[A case report of exercise-induced anaphylaxis]

We report a case of 44-year-old Japanese man who presented with exercise-induced anaphylaxis. He was admitted to our hospital with chief complaints of repeated episodes of urticaria and nausea induced by exercise. He had allergy to the radiologic contrast iodine material, but no history of atopic dermatitis. Physical and neurological examinations were unremarkable. Treadmill test induced urticaria and nausea in 10 minutes after starting the exercise and the test was discontinued. The systolic blood pressure finally fell down to 51mmHg about 17 minutes after ceasing the exercise, and it returned to normal value with hydrocortisone and noradrenalin injection. Treadmill test increased the serum histamine level, but did not increase serotonin nor IgE levels. Administration of antihistamines and avoidance of hard exercise has protected him from a new attack. We have to pay attention to exercise-induced anaphylaxis as one of the important causes of syncope.

[Hormone therapy of endometrial carcinoma]

Various hormone therapies for endometrial carcinoma have been reported in the literature using progestins, tamoxifen (anti-estrogen), danazol, Gn-RH etc. The response rates of these hormone therapies are reported to be approximately 30%, which is no longer superior to other types of treatment methods. On the other hand, endometrial carcinoma is considered to be one of hormone dependent tumors. Although sex steroid hormones play an important role in the mechanism of carcinogenesis and the progression of early and well-differentiated endometrial carcinoma, most of the advanced carcinomas treated by hormone therapy have transformed into hormone independent state. It is expected that endometrial hyperplasia and well-differentiated carcinoma especially in younger patients should be effective materials for hormone therapy.

Androgen-dependent expression of fibroblast growth factor-1 in submaxillary gland of mouse

We have purified a 16,000 dalton protein that stimulates growth of human umbilical cord vein-derived endothelial cells (HUV-EC) from mouse submaxillary glands by using heparin-Sepharose affinity and C4 reverse phase chromatography. The purified molecule was identified as an FGF-1 on the basis of its biological activities, its affinity for heparin and its N-terminal amino-acid sequence. The concentrations of FGF-1 in the submaxillary gland of male or testosterone-treated female mice were about 12 times those of untreated females or castrated males. The 2.3 and 4.1 kb FGF-1 mRNAs were expressed in the glands of male mice older than 4 weeks but not in the glands of female mice. These results suggest that FGF-1 may have important functions for growth, differentiation and development of mouse submaxillary glands, and it may act as an endocrine hormone.

Unique case of growth hormone (GH) deficiency accompanied by clinical anophthalmia, hypoplastic orbits, digital dysplasia, short stature, obesity, and diabetes mellitus

A 43-year-old female was admitted to our hospital for polydipsia and hyperglycemia. She had total blindness and globes were not recognized by inspection, indicating clinical anophthalmia. Physical examination revealed short stature, obesity, prematurely gray hair, shortness of fingers and toes, syndactyly, and multiple dental caries. Laboratory examination showed hyperglycemia, increased glycosilated hemoglobin (HbA1c) and insulin resistance on euglycemic glucose clamp. Blunted growth hormone (GH) secretion was shown in response to insulin-induced hypoglycemia, arginine infusion, and GH-releasing hormone (GHRH) loading test, and in 24 h spontaneous GH profile. Magnetic resonance imaging (MRI) and computed tomography (CT) showed dysostosis of orbit, defect of optic nerve, enlarged suprasellar cistern, and prolonged pituitary stalk. This may be the first report of a unique case with GH deficiency accompanied by clinical anophthalmia, hypoplastic orbits, digital dysplasia, short stature, obesity, and diabetes mellitus.

Stimulating effect of 6R-tetrahydrobiopterin on Ca2+ channels in neurons of rat dorsal motor nucleus of the vagus

We have recently found that 6R-tetrahydrobiopterin (6R-BH4), a natural cofactor for aromatic L-amino acid hydroxylases and nitric oxide synthase, enhances dopamine release. Here, using a slice patch method, we examined the effect of 6R-BH4 on Ca2+ channels in neurons of rat dorsal motor nucleus of the vagus, where dopaminergic neurons are densely located. 6R-BH4 enhanced N-type Ca2+ channel currents, whereas 6S-BH4, a diastereoisomer of 6R-BH4, had little effect. Neither sodium nitroprusside, a nitric oxide generator, nor L-DOPA, a product of tyrosine hydroxylation, mimicked the effect of 6R-BH4. These findings suggest that 6R-BH4 enhances N-type Ca2+ channel currents in stereospecifically and independently of its cofactor activities as observed in its dopamine releasing action, and raise possibility that 6R-BH4 enhances dopamine release by activating Ca2+ channels.

The crystal structure of human glycosylation-inhibiting factor is a trimeric barrel with three 6-stranded beta-sheets

Glycosylation-inhibiting factor (GIF) is a cytokine that is involved in the regulation of IgE synthesis. The crystal structure of recombinant human GIF was determined by the multiple isomorphous replacement method. The structure was refined to an R factor of 0.168 at 1.9 angstrom resolution. The overall structure is seen to consist of three interconnected subunits forming a barrel with three 6-stranded beta-sheets on the inside and six alpha-helices on the outside. There is a 5-angstrom-diameter "hole" through the middle of the barrel. The barrel structure of GIF in part resembles other "trefoil" cytokines such as interleukin 1 and fibroblast growth factor. Each subunit has a new class of alpha + beta sandwich structure consisting of two beta-alpha-beta motifs. These beta-alpha-beta motifs are related by a pseudo-twofold axis and resemble both interleukin 8 and the peptide binding domain of major histocompatibility complex protein, although the topology of the polypeptide chain is quite different.

Impaired compensatory adaption to B-cell mass reduction in young spontaneously hypertensive rats (SHR)

The aim of this study was to examine the effect of insulin resistance on B-cell function and replication. To this end insulin-resistant spontaneously hypertensive rats (SHR) and age-matched normotensive Wistar-Kyoto rats (WKY) as a control were subjected to 90% pancreatectomy (Px) or sham operation at the age of 4 weeks. Islet function and regeneration were examined 4 weeks after surgery. Plasma glucose levels were higher in SHR than in WKY 4 weeks after Px (488 +/- 30 vs. 395 +/- 31 mg/dl; p < 0.01). In sham-operated animals, plasma glucose responses to intravenous injections of glucose (0.5 g/kg body weight) were much higher in WKY than in SHR, while plasma insulin responses were greater in SHR than in WKY. There was no insulin response to glucose in either strain of Px rats. In sham-operated rats, the insulin content of the remnant equivalent pancreas (4.6 +/- 0.8 vs. 3.0 +/- 0.3 micrograms; p < 0.05) and whole pancreas (62.2 +/- 2.8 vs. 53.3 +/- 2.1 micrograms; p < 0.05) were greater in SHR than in WKY. However, the insulin content was lower in SHR than in WKY (1.9 +/- 0.3 vs. 2.5 +/- 0.7 micrograms; p < 0.05) 4 weeks after Px. Fibrotic degeneration of pancreatic islets was greater in Px-SHR than in Px-WKY. These data suggest that the B cells of SHR are more vulnerable to reduction of islet mass than those of WKY. A diminished capacity for islet cell regeneration in SHR may be linked to insulin resistance presented in this animal model of hypertension.

Two distinct quinoprotein amine oxidases are induced by n-butylamine in the mycelia of Aspergillus niger AKU 3302. Purification, characterization, cDNA cloning and sequencing

Two distinct quinoprotein amine oxidases were found in Aspergillus niger mycelia grown on n-butylamine medium and purified using chromatographic techniques. The respective enzymes were termed AO-I, which had already been isolated, and AO-II, a new enzyme found in this study. HPLC indicated that their molecular masses are 150 kDa and 80 kDa, respectively. On SDS/PAGE, the enzymes gave a similar but distinct mobility, which corresponds to 75 kDa for the subunit dimeric AO-I and 80 kDa for monomeric AO-II. The absorption spectra of both enzymes were different from each other; the absorption maxima in the visible region were at 490 nm for AO-I and 420 nm for AO-II. The enzymes showed positive quinone staining, comparable substrate specificity, and sensitivity to inhibitors typical for copper/topa quinone-containing amine oxidases, but they had different copper contents and also differed in their N-terminal sequences. Their peptide maps showed almost identical patterns, with the exception of two additional bands for AO-II. Among the peptides obtained from digestion of AO-II, peptides with sequences corresponding to the N-terminal part of AO-I were detected. Polyclonal antibodies raised against AO-I and AO-II recognized both enzymes, but with different specificities. Using precipitation with AO-I, the antibody prepared against AO-II was purified and was shown to be specific only for AO-II. The cDNA of AO-I was cloned and sequenced. A highly conserved tetrapeptide sequence, Asn-Tyr-Glu-Tyr, was identified in which the first tyrosine residue (Tyr404) that could be converted to topa quinone was present in the 670-residue deduced amino acid sequence. Northern blot analysis indicated that AO-I was highly expressed in A. niger grown on n-butylamine as a single nitrogen source. Genomic Southern blot analysis confirmed that both enzymes are likely to be encoded by the same gene.

[Mid mediastinal lipoma--a case report]

Mediastinal lipomas are relatively rare neoplasm in Japan. They are generally asymptomatic tumors because they often arise from anterior mediastinum especially nearby diaphragma. We experienced a 67-year-old man who presented with transient edema on the face and upper limbs. The phlebography showed compression of left brachiocephalic vein, superior vena cava and right pulmonary artery by the tumor. The sagittal view of the chest MRI gave precise and useful anatomical informations. The complete resection of the tumor was performed uneventfully. The tumor was 15 x 12 x 5 cm in size, and there was no secondary change at the superior vena cava. Postoperative chest CT showed the complete decompression of the superior vena cava. The pathological diagnosis of the tumor was benign mature lipoma. Postoperative course was uneventful and the patient is now being well. There is no evidence of recurrence 6 months after the operation. This is the first report of the mediastinal lipoma which arised from the mediastinum in Japanese literature as far as we have reviewed.

Characterization of lipopolysaccharides of polymyxin-resistant and polymyxin-sensitive Klebsiella pneumoniae O3

Lipopolysaccharides isolated from the polymyxin-resistant Klebsiella pneumoniae O3 mutant OM-5 and its polymyxin-sensitive parent LEN-1 were analyzed for chemical composition, and their lipid A portions were structurally characterized. The lipopolysaccharide of OM-5 contained approximately five times more 4-amino-4-deoxy-L-arabinopyranose than that of LEN-1. Other saccharide and phosphate components exhibited no significant differences. Structural characterization, including analyses by phosphorus magnetic resonance spectroscopy and by fast atom bombardment mass spectrometry, revealed a novel type of lipid A. In the OM-5 lipopolysaccharide, both phosphates of lipid A were almost totally present as phosphodiesters with 4-amino-4-deoxy-L-arabinopyranose. In the sensitive-type LEN-1 lipid A, the extent of this substitution was much lower, especially in the glycosidically linked phosphate. Phosphate in these K. pneumoniae lipopolysaccharides was almost exclusively found in lipid A. These results show that cationic substituents of phosphates of lipid A play a decisive role in determining polymyxin reactivity. OM-5 was also found to contain a large proportion of heptaacyl lipid A, which represented only a small fraction of lipid A in LEN-1.

Molecular cloning of the cDNAs encoding pituitary glycoprotein hormone alpha- and gonadotropin II beta-subunits of the Japanese eel, Anguilla japonica, and increase in their mRNAs during ovarian development induced by injection of chum salmon pituitary homogenate

cDNAs encoding the glycoprotein hormone alpha- and gonadotropin (GTH) II beta-subunits of Japanese eel (Anguilla japonica) pituitary were cloned using the polymerase chain reaction. The nucleotide sequence of the glycoprotein hormone alpha-subunit cDNA was 364 base pairs (bp) long, encoding 117 amino acids, and that of the GTH II beta-subunit cDNA was 433 bp long, encoding 140 amino acids. The deduced amino acid sequence of each mature subunit showed high homology with those of other teleosts, indicating that the structure of GTH subunits has been conserved during the evolution of teleosts. Changes in the expression of these subunit genes during ovarian development induced artificially by the injection of chum salmon pituitary homogenate were examined using Northern blot analysis. Glycoprotein hormone alpha-subunit mRNA increased almost linearly during ovarian development, whereas GTH II beta-subunit mRNA was detected only at the late vitellogenic and migratory nucleus stages. These data indicate that eel GTH II is synthesized mainly at the late vitellogenic and migratory nucleus stages, and suggest that GTH II plays an important role in final oocyte maturation of Japanese eel. Changes in the expression of glycoprotein hormone alpha- and GTH II beta-subunits mRNA correlate with the serum estradiol-17 beta (E(2)) and testosterone profile during ovarian development. The increase in mRNA of both subunits is probably due to positive feedback of E(2) and testosterone produced by ovarian follicles in response to the GTH contained in chum salmon pituitary homogenate.

Low temperature preservation of mouse fetal germ cells at 4 °C

Mouse fetal germ cells(FGCs) isolated or within genital ridges from male fetuses at 15.5 d post coitum were preserved at 4 degrees C for 3-15 d with TCM-199 medium supplemented with 10, 50 or 100% fetal bovine serum (FCS) and 0.1, 0.6 or 1.0 M sucrose. The viability of FGCs was assessed by the dye exclusion test with trypan blue and nuclear transfer into enucleated oocytes and then into enucleated 2-cell embryos. Forty-one to 45 % of FGCs survived for 5 d after preservation in the medium containing 50% FCS and 0.1 M sucrose according to the results of the dye exclusion test. But significant good effect of sucrose was not observed regardless of its concentration. When genital ridges were preserved, 15-22% of FGCs survived even 10 d after preservation. The efficiency of the in vitro development of FGCs to blastocysts was similar when they were fused with enucleated oocytes and 2-cells blastomeres after 2 to 4 d storage(27-33%) compared with that of control FGCs(56%).

Clinical usefulness of 3-D CT endoscopic imaging of cerebral aneurysms

Usefulness of endoscopic imaging of cerebral aneurysms is presented. 3-D luminal images were obtained using a new processing technique which extracts CT numbers in the boundary region between the vessel wall and contrast media filled in the vascular lumen. Clinical application of this technique to complicated large cerebral aneurysms showed that, with this 3-D CT endoscopic imaging, anatomical details of cerebral aneurysms such as the orifice of the aneurysm, intraluminal thrombus, and calcification of the wall could be clearly demonstrated. Using a 3-D imaging method by Helical CT virtual views of various surgical approaches were compared preoperatively. With this technique, not only virtual surgical views of aneurysms and related vasculature, but also surgical views after virtual resection of skull base bone to a desirable extent are freely available. We operated on two large, complicated aneurysms and one broad-based aneurysm after obtaining 3-D CT endoscopic images of the aneurysms. Such information was found to be very useful for determining difficult and complicated cerebral aneurysms and broad-based aneurysms for coil embolization or direct open surgery.

Short-term treatment with different doses of human growth hormone in adult patients with growth hormone deficiency

We studied the effects of short-term replacement with human GH at three doses (0.124, 0.250 and 0.375 IU/kgBW/week) in 12 adult patients with GH deficiency (GHD). The patients were divided at random into three groups of 4 patients (groups A, B and C) and each group was treated with three doses of GH and placebo for 10 weeks in shifts of two weeks each. The replacement was started with one of three doses of GH given sc daily at 2100 h for 2 weeks, which was followed by placebo treatment for 2 weeks. The various doses of GH and placebo were then given alternately. GH treatment increased serum IGF-I and IGF-BP3 levels in all the patients examined although the responses were partly influenced by the order of GH treatment. When the data obtained with the same doses of GH in the three groups were combined, a dose-response was demonstrated. There was a close correlation (r = 0.726) between serum IGF-I and IGFBP-3. Serum triiodothyronine as well as non-esterified fatty acid (NEFA) levels also increased after GH replacement. Adverse side effects included edema in two cases and sleep distress in one case during the GH treatment at the highest dose of 0.375 IU/kgBW/week. These findings indicate that short-term replacement with GH at the doses of 0.125 and 0.250 IU/kgBW/ week is safe and effective in adult patients with GHD.

Effect of antihypertensive treatment with alacepril on insulin resistance in diabetic spontaneously hypertensive rats

Recent clinical reports have described the close relationship between insulin resistance and hypertension. Previous reports from our laboratory documented that spontaneously hypertensive rats (SHR) have mild insulin resistance, and that this insulin resistance is more intense in SHR with diabetes induced by streptozotocin (STZ). The aim of this study was to elucidate the effects of antihypertensive treatment with alacepril on insulin resistance in these diabetic SHR. Animals were divided into four groups as follows: group A, nondiabetic SHR; group B, diabetic SHR group C, diabetic SHR treated with 0.05% alacepril; and group, D diabetic SHR treated with 0.1% alacepril. Diabetes was induced by intravenous (IV) injection of STZ (35 mg/kg bodyweight [BW]). Alacepril was given orally by mixing in laboratory chow. Mean (+/- SD) blood pressure was lowered in the alacepril-treated groups (A 212 +/- 7mm Hg and B 213 +/- 8 v C 184 +/- 6 and D 167 +/- 9; P < .01). Total integrated plasma glucose levels were different among all the groups by oral glucose tolerance test (OGTT) (B 53.6 +/- 3.3 mmol/L > C47.2 +/- 4.5 > D 42.3 +/- 1.4 > A 34.2 +/- 1.2; P < .01). Steady-state plasma glucose (SSPG during the insulin suppression test was higher in group B than in group A (15.7 +/- 1.5 mmol/L v 10.4 +/- 0.8; P < .001). The SSPG level (12.9 +/- 0.7) was significantly (P < .001) lower in group D than in untreated group B. In the diabetic groups, blood pressure was positively correlated with integrated plasma glucose (PG) (r = .79, P < .001), SSPG (r = .53, P < .02), and plasma triglyceride (r = .70, P < .001), and negatively with high-density lipoprotein (HDL)-cholesterol (r = -.74, P < .001). Alacepril treatment not only dose-relatedly lowered mean blood pressure, but also dose-relatedly improved abnormalities in carbohydrate and lipid metabolism in STZ-induced diabetic SHR. These results suggest that an angiotensin-converting enzyme inhibitor, alacepril, has an antihypertensive effect, but also improves insulin resistance in hypertension with diabetes mellitus.

Thymidine phosphorylase/platelet-derived endothelial cell growth factor expression associated with hepatic metastasis in gastric carcinoma

It is known that angiogenesis plays an important role in the growth and metastasis of solid tumours. Several angiogenic factors have been identified and platelet-derived endothelial cell growth factor (PD-ECGF) is thought to be one such factor. Recently, it was reported that thymidine phosphorylase (dThdPase) is identical to PD-ECGF. Using immunohistochemical staining with an anti-dThdPase antibody, we investigated the correlation between dThdPase expression and the microvessel density in 120 gastric carcinomas. The microvessel density, determined by immunostaining for factor VIII-related antigen, was significantly higher in dThdPase-positive tumours than in dThdPase-negative tumors. There was a significant correlation between dThdPase expression and the increment of microvessel density. Moreover, regarding distant organ metastasis, the frequency of hepatic metastasis was significantly higher (P < 0.01) in patients with dThdPase-positive tumours than in those with dThdPase-negative tumors. In summary, it was suggested that dThdPase expression is closely associated with the promotion of angiogenesis and hepatic metastasis in gastric carcinoma.

Enhancement of SPARC (osteonectin) synthesis in arthritic cartilage. Increased levels in synovial fluids from patients with rheumatoid arthritis and regulation by growth factors and cytokines in chondrocyte cultures

OBJECTIVE

To investigate the roles of SPARC (secreted protein, acidic and rich in cysteine) (osteonectin) in arthritis, using cartilage and synovium specimens and synovial fluids (SF) from patients with rheumatoid arthritis (RA) or osteoarthritis (OA), and to examine the effects of cytokines, growth factors, and hormones on SPARC synthesis by chondrocytes in culture.

METHODS

SPARC in cartilage and synovium was immunostained with monoclonal antibodies. SPARC synthesis by cultured chondrocytes was measured by Northern blot analysis, immunoblotting, and sandwich enzyme-linked immunosorbent assay.

RESULTS

SPARC was identified in numerous chondrocytes in the superficial and middle zones and in regenerating chondrocytes of RA and OA joints, whereas such staining was absent in these zones of normal cartilage, except for weak signals from a few chondrocytes in the deep zone. In addition, SPARC synthesis was enhanced in synovial cells of RA and OA joints. The average SPARC level in SF was 10-fold higher in the RA than in the OA population. In rabbit articular chondrocyte cultures, administration of transforming growth factor beta 1 (TGF beta 1) and bone morphogenetic protein 2 increased SPARC levels at 24-48 hours, whereas interleukin-lbeta (IL-1 beta), IL-1 alpha, tumor necrosis factor alpha, lipopolysaccharide, phorbol myristate acetate, basic fibroblast growth factor, and dexamethasone decreased SPARC levels at 24-72 hours. TGF beta increased SPARC messenger RNA (mRNA) levels at 24 hours, whereas IL-1 beta caused a marked decrease in SPARC mRNA levels at 24 hours. Furthermore, IL-1 decreased the glycosylation of SPARC.

CONCLUSION

These findings suggest that various growth factors and cytokines, including TGF beta 1 and IL-1 beta, regulate the production of SPARC by chondrocytes at pre- and posttranslational levels, and that SPARC synthesis is markedly enhanced in arthritic joints.

Restricted propagation of cytoplasmic Ca2+ oscillation into the nucleus in guinea pig cardiac myocytes as revealed by rapid scanning confocal microscopy and indo-1

Two-dimensional images of cytoplasmic and nuclear free Ca2+ movements in cardiac myocytes were obtained at 67-msec intervals using a Ca(2+)-sensitive fluorescence probe, indo-1, and a rapid scanning confocal laser microscope, Nikon RCM8000. Isolated guinea pig ventricular cells were loaded with indo-1 and stimulated at 0.5 Hz through patch pipettes. On stimulation, nuclear Ca2+ concentration ([Ca2+]) was observed to rise and fall following cytoplasmic [Ca2+] with an obvious delay. Application of isoproterenol significantly increased the peak [Ca2+] on stimulation in both the cytoplasm and nucleus with no substantial change in the basal [Ca2+]; the increase in peak [Ca2+] produced by application of isoproterenol was larger in the cytoplasm than in the nucleus. Under a low [Na+] condition, the basal [Ca2+] was increased from the control values in both the cytoplasm and nucleus; no difference in basal [Ca2+] was observed between the two regions. The increase in peak [Ca2+] by low [Na+] in the cytoplasm was significantly larger than that in the nucleus. When the cells were voltage clamped at 0 mV for 3 sec, no difference in the steady state [Ca2+] was observed between the cytoplasm and nucleus. Nuclear [Ca2+] was also observed to increase following a Ca2+ wave, a local increase in [Ca2+] propagating within the cytoplasm, with a delay. Thus, we demonstrated in isolated myocardial cells that cytoplasmic Ca2+ movements, although hampered by the nuclear envelope, are propagated into the nucleus, a mechanism through which factors affecting cytoplasmic Ca2+ may influence intranuclear events.

Genetic mechanisms in esophageal carcinogenesis: frequent deletion of 3p and 17p in premalignant lesions

Although dysplasia of the esophagus is thought to be the precursor lesion of esophageal squamous cell carcinoma (ESC), the sequence of genetic events during esophageal carcinogenesis is unclear. Using the polymerase chain reaction, we examined allelic losses at microsatellite loci in DNAs isolated from 106 lesions among 32 patients with ESC. Allelic losses on 3p or 17p occurred frequently even in dysplastic lesions (9 of 21 and 13 of 24 samples, respectively) including lesions with mild dysplasia (3p, 4 of 10 samples; 17p, 6 of 14 samples, respectively), and allelic losses on these chromosomal arms were also observed in cancerous tissues. We also detected allelic losses of the short and long arms of chromosome 9 at a low frequency in lesions with mild dysplasia and often in lesions with severe dysplasia and in intraepithelial cancers. Our results suggested that inactivation of tumor suppressor genes on 3p and 17p occurs at a very early stage of esophageal carcinogenesis and that genes on 9p and 9q are likely to play important roles in malignant changes. Comparison of the genetic alterations in precancerous dysplastic lesions with those in carcinomas supports the idea that ESC arises from the dysplastic lesion.

Prevalence of hepatitis B or C virus infection in patients with fulminant viral hepatitis. An analysis using polymerase chain reaction

BACKGROUND/METHODS

The cause of fulminant hepatitis is still not fully understood. We studied 23 patients with fulminant hepatitis, using polymerase chain reaction to detect hepatitis virus genomes. Tests for HBsAg and IgM anti-HAV and IgM anti-HBc were performed in all patients. Serum samples were stored at -70 degrees C for later analysis of anti-HCV and hepatitis virus genomes such as hepatitis B virus, hepatitis C virus and hepatitis D virus.

RESULTS

Of 23 patients, 17 (74%) had HBV-DNA and two (9%) had HCV-RNA. No patient was positive for both viruses or positive for HDV-RNA. Serological tests indicated that two patients, negative for HBV-DNA and HCV-RNA, were positive for IgM anti-HAV. In contrast, 8 of 17 (47%) HBV-DNA positive patients were negative for both IgM anti-HBc and HBsAg in conjunction with low levels of viremia. Four patients were positive for anti-HCV, but only one was positive for HCV-RNA. One patient, positive for HCV-RNA, was negative for anti-HCV.

CONCLUSIONS

Our results indicate that analysis of hepatitis virus genomes using polymerase chain reaction allows accurate identification of the virus causing fulminant hepatitis.

Apoptotic cell death in the response of D-galactosamine-sensitized mice to lipopolysaccharide as an experimental endotoxic shock model

The apoptotic cell death induced in D-galactosamine-sensitized mice by administration of lipopolysaccharide was characterized. Administration of lipopolysaccharide caused apoptotic cell death in livers of D-galactosamine-sensitized mice. Apoptotic cells were also detected in the kidney, thymus, spleen, and lymph node. Severe hepatic apoptosis in D-galactosamine-sensitized mice was reproduced by transfer of the sera from mice injected with D-galactosamine and lipopolysaccharide. The hepatocyte apoptosis induced by lipopolysaccharide was completely prevented by an anti-tumor necrosis factor alpha antibody but not by an anti-gamma interferon antibody. Administration of recombinant tumor necrosis factor into D-galactosamine-sensitized mice also caused hepatocyte apoptosis. Lipopolysaccharide-induced hepatocyte apoptosis in D-galactosamine-sensitized mice did not seem to be mediated by Fas antigen. It was suggested that lipopolysaccharide- induced hepatic injury and failure in D-galactosamine-sensitized mice was due to the apoptotic cell death of hepatocytes caused by tumor necrosis factor alpha released in the circulation.

Comparative study of C-reactive protein in chronic hepatitis B and chronic hepatitis C

C-reactive protein (CRP) is a liver-specific acute-phase protein, and its expression in hepatocyte is regulated by cytokines such as interleukin-1, interleukin-6 and tumor necrosis factor-alpha. Although several alterations in cytokines have been found in patients with chronic viral hepatitis, it remains obscure how CRP expression is associated with progression of the disease in chronic viral infection. In the present study, CRP expression was evaluated in 45 patients with chronic hepatitis B and in 38 patients with chronic hepatitis C. By the immunohistochemical analysis, the intensity of CRP expression in hepatocyte was closely associated with the histology activity index (HAI) score in chronic hepatitis B. In contrast, the association was not found in chronic hepatitis C. When serial changes in serum levels of CRP were compared in long-term follow-up patients including 5 patients with chronic hepatitis B and 4 patients with chronic hepatitis C, serum levels of CRP fluctuated simultaneously with serum levels of alanine aminotransferase in chronic hepatitis B, whereas the correlation was not recognized in chronic hepatitis C. These results suggest that CRP expression correlates with progression of the disease in chronic hepatitis B, but not in chronic hepatitis C. It is also possible that cytokine-mediated response is more pronounced in chronic hepatitis B than in chronic hepatitis C.

Testosterone metabolism in new squamous cell carcinoma cell line (RSS18) from 7,12-dimethylbenz[a]anthracene-induced submandibular gland of female rat

We established a new squamous cell carcinoma cell line, designated RSS18, from a 7,12-dimethyl-benz[a]anthracene (DMBA)-induced submandibular gland of the female rat, and investigated a testosterone metabolism in the cells. During 6 h incubation of RSS18 cells with testosterone as a substrate, the cells produced a significant amount of 5alpha-dihydrotestosterone (DHT) and three kinds of minor metabolites, and their percentages metabolized against total metabolites were in descending order of DHT (89 %) > 5alpha-androstane-3alpha,17beta-diol (9.0 %) > 5alpha-androstanedione(1.6%) > 4-androstene-3,17-dione (0.69%). Therefore, testosterone in RSS18 cells was predominantly converted to DHT by 5alpha-reductase. Growth of RSS18 cells was stimulated by DHT (10(-11)-10(-9) M) to around 170%. By reverse transcription-polymerase chain reaction, the androgen receptor mRNA was significantly detected in RSS18 cells. As a result of these findings, DHT production from testosterone and expression of androgen receptor mRNA, we concluded that RSS18 proliferation may be stimulated by DHT through 5alpha-reductase from testosterone.

Clinico-pathological predictive factors of response to interferon therapy in chronic hepatitis C

We performed a clinico-pathological study to determine which pre-treatment factors could predict the response to interferon (IFN) therapy in 55 Japanese patients with chronic hepatitis C. Responses to the IFN therapy were evaluated as sustained response, relapse and non-response by the presence or absence of serum hepatitis C virus (HCV) RNA during the course of treatment and at least 6-months post-treatment. The numbers of sustained response, relapse and non-response were 16 (29.0%), 25 (45.5%) and 14 (25.5%), respectively. Eight out of 16 sustained response cases (50%) showed HCV genotype III. Eight among 10 patients with HCV genotype III (80%) were sustained responders. HCV genotypes were found to be correlated with the response to the IFN therapy (p < 0.0001). None of the histological features, the types of the IFN therapy and other clinical factors showed significant differences. These findings suggest that outcome of the IFN therapy in chronic hepatitis C can be predicted by a virological factor, and that HCV genotype III is a useful predictor of a favorable outcome.

Is the intracellular pH threshold an anaerobic threshold from the view point of intracellular events?: a brief review

Intracellular biochemical changes could be monitored noninvasivery and continuously by using nuclear magnetic resonance (NMR). In about the last decade, intracellular behavior of phosphorus compounds and pH during muscle contraction in man have been studied by 31P nuclear magnetic resonance spectroscopy (31P-MRS). During incremental load, lactic acidosis was followed by a decline in intracellular pH. 31P-MRS studies has been definitely proved that this change in intracellular pH shows the threshold behavior. Some reports discussed the intracellular pH threshold (pHT) as an anaerobic threshold (AT) from the view point of intracellular events. However, our studies revealed that pHT did not reflect the onset of lactate production. In this article, studies of intracellular pH of working muscle were reviewed in relation to an anaerobic threshold.