[On line display of the reconstructed pressure waves of the radial artery from the monitored output pressure waves at the same site]

The input-output relationship of transducer and catheter system is described by linear, second-order differential equation with three coefficients: inductance (L), resistance (R), and capacitance (C). Once the natural frequency (fo) and the damping ratio (beta) of the monitoring system have been measured, three coefficients of the differential equation are uniquely obtained. We measured the frequency response of the monitoring system, which we usually use in our hospital, to obtain fo and beta, and reconstructed the original input arterial pressure wave from output signal on the display using the simple time-domain approach. The analysis of this linear, second-order differential equation, is applicable in on-line bedside monitoring, because the calculation of this equation is simpler than that using Fourier's translation. The pressure waves of the radial artery both monitored (output) and restored (input) were depicted on the same display at the same time. We can evaluate the changes in systemic circulation from the changes in the wave shapes of arterial blood pressure.

Primary diffuse tracheobronchial amyloidosis: radiologic findings

Reports detailing the radiologic features of tracheobronchial amyloidosis are scant and typically describe only the computed tomography findings of this disease. No reports have described the magnetic resonance (MR) findings of tracheobronchial amyloidosis. With this case, the authors describe the radiologic findings in a patient with diffuse tracheobronchial amyloidosis, focusing particularly on the MR and bone scintigraphy findings in this disease.

IL-4 is required for defense against mycobacterial infection

Although the involvement of T helper (Th1) cells is central to protection against intracellular bacteria, including Mycobacterium tuberculosis, the involvement of Th2 cells, characterized by potent interleukin (IL)-4 secretion in mycobacterial infection is still unclear. In order to clarify the role of IL-4 in murine tuberculosis, IL-4-deficient mutant mice, IL-4 knockout (IL-4 KO) mice, were utilized. The mice were infected with H37Rv, Kurono or BCG Pasteur via an airborne infection route by placing them in the exposure chamber of a Middlebrook airborne infection apparatus. Their capacity to control mycobacterial growth, granuloma formation, cytokine secretion, and nitric oxide (NO) production were examined. These mice developed large granulomas, but not necrotic lesions in the lungs, liver or spleen (P<0.05). This was consistent with a significant increase in lung colony-forming units (CFU). Compared with levels in wild-type mice, upon stimulation with mycobacteria, splenic IL-10 levels were low and IL-6 levels were intermediate, but interferon (IFN)-gamma and IL-12 levels were significantly higher. IL-18 levels were within the normal range. The level of NO production by alveolar macrophages of the IL-4 KO mice was similar to that of the wild-type mice. Granulomatous lesion development by IL-4 KO mice was inhibited significantly by treatment with exogenous recombinant IL-4. These findings were not specific to the IL-4 KO mice used. Our data show that IL-4 may play a protective role in defense against mycobacteria, although IFN-gamma and TNF-alpha play major roles in it. Our data do not rule out an IFN-gamma-independent function of IL-4 in controlling tuberculosis.

Advanced glomerulosclerosis is reversible in nephrotic mice

Advanced glomerulosclerosis, a common hallmark of chronic renal diseases (CRD) is believed to be irreversible, and it is thought that glomerular hyperfiltration and hypertrophy may participate in its pathogenesis. We demonstrate here that glomerulosclerosis is "reversible" in an animal model. We used nephrotic ICGN (nep/nep) mice which showed a rapid progression of glomerulosclerosis, accompanied by histological findings for glomerular hyperfiltration. It is known that ureter ligation reduces glomerular filtration in ligated kidneys. When ureter ligation was applied to our model, glomerulosclerosis (characterized by myofibroblast hyperplasia and over-accumulated matrix protein) weakened in conjunction with suppressed glomerular hypertrophy. During this process, glomerular myofibroblasts showed apoptotic cell death after unilateral ureter ligation (UUO) treatment. Our results suggest that inhibition of glomerular filtration in sclerotic tufts may cause glomerular remodeling through the modulation of molecular and cellular sclerogenesis.

Three-dimensional computed tomographic angiography in four patients with dissecting aneurysms of the vertebrobasilar system

BACKGROUND

Recently, three-dimensional computed tomographic angiography (CTA) has been used for the diagnosis and treatment planning of cerebral aneurysm presenting with or without subarachnoid haemorrhage, but the diagnostic value of CTA has not been established. This study evaluated the usefulness of CTA in patients with dissecting aneurysms of the vertebrobasilar system.

METHOD

Four patients with acute dissecting aneurysms were examined by CTA, including 3 women and 1 man with a mean age of 60.5 +/- 8.5 years (range: 52-67 years). There were three patients with subarachnoid haemorrhage and one patient presenting with ischaemia. One patient underwent CTA twice and digital subtraction angiography (DSA) once, while one patient had both examinations three times. CTA was performed with a nonionic contrast medium (100 ml of iomeprol 350 mg I/ml) administered via an auto-injector into an antecubital vein at 1.5-1.7 ml/s. To reconstruct three-dimensional images, the volume rendering method was utilized.

FINDINGS

All initial CTA studies were performed safely within 5 hours after onset. In patients with subarachnoid haemorrhage, all lesions were demonstrated by finding either the "pearl and string sign" or a "double shadow" on CTA. In the patient presenting with ischaemia, "pearl and string sign" and "double shadow" was shown after the second CTA, and follow-up CTA was able to demonstrate the change of the lesion morphology. All lesions had more irregular luminal surfaces than the non-lesional segments of the involved vessels.

INTERPRETATION

CTA was safe in patients with acute vertebrobasilar dissection and demonstrated either the "pearl and string sign" or a "double shadow" which were commonly showed on DSA. An "irregular luminal surface sign" on CTA seems to be one of the characteristics of vertebrobasilar dissection. The view shown by CTA is not less useful than that by DSA to diagnosis and treatment planning in the acute phase of vertebrobasilar dissection, and can also be employed to follow the changes of lesion morphology over time.

Role of PAF in acute liver injury after extended hepatectomy: overexpression of PAF receptor mRNA in Kupffer cells

To clarify the pathophysiology of acute liver injury after extended hepatectomy, we investigated the relationship between the site and levels of expression of platelet activating factor (PAF) receptor mRNA, and the blood levels of endotoxin, cytokines, and prostaglandin E2 (PGE2), using a rat model of 70% hepatectomy. After hepatectomy, a significant rise in serum tumor necrosis factor-alpha (TNF-alpha) was observed at 1 hr, the interleukin-6 (IL-6) levels had increased at 3 hr, and PGE2 levels had increased at 6 hr, but there were no significant increases in endotoxin levels in portal vein blood. Overexpression of PAF receptor mRNA in liver tissue was observed as early as 1 hr after hepatectomy, with peak expression occurring at 6 hr, and PAF receptor mRNA was significantly overexpressed in Kupffer cells. The PAF produced in the vicinity of Kupffer cells appears to play a very important role as one of the initial mediators of the acute liver injury that occurs after major hepatectomy.

Quantitation of chondroitin-sulfates, disaccharides and hyaluronan in normal, early and advanced osteoarthritic sheep temporomandibular joints

OBJECTIVE

To determine the relationship between synovial fluid, chondroitin sulfate disaccharide and hyaluronic acid to differing degrees of experimental temporomandibular joint (TMJ) osteoarthritis (OA).

DESIGN

Twenty-four merino sheep were divided into three groups and had different TMJ surgical procedures to produce OA. Group I; control (six sheep), Group II; disc perforation (nine sheep) and Group III; disc perforation and articular damage (nine sheep). Synovial fluid was collected initially and at sacrifice at 3 months. Chondroitin 4-sulfate, chondroitin 6-sulfate and hyaluronic acid were measured and correlated to the OA histologic score.

RESULTS

The chondroitin-sulfate levels were significantly increased (Group I to Group II P< 0.001; Group I to Group III P< 0.001), the hyaluronic acid levels decreased (Group I to Group II P< 0.01; Group I to Group III P< 0.01) with the increasing OA score.

CONCLUSION

Chondroitin-sulfate and hyaluronic acid show a correlation with surgically created TMJ osteoarthritis in sheep model.

Co-localization of chicken DNA topoisomerase IIalpha, but not beta, with sites of DNA replication and possible involvement of a C-terminal region of alpha through its binding to PCNA

Clones for DNA topoisomerase IIalpha and beta (topo-IIalpha and beta) were isolated from a cDNA expression library of chicken MSB-1 cells by immunoscreening. The deduced sequences of chicken topo-IIalpha and beta were about 80% identical for the N-terminal ATPase domain and the central core domain but only 37% for the C-terminal domain. Polyclonal antibodies were raised against C-terminal polypeptides specific to topo-IIalpha and beta. Indirect immunofluorescence with these antibodies to chicken embryonic fibroblasts demonstrated that topo-IIalpha was distributed in discrete intranuclear spots, which coincided with sites of DNA replication as indicated by incorporation of 5-bromo-2'-deoxyuridine, whereas topo-IIbeta was distributed rather uniformly within a nucleus. Examination of intranuclear distribution patterns of chimeric constructs between topo-IIalpha and beta suggested that a sequence region (residues 1280-1294) in the C-terminal domain of topo-IIalpha was effective in co-localization with sites of DNA replication. This region consists of a QTxhxF motif (x, any residue; h, hydrophobic residue) followed by a KR-rich sequence, which resembles those found in several proteins known to associate with proliferating cell nuclear antigen (PCNA) or targeted to the replication factory. An in vitro pull-down assay with glutathione-S-transferase-PCNA and (His)6-tagged truncated forms of topo-IIalpha demonstrated that polypeptides containing the above region (residues 1158-1553 or 1158-1294) bound to PCNA in vitro.

Early shifts in gene expression during chondroinduction of human dermal fibroblasts

Treatment options for damaged articular cartilage are limited because of that tissue's poor capacity for repair. Possible approaches to this problem are to stimulate cartilage matrix production in situ or to engineer replacement tissue. Both of these approaches would benefit from a detailed understanding of the molecular mechanisms of chondroblast differentiation. In previous studies, we described a novel in vitro model of postnatal chondroblast differentiation. That model of induced chondrogenesis was used to test the hypothesis that cellular interactions with demineralized bone powder (DBP) would induce specific, early shifts in gene expression, prior to the expression of cartilage matrix genes. Differentially expressed genes were identified by representational difference analysis of human dermal fibroblasts cultured for 3 days with DBP in three-dimensional collagen sponges. Genes that were upregulated by DBP comprised several functional classes, including cytoskeletal elements, protein synthesis and trafficking, and transcriptional regulation. Kinetic analysis of gene expression over 21 days showed that vigilin was transiently upregulated on day 3. In contrast, expression of cartilage signature genes continued to increase. These results are an important step toward complete characterization of the mechanisms by which DBP induces chondroblastic differentiation in postnatal cells.

Homologues of fibroin L-chain and P25 of Bombyx mori are present in Dendrolimus spectabilis and Papilio xuthus but not detectable in Antheraea yamamai

Low molecular mass protein components of fibroin, whose electrophoretic patterns before and after the reductive cleavage of disulfide bonds were similar to those of L-chain and P25 of Bombyx mori, were identified in fibroin samples of Bombyx mandarina, Dendrolimus spectabilis and Papilio xuthus but not of Antheraea yamamai. Fibroin of A. yamamai is suggested to form a dimer of H-chain. Full length cDNA sequences were cloned for the homologues of L-chain and P25 from B. mandarina, D. spectabilis and P. xuthus. The deduced sequences of L-chain and P25 of B. mandarina are almost identical to those of B. mori, each containing a single amino acid change. Homologues of L-chain and P25 of D. spectabilis and P. xuthus show about 50% overall identity, respectively, with those of B. mori, but essential structural features; i.e. the three Cys residues in an L-chain and the eight Cys residues and one of the potential N-glycosylation sites in P25, are conserved in both species. These results, together with the published results for Galleria mellonella, suggest that the three-components (H-chain, L-chain and P25) complex of fibroin is rather common among Lepidopteran silk-producing insects, in contrast to the H-H dimer type found in the saturnid silkworm.

The efficiency of N-linked glycosylation of bovine DNase I depends on the Asn-Xaa-Ser/Thr sequence and the tissue of origin

Bovine DNase I contains two potential N-linked glycosylation sites with the sequences Asn(18)-Ala-Thr and Asn(106)-Asp-Ser. A previous report established that pancreatic DNase I has only one sugar chain at Asn(18) [Liao, Salnikow, Moore and Stein (1973) J. Biol. Chem. 248, 1489-1495]. We found, however, that bovine DNase I expressed in COS-1 cells was glycosylated about 70% at Asn(106) in addition to being completely glycosylated at Asn(18). Glycosylation of Asn(106) increased to 97% when Asp(107) was mutated to Glu or when Ser(108) was mutated to Thr. Mutation of Asp(107) to Trp had no effect, whereas a substitution with Pro at this position abolished glycosylation of Asn(106). Analysis of the state of glycosylation of DNase I purified from a variety of bovine tissues revealed that DNase I from spleen, submaxillary gland, lung and adrenal had two sugar chains, whereas enzyme from pancreas and kidney had only one sugar chain. These findings demonstrate a major difference in the ability of various tissues to utilize N-linked glycosylation signals that contain suboptimal residues in the second and third positions.

Hepatocyte growth factor suppresses interstitial fibrosis in a mouse model of obstructive nephropathy

BACKGROUND

As tubulointerstitial fibrosis (TIF) reflects the prognosis of patients with various chronic renal diseases, the pathogenesis of TIF has to be clarified. Transforming growth factor-beta (TGF-beta) is a key mediator for renal fibrosis. We reported that hepatocyte growth factor (HGF) prevents renal fibrosis in nephrotic mice. However, the function of HGF in chronic renal failure, except for nephrotic syndrome, remains to be determined.

METHODS

Using mice subjected to unilateral ureter-ligated obstruction (UUO), we investigated the roles of HGF in TIF, as induced by obstructive nephropathy. Pathophysiological changes in the kidney after UUO treatment were analyzed focusing on expressions of renal HGF and TGF-beta, TIF, tubular proliferation, and apoptosis. Neutralizing antibody against rodent HGF, or recombinant human HGF (rhHGF), was administrated to the UUO mice, and pathophysiological changes after neutralization or supplements of HGF were analyzed.

RESULTS

In this UUO model, TIF with tubular apoptosis became evident, and it was accompanied by a decrease in renal HGF expression and an increase in renal TGF-beta expression. Neutralization of endogenous HGF accelerated the progression of TIF, accompanied by increases in TGF-beta expression and tubular apoptosis as well as by decreases in tubular proliferation. In contrast, rhHGF attenuated TIF progression, and there were decreases in TGF-beta expression and tubular apoptosis, and an increase in tubular proliferation.

CONCLUSIONS

Endogenous as well as exogenous HGF attenuated the progression of the fibrosis caused by obstructive nephropathy in these mice. Thus, local reduction in HGF levels may account for TIF in chronic renal diseases.

Effects of hyaluronan on engineered articular cartilage extracellular matrix gene expression in 3-dimensional collagen scaffolds

Hyaluronan (HA) is a component of cartilage matrix with known effects on chondrocytes. We tested the effects of adding HA to 3-dimensional (3-D) collagen. sponges on chondrocyte function in vitro. Bovine articular chondrocytes isolated by collagenase digestion were injected into either collagen or HA/collagen scaffolds comprising different amounts of HA (2, 5, 10, and 14% w/w). Expression of aggrecan and type II collagen genes was measured by gene-specific quantitative competitive reverse transcriptase-polymerase chain reactions, and the extracellular matrix was estimated by histomorphometrical analyses. After 7-day culture, the chondrocytes in 2% (w/w) HA sponges expressed fourfold more mRNA transcripts for type II collagen (p = 0.002) and twofold more mRNA transcripts for aggrecan (p = 0.022) than in control collagen sponges. Furthermore, there was 45% more extracellular matrix in 2% (w/w) HA sponges and 43% less matrix in the 10% (w/w) HA sponges compared with plain collagen sponges (p > 0.05). In sum, a small amount of HA in 3-D collagen scaffolds enhanced chondrogenesis, but a greater amount was inhibitory. This 3-D system represents a novel tool to identify mechanisms by which extracellular matrix molecules influence chondrocyte function. Further, these results show the potential for modifying scaffolds to improve production of engineered cartilage for in vivo applications.

Coronary lesion morphology and prognosis in young males with myocardial infarction with or without familial hypercholesterolemia

The present study examined the angiographic characteristics and prognosis of young males under 40 years of age with acute myocardial infarction (AMI) and familial hypercholesterolemia (FH). The study group was divided into an FH group (n=16) and a non-FH group (n=27). Lesion morphology was classified as complex or smooth. Overall 36 patients were followed up for an average of 9.4 years. The frequency of angiographic normal or nonobstructive culprit lesions was significantly higher in the non-FH group (p<0.01). In contrast, the incidence of complex or totally occlusive lesions was higher in the FH group (p<0.01). At 10-year follow-up, survival rates from cardiac death (FH 85% vs non-FH 100%, p=0.06), from AMI (FH 43% vs non-FH 80%, p<0.05), and from any ischemic event at a new lesion (FH 9% vs non-FH 67%, p<0.01) were all reduced in the FH group. These results suggest that the mechanism of AMI in young male patients with FH differs from that in similar aged patients without FH, and that the overall prognosis of these patients is less favorable.

Evaluation of accumulated mucopolysaccharides in the brain of patients with mucopolysaccharidoses by (1)H-magnetic resonance spectroscopy before and after bone marrow transplantation

In seven patients with mucopolysaccharidoses (1 Hurler, 1 Hurler-Scheie, 4 Hunter, 1 Sly), cranial (1)H-magnetic resonance spectroscopy was performed to evaluate the accumulation of mucopolysaccharides and biochemical changes in the CNS in vivo before and after bone marrow transplantation (BMT). In two of seven patients, (1)H-magnetic resonance spectroscopy was performed before and after BMT. Nuclear magnetic resonance spectra of dermatan sulfate and chondroitin sulfate-C and magnetic resonance spectroscopy of chondroitin sulfate-C and urine from patients with mucopolysaccharidoses showed resonance higher than the chemical shift of myoinositol in the brain (3.7 ppm). The resonance was considered to contain signals from mucopolysaccharide molecules. The resonance was measured as presumptive mucopolysaccharides (pMPS). In white matter lesions detected by magnetic resonance imaging, pMPS/creatine ratios and choline/creatine ratios were consistently higher than control ratios. In white matter without lesions, choline/creatine ratios were higher than control ratios. Patients with higher developmental quotient or intelligence quotient tended to show higher N:-acetylaspartate/creatine ratios and lower pMPS/creatine ratios in basal ganglia. After BMT, the pMPS/creatine ratio in white matter lesions of patient 3, with Hunter syndrome, was slightly decreased, but in none of the patients was the ratio ever below the control ratios, even 7 y after BMT. In white matter without lesions, the pMPS/creatine ratio in patient 3 was decreased to the control ratios after BMT, but although the choline/creatine ratios were gradually decreased, they remained higher than the control ratio, 2 y after BMT. These results suggest that evaluation of pMPS, choline, and N:-acetylaspartate by (1)H-magnetic resonance spectroscopy is an important technique that may provide useful biochemical information in vivo on the neurologic process and the efficacy of BMT in patients with mucopolysaccharidoses.

Immunohistochemical analysis of molecular events in tubulo-interstitial fibrosis in a mouse model of diffuse mesangial sclerosis (ICGN strain)

Diffuse mesangial sclerosis (DMS) is one of the hereditary glomerular diseases and histologically characterized by severe glomerulosclerosis and subsequent tubulo-interstitial fibrosis (TIF). In DMS patients, renal dysfunction correlates well with TIF, rather than with glomerular lesions. Thus, molecular mechanisms whereby TIF in DMS progresses should be addressed. Previously, we found that nephrotic ICGN mice manifest DMS-like lesions and develop renal dysfunction in accordance with onset of TIF. In the present study, we investigated fibrogenic events involved in the progression of TIF after DMS manifestation, using the DMS mouse model. Immunohistochemistry revealed that expression of transforming growth factor-beta (TGF-beta) was rare in the interstitial cells of the nephrotic mice at the early-stage of DMS, while the TGF-beta expression became evident in the late-stage DMS mice. Platelet-derived growth factor (PDGF) was mildly expressed in the distal tubules of the early-stage DMS mice, whereas the PDGF expression markedly increased at the late-stage of DMS. As a result, alpha-actin-positive myofibroblastic cells were found dominant in the interstitial spaces of the late-stage DMS mice. Finally, TIF became severe in accordance with the overexpressions of these molecules. Our results suggest that in our murine model: 1) persistent proteinuria leads to over-expression of TGF-beta and PDGF in non-glomerular areas; 2) these cytokines provoke interstitial myofibroblast accumulation; and 3) the myofibroblasts produce fibrotic matrix proteins in the interstitial spaces. This process may possibly contribute to the development of TIF in DMS patients.

A case of an unclassified tumor closely resembling dysembryoplastic neuroepithelial tumor with rapid growth

We describe a rare case of a tumor resembling dysembryoplastic neuroepithelial tumor. A 3-year-old girl had a generalized convulsion as the initial symptom, without other neurological deficits. Computed tomography showed a hypodense lesion with calcific hyperdensity in the left frontal lobe associated with deformity of the overlying calvarium. Four months later, she had a second seizure, and computed tomographic scan showed that the lesion had increased in size. Subtotal removal of the tumor was performed, and the postoperative course was uneventful without radiation therapy. Histological examination revealed a cortical lesion in which an oligodendrocyte-like area and an astrocyte-like area with cytological atypia were observed. Although the clinical course and the radiological findings closely resembled those of dysembryoplastic neuroepithelial tumor, specific glioneuronal elements were not found histologically. Daumas-Duport reported a complex form of dysembryoplastic neuroepithelial tumor that contained glial nodules in addition to a specific glioneuronal element. The histological findings of the glial nodules in this case were quite similar to those she described. We conclude that this could be an unclassified tumor closely resembling dysembryoplastic neuroepithelial tumor without a specific glioneuronal element.

Disruption of nuclear factor-interleukin-6, a transcription factor, results in severe mycobacterial infection

Nuclear factor-interleukin-6 (NF-IL-6) is one of several nuclear transcription factors (NF-IL-6, NF-kappaB, PU.1, interferon-regulatory factor 1, Egr-1, and Stat-1). NF-IL-6 and NF-kappaB are expressed in macrophages and is induced by bacterial lipopolysaccharides. To evaluate whether NF-IL-6 is required for the inflammatory immune response to mycobacterial infection, in which epithelioid macrophages comprise the leading cell population, we generated NF-IL-6 knockout (KO) mutant mice. Airborne infection of these mice with Mycobacterium tuberculosis strains induced disseminated tuberculosis lacking granuloma formation, although interferon-gamma, tumor necrosis factor-alpha, and interleukin-12 mRNA expression levels were within the normal range compared with those of wild-type mice. Generation of O2- and mycobacterial killing by neutrophils from these mice were impaired severely compared with wild-type mice. We conclude that NF-IL-6 is a critical transcription factor in mycobacterial control as well as in granulocyte-colony stimulating factor induction resulting in neutrophil activation.

Effects of medium perfusion on matrix production by bovine chondrocytes in three-dimensional collagen sponges

Various culture systems have been used for examining the anabolic and catabolic functions of isolated chondrocytes as well as for tissue engineering purposes. Perfusion or frequent medium change is beneficial for three-dimensional (3D) cultures of many cell types. In this study, bovine articular chondrocytes (bACs) were grown in 3D collagen sponges with or without medium perfusion (0.33 mL/min) for up to 15 days. The influence of medium perfusion was evaluated using markers of cartilage matrix accumulation, synthesis, and gene expression. Metachromatic matrix, collagen type II, and hyaluronan accumulated around the cells within the collagen sponges. Sulfated glycosaminoglycans (S-GAGs) that accumulated in the sponge exposed to nonperfused control were 130% of that in the perfused sponge at day 7. S-GAG accumulation after 15 days in the nonperfused control was 230% more than at day 7 (p < 0.01). (35)S-sulfate incorporation during the final 18 h of culture in the sponge exposed to nonperfusion was 180% greater than that in the perfused sponge (p < 0.01). Quantitative analyses show that at day 7, aggrecan and collagen type II gene expression were 350% and 240% greater, respectively, in the nonperfused culture than in the perfused one. These results indicate that perfused conditions that are beneficial for other cell types inhibit chondrogenesis by articular chondrocytes in 3D culture.

[A case of radiologically negative small-cell lung carcinoma successfully detected early by whole-body FDG-PET]

A 68-year-old man was referred to our hospital after being treated for early gastric cancer to investigate the causative malignancy, as his serum carcinoembryonic antigen (CEA) level was increased. Chest radiography showed no abnormal opacities. Subsequently, a whole-body FDG-PET was performed, which detected some tiny lesions in the mediastinum and the right lower lung field. A diagnosis of small-cell lung carcinoma was made after mediastinoscopic and bronchoscopic examinations. After chemoradiotherapy, the previously abnormal uptake of FDG was attenuated and the bronchoscopic appearance was improved, while the serum CEA and NSE levels returned to normal. Our findings demonstrated that whole-body scanning by FDG-PET could be useful for early detection of lung cancer, especially in cases of small-cell lung cancer.

Silk fibroin of Bombyx mori is secreted, assembling a high molecular mass elementary unit consisting of H-chain, L-chain, and P25, with a 6:6:1 molar ratio

Silk fibroin produced by the silkworm Bombyx mori consists of a heavy chain, a light chain, and a glycoprotein, P25. The heavy and light chains are linked by a disulfide bond, and P25 associates with disulfide-linked heavy and light chains by noncovalent interactions. Quantitative enzyme-linked immunosorbent assay revealed that molar ratios of the heavy chain, light chain, and P25 were 6:6:1, both in cocoons and in fibroin secreted into the lumen of posterior silk gland. Trace amounts of fibroin produced by three "naked pupa" mutants of B. mori lacked the light chain, but the molar ratio of heavy chain and P25 was also 6:1. Gel filtration chromatography and sedimentation equilibrium analysis demonstrated that a large protein complex of approximately 2.3 MDa, designated an elementary unit of fibroin having 6:6:1 molar ratios of the heavy chain, light chain, and P25, existed in posterior silk gland cells. Inaccessibility of biotinylated concanavalin A to the native elementary unit and partial dissociation of the elementary unit after incubation with excess N-glycosidase F or endoglycosidase H suggest that a single molecule of P25 is located internally and plays an important role in maintaining integrity of the complex.

Myocardial protection from ischemia/reperfusion injury by endogenous and exogenous HGF

Using a rat model of ischemia/reperfusion injury, we demonstrate here that HGF is cardioprotective due to its antiapoptotic effect on cardiomyocytes. Following transient myocardial ischemia and reperfusion, c-Met/HGF receptor expression rapidly increased in the ischemic myocardium, an event accompanied by a dramatic increase in plasma HGF levels in the infarcted rats. When endogenous HGF was neutralized with a specific antibody, the number of myocyte cell deaths increased markedly, the infarct area expanded, and the mortality increased to 50%, as compared with a control group in which there was no mortality. Plasma from the myocardial infarcted rats had cardioprotective effects on primary cultured cardiomyocytes, but these effects were significantly diminished by neutralizing HGF. In contrast, recombinant HGF administration reduced the size of infarct area and improved cardiac function by suppressing apoptosis in cardiomyocytes. HGF rapidly augmented Bcl-xL expression in injured cardiomyocytes both in vitro and in vivo. As apoptosis of cardiomyocytes is one of the major contributors to the pathogenesis in subjects with ischemia/reperfusion injury, prevention of apoptosis may prove to be a reasonable therapeutic strategy. Supplements of HGF, an endogenous cardioprotective factor, may be found clinically suitable in treating subjects with myocardial infarction.

[Analyses of factors prolonging the length of hospital stay in elderly patients beginning hemodialysis]

The aim of the present study is to clarify the factors causing prolongation of the length of hospital stay in elderly patients beginning hemodialysis. Patients aged over 60 years who had newly started hemodialysis (98 cases) were studied. These were 59 men and 39 women. The age was 73 +/- 7 years (mean +/- standard deviation). In each patient, the cause of renal failure (non-diabetes/diabetes), body mass index, comorbid conditions (cerebrovascular disease, ischemic heart disease, etc.), ambulation, cognitive function, urgency of the initiation of dialysis, occurrence of access failure, marital status, younger cohabitants, and the length of stay after initiation of dialysis were surveyed. The median and the mean of the length of stay were 37 and 49 days. Because of this disparity, a normal distribution of the length of stay could not be obtained. However, the distribution was transformed to close to normal by logarithmic conversion of the number of days. We used the log-converted value as the length of stay for statistical analyses. We investigated the influence of the differences of each factor on the length of stay. The subjects were divided into two groups for each factor. The mean and standard deviation of the length of stay was calculated respectively. Comparisons were carried out by unpaired t-test. Multiple regression analysis was also performed using background factors as explanatory variables, and the length of stay as a dependent variable. The factors presented by the nominal scale were converted to dummy variables. Eight variables in the unpaired t-test and seven variables in multiple regression analysis were statistically significant. All but one variable were common to both analyses. The gender was statistically significant only in the unpaired t-test. It could be explained by close correlation of gender with marital status. Access failure and urgent initiation of dialysis were dominant factors for the prolongation of the length of stay. Ischemic heart disease, diabetes, inability to walk, impaired cognitive function, and absence of a partner also prolonged the length of stay.