Effects of lipo-prostaglandin E1 on random pattern flaps in rabbits

The effects of lipo-prostaglandin (PG) E1, which are lipid microspheres containing PGE1, were examined using 2 x 12 cm random pattern skin flaps on the backs of five rabbits. Five rabbits acted as controls. Both surviving length (8.5 (3.1) compared with 4.9 (1.8) cm) and surviving area (22.1 (9.3) compared with 11.5 (6.1) cm2) of the skin flap were significantly increased (p < 0.03 in each case). In three additional rabbits the blood flow on the distal side of the skin flap, where it was poor, was measured using a laser image blood flowmeter. Blood flow was improved five to 15 minutes after injection of lipo-PGE1 and was maintained for at least 60 minutes. In conclusion, lipo-PGE1 increased the blood flow of the random skin flaps, resulting in significant enlargement of the surviving area of skin flaps.

Surgical treatment for the recurrence of colorectal cancer

We report the results of a retrospective study conducted on patients who developed recurrence following surgery for colorectal cancer, and present a practical plan to improve the survival rates. Of 974 patients who underwent surgery for colorectal cancer in our hospital during the 20 years between 1974 and 1993, 152 developed recurrence, as local recurrence in 70 (7.2%), as liver metastasis in 47 (4.8%), and as pulmonary metastasis in 35 (3.6%). The number of patients who underwent reoperation or curative resection was 54 (77.1%) and 13 (24.1%), respectively, of those with local recurrence, 16 (34.0%) and 6 (37.5%) of those with liver metastasis, and 6 (17.1%) and 6 (100.0%) of those with pulmonary metastasis. The 3- and 5-year survival rates were 13.4% and 8.9%, respectively, after reoperation for local recurrence, 14.4% and 0%, after reoperation for liver metastasis, and 53.3% and 53.3% after reoperation for pulmonary metastasis. Although evaluation was difficult owing to the small number of patients with lung metastasis, resection of a pulmonary lesion resulted in a good outcome. Furthermore, a significant difference in 3- and 5-year survival rates was observed between patients who underwent reoperation and those who underwent conservative treatment, for whom the survival rates were 0% and 0% following local recurrence, 4.6% and 0% following liver metastasis, and 0% and 0% following lung metastasis, at 3 and 5 years, respectively. These findings indicate that aggressive surgery for recurrence may result in a better outcome.

Regulation of endothelial growth factor expressions in breast cancer

Expression of various endothelial growth factors including vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), Platelet-derived endothelial cell growth factor (PD-ECGF) and hepatocyte growth factor (HGF) was investigated in human breast carcinoma tissues, and the results were compared to the intratumoral microvessel density evaluated by the immunostaining to anti-factor VIII related antigen. VEGF and PD-ECGF were examined by immunostainings, and bFGF and HGF were assessed by enzymatic immunoassays. As a result, VEGF and PD-ECGF were significantly associated with the increment of microvessel density, although no significant correlation was found with bFGF and HGF. In addition, interestingly, a tendency of co-expression between VEGF and PD-ECGF was demonstrated. It was suggested that VEGF and PD-ECGF play important roles in the promotion of angiogenesis in human breast cancer.

Mechanism of lower oxidizability of eicosapentaenoate than linoleate in aqueous micelles

The aerobic oxidation kinetics of methyl eicosapentaenoate (20:5n-3) and methyl linoleate (18:2n-6) were compared in homogeneous chlorobenzene solution and in Triton X-100 aqueous micelles at 37 degrees C. The rate of disappearance of 20:5n-3 was two times faster than that of 18:2n-6 in chlorobenzene, while the former was five times slower than the latter in aqueous micelles. It was also observed that delta O2 = delta 18:2n-6 and delta O2 = 2 delta 20:5n-3 in aqueous micelles. In the oxidation of a 1:1 mixture of 20:5n-3 and 18:2n-6 in micelles, the rate of disappearance of 20:5n-3 was 3.6 times faster than that of 18:2n-6, and the rate of total substrate disappearance was reduced by a factor of 5 as compared with 18:2n-6 oxidation. These data suggest that the peroxyl radical derived from 20:5n-3 is more polar than that from 18:2n-6, and the former is likely to diffuse from the core to the micelle surface. This lowers the oxidizability for 20:5n-3 in aqueous micelles by enhancing the termination reaction rate for peroxyl radicals and by reducing the rate of propagation since there may be more 20:5n-3 peroxyl radicals at the surface than in the micelle core.

Properties of the inhibitory junction potential in smooth muscle of the guinea-pig gastric fundus

1. In circular smooth muscle of the guinea-pig gastric fundus, transmural nerve stimulation evoked a cholinergic excitatory junction potential (e.j.p.), and blockade of the e.j.p. by atropine revealed a non-adrenergic non-cholinergic (NANC) inhibitory junction potential (i.j.p.). 2. The amplitude of the e.j.p. was increased by apamin, suramin or NGnitro-L-arginine (L-NOARG), with no significant change in the membrane potential. 3. The i.j.p. consisted of two components (fast and slow); apamin inhibited the former, nitroarginine inhibited the latter, and suramin inhibited both components. 4. Apamin inhibited the hyperpolarization produced by adenosine 5'-triphosphate (ATP) but not by vasoactive intestinal polypeptide (VIP). Suramin inhibited the hyperpolarization produced by VIP but not by ATP. The sodium nitroprusside (SNP)-induced hyperpolarization was not blocked by apamin or suramin. L-NOARG or tetrodotoxin did not inhibit the hyperpolarization produced by ATP, VIP or SNP. 5. The data did not support the hypothesis that ATP, VIP or nitric oxide (NO) is the main transmitter responsible for generation of the NANC i.j.p. in the fundus. 6. Actions of L-NOARG suggest that endogenous NO may be involved in junctional transmission, mainly as an inhibitory modulator of cholinergic transmission.

Genetic engineering of the processing site of D1 precursor protein of photosystem II reaction center in Chlamydomonas reinhardtii

The D1 protein (D1) of photosystem II (PSII) reaction center is synthesized as a precursor (pD1) and then processed at its carboxyl terminus to establish the function of water cleavage. The amino acid sequence of the carboxyl terminal extension excised by this process is poorly conserved except for a residue after the cleavage site at position of 345. We have constructed a vector for site-directed mutagenesis of the chloroplast psbA gene encoding D1 of the green alga, Chlamydomonas reinhardtii. The vector enables one to transform the chloroplasts of a psbA deletion mutant (Fud7) and directly select transformants for resistance to spectinomycin. Using this transforming vector, we have substituted Ser345 to Gly, Cys, Val and Phe in order to investigate effects of the amino acid side chain at this position on the processing rate. All of the resulting transformants exhibited the PSII activity as wild type and grew normally under photoautotrophic conditions even under strong light where rapid turnover of D1 protein is expected to occur. Western blotting analysis demonstrated that mature D1 accumulates in these transformants at wild type level. Pulse and chase labeling of chloroplast-encoded proteins using [35S] sulfate revealed that the processing of D1 precursor protein occurs in all four transformants as efficiently as in wild type, at least under the experimental conditions examined. The results suggest that either the amino acid side chain at position of 345 (+1 position) is not crucial to the enzymatic cleavage of pD1 in vivo or the apparent rate of processing in vivo is not limited by the enzymatic cleavage.

[A case of Kennedy-Alter-Sung (KAS) syndrome presenting as hypersexuality and elevated serum CK: usefulness of genetic analysis]

We report a unique case of KAS syndrome presenting as hypersexuality and elevated serum creatine kinase (CK). None of the other members of the patient's family had KAS. The patient had engaged in sexual behavior 4 approximately 5 times a week since his marriage. He did not have gynecomastia or hepatomegaly. Neurological examination revealed facial twitching and tongue atrophy and fasciculations. Mild to moderate muscular atrophy and weakness were evident in the proximal portion of the upper and the distal portion of the lower extremities. Deep tendon reflexes were absent, as were sensory disturbance and sphincter dysfunction. Laboratory data showed mild elevation of transaminase (GOT 113 U/L, GPT 69 U/L) and extreme elevation of CK (4,600 U/L) in serum. Electromyography and muscle biopsy from the left biceps showed chronic neurogenic atrophy. Genetic analysis showed increased expansion of a CAG repeat (44 repeats) in exon 1 of the androgen receptor gene. We diagnosed KAS syndrome based on the genetic analysis. This case is important in illustrating the clinical varieties of KAS syndrome, as well as the importance of genetic analysis in KAS syndrome cases presenting with atypical manifestations and without a family history.

IgA2 genotyping by polymerase chain reaction (PCR) using allele-specific amplification primers

A method of genotyping IgA2 alleles in the human immunoglobulin alpha 2 heavy chain constant region (C alpha 2 gene) was developed by using the polymerase chain reaction (PCR). By this method, the genotype was determined by discriminating base substitution in the 3'-flanking region of alleles, A2m*1 and A2m*2, which manifest A2m serum types, by nested PCR using allele-specific primers. Three types, IgA2*1/IgA2*1, IgA2*2/IgA2*1, and IgA2*2/IgA2*2, were detected from DNA extracted from lymphocytes. Genotyping was possible from 100 pg of DNA by this method. The estimated allele frequency in 318 Japanese subjects was 0.561 for IgA2*1 and 0.439 for IgA2*2. Analysis of 29 cases of paternity tests suggested that the data follow Mendel's law of inheritance. This genotype could also be detected in whole blood, blood stains, saliva stains, and various organs and tissues. These results suggest the usefulness of the present method for paternity testing and individual identification in forensic medicine.

Facial contouring surgery with the scapular osteo-adipo-fascial flap

Recently, deepithelialized scapular or parascapular flaps have been used for reconstruction of facial contour. The authors used a scapular osteo-adipo-fascial flap, based on the subscapular vascular system, accompanied with scapular bone on the angular branch, for surgical correction of facial contour in two cases. At follow-up, both patients showed aesthetic improvements, and were pleased with the results. The scapular osteo-adipo-fascial flap provides a technique to reconstruct facial contour, including the bony structure as well as the soft tissue.

Cloning and sequence analysis of the pfl gene encoding pyruvate formate-lyase from Streptococcus mutans

We have isolated a sorbitol-negative mutant of Streptococcus mutans GS-5 following random mutagenesis with plasmid pVA891 clone banks. This mutant did not metabolize sorbitol anaerobically but did so aerobically. A 10-kb chromosomal DNA fragment flanking the pVA891 insertion was deleted in this mutant. The corresponding region from the parental strain GS-5 was then recovered by a marker rescue method with Escherichia coli. The pyruvate formate-lyase gene, pfl, was identified within a 3-kb PstI-XbaI fragment located in the middle of the deleted region of the chromosome, and its inactivation in S. mutans produced the same sorbitol-negative phenotype. Nucleotide sequence analysis of the pfl gene revealed a 2.3-kb open reading frame (ORF) preceded by potential ribosome-binding and promoter-like sequences. The ORF specified a putative protein of 775 amino acid residues with a calculated molecular weight of 87,533. The amino acid sequence deduced from the ORF exhibited significant similarity to that of the E. coli pfl gene.

Surface morphologies of sputter-deposited aluminum films studied using a high-resolution phase-measuring laser interferometric microscope

Sputter-deposited aluminum (Al) film surface morphologies were studied with a new nondestructive method that incorporates a high-resolution phase-measuring laser interferometric microscope. Good correlation is obtained between rms roughness and reflectivity for various conditions of temperature and argon gas pressure. It should be noted that the rms roughness is much more sensitive than reflectivity when reflectivity exceeds 90%. A drastic change is observed in the temperature dependence of the rms roughness and the skewness at 200 °C. As a result there are changes in Al grain sizes and surface morphologies based on concomitant scanning electron microscope observations. We found that the rms roughness value depends on the resolution of the objective especially when the Al grain sizes are comparable to the resolution.

Role of brain cocaethylene levels in combined cocaine-ethanol lethality in mice

The purpose of this study was to examine the lethal effects of combining cocaine with ethanol in mice by assaying for cocaethylene at the time of death. After the voluntary oral ingestion of ethanol in the form of a liquid diet containing 35% ethanol-derived calories for 5 days, intraperitoneal cocaine (60 mg/kg) was administered daily for up to 5 days while the ethanol diet continued (ethanol diet group). The mice in the ethanol diet group were paired with control mice that received a control liquid diet containing equivalent carbohydrate calories in the form of sucrose instead of ethanol (control diet group). In order to analyze the drugs, samples (blood, liver and brain) were collected for both groups from the dead animals that could not tolerate the 5 days of cocaine administration. A higher rate of lethality was observed in the ethanol diet group as compared to the control diet group. Furthermore, various patterns of cocaine lethality were revealed under different conditions of ethanol intake. According to the survival times after the last cocaine administration, observed respiratory and locomotive disorders, and drug concentrations, a total of 5 subgroups in the ethanol diet group (Groups E1-E5) and a total of 3 subgroups in the control diet group (Groups C1-C3) were differentiated. The ratio of the mean cocaethylene concentration relative to the mean cocaine concentration was over 30% in the livers of animals in an earliest lethal subgroup (Group E1). In addition, examination of all of the dead animals in the ethanol diet group revealed the prolonged presence of cocaethylene in the brain of the mice that died within 2 hours. Thus, it was suggested that cocaethylene has strong effects on the brain receptors and influences cocaine lethality.

Reduced thyroidal uptake of inorganic iodine in liver cirrhosis

Thyroid function was investigated in patients with liver cirrhosis. 123I uptake after four hours was significantly reduced in the liver cirrhosis group (n = 19) compared with the control group (n = 16) (2.6 +/- 0.3% vs. 5.0 +/- 0.6%, mean +/- SE, p < 0.01). There was no significant difference in the blood inorganic iodine level between the two groups, and the blood 123I count after ingestion of 123I capsules was not significantly different between the two groups. The area of the thyroid was slightly smaller in the cirrhosis group. A thyroid stimulating hormone (TSH) loading test showed no significant difference in the TSH value at any time point. The serum albumin level and prothrombin time were significantly associated with the 4-hour thyroidal 123I uptake (p < 0.01, p < 0.05, respectively). We show that the thyroidal inorganic iodine uptake was reduced in patients with liver cirrhosis and this reduction correlates with the severity of liver cirrhosis. Possible mechanisms include abnormal thyroid iodine transport capacity or reduced turnover of thyroid hormones resulting in a reduction in iodine uptake in liver cirrhosis.

Graft size-matching in living related partial liver transplantation in relation to tissue oxygenation and metabolic capacity

The influence of graft size-matching on tissue oxygenation and metabolic capability was studied in living related partial liver transplantations for 47 pediatric patients. Their age ranged from 4 months to 17 years 3 months, their body weight from 4.0 to 58.0 kg, graft weight from 191 to 440 g, and graft weight/recipient body weight ratio from 0.61% to 6.0%. Tissue oxygenation and its heterogeneity were investigated by measuring oxygen saturation of hemoglobin in the liver sinusoid (SO2), coefficient of variation of SO2, and arterial ketone body ratio. The metabolic capacity of the graft was investigated by measuring bilirubin clearance, recovery of cholesterol esterification, and ketone body production. In infants with a relatively large liver graft, both intra- and extracellular oxygenation remained low soon after reperfusion but recovered to the control value by the end of the operation. In adolescent recipients of a relatively small graft, by contrast, synthetic and detoxification capacities were relatively deficient; however, these improved with time. These results indicate that sufficient tissue oxygenation and liver regeneration are essential for successful liver transplantation with relatively large and small grafts, respectively.

Infraorbital glands of a male Formosan serow (Capricornis crispus swinhoei)

The morphology of the infraorbital glands of a male Formosan serow was examined. The glands consisted of an inner sebaceous portion and an outer apocrine portion. The inner sebaceous portion was much larger than that of the male Japanese serow. The sebaceous portion of the gland consisted of the ordinary and modified types of tissue that are present in the infraorbital gland of the female Japanese serow, and the modified tissue contained some melanin granules and melanocytes. The apocrine portion of the glands was composed of tubules in which the myoepithelial cells stained intensely to very weakly upon immunohistochemical staining with antibody against a smooth muscle actin. Nerve fibers that contained calcitonin gene-related peptide were scattered in the apocrine portion. These findings indicate that the sebaceous gland of the male Formosan serow is different from that of the male Japanese serow but rather similar to that of the female Japanese serow. Moreover, the apocrine gland is innervated by peptide-containing nerve fibers.

Long survival in small-cell (neuroendocrine) carcinoma of the mediastinum

Extrapulmonary small-cell carcinoma is uncommon. We report a rare case of small-cell carcinoma located in the mediastinum. The patient is still alive 6 years after combined local resection and chemotherapy. This seems to be the first reported case with such long survival.

Enhancement of coronary reactive hyperemia in patients with ischemic myocardial tolerance during angioplasty

The purpose of this study was to elucidate the effect of repeated brief coronary occlusions on reactive hyperemia during percutaneous transluminal coronary angioplasty (PTCA) in patients with or without ischemic tolerance. Seventeen patients undergoing PTCA for chronic stable angina were studied. Patients with well developed collateral vessels were excluded. After successful predilatation, coronary flow velocity was recorded with the use of a Doppler flow guide wire, and reactive hyperemia was assessed immediately after each of two 2-min coronary occlusions followed by 2 mins of reperfusion. The intracoronary electrocardiogram (icECG) was recorded via the flow guide wire placed in the center of the ischemic zone. Patients were divided into two groups: those who showed a reduction of ST elevation in the icECG recorded at the time of the second coronary occlusion (group I), and those who showed no difference in ST elevation between the two occlusions (group II). There were no significant differences in blood pressure, heart rate, or baseline coronary flow velocity between the two groups before the first occlusion, but the ST elevation at the time of the first coronary occlusion was greater in group I than in group II (8.9 +/- 6.2 versus 1.1 +/- 2.0 mm, P < 0.01). Reactive hyperemia was significantly greater after the second coronary occlusion than after the first in group I (22.1 +/- 15.8 versus 30.4 +/- 21.0 cm/s, P < 0.05), but it did not change in group II (25.6 +/- 13.0 versus 23.5 +/- 11.2 cm/s NS). Reactive hyperemia was enhanced in patients with ischemic tolerance who showed a reduction in St elevation in the icECG. These results suggest that observed reactive hyperemia does not necessarily reflect the severity of ischemia.

Extension of the indication for living related liver transplantation from children to adults based on resolution of graft size mismatch in relation to tissue oxygenation and metabolic load: a case report

We extended the indication for living related partial liver transplantation from pediatric to adult cases. Our first case was a 49-year-old woman with primary biliary cirrhosis. Her sister's left lobe, weighing 280 g, was employed as a graft, and the graft weight/recipient's body weight ratio was calculated as 0.59%. To decrease the metabolic load to the relatively small graft, the total bilirubin was decreased from a maximum value of 75.0 mg/d1 to the most recent preoperative value of 36.2 mg/dl by plasma exchange. Intraoperative recovery of tissue oxygenation and its heterogeneity were satisfactory due to a relatively high blood supply. A postoperative decrease in bilirubin and increase in cholesterol esterification were facilitated, concomitant with regeneration of the graft, which weighed 280 g, to 860 cm3 at 3 weeks. Linear regression analysis with respect to tissue oxygenation and metabolic capacity obtained in pediatric cases were applied to this adult case.

Expression of CD45-restricted form B in (NZW x BXSB) F1 and MRL/Mp-lpr/lpr mice

Expression of CD45RB on CD4+ or CD8+ cells in combination with TCRV beta usages (V beta 6, V beta 8.1, V beta 8.2, V beta 11 and V beta 17a) in normal mouse strains (BALD/c and C57BL/6) was compared with autoimmune-prone strains (NZW x BXSB) F1 and MRL/lpr) at young and old ages. The frequencies, and also the numbers of CD45RB- cells in CD4+ T cells with various TcR repertoires was significantly less in the autoimmune-prone stains at old ages, while, in normal control strains, they remained unchanged. Furthermore, CD4+/CD45RB- cells are CD44high and CD62L (L- selectin).low These findings suggest that most T cells, especially CD4+ T cells, in old W/BF1 and old MRL/lpr mice, were activated and this may reflect the elevation of autoantibodies and the progress of autoimmune status in aged autoimmune-prone mice. This will be discussed in relation to the progress of the autoimmune diseases.