[Immunohistological investigation of squamous metaplasia and expression of cytokeratin subclasses in laryngeal epithelia]

The expression of cytokeratin (CK) subclasses was immunohistologically investigated in normal laryngeal epithelia by the ABC technique using monospecific monoclonal antibodies. There are two types of epithelium in the larynx; squamous epithelium of the glottis and ciliated epithelium mainly of the supraglottis. A difference in expression pattern was observed between these two epithelia only in 3 CKs, specifically CK-8, CK-13 and CK-19. In the glottis, CK-8 was negative in all layers, CK-13 was positive in the suprabasal and superficial layers, and CK-19 was strongly positive in the basal layer, but apparently reduced in suprabasal layers and completely negative in the superficial layers. In the supraglottis, on the contrary, CK-8 was positive except in the basal layer, CK-13 was negative in all layers, and CK-19 was positive in all layers. When ciliated epithelia were reduced to squamous metaplasia, the epithelial cells were morphologically similar to the squamous cells, and the CK expression also showed the same pattern. In proximity to this squamous metaplasia, however, there were lesions whose cell type morphologically still resembled that of the ciliated epithelium, but whose pattern of CK expression had already been reduced to that of the squamous cell.

Conduction slowing without conduction block of compound muscle and nerve action potentials due to sodium channel block

We studied the effect of lidocaine on nerve conduction in vivo. Recovery of the compound muscle action potential (CMAP), sensory nerve action potential (SNAP), and single motor unit potential (MUP) of median nerve stimulation was recorded in four healthy volunteers after intravenous infusion of 20 ml of 0.5% lidocaine. During loading, CMAP and SNAP amplitudes rapidly decreased and their latencies increased. After recovery of the CMAP and SNAP amplitudes, nerve conduction velocity improved gradually over a period of 3-6 h, the amplitudes and configurations of CMAP and SNAP remaining unchanged. The conduction velocity of the single MUP markedly slowed before it is blocked. This indicates that maximum conduction velocity of CMAP and SNAP could be slowed by the partial inactivation of sodium channels without accompanying conduction block. Prolongation of the rise time of depolarization of the axonal membrane potential may be the active mechanism in this slowing because of sodium channel inactivation. Abnormalities in sodium channels at the nodes of Ranvier should be considered as a mechanism of conduction slowing even when there is no conduction block.

Hyaluronate depolymerization activity induced by progesterone in cultured fibroblasts derived from human uterine cervix

High-molecular-weight [14C]hyaluronate was incubated with cultured fibroblasts from human uterine cervix and skin, and then the depolymerization of the hyaluronate was investigated. [14C]Hyaluronate in the medium of skin fibroblasts was depolymerized into a constant molecular weight (M(r) about 40,000), whereas that of cervix fibroblasts was not depolymerized, irrespective of incubation period. However, when progesterone was added to the medium of cervix fibroblasts, hyaluronate was depolymerized to the same extent as that in skin fibroblasts. The reducing terminal sugar of the depolymerized hyaluronate was N-acetylglucosamine. These results suggest that a hyaluronate-depolymerizing enzyme, endo-beta-N-acetylglucosaminidase, was induced by progesterone in cultured fibroblasts derived from human uterine cervix.

Beta 1-integrin-mediated adhesion of melanoma cells to the propolypeptide of von Willebrand factor

Cell-adhesion activity of the bovine propolypeptide of von Willebrand factor (pp-vWF) was assessed by means of an in vitro assay with several cell lines of both normal and tumor-cell origin. pp-vWF promoted adhesion and spreading of B16 mouse melanoma cells and G-361 human melanoma cells. However, it could not induce adhesion of any other cell lines tested including endothelial cells, normal fibroblasts, and tumor cells of sarcoma, carcinoma, neuroblastoma and leukemia origin. A monospecific polyclonal antibody against pp-vWF, but not against fibronectin, laminin, and von Willebrand factor (vWF), completely blocked the pp-vWF-mediated adhesion, indicating that the cell adhesion was due to the pp-vWF molecule and not due to possible contamination of these three well-known adhesive proteins. The cell-adhesion activity was also observed with human pp-vWF and, furthermore, the adhesion to both bovine and human pp-vWF was not affected by a peptide containing the Arg-Gly-Asp sequence while the peptide abolished the cell adhesion to vWF. The adhesion was completely dependent on Mg2+ and inhibited by Ca2+. Inhibition by an anti-(beta 1 integrin) mAb (4B4) indicates that the receptor for this protein belongs to the beta 1-integrin family. A monoclonal antibody (TC4) among several antibodies directed against bovine pp-vWF inhibited the B16 adhesion to immobilized pp-vWF. The epitope for this monoclonal antibody lies in a central 8-kDa portion of pp-vWF, suggesting that this region is important for the cell-adhesion activity. This idea was supported by the finding that purified 8-kDa fragment promoted adhesion of B16 cells in a concentration-dependent manner. As pp-vWF shows unique cell-type specificity in its adhesion activity, which is completely different from that of fibronectin, laminin, vWF and collagen, it may be a novel type of adhesive glycoprotein that utilizes a beta 1-integrin receptor.

Impact of monocyte colony-stimulating factor upon beta-very low density lipoprotein (beta-VLDL) cholesterol metabolism in tetradecanoyl phorbol acetate-derived THP-1 cells

The effect of monocyte colony stimulating factor (M-CSF) on the beta-very low density lipoprotein (beta-VLDL) metabolism in THP-1 cells (human leukemia cell line) was studied. THP-1 cells treated with M-CSF decreased Latex Bead phagocytosis, but the cells incubated with 12-tetradecanoyl-phorbol-13-acetate (TPA) enhanced phagocytosis 2.5-fold. Binding activity of 125I-M-CSF to THP-1 cells was higher than that in THP-1 cells elicited with TPA. THP-1 cells incubated with M-CSF before TPA treatment were designated MT macrophages, and those incubated with M-CSF after TPA treatment were called TM macrophages. When these cells were incubated with beta-VLDL, the cholesterol ester content in MT macrophages was less than in TM macrophages. The uptake of [3H]cholesterol oleate-beta-VLDL in MT macrophages was the same as in TM macrophages. The released radioactivity from [3H]cholesterol oleate-beta-VLDL loaded MT macrophages was higher than that from TM macrophages. Acid cholesterol esterase activity and ACAT activity were the same in both types of macrophages. Neutral cholesterol esterase activity was higher in MT than in TM macrophages. These results suggested that beta-VLDL-induced cholesterol ester deposition in THP-1 cells-derived macrophages was suppressed by M-CSF, when M-CSF acted at the stage of monocytes (THP-1 cells), and that the reduction of cholesterol ester might be due to enhanced release of cholesterol from the cells with high neutral cholesterol esterase activity.

The relationship of p53 protein and lymph node metastases in invasive breast cancer

The p53 expression in invasive breast cancers from 106 patients was correlated with clinicopathological variables to ascertain its usefulness for estimating prognosis. The p53 expression was significantly associated with the number of axillary lymph node metastases and the presence of internal mammary lymph node metastases; however, it was not associated with age, menopausal status, histologic type, or tumor size. Although p53 expression was a significant prognostic factor according to univariate analysis, it did not appear to be an independent prognostic factor according to multivariate analysis. Thus, the prognostic power of p53 expression is likely to be weak and therefore probably of limited clinical value. Nevertheless, the number of patients in our study was small, and we believe that an investigation of a larger series of patients is indicated.

[Possible involvement of activation of pulmonary macrophages in respiratory failure with acute pancreatitis]

We examined the stimulatory state of pulmonary macrophages (Mø) in rats with caerulein-induced pancreatitis by measuring their activity for free radical production in vitro and in situ using nitroblue tetrazolium (NBT) under treatment of phorbol myristate acetate. The Mø from bronchoalveolar lavage were significantly activated 24 h after caerulein administration. The lung perfusion with NBT in the presence of PMA confirmed in situ that pulmonary Mø were also significantly activated in the same condition. Thereafter significant hypoxia was observed. These results indicate that the activation of pulmonary Mø may be involved in the respiratory failure in acute pancreatitis.

Diagnosis of post-transfusion graft-versus-host disease after formalin-fixation

A 72-year-old woman with multiple recurrence of gallbladder cancer was treated by intrahepatic-arterial infusion of doxorubicin using an extracorporeal system of direct hemoperfusion with venovenous bypass. During this treatment, the patient received 600 ml of fresh whole blood and 30 units of platelet concentrate from five unrelated donors. Thereafter, high fever, skin rash over the whole body, and watery diarrhea developed, followed by leukopenia progressing to a fatal sepsis. Post-transfusion graft-versus-host disease (PT-GVHD) was suspected by the clinical manifestations and postmortem pathologic findings. To establish the diagnosis of PT-GVHD, polymerase chain reaction (PCR) amplification of DNA polymorphism associated with length variation in dinucleotide or trinucleotide microsatellite repeats at the loci of D6S89, int-2 protooncogene, and human growth factor with each of the different primer sets was performed using DNA from blood drawn from the patient with clinically established PT-GVHD of a donor origin and formalin-fixed pancreas of recipient origin. Genetic analysis revealed the changes in the patient's lymphocytes from that of the patient to that of donor origin. The present finding that formalin-fixed tissues can be used as a material of patient origin may contribute to accurate diagnosis of PT-GVHD after autopsy.

Enhanced arterial intimal thickening after balloon catheter injury in diabetic animals accompanied by PDGF beta-receptor overexpression of aortic media

Cultured aortic smooth muscle cells (SMC) of diabetic rats and rabbits, which overexpress platelet-derived growth factor (PDGF) beta-receptor compared with controls, have a unique phenotype. In this study we report on the PDGF beta-receptor overexpression in aortas of diabetic animals and the increased intimal thickening of carotid arteries in diabetic rabbits after balloon catheter injury compared with that in controls. In diabetic aortas with no treatments of balloon catheter injury, intimal thickening was not observed in spite of the overexpression of PDGF beta-receptor, indicating that the growth property of medial SMC in diabetic aortas was changed before the intimal thickening could take place. PDGF is known to be the main contributor to the intimal thickening induced by balloon catheter injury, which is one of several forms of arterial injuries. Intimal thickening after balloon catheter injury in diabetic rabbits increased compared with that in controls. These results imply that PDGF beta-receptor overexpression of SMC in medial layers plays an important role in intimal thickening in the formation of advanced diabetic macroangiopathy.

[The experimental studies on concomitant occlusion of the superior mesenteric artery during intraarterial chemotherapy of the liver]

We investigated the effect of temporary occlusion of the superior mesenteric artery (SMAO) on the hepatic tissue concentration of anticancer drugs in hepatic artery infusion. Adriamycin (ADR: 1 mg/kg weight) was continuously administered into the hepatic artery for five minutes in dogs. Depending on the use and method of vascular occlusion, animals were allocated into five groups and hepatic tissue ADR levels were determined: Group I, SMAO; Group II, no vascular occlusion; Group III, occlusion of the common hepatic artery (CHAO); Group IV, combined SMAO and CHAO; Group V, occlusion of the portal vein. The hepatic tissue ADR level at 10 minutes was significantly higher in Group I than those in Group II and III. The tissue ADR level in Group IV and V tended to be slightly higher than in Group I, although there is no statistically significant difference. These results indicate that SMAO may provide a useful means of increasing local drug level during regional chemotherapy of the liver.

Allorecognition in compound ascidians

In botryllids (colonial ascidians), there are two types of allorecognition: colony specificity and colony resorption. Colony specificity is manifested by fusion and rejection between two conspecific colonies. The genetic basis for this colony specificity resides in a single highly polymorphic gene locus (fusibility locus) with codominantly expressed alleles. Two colonies with no alleles in common at this locus reject each other, whereas colonies sharing at least one allele at the fusibility locus fuse and form a chimera. That is, in colony specificity, self components are distinguished from nonself components, and failure to recognize self induces rapid rejection reactions. The process of rejection in colony specificity is not uniform among all botryllid ascidians. Colony resorption can occur after the establishment of fusion between two colonies. Zooids of one partner of a chimera are resorbed more than 1 week after fusion, or, by amputation of fused blood vessels, the chimera becomes separated into the two original colonies. Colony resorption is also controlled mainly by the fusibility locus. It usually occurs in a chimera between two colonies sharing only one allele at this locus. In colony resorption, nonself determinants are recognized and chronic rejection reactions are induced resembling MHC-dependent graft rejection. Based on these findings, the fusibility locus of botryllids seems to be very similar to the MHC of vertebrates. Considering that vertebrates evolved directly from ascidians, it is likely that the fusibility locus is an ancestral form of the vertebrate MHC.

Pregnancy enhances the antinociceptive effects of extradural lignocaine in the rat

We have compared the antinociceptive effect of extradural lignocaine on somatic and visceral nociception in pregnant (n = 11) and non-pregnant rats (n = 9). Colorectal distension (CD) threshold and tail flick (TF) latency were measured as visceral and somatic nociception, respectively, for 60 min after extradural injection. On days 19, 20 and 21 of pregnancy, rats received lignocaine 200, 400 or 800 micrograms or normal saline via a chronically implanted lumbar extradural catheter. Extradural lignocaine produced dose-dependent antinociceptive effects on TF latency and CD threshold. Lignocaine 200 or 400 micrograms produced significantly greater peak effects in pregnant than in non-pregnant rats. Although the peak effects with lignocaine 800 micrograms were not different between groups, the duration of the effects were longer in pregnant compared with non-pregnant rats. We conclude that both somatic and visceral antinociceptive effects of extradural lignocaine were potentiated in pregnant rats near term compared with those in non-pregnant rats.

Survival of patients with multiple system atrophy

We investigated the survival of patients with multiple system atrophy (MSA) in a follow-up study of 59 patients admitted to Nagoya University Hospital between 1976 and 1991. They consisted of 24 patients with olivopontocerebellar atrophy (OPCA), 25 with Shy-Drager syndrome (SDS) and 10 with striatonigral degeneration (SND). The mean age at onset was 54 years, the 3-year survival rate from onset was 90%, and the 6-year survival rate was 54%. Comparison of survival curve by clinical type revealed poorer survival in SDS and SND than in OPCA cases. Although in OPCA, SND and SDS the pathological alterations of the central nervous system are known to be very similar, characterized as MSA, the present study suggests that the earlier and the more severe the involvement of the autonomic nervous system, and to a lesser extent the striatonigral system, the poorer the prognosis may be.

The effects of frequently rotating shiftwork on sleep and the family life of hospital nurses

The effects of three frequently rotating shifts in an irregular sequence on the daily activities of 239 Japanese female hospital nurses were studied by the time-budget method. The nurses recorded their daily activities for several consecutive days. The questionnaire was returned by 80.8% of the participants, and recordings of 1016 days were analysed. A two-way analysis of variance clarified that the shift combination influenced the daily activities. The most distinct result was that nurses spent significantly more time on free-time activities on the day when they worked the night shift followed by the evening shift than they did on the day when they worked any other shift combination. Nurses offset sleep deprivation either by sleeping during the day before and after working the night shift (82-100%) or by sleeping 2 to 4 h later in the morning after working the evening shift and on days off. There was a strong positive correlation between total sleep time (including day sleep) and the length of the interval between two consecutive shifts (r = 0.95, p < 0.001). This result suggests that more than 16 h between work shifts is required to allow more than 7 h of total sleep time. In an analysis by household status, nurses who had young children (average age, 2.8 years) slept less and spent less time on free-time activities than did other nurses.

[Hyperbaric oxygen therapy in the Hokkaido University Hospital]

We surveyed the hyperbaric oxygen therapy during the past seven years in the Hokkaido University Hospital. The mean number of patients was 27 per year. The average number of the therapy was 328 per year. There were neither complications nor accidents attributable to the hyperbaric oxygen therapy. Three representative diseased states hypoxic brain damage, sudden deafness and occlusion of retinal arteries, showed remarkable recovery by this therapeutic modality. A safety standard has been revised in 1991. We have been operating the hyperbaric oxygen therapy according to the revised standard. The inter-departmental approach in this therapeutic modality is mandatory in order to achieve effective outcome.

Purification and characterization of an endogenous inhibitor specific to the Z-Leu-Leu-Leu-MCA degrading activity in proteasome and its identification as heat-shock protein 90

We previously identified a benzyloxycarbonyl(Z)-Leu-Leu-Leu-4-methylcoumaryl-7-amide (ZLLL-MCA) degrading activity in proteasome as a candidate for the regulator of neurite outgrowth. As its counterpart, we purified a protein from bovine brain that specifically inhibits the ZLLL-MCA degrading activity in proteasome. This protein is heat stable and has no effect on the other catalytic activities in proteasome, or on the activities of trypsin, chymotrypsin, or m- and mu-calpains either. The molar ratio of inhibitor-to-proteasome that inhibits 50% of the ZLLL-MCA degrading activity of proteasome is 1:1. The inhibitory mechanism of the inhibitor against proteasome is non-competitive. Finally, the inhibitor was identified as heat-shock protein 90 (HSP90) by partial amino acid sequencing and immunodetection. The results suggest that HSP90 initiates neurite outgrowth through the inhibition of the ZLLL-MCA degrading activity in proteasome.

Localization of double, roentgenographically occult lung cancer. Cytologic findings from selective brushing of all segmental and subsegmental bronchi

Using selective brushing of all segmental and subsegmental bronchi, six patients were diagnosed as having synchronous, double, roentgenographically occult lung cancers. Experienced bronchoscopists failed to detect four "second cancer" lesions in six patients. The appearance of atypical cells as shown by cytologic examination indicated the probability of the presence of cancer in the examined bronchus. Single cancer cells or tiny clusters of cells with orangeophilic cytoplasm can appear in specimens obtained from all bronchi, and such cells should not be considered to have originated in the bronchi under examination. Medium-sized or large clusters of cancer cells without degeneration and with basophilic cytoplasm appear only in specimens obtained from bronchi in which a cancer lesion exists, and thus they should be considered to have originated in the bronchi under examination. Cancer cells with orangeophilic cytoplasm in clusters should be considered to have originated in unknown locations. To determine the origin of such cells, one must compare the specimens with those obtained from other segmental and subsegmental bronchi. Our findings suggest that selective brushing of all segmental and subsegmental bronchi is a useful method of detecting unrecognizable second cancers and that the method should be employed for all patients with positive sputum cytology.

Comparison of continuous epidural infusion of morphine/bupivacaine with fentanyl/bupivacaine for postoperative pain relief

The efficacy and safety of postoperative analgesia with continuous epidural infusion of either morphine or fentanyl in combination with bupivacaine were evaluated in 85 patients, ASA physical status I or II, undergoing thoracic and/or upper abdominal surgery. Patients were treated with one of the combinations for 48 h after surgery. The morphine/bupivacaine group (MB; n = 45) received morphine at the rate of 0.2 mg.h-1, and bupivacaine at the rate of 10 mg.h-1 for the first 24 h or 5 mg.h-1 for the second 24 h; the fentanyl/bupivacaine group (FB; n = 40) received fentanyl at the rate of 20 micrograms.h-1, and bupivacaine at the rate of 10 mg.h-1 for the first 24 h or 5 mg.h-1 for the second 24 h. The degree of pain relief assessed by the visual pain scale and the modified Prince Henry pain scale was satisfactory in most patients in both groups. In group MB 74% and in group FB 76% of patients did not need any supplementary analgesics. No significant differences were observed between the groups in assessment of pain. The incidence of hypotension (P < 0.05) and pruritus (P < 0.05) was higher in group MB than in group FB. None of the patients developed respiratory depression in either group.

[An experience of suprahyoid release for resection and reconstruction of the lower part of trachea]

An experience of suprahyoid release for resection and reconstruction of the lower part of trachea was reported. 51-year-old woman, complaining of continuous stridor, was diagnosed as tracheal tumor at another hospital and was transferred to our hospital for consecutive examination and surgical treatment. The size of the tumor was about 3 cm in longitudinal diameter and the distance between tracheal carina and lower edge of the tumor was estimated about 2 cm by tomography. At operation, following suprahyoid release in supine position, 6 tracheal rings were resected and reconstructed by end-to-end anastomosis through right posterolateral incision. Patients neck was forced to bend for three weeks and intravenous byperalimentation without oral intake was employed for two weeks to avoid misswallowing and dysphagia postoperatively. Oral intake was started at two weeks after operation and parenteral nutrition was no more necessary at 3 weeks after surgery. Misswallowing and dysphagia were not encountered at all. The tumor was diagnosed as adenoid cystic carcinoma pathologically and residual tumor was demonstrated in submucosal space at the oral margin of the resected specimen as well. She discharged from the hospital uneventfully after postoperative radiotherapy. The recurrence of the tumor has not been observed for 3 years postoperatively. It was confirmed that suprahyoid release is an useful technique and should be ready to introduce in the extensive resection of the trachea because of its little influence on laryngeal function.

Evaluation of fermentability of acid-treated maize husk by rat caecal bacteria in vivo and in vitro

Fermentable energy in insoluble dietary fibre (DF) sources was evaluated by in vivo and in vitro methods using rats. Test diets contained 50 and 100 g maize husk or organic-acid-treated maize husk/kg diet. Soluble fractions were removed from both the DF sources by washing. The acid treatment increased digestibility by a microbial hemicellulase from 12.7% to 32.6%. The fermentability of DF was evaluated by measurement of the production rate of short-chain fatty acids (SCFA) in a short-term in vitro incubation of the caecal contents of rats fed on test diets for 22 d. The production rates of the major SCFA, acetic, propionic and butyric acids, were increased by feeding both DF sources, and these production rates in the acid-treated DF group were significantly higher than those in the untreated DF group. The production rate of a minor SCFA, isovaleric acid, was decreased by feeding both diets. The production rate of total SCFA in rats given the acid-treated maize husk was 32.6% higher than that in rats given the untreated maize husk. The fermentable energy in DF was estimated in vivo by subtracting the faecal excretion of DF energy from ingested DF energy. The fermentable energy in DF was increased by the acid treatment (32.5% in maize husk and 63.4% in acid-treated maize husk), which agreed with the SCFA production rate predicted in the caecum. These results indicate that a short-term incubation of caecal contents is a useful method for evaluation of the fermentability of DF sources, and that acid treatment can increase the fermentability of an insoluble DF source.

Antihypertensive effects of peptide in sake and its by-products on spontaneously hypertensive rats

Systolic blood pressure (SBP) decreased significantly when the hydrolysate of sake lee (HSL) and peptide fraction of sake (PFS) were orally administrated to spontaneously hypertensive rats (SHR). SBP of "young" SHR decreased significantly after orally administering Val-Tyr, His-Tyr, Arg-Phe, Val-Trp, and Tyr-Trp that were isolated from PFS and HSL. The hypotensive effect of Val-Tyr and His-Tyr that was observed in "young" SHR disappeared as they got older, but PFS and HSL maintained their antihypertensive effect on "aged" SHR. SHR fed on a diet with HSL replacing half of the protein source for 3 weeks showed a significant decrease in SBP after 10 days of feeding.

[Feasibility of DNA analysis for prognostic evaluations of colorectal cancer using touch preparations and image cytometry]

The purpose of this study is to demonstrate the applicability of DNA ploidy analysis by using touch preparations obtained from fresh and frozen tissues on the prognostic evaluations of colorectal cancer, especially the development of hepatic metastases. The specimens obtained from surgically resected colorectal carcinomas (32), and hepatic metastases (4), were lightly touched with the slide glasses. Among the 32 patients with colorectal cancers, 7 had synchronous liver metastases, and 5 metastases developed metachronously. After formalin-fixation and Feulgen staining, the DNA analysis was performed by image cytometer (ICM, CAS200R). The data were expressed as the ploidy patterns and DNA indices (p-DNAI: peak DNA index, m-DNAI: mean DNA index), and were correlated very well with those obtained from cytophotometry. The DNA ploidy pattern among the 32 colorectal cancer specimens were Aneuploid(A) in 16, Polyploid (P) in 7, Diploid (D) in 4 and D+P in 5. The cases with synchronous or metachronous liver metastases had a higher m-DNAI (1.74 +/- 0.28) and were Aneuploid in 8, P in 3, and D+P in 1 case. Aneuploidy or Polyploidy predominated among the cases with metachronous liver metastases (4 in 5 cases), with m-DNAI higher than 1.5. Thus, "m-DNA > 1.5" could be a useful prognostic indicator of the high risk group of liver metastases. The liver metastases specimens had Aneuploid and Polyploid patterns in 2 cases each, with m-DNAI ranging from 1.88 to 2.31. DNA ploidy pattern analysis using touch preparations with image cytometry may be useful in determining the prognosis for colorectal cancer.