformed C127 cells. By repeated selections of rare foci developing on untransformed cell monolayers, we obtained a cellular clone of BPV transformants which formed foci on the untransformed C127 cells as efficiently as on plastic surface. The BPV genome in the mutant cells showed extensive genetic rearrangements, duplication of upstream regulatory region and deletion of pBR322-derived sequence and its flanking. There was an increase in BPV-transformant in contact with the untransformed C127 cells resulted in a marked reduction of the BPV transcripts, while in the case of the mutant transformant the reduction was much slighter. This indicates that the transcription level of the BPV genome was controlled by a cell-cell contact signal.

[Evaluation of hepatic tumors by contrast ultrasonography with carbon dioxide]

For evaluating hepatic tumors, ultrasonograms using carbon dioxide by arterial injection (CO2US) was performed in 37 patients, including 28 hepatocellular carcinomas, 11 hepatic metastases, and 3 hepatic hemangiomas. Hepatic tumors were enhanced by CO2US and easily identified. CO2US of hepatic tumors were classified into six patients. Generally, on CO2US hepatocellular carcinomas were well enhanced, and hepatic metastases had ring-like enhancement. Hepatic hemangiomas showed peripheral patchy enhancement. In the patients with hepatocellular carcinoma, the primary tumors were better identified on CO2US than conventional sonography. The daughter nodules with hepatocellular carcinoma were also better demonstrated than other examinations. CO2US is helpful in evaluating and differentiating hepatic tumors.

Homologous recombination in bovine papillomavirus shuttlevecter; effect of relative orientation of substrate sequences

Relative orientation of recombination substrates, neo gene, strongly influenced homologous recombination events in a bovine papillomavirus shuttle vector. Between direct repeats, recombination occurred at a high frequency while between inverted repeats, it was rare. Double strand break near the mutation site increased the recombination frequency between inverted repeats but not between direct repeats. Formation of long heteroduplex as a recombination intermediate may explain this apparently paradoxical phenomenon.

[Internal rotation angle measurement of the elbow with 3D reformatted CT image]

The examination of internal rotation angle at the elbow is difficult on conventional radiographs. The angle of internal rotation has been measured with three dimensional reformatted CT image of GE CT/T9800. The angle of internal rotation with the cubitus varus deformity was measured both preoperatively and postoperatively. Postoperatively the angle of internal rotation became equal on both sides. Three dimensional CT reconstruction is useful in determining the internal rotation angle of elbow.

Analyses of airstepping movement in adult spinal dogs

Airstepping of the hind limbs, which occurred when the adult chronic spinal dog was lifted up vertically, was analyzed by high-speed cinematography and electromyography (EMG). In the film analysis, the amplitude of the step increased with decreasing cycle period of the step. The time courses of changes in the joint angles of the hind limb throughout the step were not changed and the maximum flexion of each joint occurred in the knee, ankle and hip joint in that order at any cycle period. In the EMG analysis, alternating EMG activities of the ankle extensor and flexor, and also of the bilateral knee extensors appeared. The EMG burst durations of the knee and ankle extensors correlated closely with the cycle period of the step, although that of the ankle flexor was independent of changes of the cycle period. Since similar results were observed in analyses of treadmill locomotion in the normal and adult spinal dogs, it was thought that airstepping and treadmill locomotion were regulated by the same central pattern generator existing in the lower spinal cord.

Analyses of treadmill locomotion in adult spinal dogs

The locomotion of the hindlimbs of two adult female spinal dogs, who were able to walk steadily on their hindlimbs 10 months after transection of the spinal cord (T10), and of two normal dogs was analyzed on a treadmill by means of high-speed cinematography and electromyography. With increase in walking speed, the duration of the step cycle was shortened by reduction of the duration of the stance phase, and the stride length was extended mainly by elongation of the transfer distance during the swing phase in both normal and spinal dogs. The patterns of muscle discharges of the hindlimbs in spinal dogs were similar to those in normal dogs. With increase in walking speed, reductions in the burst duration of the extensors were observed in both normal and spinal dogs. These results indicate that spinal dogs can adjust their locomotion speed in the same manner as normal dogs; this supports the theory that a central pattern generator regulating the locomotive activities of the hindlimbs exists in the spinal cord below the transection site.

[Anti-allergic effects of tazanolast [butyl 3'-(1H-tetrazol-5-yl) oxanilate, WP-833] metabolites]

WP-833 is an orally active new antiallergic drug. The effects of WP-833 metabolites on experimental allergic reactions were investigated in various animal models. MTCC [3'-(1H-tetrazol-5-yl) oxanilic acid], the main metabolite of WP-833, dose-dependently inhibited 48-hr homologous passive cutaneous anaphylaxis (PCA) in rats and 8-day PCA in guinea pigs after intravenous administration. The inhibitory effect of MTCC on PCA was nearly equal to that of WP-833. MTCC also inhibited 48hr PCA in rats after the peroral administration, although its inhibitory effect was about 6 times weaker than that of WP-833. MTCC also showed a dose-dependent inhibition on the release of histamine or slow reacting substance of anaphylaxis (SRS-A) from passively sensitized rat peritoneal mast cells and guinea pig lung fragments in vitro with a similar potency to WP-833. MTA [3-(1H-tetrazol-5-yl) aniline] and MTAA [3'-(1H-tetrazol-5-yl) acetanilide], other metabolites of WP-833, inhibited PCA and anaphylactic histamine release from rat peritoneal mast cells at considerably higher doses than WP-833, and they showed no effects on the release of histamine and SRS-A from guinea pig lung fragments. Moreover, only small amounts of MTA and MTAA were detected in the blood after the oral administration of WP-833. From these results, it was suggested that MTCC may be the main active metabolite of WP-833.

[The clinical studies of intermittent hepatic artery occlusion with infusion chemotherapy--19 cases of unresectable hepatocellular carcinoma and 14 cases of metastatic liver cancer]

For unresectable liver tumors, intermittent occlusion of the feeding artery by means of surgical placement of double lumen balloon catheter in the hepatic artery was combined with chemotherapy. Through the catheter, fluorouracil was continuously infused and one-shot injections of mitomycin or adriamycin were given at the time of balloon inflations. Nineteen patients with primary hepatocellular carcinoma (7 were at Stage III and 11 were at Stage IV) and 14 patients with metastatic liver tumors (4 were at H2 and 9 were at H3 stages) received this newly developed anticancer methodology. In terms of Karnofsky's criteria, 17 of 19 cases with hepatocellular carcinoma achieved Group I responses (89.5%). Fourteen were classified to I-B (73.7%), and one year survival rate was 51.6%. Of 14 cases with metastatic tumors, 13 achieved Group I responses (92.9%). Five were classified to I-B (35.7%), and one year survival was 23.1%. Intermittent occlusion method has advantages in minimizing adverse effects, enabling controlled arterial infusion of anticancer agents and stepwise occlusion of the feeding artery. Despite advanced stages and poor conditions of the patients, remarkable responses were achieved without any serious problems. We are at a conclusion that intermittent occlusion of the hepatic artery when combined with infusion-chemotherapy would, in synergism, be a potential modality against unresectable liver tumors.

A multichannel FES system for the restoration of motor functions in high spinal cord injury patients: a respiration-controlled system for multijoint upper extremity

A multichannel functional electrical stimulation (FES) system for the restoration of quadriplegic upper extremity function is described. The system is composed of a personal computer NEC PC-8801mkII, peripheral electronic circuits, CRT display and respiratory sensors for volitional control by the patient, and percutaneous electrodes. A C4 quadriplegic patient could drink canned tea by herself by using this FES system. Distinct features of the system are as follows: 1) Versatile volitional control was realized by controlling the memory allocation of the stored stimulation data by voluntary respiratory signals. 2) Sophisticated fine control of the fingers, wrists, and elbow was realized by creating the multichannel stimulation data from recorded myoelectric activities of normal subjects during movements of the upper limb.

Isolation and characterization of the human chromosomal gene for polypeptide chain elongation factor-1 alpha

The cDNA for human elongation factor-1 alpha was isolated from a cDNA library of human fibroblast cells. Using the cDNA as a probe, a number of chromosomal genes encoding the human elongation factor-1 alpha were isolated. Characterization of the clones by restriction enzyme mapping and nucleotide sequence analysis has revealed that only one of them is an active gene, whereas all of the other genes are processed pseudogenes. The active gene consists of 8 exons and 7 introns spanning about 3.5 kilobases, and the sequence of its exons is completely identical to that of the human elongation factor-1 alpha cDNA. The first non-coding exon of 33 base pairs is separated by a 943-base pair intron from the coding exons. The primer extension of human elongation factor-1 alpha mRNA has indicated that the transcription of human elongation factor-1 alpha gene starts from a C residue, and a "TATA" box was found 24 base pairs upstream of the initiation site. Three and five Sp1 binding sites are present on the 5'-flanking region and the 1st intron, respectively. Furthermore, one Ap-1 binding site is located in the 1st intron. By using nuclear extracts from HeLa cells, the promoter of human elongation factor-1 alpha gene could stimulate in vitro transcription better than the adenovirus major late promoter.

Metastatic liver tumor with tumor thrombi of the portal vein

Tumor thrombi of the portal vein are an important prognostic indicator for primary hepatocellular carcinoma (hepatoma), and their presence is a major criterion in differentiating intrahepatic tumors. We report four cases of metastatic liver tumors with tumor thrombi, one a gastric tumor and the others colorectal cancers, two of which were difficult to differentiate from hepatoma. The angiographic features of hepatoma are reviewed and differentiation between the two is discussed. Angiography showed the vessels of metastatic liver tumors to be of fine to mixed types. Chaotic vessels and pooling are characteristic of hepatomas, and dense tumor stains are observed only in hepatomas. The mean survival period after angiography was 3.8 months, and the prognosis was not favorable in patients having "thread-and-streak" sign on angiography.

Molecular cloning of the closed circular provirus of human T cell leukaemia virus type I: a new open reading frame in the gag-pol region

A DNA clone of human T cell leukaemia virus type I (HTLV-I) was isolated from extrachromosomal closed circular copies in chronically infected promyelocytic leukaemia HL60 cells. The new HTLV-I isolate had an intact reading frame in the gag-pol region which could encode protein of 234 amino acids. This open reading frame has not been observed in previous HTLV-I isolates, although similar open reading frames have been reported in the corresponding locations in the related bovine leukaemia virus and HTLV type II. We consider that this open reading frame codes for the virus-encoded protease, on the basis of the homology of the predicted amino acid sequence with those of previously identified retrovirus proteases.

Functional recovery of locomotive behavior in the adult spinal dog

Complete transection of the midthoracic spinal cord was performed on adult female dogs. Development of reflexes and locomotive movements in the hindlimbs after spinal transection was investigated over several months. In the earlier stages after the surgery, dogs showed flaccid paralysis of the hindlimbs. Within several weeks, muscle tone of the hindlimbs was gradually increased accompanied by development of flexion reflex with after-discharge in addition to monosynaptic reflexes. Alternating stepping movement also began to develop. Afterward, extensor thrust and crossed extension reflex were observed. Standing behavior of the hindlimbs was found after enough development of the extensor thrust and correct placement of the pads of the toes. Steady development of stepping and standing caused forward locomotion using fore- and hindlimbs. This walking behavior of the hindlimbs was never inhibited by additional spinal cord transection. These findings indicate that the isolated spinal cord caudal to the transected site is responsible for the locomotive behavior of the hindlimbs in adult spinal dogs. Spinal automatism and development of responses induced by afferent inflow from outside the cord may help to explain such functional recovery of the paralyzed hindlimbs.

Serum CA 19-9 concentrations and computed tomography findings in patients with pancreatic carcinoma

Carbohydrate antigen (CA) 19-9 is a new tumor marker, defined by a monoclonal antibody. Serum CA 19-9 concentrations and computed tomography (CT) findings were studied in 55 patients with histologically proven adenocarcinoma, and in 22 patients with chronic pancreatitis. CA 19-9 was useful in 83% of cases for the differential diagnosis between pancreatic carcinoma and chronic pancreatitis, and serum CA 19-9 levels in pancreatic carcinoma were highly related to the size of tumors. Serum CA 19-9 levels greater than 37 U/ml were seen in patients with a tumor of less than 3 cm, 3 to 5 cm, and greater than 5 cm in diameter 13% (1/8), 90% (19/21), and 92% (24/26) of cases, respectively. Tumor location, however, was unrelated to serum CA 19-9 value. These results indicated that the measurement of serum CA 19-9 concentrations would be useful in most, if not all, cases for the differential diagnosis between pancreatic carcinoma and chronic pancreatitis, and for the evaluation of tumor burden in patients with pancreatic carcinoma.