Factors affecting the variability of the torque curves at isokinetic trunk strength testing

OBJECTIVES

To evaluate the relation between variability of the torque curves and factors such as age, gender, measurement speeds, and period from low back pain (LBP) onset at isokinetic trunk strength testing.

DESIGN

Observational.

SETTING

Hospital.

PATIENTS

One hundred forty-three consecutive LBP patients (acute, subacute, and chronic) who received physical therapy, and 200 healthy volunteer subjects.

MAIN OUTCOME MEASURES

The variability of the torque curves is an indicator of consistency of effort, and was measured as the coefficient of variance (CV) at different measurement speeds in isokinetic trunk flexion/extension strength testing.

RESULTS

The CV was lower in men than in women at the faster measurement speed. LBP patients had higher CV values than healthy subjects. The CV was different according to gender and measurement speed, but not different according to age and periods from LBP onset.

CONCLUSION

The CV was affected by measurement speed and gender, but not by age or period from LBP onset. Because the CV was higher in LBP patients than in healthy subjects, this value may be usable as an adjunctive index of LBP.

Correlation of suppressed linoleic acid metabolism with the hypocholesterolemic action of eritadenine in rats

The dose-dependent effects of dietary eritadenine on the metabolism of linoleic acid and on the plasma cholesterol concentration were investigated to clarify the mechanism of the hypocholesterolemic action of eritadenine in rats. Rats were fed control or eritadenine-supplemented (2 to 20 mg/kg) diets for 14 d. Eritadenine supplementation significantly decreased both the plasma cholesterol concentration and the 20:4n-6/18:2n-6 ratio of liver microsomal and plasma phosphatidylcholine (PC) in a dose-dependent manner. Eritadenine was also found to decrease the activity of delta 6 desaturase in liver microsomes; there was significant correlation between the delta 6-desaturase activity and the 20:4n-6/18:2n-6 ratio in the PC of liver microsomes (r = 0.989, P < 0.001) or plasma (r = 0.986, P < 0.001). Certain plasma PC molecular species, as represented by 16:0-18.2, were increased by eritadenine in a dose-dependent manner, and certain plasma PC molecular species, as represented by 18:0-20:4, were conversely decreased by eritadenine. There was a significant correlation between the plasma total cholesterol concentration and the proportion of the sum of plasma PC molecular species which contain 18:1 or 18:2 in the sn-2 position. These results support the idea that the suppression of linoleic acid metabolism by eritadenine might be associated with the hypocholesterolemic action of eritadenine.

Methionine content of dietary proteins affects the molecular species composition of plasma phosphatidylcholine in rats fed a cholesterol-free diet

The effects of dietary protein types and methionine supplementation on phospholipid metabolism were investigated to clarify the mechanism of the hypocholesterolemic action of soybean protein in rats fed a cholesterol-free diet. The effect of switching from a casein diet to a soybean protein diet was also investigated. Rats were fed casein, soybean protein or soybean protein + methionine diet for 14 d. Compared with casein diet, feeding of soybean protein diet led to significantly higher proportions of linoleic acid and linoleic acid-containing molecular species, especially 16:0-18:2, in plasma and liver microsomal phosphatidylcholine (PC). In addition, significantly lower plasma cholesterol concentration, hepatic S-adenosylmethionine concentration and liver microsomal PC:phosphatidylethanolamine ratio resulted. These alterations caused by the soybean protein diet were significantly suppressed by supplementing methionine to the level of the casein diet (3.4 g/kg diet). The proportion of the sum of certain plasma PC molecular species, which contain 18:1 or 18:2 in the sn-2 position, increased in response to the switch from the casein diet to the soybean protein diet at a rate similar to the decrease in plasma cholesterol concentration; there was a significant correlation between the two variables (r = -0.992, P < 0.001). These results indicate that about 40% of the hypocholesterolemic action of soybean protein is due to the low methionine content of the protein and might be associated with alterations of the plasma phospholipid molecular species profile.

Dietary eritadenine modifies plasma phosphatidylcholine molecular species profile in rats fed different types of fat

The effect of dietary eritadenine on plasma phosphatidylcholine (PC) molecular species composition was investigated in relation to its hypocholesterolemic action in rats fed different types of fats (olive oil, corn oil and linseed oil; 100 g/kg diet). Eritadenine supplementation (50 mg/kg diet) significantly decreased the plasma total cholesterol concentration, irrespective of dietary fat sources, and without change in the order of plasma cholesterol concentration among the fat groups (corn oil > olive oil > linseed oil). Eritadenine significantly decreased the ratio of phosphatidylcholine (PC) to phosphatidylethanolamine (PE) in liver microsomes of all the fat groups, while the PC:PE ratio was unaffected by dietary fat type. The fatty acid and molecular species composition of plasma PC was affected either directly or indirectly by the fatty acid composition of dietary fats. The proportion of linoleic acid and linoleic acid-containing molecular species (16:0-18:2 and 18:0-18:2) in plasma PC was the highest in rats fed linseed oil, despite the fact that linoleic acid concentration of linseed oil was only 1/3 that of corn oil. Eritadenine supplementation significantly increased the proportion of linoleic acid and linoleic acid-containing molecular species, especially 16:0-18:2, in plasma PC, irrespective of dietary fat source. Altered plasma PC molecular species composition, as represented by an increase in 16:0-18:2 PC, might contribute to the hypocholesterolemic action of eritadenine.

Exon/intron organization, chromosome localization, alternative splicing, and transcription units of the human apolipoprotein E receptor 2 gene

Apolipoprotein E receptor 2 is a recently identified receptor that resembles low and very low density lipoprotein receptors. Isolation and characterization of genomic clones encoding human apolipoprotein E receptor 2 revealed that the gene spans approximately 60 kilobases and contains 19 exons. The positions of the exon/intron boundaries of the gene are almost identical to those of low and very low density lipoprotein receptors. Fluorescent in situ hybridization of human chromosomes revealed that the gene is located on chromosome 1p34. Isolation of a cDNA encoding a variant receptor and reverse transcription-polymerase chain reaction indicate the presence of multiple variants with different numbers of cysteine-rich repeats in the binding domain of the receptor. We also found a variant receptor lacking a 59-amino acid insertion in the cytoplasmic domain. The transcription start site was mapped to the position 236 base pairs upstream of the AUG translation initiator codon by primer extension analysis. Sequence inspection of the 5'-flanking region revealed potential DNA elements: AP-2, GC factor, PEA3, and Sp1. The minimal promoter region and a region required for nerve growth factor inducibility in PC12 cells were also determined.

[A case of psittacosis with psychiatric symptoms, abnormal EEG, and abnormal SPECT]

A 40-year-old woman was admitted to our hospital with disorientation, delusional idea, and sensory disturbance of lower face after having a fever and cough for 5 days. A chest X-ray examination revealed an infiltration in the left lower lobe field. Psittacosis was diagnosed because the serum antibody titer against chlamydia psittaci was elevated. Electroencephalogram showed right temporal lobe spikes. SPECT showed decreased accumulation of 99mTc-HMPAO in the right frontal and temporal lobe. Computed tomography scan of the brain was normal. This patient was diagnosed as ornithsis Encephalitis.

Sphingosine inhibition of NADPH oxidase activation in a cell-free system

The effects of sphingoid bases, sphingosine and dihydrosphingosine, which are protein kinase C (PKC) inhibitors, on NADPH oxidase were examined in a cell-free system. The bases inhibited cell-free activation of NADPH oxidase by arachidonic acid at lower concentration than N-acetylsphingosine. Thus, positive charge in the molecules may play a critical role in inhibition of the oxidase. Sphingosine did not change the Km value for NADPH, but shifted the optimum concentration of arachidonic acid for activation of the oxidase. Moreover, sphingosine suppressed the translocation of p47-phox, one of the cytosolic components of the oxidase, to the membrane fraction, suggesting that the base inhibits the assembly of the components.

[Polymyositis followed by myasthenia gravis]

A 63-year-old woman was admitted to the hospital because of swelling of both forearms and muscle weakness in the limbs. Laboratory examination revealed abnormally high levels of serum creatine kinase, glutamic-oxaloacetic transaminase, glutamic-pyruvic transaminase, and lactate dehydrogenase. Polymyositis was diagnosed, and prednisolone was administered. Her condition had been well controlled on prednisolone until several months before admission, when bilateral blepharoptosis and diplopia developed. An edrophonium test was positive: muscle weakness was transiently alleviated. High titers of anti-acetylcholine receptor antibodies were found. A chest CT scan showed a mass in the anterior part of the mediastinum. We diagnosed myasthenia gravis associated with thymoma. After an extended thymectomy, the patient's condition improved. When muscle weakness recurs after remission of polymyositis, myasthenia gravis should be considered.

Functional contribution of preoperative portal vein occlusion to hepatectomy. With special reference to hepatic energy charge and DNA synthesis after hepatectomy in rats

OBJECTIVE

To examine possible functional contributions of preoperative portal branch ligation before hepatectomy (PBL-Hx).

DESIGN

Rats were randomly divided into 3 groups. In the PBL-Hx group, the portal branch supplying the left lateral and median lobes of the liver was ligated and the corresponding lobes (48% of the whole liver) were excised 2 days later. In the sham groups (one 68% Hx; the other 47% [hereafter, sham-67% Hx, and sham-47% Hx]), originally ligated lobes and left lateral and caudate lobes, similar to the excised liver volume in the PBL-Hx group, respectively, were excised 2 days after sham operation without PBL.

MAIN OUTCOME MEASURES

Hepatic adenine nucleotides and energy charge, which are essential for vital function of hepatocytes, and liver regeneration were assessed by the DNA synthesis rate and weight before Hx and on days 1, 2, 3, and 7 after Hx.

RESULTS

The remaining liver weight was restored similarly in the PBL-Hx and sham-47% Hx groups and more rapidly than in the sham-68% Hx group. Further enhancement of DNA synthesis did not occur after Hx in the PBL-Hx group, and hepatic energy charge did not decrease. In contrast, hepatic DNA synthesis was significantly activated depending on the excised liver volume in both the sham-Hx groups and was accompanied by corresponding decreases in hepatic energy charge.

CONCLUSION

Preoperative PBL has a functional advantage because the recovery of the remaining liver volume is not impaired and hepatic energy charge is preserved with no further enhancement of DNA synthesis after Hx.

[Analgesic effect of dextromethorphan for postherpetic neuralgia]

We investigated the analgesic effect of dextromethorphan (DM), a non-selective NMDA receptor antagonist, in 25 patients with postherpetic neuralgia (PHN). We administered DM 45mg.day-1 orally for 14 days and then 90mg.day-1 for next 14 days. Decrease in pain intensity and alleviation of allodynia were observed in 9 patients (36%). Side effects with no severe cases occurred in 8 patients (32%) and these were mainly digestive symptoms. We concluded that DM might be useful to treat PHN with allodynia probably due to central sensitization.

[Anesthetic management of a patient with ornithine transcarbamylase deficiency]

A 6-year-old female with disturbance of consciousness (JCS: 3 points) due to hyperammonemia caused by ornithine transcarbamylase deficiency is presented. She underwent an emergency insertion of a catheter for peritoneal dialysis under general anesthesia. Anesthesia was induced by intravenous administration of thiamylal sodium and maintained with inhalation of sevoflurane and oxygen after tracheal intubation. One percent mepivacaine was infiltrated around the surgical field to diminish the dose of sevoflurane. The operation proceeded uneventfully, although her consciousness could not recover rapidly to the normal level during the emergence from anesthesia. Peritoneal dialysis was started immediately after the operation and her consciousness recovered to the normal level gradually during the following six days with decreasing plasma ammonia levels. Ten days later, extirpation of the peritoneal catheter was scheduled. The course of anesthesia and operation was uneventful using the same anesthetic method as with the former anesthesia. In the anesthetic management for a patient with ornithine transcarbamylase deficiency, we have to be careful about the nitrogen balance, which can be affected by the kind and doses of anesthetic drugs, to avoid hyperammonemia. From this point of view, local anesthesia combined with general anesthesia might be useful to prevent the serum ammonia level from increasing.

Human apolipoprotein E receptor 2. A novel lipoprotein receptor of the low density lipoprotein receptor family predominantly expressed in brain

Isolation and characterization of a human cDNA demonstrated a novel lipoprotein receptor designated apolipoprotein E receptor 2 (apoER2). The new receptor consists of five functional domains resembling the low density lipoprotein (LDL) and very low density lipoprotein (VLDL) receptors. LDL receptor deficient Chinese hamster ovary cells expressing human apoER2 bound apoE rich beta-migrating VLDL with high affinity and internalized. LDL was bound with much lower affinity to these cells. The 4.5- and 8.5-kb mRNAs for the receptor were most highly expressed in human brain and placenta. In rabbit tissues, multiple species of the mRNA with 4, 4.5, 5.5, 8.5, and 11 kb were detected most intensely in brain and testis and, to a much lesser extent, in ovary, but were undetectable in other tissues. In rat adrenal pheochromocytoma PC12 cells, the receptor mRNA was induced by treatment of the cells with nerve growth factor. The receptor transcripts were detectable most intensely in the cerebellar cortex, choroid plexus, ependyma, hippocampus, olfactory bulb and, to a much lesser extent, in the cerebral cortex as revealed by in situ hybridization histochemistry. In the cerebellar cortex, the receptor transcripts were densely deposited in Purkinje cell somata.

Involvement of several protein kinases in the phosphorylation of p47-phox

Protein kinases are stimulated during the microbicidal responses of neutrophils. In particular, the activation of protein kinase C causes the phosphorylation of p47-phox, one of the cytosolic components of NADPH oxidase. Phosphorylated p47-phox was accumulated not only by PMA treatment, but also by calyculin A treatment. However, p47-phox phosphorylated by calyculin A treatment lost its ability to activate NADPH oxidase. Several protein kinases were activated by calyculin A treatment. Furthermore the phosphorylation sites of p47-phox by calyculin A treatment were different from those by PMA treatment. These results indicated that calyculin A-activated kinases phosphorylated p47-phox at the site different from that phosphorylate by protein kinase C, resulting in suppression of NADPH oxidase activation.

[Hydrostatic weighing, skinfold thickness, body mass index relationships in high school girls]

A study was conducted to evaluate body composition by hydrostatic weighing, skinfold thickness, and body mass index (BMI) in 102 senior high school girls, aged 15 to 18 in Nagasaki City. Body density measured by the underwater weighing method, was used to determine the fat weight (Fat) and lean body mass (LBM. or fat free weight: FFW) utilizing the formulas by Brozek et al. The results were as follows; 1. Mean values of body density were 1.04428 in the first grade girls, 1.04182 in the second grade, and 1.04185 in the third grade. 2. Mean values of percentage body fat (%Fat) were 23.5% in the first grade, 24.5% in the second and 24.5% in the third. 3. Percentage body fat (%Fat), lean body mass (LBM) and LBM/Height were not significantly with different advance of grade from the first to the third. 4. The correlation coefficients between percent body fat and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses and the sum of seven skinfold thicknesses was 0.78, 0.79, and 0.80 respectively and were all statistically significant (p < 0.001). 5. The correlation coefficients between BMI and the sum of two skinfold thicknesses, the sum of three skinfold thicknesses and the sum of seven skinfold thicknesses was 0.74, 0.74, and 0.74 respectively and were all statistically significant (p < 0.001). 6. Mean values of BMI, Rohrer index and waist-hip ratio (WHR) in all subjects (n = 102) were 20.3, 128.2 and 0.72 respectively.

Biochemical modulation of Doxorubicin using an isoprenoid derivative, N-1379 - plasma transmembrane potential as a target site

A new isoprenoid derivative, N-1379, was evaluated as a modulating agent of doxorubicin (DOX)-induced anticancer efficacy. The level of plasma transmembrane potential, measured using DiOC6(3), correlated with cellular sensitivity to DOX in K562 myelogenous leukemia, SH101 stomach, and PH101 pancreatic cancer cells. Non-toxic N-1379 increased the cellular transmembrane potential and DOX efficacy for three cell lines. The modulation of membrane function was accompanied by increases of DOX accumulation and S/G(2)M phase population in these cells. Overexpression of a 170 kD plasma membrane glycoprotein (GP-170) was not observed in any cells examined. We suggest therefore that interaction between electronegative transmembrane potential and positive charge of DOX may be linked to intracellular DOX accumulation. N-1379 may augment DOX efficacy through its increasing effect on plasma membrane potential independently of GP-170 overexpression.

Respiratory burst and tyrosine phosphorylation by vanadate

We studied involvement of tyrosine-phosphorylated proteins in activation of NADPH oxidase in guinea pig neutrophils. Pervanadate, which is the oxidized form of orthovanadate, induced O2- production and protein tyrosine phosphorylation in neutrophils. O2- production induced by pervanadate was more sensitive to the tyrosine kinase-specific inhibitor, ST-638, as compared with the production induced by PMA. On the other hand, staurosporine more selectively inhibited PMA-induced O2- production than pervanadate-induced production. These results indicate that tyrosine kinase, not protein kinase C, is involved in pervanadate-induced O2- production. The tyrosine-phosphorylated proteins were detected in both the cytosol and membrane fractions prepared from pervanadate-induced neutrophils. In order to examine if tyrosine residues of some components of NADPH oxidase were directly phosphorylated, tyrosine-phosphorylated proteins were removed from solubilized membranes prepared from the pervanadate-stimulated neutrophils by immunoprecipitation with an anti-phosphotyrosine anti-body. NADPH oxidase activity in the solubilized membranes was not decreased by the treatment. These findings suggest that the components of NADPH oxidase are not tyrosine-phosphorylated by pervanadate treatment, that tyrosine phosphorylation may be involved in the signal transduction pathway of NADPH oxidase activation by pervanadate, and that this pathway is independent of the activation by protein kinase C.

Hyperphosphorylated p47-phox lost the ability to activate NADPH oxidase in guinea pig neutrophils

p47-phox is one of the cytosolic activation factors of NADPH oxidase in neutrophils and known to translocate to plasma membranes and function by protein kinase C-phosphorylation. In cytosol fraction, prepared from calyculin A-treated neutrophils, the activity of cytosolic factor to activate NADPH oxidase was more reduced than that from PMA-treated cells. But, p47-phox did not translocate to the membranes, even if p47-phox was hyperphosphorylated in the calyculin A-treated neutrophils. Such hyperphosphorylated p47-phox seemed to lose the activity to constitute NADPH oxidase complex.

[Body density assessment utilizing skinfold thickness and age in Japanese men]

A study was conducted to investigate the validity of skinfold-based prediction equations for body density (g/ml) by Nagamine and Suzuki (1964), and to formulate more convenient and more useful equations for predicting body density from skinfold and age in men. Subjects of the study were 257 healthy men aged 19-60 years in or near Nagasaki City. The regression equation for the dependent variable, body density, was determined by hydrostatic weighing. Independent variables included eight skinfolds, the sum of two skinfolds (triceps, subscapular), the sum of three skinfolds (triceps, subscapular, and abdominal), age, and body surface area. Skinfolds were measured with an Eiken-model skinfold caliper. Age (mean 33.1, range 19-60 yrs.), weight (mean 65.3, range 46.6-107.7 kg), height (mean 168.8, range 152.3-185.4 cm), and body density (mean 1.05874, range 1.00860-1.09020 g/ml) were also recorded. Percent body fat was calculated using the formula by Brozek et al. and ranged from 6.1% to 38.9%. Multiple correlation coefficients (MR) and standard error (SE) of 10 regression equations (A-J) for predicting body density in men were obtained. The best-fitting and the most convenient prediction equation for body density was equation-E.: body density = 1.09556-0.00062 x sum of three skinfolds (mm)-0.00028 x age (MR = 0.815 and SE = 0.0087 g/ml). The equation was cross-validated on a different sample of 45 men. The correlation coefficient between predicted and hydrostatically determined body density was 0.781 (p < 0.001). Equation-E (Tahara's equation) appears to be useful in body density analysis particularly when the subjects are Japanese men, aged 18-50 yrs, with percent body fat 10 to 30%.

DT-diaphorase as a target enzyme for biochemical modulation of mitomycin C

We studied a selective enhancement of the mitomycin C (MMC)-induced antitumor effect focusing on the intracellular metabolism by NAD(P)H:quinone oxidoreductase (DT-diaphorase, DTD). The level of cellular DTD activity related well to the degree of MMC-induced DNA total cross links and cell growth inhibition in human cancer cell lines, KB, PH101, SH101 and K562. A DTD inhibitor, dicoumarol (DIC) or flavin adenine dinucleotide (FAD), inhibited the MMC-induced DNA damage and cytotoxicity at a non-toxic concentration. The DTD-mediated MMC activation was pH-dependent, and highest at pH 6 and lowest at pH 8. Although an inverse relationship appeared to exist between DTD activity and MMC efficacy in human xenografts implanted into nude mice and 9 fresh human tumor specimens, the investigation in 3 culture cells, HEC-46, HCC-48 and HCC-50, established from those xenografts, showed that DTD activated MMC in a pH-dependent manner as well as the other cell lines. Significant tumor pH reduction from 7.1 to 6.7 by continuous glucose infusion also increased the MMC-induced tumor growth inhibition in the human tumor xenografts. Thus, we conclude that bioreductive activation by DTD in a pH-dependent manner may be of key importance in the MMC-induced antitumor effect and that an increased MMC efficacy at a reduced pH caused by hyperglycemia may be applied to clinical use as a new manipulation for a biochemical modulation of MMC.

Ground-Water Radon Anomaly Before the Kobe Earthquake in Japan

Radon concentration in ground water increased for several months before the 1995 southern Hyogo Prefecture (Kobe) earthquake on 17 January 1995. From late October 1994, the beginning of the observation, to the end of December 1994, radon concentration increased about fourfold. On 8 January, 9 days before the earthquake, the radon concentration reached a peak of more than 10 times that at the beginning of the observation, before starting to decrease. These radon changes are likely to be precursory phenomena of the disastrous earthquake.

Preservation of the lower esophageal sphincter during total gastrectomy for gastric cancer to prevent postoperative reflux esophagitis

The lower esophageal sphincter (LES) is usually removed during total gastrectomy to successfully perform a curative operation. In this study, the preservation of the LES in curative total gastrectomy was attempted to reduce the reflux. An experimental study using dogs has revealed that the high-pressure zone of the LES can be preserved by making a resection at the gastroesophageal junction, which thus helps to protect the reflux. A previous clinicopathological study revealed that the LES can be preserved without any fear of recurrence at the resection site, if the tumor is located more than 2.0 cm and 3.0 cm from the gastroesophageal junction to the oral margin in node-negative and -positive cases, respectively. Clinically, 8 patients underwent an LES-preserving total gastrectomy [LES(+) gastrectomy] while 19 had an LES(-) gastrectomy in the same period. Of the five LES(+) cases examined, all showed a high pressure zone, whereas none of the four LES(-) cases examined showed such a high-pressure zone after the operation. Endoscopic examination showed that only one of the seven LES(+) cases but six of nine LES(-) cases revealed esophagitis.

Accumulation of plasma cells in atherosclerotic lesions of Watanabe heritable hyperlipidemic rabbits

By screening a cDNA library constructed from aortic total RNA derived from Watanabe heritable hyperlipidemic (WHHL) rabbits by differential hybridization, we have obtained a cDNA encoding the kappa light chain of immunoglobulin. Northern blot analysis of total RNA prepared from aortas of WHHL and normal rabbits of various ages revealed that this light-chain mRNA accumulates gradually with age in aortas in WHHL rabbits. Northern blotting and in situ hybridization with an antisense oligonucleotide specific to rabbit immunoglobulin gamma heavy-chain mRNA also detected accumulation of this heavy-chain mRNA in advanced lesions of WHHL rabbit aortas. Moreover, immunohistochemical and electron microscopic analyses demonstrated the presence of plasma cells in the atherosclerotic lesions.