The pyramidal cell layer of sector CA 1 shows the lowest hippocampal succinate dehydrogenase activity in normal and postischemic gerbils

We examined regional differences in the activity of a mitochondrial respiratory enzyme, succinic dehydrogenase (SDH), in the hippocampi of normal and postischemic gerbils, using a quantitative imaging method. Gerbils (n = 21) without ischemia, and gerbils which had experienced 5 min of bilateral common carotid artery occlusion 12 h or 2 days previously, were sacrificed. Coronal sections of the brains were prepared for quantitative imaging of SDH activity and histological examination. In the control gerbils, SDH activity in the pyramidal cell layer of the CA 1 sector (Sommer's sector) was 106.3 +/- 10.3% (mean +/- SD; SDH activity as a percentage of the cerebellar SDH activity), which was lower than in the other subfields of the hippocampus. SDH activity in the oriens layer, stratum radiatum and lacunosum molecular layer of the CA 1 sector was lower than in the corresponding layers of the CA 2 and CA 3 sectors. After transient ischemia, SDH activity remained unchanged in the CA 1 sector. Histologically, selective neuronal necrosis was observed in the pyramidal cell layer of the CA 1 sector 2 days after ischemia. The observed low level of this mitochondrial respiratory enzyme in the pyramidal cell layer of the CA 1 sector should be taken into account as a possible trigger of the selective vulnerability of the region to ischemia.

A research to develop a predicting system of mammalian subacute toxicity. I. Prediction of subacute toxicity using the biological parameters of acute toxicities

Predicting equations of subacute toxicity were developed by analyzing rat acute and subacute toxicity data of 56 chemicals of various structures. Minimum or 10% effect level in acute or subacute toxicity was estimated as a "biological parameter". Good regression equations were established between the geometrical means ("combined parameters") of any two of the parameters of acute and subacute toxicities and introduction of log P to the equations improved the correlations with a statistically significant multiple regression coefficient. The lowest predicted effect level of the subacute toxicity, which is selected from the data calculated by the above several correlations, can predict the upper limit of the no observed effect level. In recent years, for research and development of new chemical substances, it becomes one of the important factors that these have a lower environmental load in nature. Eventually, it becomes essential to evaluate not only their acute effects on human or environments, but also their chronic influences when they are to be exposed for a long period of time, and the cost for such verification is becoming a breaking factor for research and development. Thus, the development of a new technique which estimates the environmental load of a chemical substance including toxic effects on human with lower cost is now being attempted. For example, the development of in vitro new alternative methods using cultured cells, the utilization of a data base or software which relates mammalian and environmental toxicities and so on are internationally carried forwards. As for the latter, quantitative structure-activity relationship (QSAR) techniques have been applied practically to decide appropriate toxicity tests needed for regulatory purposes by EPA/TSCA, ITC/TSCA and FDA/FDAA in the USA. In addition, it was concluded recently in a joint meeting of EU and US-EPA that the approach by QSAR techniques was useful to specify the new chemical substances which are to be required toxicological examinations. In these QSAR techniques, however, while there are some considerations about common mechanisms of toxicity among chemicals with a similar structure (Congeneric chemicals, Congeners) for establishing of correlation formulas, for chemicals with various structures (Non-congeneric chemicals, Non-congeners) there often lack such common considerations. In addition, biological or physiological factors which are basic toxic indices are often ignored. In a previous study, we researched acute and subacute oral toxicities of industrial common chemicals in rats and reported the followings; 1) their subacute toxicological spectrum in target organs/tissues and morphologic changes was very limited and specific, 2) the important targets were liver, kidneys, blood (spleen) and stomach and these are considered the sites of dominant exposure due to the kinetics of chemical substances, 3) the morphological changes were hepatocellular hypertrophy, deposition of substance in renal tubules, extramedullary hematopoiesis in spleen and mucous lesion in stomach, and these are implying adaptation such as induction of drug-metabolizing enzymes, overload to renal function, anemia from erythrocyte destruction, and direct reaction, respectively, 4) there seems to occur a series of direct and adaptive reactions to exclude the "foreign compounds" which do not show any specific biological activities, 5) it is also considered that there is a possibility to establish a correlation between toxicological findings or target organs/tissues of both acute and subacute toxicities by their continuity. Therefore, in the present study, a predicting equation of subacute (28-day repeated dose) toxicity is attempted to develop from acute (single dose) toxicity data by considering both common mechanisms and biological factors for non-congeneric industrial chemical substances.

Low levels of mRNA for dopamine D4 receptor in human cerebral cortex and striatum

Significant densities of mRNA for the dopamine D4 receptor in cerebral cortex, particularly in frontal lobe, have been reported in rats and monkeys, supporting the D4 hypothesis in the pathology of schizophrenia. Using northern blot analysis and the competitive reverse transcription-polymerase chain reaction (RT-PCR) method, we determined the relative levels of D4 mRNA in human brain regions to clarify whether the cortical level is also higher in humans. Northern blot analysis revealed an unexpected profile of D4 mRNA in the brain. The detected mRNA size, 1.5 kb, was quite different from the 5.3 kb reported in human neuroblastoma SK-N-MC cells. Higher levels of D4 mRNA were detected not only in the mesolimbic system but also in the corpus callosum, spinal cord, medulla, and subthalamic nucleus. It was surprising that in the cerebral cortex regions as well as the striatum, D4 mRNA was hardly detected. The competitive RT-PCR revealed these relative densities to be at least three orders of magnitude lower than that of the striatal D2 receptor. Our results demonstrate a remarkable difference in cortical D4 mRNA density in humans compared with that in rats and monkeys. Furthermore, the mRNA distribution suggests that the higher density of D4-like binding sites reported recently in normal human striatum is not due to the D4 receptor.

Comparison of aortic valve replacement and percutaneous aortic balloon valvuloplasty for elderly patients with aortic stenosis

The outcome of aortic balloon valvuloplasty (ABV) was compared with that of aortic valve replacement (AVR) in aortic stenosis (AS) patients more than 60 years old. The indications for ABV included low respiratory and renal function, cancer, the patient's refusal of surgery, and low daily activity. Twenty six patients underwent AVR and 13 underwent ABV. Initially, the AVR group was younger and more symptomatic than the ABV group. Two perioperative deaths occurred in the AVR group, while there were none in the ABV group. Twenty-four AVR patients and 12 ABV patients had a successful outcome, with remarkable pressure gradient reduction in both groups. In the follow-up, only 1 death and no cardiac events were detected in the AVR group (mean follow-up of 27 months), whereas 3 deaths, 6 heart failures, 2 repeated ABV, and 4 AVR were seen in the ABV group (mean follow-up of 10 months). The data showed that ABV was safer than AVR, but a higher rate of restenosis limited its efficacy. In the ABV group, a higher ratio of balloon size to aortic diameter correlated with longer event-free survival. We concluded that for elderly AS patients, ABV should be used only in those with high surgical risk as a palliative therapy or a bridge therapy to AVR, and AVR should be primarily recommended under rigid evaluation of the patient's physical status.

Indeloxazine hydrochloride improves impairment of passive avoidance performance after fluid percussion brain injury in rats

We studied behavioral and histological changes after fluid percussion brain injury and the effects of indeloxazine hydrochloride, a cerebral activator, on these post-traumatic changes in rats. An acquisition trial in passive avoidance task was conducted on the 3rd day after injury. The latency of step-through in injured rats was significantly (p < 0.05) shorter than that in sham-operated rats on the 4th, 10th and 14th days after the operation. There were injury-induced neurological deficits on days 1-4 post-injury. Histological changes were observed in the peripheral area of the cortical lesion at the impact site and in the thalamus but not in the hippocampus on the 14th day. Indeloxazine (10 and 20 mg/kg, p.o.) administered once a day from the 3rd (30 min prior to the acquisition trial) to the 9th day after injury significantly (p < 0.05) improved the impairment of the passive avoidance performance without affecting locomotor activity. Indeloxazine showed no significant effects on either neurological deficits or the cortical lesion area. These results suggest that impairment of passive avoidance performance occurs without apparent histological damage in the hippocampus after fluid percussion brain injury and is attenuated by post-traumatic treatment with indeloxazine.

Q fever pneumonia in children in Japan

The prevalence of Q fever pneumonia among children with atypical pneumonia from whom only an acute-phase serum sample was available was traced by using an indirect immunofluorescence (IF) test, nested PCR, and isolation. Twenty (34.5%) of 58 sera were found to have both polyvalent and immunoglobulin M antibodies to the phase II antigen of Coxiella burnetii by the IF test. Q fever pneumonia was present in 23 (39.7%) of 58 patients as determined by both the nested PCR and isolation and in 20 patients as determined by the IF test. The sensitivities for nested PCR and isolation were 100%, and that for the IF test was 87%. Our results indicate that nested PCR was faster and more sensitive than isolation and the IF test in the diagnosis of acute Q fever when a single acute-phase serum was available. These findings suggest that C. burnetii is an important cause of atypical pneumonia in children in Japan.

Early gastric lymphoma: a clinicopathologic study of ten patients, literature review, and comparison with early gastric adenocarcinoma

BACKGROUND

Improved diagnostic techniques have increased early detection of gastric lymphoma as well as the early detection of adenocarcinoma. However, clinicopathologic features of early gastric lymphoma are presently undefined.

METHODS

Clinicopathologic features of 10 patients with early gastric lymphoma were compared with the same features of 180 patients with early gastric adenocarcinoma. In addition, 46 articles were reviewed to evaluate clinicopathologic differences.

RESULTS

Early gastric lymphoma was found in 29.2% of the patients who underwent surgery for gastric lymphoma. Early gastric lymphoma was associated with lymph node involvement in 29.9% of the patients, superficial spreading tumors in 48.6%, and multifocal lesions in 40%. These rates are greater than those in patients with adenocarcinomas (P < 0.05%). The survival rate was identical in both groups. Early gastric lymphoma may develop into large, multifocal tumors, accompanied by lymph node involvement.

CONCLUSIONS

Surgical treatment with a wide resection of the stomach and extensive lymph node dissection is necessary for early gastric lymphomas.

Lung cancer producing interleukin-6

A patient with complaints of high fever and left shoulder pain was found to have a large mass in the left upper lobe on chest roentgenogram. Laboratory evaluation revealed marked thrombocytosis, hypoalbuminemia, and increased serum concentrations of CRP, fibrinogen and interleukin-6 (IL-6). A transcutaneous biopsy specimen revealed large cell carcinoma. Tumor production of IL-6 was confirmed by immunohistochemical staining with an anti-human IL-6 monoclonal antibody (MH60).

Clinicopathological characteristics of gastric cancer in the elderly

The clinicopathological features of 380 elderly patients 70 years of age or older with gastric cancer were reviewed retrospectively from hospital records between 1969 and 1993. They were then compared with 1134 middle-aged patients between 40 and 69 years. The elderly constituted 18.4% of all gastric cancer patients 20 years ago but now comprise 24.4% of all patients in the most recent decade, despite the overall decrease in the rate of gastric cancer. The distinguishing histological features of gastric cancer in the elderly were an intestinal type of cancer, expansive tumour growth and synchronous multiplicity of the lesions. Elderly patients had a similar rate of tumour extension but had poorer survival as compared with the middle-aged patients. Post-operative death within 30 days after surgery was also higher in the elderly than in the middle-aged patients.

[Evaluation of coronary arterial remodeling using intravascular ultrasound imaging]

Previous pathological studies demonstrated that the atherosclerotic coronary artery enlarges in response to developing atherosclerotic plaque. To clarify this phenomenon of coronary arterial remodeling, 24 segments of the left anterior descending artery were studied with intravascular ultrasound imaging. The luminal area and vessel area (area bounded by the echolucent zone) were measured by planimetry, and the percentage plaque area was calculated. Vessel area was correlated with plaque area (y = 12.3 + 0.72, r = 0.54, p < 0.001). When the 24 coronary segments were divided into two categories according to the percentage plaque area, there was no correlation between plaque area and lumen area in the coronary segment with less than 40% plaque area (n = 14, r = 0.20, p = NS) or less than 30% plaque area (n = 9, r = 0.18, p = NS). However, there was a correlation between plaque area and lumen area in the coronary segments with greater than 40% plaque area (n = 10, y = 22.1-0.27x, r = -0.82, p < 0.01). The correlation was somewhat better in cases with greater than 30% plaque area (n = 15, y = 22.5-0.28x, r = -0.89, p < 0.0001). Intravascular ultrasound imaging demonstrates the phenomenon of coronary arterial remodeling in vivo, which indicates that human coronary artery enlarges in response to increasing plaque area until the plaque occupies 30% of the vessel area. However, if the plaque occupies more than 30%, an increase in plaque area leads to a decrease in lumen area. Therefore, the phenomenon of coronary arterial remodeling is a compensatory mechanism to prevent luminal narrowing in the early stage of human coronary atherosclerosis.

Prognostic evaluation of preoperative combined treatment for advanced cancer in the lower rectum with radiation, intraluminal hyperthermia, and 5-fluorouracil suppository

BACKGROUND

Since 1977, we have studied preoperative treatments using 5-fluorouracil (5-FU) suppositories alone or in combination with radiation to reduce local recurrence and improve survival of patients with rectal cancer.

PATIENTS AND METHODS

We developed a novel preoperative therapy combining radiation, intraluminal hyperthermia, and 5-FU suppositories. Thirty-five patients with rectal cancer underwent surgery after this treatment, and 41 patients underwent surgery without pretreatment.

RESULTS

The patients who underwent preoperative combination treatment showed significant tumor reduction; 2 achieved microscopically complete regression. In comparison with the patients who underwent surgery without pretreatment, the preoperative treatment group had a 16.7% lower local recurrence rate (10.4% versus 27.1%) and an improved survival rate (81.8% versus 67.6%).

CONCLUSIONS

Preoperative combination therapy is a promising modality for the patients with respectable advanced cancer in the lower rectum.

A research to develop a predicting system of mammalian subacute toxicity. II. Single dose detailed toxicity studies

"Single dose detailed toxicity study" in rats was conducted with 6 chemical substances to establish a predicting system of subacute toxicity of non-congeneric industrial chemicals. In the detailed examinations, new and previously reported biological parameters were developed and utilized for the establishment and confirmation of the correlations for both qualitative and quantitative prediction of target organs and effects in repeated dose toxicity studies of non-congeners; the new parameters were concerned with liver, kidneys and blood and the established relating equations for prediction had a correlation coefficient of 0.83 (liver), 0.49 (kidneys) and 0.94 (blood), while the old parameters effectively confirmed the previous correlations. The serial changes in the study gave a biological explanation to the established relationships between acute and subacute toxicities in terms of extrapolation.

Epitope of 24G7 anti-bilirubin monoclonal antibody

We examined an antigenic epitope recognized by an anti-bilirubin monoclonal antibody designated 24G7 (Shimizu, S., Izumi, Y., Yamazaki, M., Shimizu, K., Yamaguchi, T., and Nakajima, H. (1988) Biochim. Biophys. Acta 967, 255-260). The reactivity of bilirubin-IX alpha, its analogues (III alpha, XIII alpha, and mesobilirubin-IX alpha) and related azo compounds, with 24G7 was compared by means of an enzyme-linked immunosorbent assay (ELISA). The order of reactivity was as follows: (a) aniline azopigment > ethyl anthranilate azopigment > sulfanilic acid azopigment, (b) bilirubin-XIII alpha > bilirubin-IX alpha > bilirubin-III alpha, (c) bilirubin-IX alpha = mesobilirubin-IX alpha. These findings indicated that the epitope is present in (a) the dipyrrolic moiety of the endovinyl (correspond to N-21 and N-22 of bilirubin), or exovinyl types (N-23 and N-24); (b) the dipyrrolic moiety of the endovinyl type, which contains (c) a methyl group (C-2) but not a vinyl group (C-3) in the dipyrrolic moiety of endovinyl type. Therefore, we concluded that the epitope was the region containing the oxo group at C-1, the methyl group at C-2, C-(4,5,6,9), and the N-21 and -22 of bilirubin-IX alpha.

Expression of variant CD44-messenger RNA in colorectal adenocarcinomas and adenomatous polyps in humans

BACKGROUND & AIMS

Recent studies have shown that some variant forms of CD44, a transmembrane glycoprotein expressed on various cell surfaces, might be involved in tumor progression or tumor metastasis. The aim of this study was to analyze the expression of CD44-messenger RNA (mRNA) in colorectal cancer and colorectal adenoma to further elucidate the role of CD44 in colorectal tumorigenesis.

METHODS

The expression of CD44-mRNA was examined in 90 specimens from 44 patients with colorectal cancer or colorectal adenomatous polyps and in the peripheral blood leukocytes from 7 healthy volunteers by reverse transcription-polymerase chain reaction and Southern blot hybridization.

RESULTS

Strong expression of the epithelial form and variant forms containing exons 11 or 12 of the CD44 gene, which conferred metastatic behavior to rat cells, was detected in primary and metastatic tumor tissues, whereas it was very weak or not detectable in normal colonic mucosae, normal liver tissue, or peripheral blood leukocytes. However, adenomatous colorectal polyps also showed as strong an expression of epithelial and variant forms of CD44 as primary and metastatic tumor tissues.

CONCLUSIONS

These results suggest that variant forms of CD44-mRNA might be expressed in an early stage of colorectal carcinogenesis.

The effects of cardiac infarction on realistic three-dimensional left ventricular blood ejection

The effect of cardiac infarction on the flow patterns in cardiac left ventricular ejection was studied using a realistic model which was made from the profile of the left ventricle of a dog heart in diastole. A coordinate measuring machine was used to measure the left ventricular coordinates, and these were input into a three-dimensional flow simulation package. The left ventricular wall motion was described by having the walls moved towards the center of the aortic outlet, and in the case of infarcted tissue, the ventricular wall movement was diminished to simulate infarction flow behavior. The final ventricular volume varied from 25 percent to 54.1 percent of the initial volume in cases without and with infarction, respectively. The maximum blood ejection velocities and ventricular pressure decreased significantly in the presence of infarction. Infarcted areas showed complex blood flow vortex formation not present in the healthy ventricles. The computational technique presented here predicts infarction flow effects which could be observed with measurement techniques such as ultrasound and magnetic resonance imaging, allowing a finer detail of understanding than using either simulation or experimental measurements alone.

Applicability of monoclonal antibody Fab fragments as a carrier of neocarzinostatin in targeting chemotherapy

Two types of fragments of MAb A7 were produced to improve the efficacy and safety in targeting chemotherapy with neocarzinostatin. In this study, 125I-labeled F(ab')2 and Fab fragments of MAb A7 and 125I-labeled MAb A7 were injected intravenously into mice with pancreatic carcinoma xenografts, and the accumulation of each antibody in the tumors was compared. A greater amount of the 125I-labeled Fab fragments of MAb A7 localized in the tumor 2 h following the injection than was observed with the other probes. Relatively less 125I-labeled MAb A7 localized in the tumor 2 h following the injection than was observed with the other two probes. Moreover, reaction of rabbit antimouse IgC with the Fc portion, which is the most immunopotent region of the Fab and F(ab')2 fragments of MAb A7 and MAb A7, was determined by ELISA; the weakest reaction was observed with the Fab fragments of MAb A7. These results suggest that the Fab fragments of MAb A7 may be more suitable carriers of an anticancer drug that is inactivated rapidly in the blood, such as NCS, in targeting chemotherapy than either intact MAb A7 or the F(ab')2 fragments of MAb A7.

IL-6 mRNA synthesis by peripheral blood mononuclear cells (PBMC) in patients with chronic renal failure

We measured levels of IL-6 mRNA in PBMC obtained from patients with chronic renal failure, using polymerase chain reaction (PCR). PBMC were isolated from 45 patients on haemodialysis (HD) at the start of HD. PBMC were also isolated from 35 patients on HD at the end of HD, 23 patients on continuous ambulatory peritoneal dialysis (CAPD), 24 undialysed patients with chronic renal failure (CRF), and 19 healthy controls. Total RNA was extracted from PBMC with RNA zol and reverse transcribed into cDNA. To prepare samples containing identical amounts of beta-actin cDNA, we performed competitive PCR by co-amplifying serial dilutions of mutant templates containing a single point mutation which generated a unique Eco RI site. Next, to measure IL-6 cDNA semiquantitatively in the samples containing identical amounts of beta-actin (100 pg), we performed PCR amplification using 2 fg of the IL-6 mutant template containing a unique Eco RI site. Higher levels of IL-6 mRNA in the PBMC were observed in the HD patients than in the CAPD patients and healthy controls. The levels of IL-6 mRNA in the PBMC at the end of HD were not significantly higher than those at the start of HD. These results suggest that the dialysis session itself did not significantly affect IL-6 mRNA levels in the PBMC, but that chronic stimulation by maintenance HD may be associated with higher levels of IL-6 mRNA observed in HD patients.

Effects of calyculin A and FK506 on the O2- generation of rat peritoneal macrophages

To investigate the role of phosphatase in O2- generation, the effects of the potent phosphoprotein phosphatase inhibitors, Calyculin A and FK506, were analyzed during phagocytosis using rat peritoneal macrophages. O2- generation was continuously measured after addition of opsonized zymosan (op. ZY) or IgG-coated zymosan (IgG-ZY). The rate of O2- generation was directly proportional to the number of macrophages, up to 1-2 x 10(6) cells/ml. It was found that the rate and duration of O2- generation were markedly inhibited by Calyculin A. The addition of 100 nM of Calyculin A reduced O2- generation to about one-tenth of the control value. In contrast, FK506 did not inhibit O2- generation, suggesting that calcium calmodulin phosphatase is not involved in the activation of NADPH oxidase. This result indicates that the process of dephosphorylation might involve activation of NADPH oxidase as a control mechanism in phagocytosis by rat peritoneal macrophages. Furthermore, since Calyculin A is an inhibitor of phosphatase 1 and 2A, it is suggested that dephosphorylation may be evoked by these phosphatases.

[Endobronchial treatments made possible by extracorporeal lung assist in a patient in status asthmaticus refractory to mechanical ventilation]

A 19-year-old endotracheally intubated women was admitted to our hospital in severe status asthmaticus that was not relieved by inhalation of beta 2-agonists or by epinephrine, aminophylline, or corticosteroids. A chest radiography revealed pneumomediastinum and subcutaneous emphysema. Pressure-limited mechanical ventilation at a peak airway pressure of 20--30 cmH2O failed to ventilate the lungs, and caused a left pneumothorax and atelectasis. Extracorporeal lung assist (ECLA) was begun and enabled repeated suctioning through a fiberoptic bronchoscope for more than a minute with no serious complications. During ECLA aerosol therapy with a large dose of a beta 2-agonist (procatherol 0.15 mg) increased the tidal volume with no adverse effects. Atelectatic areas of the lungs re-expanded, pulmonary function improved, and ECLA was stopped 86 hours after it had been started. We suggest that, although it is highly invasive, ECLA can be useful in patients with status asthmaticus refractory to mechanical ventilation, and can allow endobronchial suctioning to be done safely.

Effects of competitive blood flow on arterial graft patency and diameter. Medium-term postoperative follow-up

To identify predictors of arterial graft patency, we followed up 30 internal thoracic arterial grafts and 23 right gastroepiploic arterial grafts in situ with patency documented during postoperative angiography. After 24 months of follow-up on average, repeat angiography detected that one internal thoracic artery and two gastroepiploic arteries were anatomically occluded and that the other three gastroepiploic arteries were nonfunctioning. The logistic regression model identified a relationship between graft patency and competitive flow, which was detected as stenosis in the recipient coronary arteries (coefficients, p < 0.05; model, Hosmer-Lemeshow chi2 statistic 3.59, p = 0.89). The linear regression model demonstrated that changes in graft luminal diameter correlated with competitive flow (p < 0.01), smoking history (p < 0.05), and type of arterial grafts (p < 0.001) (R2 = 0.40, adjusted R2 = 0.36). The findings suggest a temporal relationship between competitive flow and prognosis of arterial graft.

Effects of hyaluronan on cell proliferation and proteoglycan synthesis in rabbit ligamental cells

The effect of hyaluronan (HA) on cell proliferation and synthesis of proteoglycan (PG) in rabbit ligamental cells was examined in vitro. HA promoted the incorporation of 35S-sulfate in a concentration-dependent manner, significantly at 100 micrograms/ml and upward, without effect on cell proliferation. The chromatographic profile of the 35S-labelled materials extracted with 4 M guanidine hydrochloride by Sepharose CL-2B was different in the HA-treated cells as compared with untreated cells. Although the radioactivities of the low-molecular fraction peaked at Kav 0.71 did not change, those of the high-molecular fraction (Kav 0.30-0.50) increased with treatment of HA. Ligamental cells expressed the mRNA of the PG family's versican and aggrecan (large-molecular weight PGs), biglycan and decorin (small-molecular weight PGs) in dot blot analysis. Although the mRNA expression of aggrecan, biglycan and decorin did not change, that of versican increased upon treatment with HA. These findings suggest that HA is involved in promoting production of the large-molecular-weight PG versican, and in facilitating extracellular matrix formation.