Regional differences in cerebral vasomotor control by nitric oxide

Regional differences in the role of nitric oxide in cerebral vasomotor control were investigated with a nitric oxide synthesis inhibitor, NG-monomethyl-L-arginine, or a precursor of nitric oxide, L-arginine using both dog cerebral angiography for the larger artery study and rat isolated arterioles for the microcirculation study. NG-monomethyl-L-arginine (10 mumol) constricted the dog cerebral arteries, by 15.6%, 17.5%, and 27.3% in the middle cerebral, anterior cerebral, and basilar arteries, respectively. The greater constriction of the basilar artery did not reach statistical significance. However, L-arginine (100 mumol) produced significantly greater dilation of basilar arteries than the middle cerebral or anterior cerebral (31.3% vs. 16.7% or 13.1%). NG-monomethyl-L-arginine at 10(-3) M constricted rat arterioles originating from basilar arteries significantly more than the middle cerebral arteries (23% vs. 14%). L-arginine at 10(-3) M dilated rat arterioles from basilar arteries significantly more than from the middle cerebral artery (24 vs. 11%). These findings suggest that the roles of nitric oxide in vasomotor control differs by region in the brain, and it may be greater in vessels of the posterior than of the anterior circulation.

Cytophotometric study of nuclear DNA content in scirrhous gastric carcinoma

We made a cytophotometric DNA analysis using 21 scirrhous gastric carcinomas (SGC), and compared the results with those of 12 undifferentiated type early gastric carcinomas (EGC) located in the gastric body. Nuclear DNA content of tumor cells was measured in the mucosa of SGC (SGCm), serosa of SGC (SGCs) and mucosa of EGC (EGCm). DNA distribution pattern was high ploid in 18 SGCm (86%), 16 SGCs (71%) and 4 EGCm (33%). Mean DNA content was 4.02c in SGCm, 3.91c in SGCs and 3.26c in EGCm. Percentage of tumor cells with a DNA content over 3c was 77.4% in SGCm, 69.1% in SGCs and 49.5% in EGCm. Statistically significant differences in these 3 factors were present between SGCm and EGCm, but absent between SGCm and SGCs. Furthermore, DNA distribution pattern was not different between the mucosa and serosa in 19 SGC (90%). The results suggest that most scirrhous gastric carcinomas are high ploid in origin and do not change their biologic behaviour throughout the tumor progression.

Assignment of CD38, the gene encoding human leukocyte antigen CD38 (ADP-ribosyl cyclase/cyclic ADP-ribose hydrolase), to chromosome 4p15

CD38 has been used as a phenotype marker of lymphocyte differentiation. Recently, we have demonstrated that cyclic ADP-ribose can be synthesized and hydrolyzed by CD38 and acts as a second messenger in insulin secretion from pancreatic beta-cells. We have mapped the CD38 gene to human chromosome 4p15 by fluorescence in situ hybridization.

In vitro induction of cytotoxic T lymphocytes against HTLV-I-infected T-cells from adult T-cell leukemia patients, asymptomatic HTLV-I carriers and seronegative healthy donors

We investigated an in vitro method to produce cytotoxic T lymphocytes (CTLs) against HTLV-I-infected T-cells using peripheral blood mononuclear cells (PBMC) of adult T-cell leukemia (ATL) patients, asymptomatic HTLV-I carriers (AC) and seronegative healthy donors. The PBMC were restimulated repeatedly for 4 weeks with HLA-matched HTLV-I-infected T-cells which had been pretreated at 56 degrees C for 30 min to inactivate infectious HTLV-I. The culture medium included 10-100 units/ml of recombinant lymphokines (rIL-1, rIL-2, rIL-4, rIL-6 and rIL-7) and 10% fetal calf serum in RPMI-1640 medium. The cytotoxic activity was measured against HLA-matched HTLV-I-infected T-cell lines after CD4+ or CD8+ cells were positively panned from the cultured PBMC. The PBMC of ATL, AC and healthy donors were able to produce either CD4+ or CD8+ CTLs against HTLV-I-related antigens (env, gag, p21x, p27rex and p40tax) as well as the antigen(s) of as-yet unknown specificity expressed on HTLV-I-infected T-cells. All the CTLs recognized the specific antigens in the context of either class I or class II HLA types. These results indicated that ATL patients, AC and healthy donors were immunocompetent to generate CTLs against HTLV-I-infected T-cells and probably against HTLV-I-transformed T-cells.

Alpha-melanocyte-stimulating hormone (MSH) inhibits insulin secretion in HIT-T 15 cells

alpha-Melanocyte-stimulating hormone (MSH) antagonizes the binding of interleukin-1 beta (IL-1) to its type I receptors on T cells. IL-1 modulates insulin secretion in the insulin-secreting tumor cell line, HIT-T 15 cells. In the present studies, we examined a hypothesis that alpha-MSH may modulate insulin secretion in HIT-T 15 cells. The addition of alpha-MSH over the concentrations of 10(-10) M inhibited insulin secretion for 4 h. In addition, the carboxyl-terminal tripeptide of alpha-MSH [alpha-MSH(11-13)], which is supposed to be an important sequence of alpha-MSH on its antipyretic effects, significantly inhibited insulin secretion at the concentration of 10(-9) M. In contrast, acetyl-[Nle4,D-Phe7] alpha-MSH(4-10)-amide (10(-11) to 10(-9) M) failed to inhibit insulin secretion. The maximal effect of alpha-MSH on insulin secretion was obtained at the concentration of 10(-9) M. The addition of alpha-MSH from 10(-11) to 10(-9) M significantly inhibited 7.5 mM glucose-stimulated insulin secretion at each period of 0-5, 5-15, and 15-30 min. Radioreceptor assay suggested that HIT-T 15 cells possess the specific binding sites for 125I-labeled alpha-MSH. The present studies indicated that alpha-MSH inhibits insulin secretion through the specific binding site in HIT-T 15 cells.

Successful treatment of a 93-year-old patient with hypoplastic acute monocytic leukemia using macrophage colony-stimulating factor

A 93-year-old patient with hypoplastic acute monocytic leukemia (AMoL) achieved a complete remission after macrophage colony-stimulating factor (M-CSF) therapy. Initially, the patient was treated with a low dose of cytarabine, but this treatment proved ineffective. M-CSF was administered for 14 days by drip intravenous infusion, 800 x 10(4) units per day. After a gradual decrease in the number of leukemic cells, a rapid increase in neutrophils was observed in the peripheral blood, and a bone marrow examination 22 days after discontinuation of M-CSF medication revealed a complete remission. These findings suggest that M-CSF may be useful in treating some elderly patients who have hypoplastic AMoL.

[An autopsied case of primary pulmonary hypertension complicated by hepatopulmonary syndrome]

A 57-year-old man, who had received a transfusion five years before, was admitted to our hospital complaining of worsening dyspnea on exertion. Cardiac catheterization was performed, and pulmonary hypertension was diagnosed. Liver dysfunction was also documented. We administered diuretics and observed his clinical course. Gradually worsening hypoxemia and radioisotope accumulation in the kidney following a lung perfusion scintigram suggested the existence of an intrapulmonary shunt. The patient died seven years later due to exacerbation of heart failure secondary to pulmonary infection. Autopsy revealed remarkable hypertensive pulmonary arteriopathy as well as abnormal dilation of precapillary pulmonary arterioles. Esophageal varices suggested portal hypertension. Marked hypoxemia and intrapulmonary vascular dilation suggest the contribution of an hepatopulmonary syndrome.

Multiple primary gastric and colorectal cancer in Japan

The features of multiple primary gastric and colorectal cancer (MPGCC) were investigated, using 447 patients with primary gastric cancer and 199 with colorectal cancer during 1981-1992. Thirteen of these patients were found to have adenocarcinoma in both the stomach and colorectum. The increase rate for MPGCC and colorectal cancer was higher than that of primary gastric cancer (p < 0.05). Of the 13 patients with MPGCC, 8 showed synchronous MPGCC, while 5 showed metachronous MPGCC. Five of the 8 patients with synchronous MPGCC showed either Stage I or II in both lesions of the stomach and colorectum, and all 5 patients with metachronous MPGCC showed Stage I or II in the lesion of the second primary cancer. Since patients with MPGCC are expected to have a relatively good prognosis, both a preoperative examination and postoperative follow-up will be needed in order not to overlook lesions of the stomach or colorectum in patients with MPGCC.

Lansoprazole inhibits oxygen-derived free radical production from neutrophils activated by Helicobacter pylori

We studied the influence of lansoprazole on Helicobacter pylori-elicited neutrophil activation, including the oxidative burst and infiltration of gastric mucosa, and confirmed whether radiolabeled lansoprazole is actually detected in gastric neutrophils. The oxidative burst of purified human neutrophils was measured by luminol-dependent chemiluminescence (ChL). [3H]Lansoprazole uptake sites in human gastric mucosa were observed by autoradiography. The magnitude of neutrophil infiltration of gastric mucosa was assessed by tissue myeloperoxidase (MPO) content. ChL assay indicated that oxygen-derived free radical production was increased twofold by adding H. pylori water extract, which was significantly inhibited by lansoprazole (10(-4) M). Gastric biopsy samples were obtained endoscopically from patients with H. pylori-positive gastritis. Autoradiographic examination revealed that the [3H]lansoprazole binding site was present in the cytoplasmic granules of infiltrated neutrophils. Tissue MPO content was significantly decreased after treatment with lansoprazole. These data suggest that lansoprazole binds directly to neutrophils, subsequently inhibiting neutrophil accumulation and release of toxic metabolites.

[A case of Mycobacterium fortuitum pulmonary disease in a healthy young woman successfully treated with ciprofloxacin and doxycycline]

A 22 year-old woman was admitted to our hospital complaining of subtle fever and productive cough. She did not smoke and had no underlying disease. Her chest radiograph showed infiltration in the right upper lung field. A diagnosis of Mycobacterium fortuitum pulmonary disease was made on the basis of isolation of M. fortuitum from repeated sputum cultures. On admission, we administered standard antimycobacterial agents, but found the M. fortuitum isolated in this case to be completely resistant to them. We then administered antibiotics including 600 mg of ciprofloxacin and 200 mg of doxycycline. The pneumonic findings on chest X-ray and her clinical symptoms gradually improved thereafter. The in vitro susceptibility tests confirmed the efficacy of ciprofloxacin and doxycycline. We concluded that these drugs contributed significantly to improve the disease.

Computer-assisted pathology of intraepithelial adenocarcinoma and related lesions: 3-D distribution, structural aberration and discrimination

To discriminate among intraepithelial neoplasms, we have been relying on tissue microscopy, but pathologists' subjectivity sometimes impairs diagnosis. Even an individual pathologist is sometimes unable to reproduce exactly his or her own previous diagnosis. Are various atypical lesions classifiable in a reproducible way, and if they are, how? The reliability of a diagnosis will be strengthened if we can define the "natural" categories inherent in cells and tissues. Morphometry and statistical analysis using a computer can provide answers. Atypia, a morphological feature of carcinoma, is essentially multivariate. Quantification of a tissue feature requires reducing it to a set of ten or more quantities, including size, shape and position of the nucleus, nucleolus, and the cell itself. The grade of aberration from the norm can be assessed only by a synthetic approach, using a computer for multivariate cluster analysis. This classification has been attempted in adenocarcinoma and related lesions of the lung and pancreas. The categories thus established are reproducible, because the lesions fall into divisions according to their forms. We can also examine the organ distribution of intraepithelial neoplasms by three dimensional (3-D) computer-assisted mapping. To reach a higher level of reliability, as many meaningful features as possible should be taken into account. Particularly, we emphasize the significance of architectural pattern as a biomarker for intraepithelial glandular neoplasms. Computer-aided 3-D structural analysis visualizes the basic skeleton of these neoplasms around which the cells adhere. Instead of the dichotomous tree pattern of normal glands, the tumors basically harbor a 3-D network, tubular or porous, which increasingly deviates from the norm along with the transition from adenoma to well to moderately to poorly differentiated adenocarcinoma. This structural aberration, if recognizable on 2-D sectional images, will serve as a surrogate endpoint biomarker for glandular tumors.

Long-term course of bronchiectasis and bronchiolitis obliterans as late complication of smoke inhalation

We describe the long-term course of a patient with bronchiectasis and bronchiolitis obliterans, both of which developed as late complications of a smoke inhalation injury. Sequential chest X-rays obtained during the observation period showed gradual progression of bronchiectasis from the saccular to the cystic type. Symptoms, spirometry and blood gas analysis, however, remained stable for 15 years. We believe that symptoms and physiological derangement were due mainly to bronchiolitis obliterans, and that once the pathophysiological condition had been established following the initial injury, it could be maintained by conservative medical management.

Disease heterogeneity: does it impact our ability to detect dietary associations with breast cancer?

It is generally believed that breast cancer is a multistage process and that multiple and varying genetic events occur on the pathway to disease. We hypothesize that disease heterogeneity has an impact on our ability to identify risk factors. If a genetic alteration occurred in 50% of cases and a risk factor was associated only with that specific alteration, a risk estimate of 1.6 would be detected rather than the true risk estimate of 2.5 if analyses had been limited to those cases with the genetic alteration. Based on the literature we know that many genetic alterations occur in less than 50% of breast tumors. Thus, if environmental factors are related to some, but not all genetic alterations, we are decreasing our ability to identify potentially important risk factors. We therefore hypothesize that identification of dietary factors associated with breast cancer has been hampered by our inability to identify and capture the unique disease pathways which exist and contribute to the heterogeneity of common cancers such as breast cancer.

Structure and chromosomal mapping of genes for the mouse kappa-opioid receptor and an opioid receptor homologue (MOR-C)

Recent cDNA cloning studies have defined four members of the opioid receptor family, i.e., delta-, mu- and kappa-subtypes, and an opioid receptor homologue for unknown ligands. In this report, we isolated and analyzed mouse genomic DNA segments containing the kappa-opioid receptor gene and a gene for the opioid receptor homologue (designated as MOR-C). The genes are closely related each other in exon-intron organization, suggesting their evolutional relationship. Using in situ hybridization, we show that the kappa-opioid receptor gene and the MOR-C gene map to mouse chromosome 1A2-3 and 2H2-4, respectively.

Molecular genotyping for N-acetylation polymorphism in Japanese patients with colorectal cancer

BACKGROUND

N-acetylation polymorphism has been documented as a representative pharmacogenetic trait, and also has been implicated ecogenetically in an individual's susceptibility to cancer. However, there still remains controversy concerning the association between colorectal cancer and N-acetylation polymorphism.

METHODS

A newly established molecular genotyping method using polymerase chain reaction-based restriction fragment length polymorphism to analyze the distribution of polymorphism in a large group of Japanese patients with colorectal cancer was used.

RESULTS

Based on an analysis of 234 Japanese patient with colorectal cancer and 329 healthy control subjects, no significant difference was observed in either the distribution of acetylator phenotypes or of allele frequencies between the two groups. In addition, no significant difference in their distribution was found based on the age at which cancer was first detected, the location of tumors, or the histopathologic features.

CONCLUSIONS

N-acetylation polymorphism does not appear to be implicated crucially as a genetic trait affecting an individual's susceptibility to colorectal cancer.

Metabolic fates of carbon skeletons of methionine, serine, and alanine in growing rats fed soybean protein diets

The effects of dietary soybean protein isolate intakes on the metabolic fates of L-[U-14C]methionine, L-[U-14C]serine, and L-[U-14C]-alanine were investigated in growing rats. In the growth experiment for 21 days, body weight gain reached a plateau at more than 20 protein calorie percent (PC%) in the diet, and the protein efficiency ratio attained maximum in the 10 PC% group. Carcass and liver lipid contents increased greatly in the lower levels of dietary soybean protein, which was associated with their decrease in moisture contents. In the isotope experiments, the incorporation of 14C into the body protein 12h after the injection of [14C]methionine was extremely high (more than 80% of the dose) in the 5 to 15 PC% groups, but decreased thereafter in the higher PC% groups. The expired 14CO2 production from [14C]methionine was depressed in the lower PC% groups, and thereafter it increased with increasing levels of dietary protein, showing a break point at around 20 PC%. The carbon skeleton of [14C]alanine was extensively oxidized to 14CO2, even in protein-depleted rats, while serine carbon was utilized for body protein synthesis rather than for energy production. These results indicate that methionine, which is a limiting amino acid of soybean protein for rats, is preferentially utilized for body protein synthesis especially in protein-depleted rats, and the metabolic responses of methionine, serine, and alanine are quite different from each other.

Objective system for interviewer performance evaluation for use in epidemiologic studies

In this paper, the authors present an objective system to evaluate interviewer performance for use in epidemiologic studies. With this quality control system, all study interviews are audio-taped, and a random sample of interviews are coded according to interviewer behaviors, such as whether the interviewer asked the questions exactly as written and used the probes appropriately. With the use of data obtained from a large case-control study of colon cancer, the authors observed that 94.2% of all questions were asked in the same manner by all interviewers and that 89.5% of all probing behaviors were appropriate. They show that questions that required additional interviewer behaviors were more likely to result in variation in response that can be attributed to the interviewer. These findings have implications for study design and interpretation of study results. From simulations, the authors have estimated the impact of uncorrected interviewer variability on study power and ability to detect disease associations. Uncorrected interviewer variability could decrease study power from 84% to 56%. From simulations, the authors observed that odds ratios could be biased downward from 1.8 to 1.3. These findings illustrate the importance of using a continuous quality control program in epidemiologic research.

Pre-operative estimation of complete resection for patients with oesophageal carcinoma

Three hundred and seventy-nine patients were studied retrospectively regarding the possibility of a complete resection of the oesophageal carcinoma based on the combined findings of pre-operative oesophagogoraphy and computed tomography (CT). One hundred and four out of 129 patients (96.1%) having lesions which did not demonstrate all three of the aforementioned factors (a lesion shorter than 8 cm, a normal oesophageal axis, and normal contact of the lesion with neighboring organs in CT) underwent a complete resection of the oesophageal lesion. Fifty-three percent of the patients (52/97) with a lesion showing only one of these factors had a complete resection. Whereas, on the other hand, a complete removal of the malignancy was only possible in 22% of the patients with two or all three of the findings. Moreover, as a result of further analysis limited for resected cases, the number of positive factors in these pre-operative findings correlated with the advancement of the surgical stage, which reflected a curability in surgery and a rate of postoperative complications. In order to make adequate plans for the treatment of patients with advanced oesophageal cancer, the finding of (i) the length of lesion, (ii) a deep ulceration and deformity of the oesophageal axis and (iii) any abnormal contact in CT, are considered to be very useful.