Ocular surface abnormalities in aniridia

PURPOSE

The purpose of this study was to examine ocular surface abnormalities in aniridia.

METHODS

We prospectively studied the ocular surface in nine consecutive patients (18 eyes) with virtually total aniridia. Of the 18 eyes, two eyes (two patients) were excluded from the study because severe surgical damage was likely to be the main cause of their corneal abnormalities. Six volunteers whose eye examinations yielded normal results served as control subjects. Detailed slit-lamp biomicroscopic examinations were performed to assess corneal findings and confirm the presence or absence of the palisades of Vogt. Goblet cell density on the peripheral corneal epithelium and inferior conjunctival epithelium was calculated via impression cytology and was statistically compared between aniridic eyes and control eyes.

RESULTS

All 16 aniridic eyes had superficial corneal opacification and vascularization of either the peripheral or entire cornea. Palisades of Vogt were completely absent all around the limbal area. Goblet cell density on the peripheral cornea and inferior conjunctiva showed a statistically significant increase in the aniridic eyes (226 +/- 169 cells/mm2 and 406 +/- 203 cells/mm2), as compared with the control eyes (O cells/mm2 and 181 +/- 89 cells/mm2) (P = .0005 and P = .0102).

CONCLUSIONS

These findings suggest that, in the aniridic eye, conjunctival epithelium invades the cornea because of corneal epithelial stem cell deficiency.

In vitro antimycobacterial activities of pyrazinamide analogs

We synthesized various pyrazine derivatives and pyrazinamide analogs and assayed their antimycobacterial activities in vitro in order to find new drugs which are more active against Mycobacterium tuberculosis than pyrazinamide and also active against Mycobacterium avium and Mycobacterium intracellulare. Of the drugs synthesized, four drugs, namely, pyrazine thiocarboxamide, N-hydroxymethyl pyrazine thiocarboxamide, pyrazinoic acid n-octyl ester, and pyrazinoic acid pivaloyloxymethyl ester, were not only bacteriostatic but also bacteriocidal against these three species of mycobacteria in vitro under conditions in which pyrazinamide showed no or little activity. In conclusion, these four drugs are possible candidates for new antimycobacterial agents, and animal experiments are now under way.

Prospective study of chemoprevention of hepatocellular carcinoma with Sho-saiko-to (TJ-9)

BACKGROUND

Most hepatocellular carcinomas (HCC) arise in patients with cirrhosis, in whom its incidence is high. The prevention of HCC in patients with cirrhosis is important.

METHODS

A prospective, randomized, nonblind controlled study was performed to evaluate the preventive effect of Sho-saiko-to (TJ-9) on HCC development. TJ-9 is a Chinese herbal medicine that contains crude extracts of seven herbs; it has antitumor effects in experimental animals. Two hundred sixty patients with cirrhosis were randomly assigned to two groups, matched for age, sex, presence of hepatitis B surface antigen, and the severity of liver damage. The patients in the trial group were given TJ-9 at a daily oral dose of 7.5 g in addition to the conventional drugs given to the control patients. The patients were prospectively monitored for 60 months and the cumulative incidence of HCC and the survival rate in the two groups were calculated.

RESULTS

The cumulative incidence curve for 5 years of the trial group was lower than that of the control group (P = 0.071). For the patients without HBs antigen, the difference was significant (P = 0.024). The survival curve for 5 years of the trial group was higher than that of the control group (P = 0.053). For the patients without HBs antigen, the difference was significant (P = 0.043).

CONCLUSIONS

TJ-9 helped to prevent the development of HCC in patients with cirrhosis, particularly in patients without HBs antigen.

Failure of genotoxic carcinogens to produce tumors in human skin xenografts transplanted to SCID mice

Chemical carcinogenesis of human skin was investigated using human skin xenografts (16 full thickness and 48 split thickness skin grafts) transplanted to CB-17-scid (SCID) mice. Topical application of a carcinogen, i.e. 7,12-dimethylbenz[a]anthracene (DMBA), benzo[a]pyrene, methylcholanthrene or N-methyl-N'-nitro-N-nitrosoguanidine, to the human skin xenografts once a week for 25-30 weeks failed to produce skin tumors. Both DMBA application plus UV-B irradiation and alternate applications of the above four carcinogens in combination with UV-B irradiation also failed to produce tumors. All of these treatments induced skin papillomas in skins of host SCID mice. DMBA induced skin papillomas in allogenic CD-1 mouse skin grafts transplanted to SCID mice. These results indicate that susceptibility of human skin to these carcinogenic stimuli is much lower than that of mouse skin.

Observation of enhanced backscattering from a plane mirror viewed through polymer-film-dispersed liquid crystals

We report experimental results on enhanced backscattering from a plane mirror that is viewed through polymer-film-dispersed nematic liquid crystals. The distribution of the averaged intensity of the light reflected from the mirror placed behind the polymer film is investigated with an image-processing system when a Gaussian beam wave is incident. The enhanced light peak is observed in an incident beam direction, the result of which is predicted by a theory based on the circular Gaussian statistic random-phase-screen model. We pay attention to the enhancement dependence on parameters such as the distance between the polymer film and the flat mirror. The observed result is similar to a previous study by Jakeman et al. in which a random diffusive glass plate was used as a random-phase screen [J. Phys. D 21, 32 (1988)].

Saiboku-To, a herbal extract mixture, selectively inhibits 5-lipoxygenase activity in leukotriene synthesis in rat basophilic leukemia-1 cells

Saiboku-To, a mixture of extracts from 10 medicinal herbs, has been used for the treatment of bronchial asthma in Japan. Inhibitory action of this drug on arachidonate 5-lipoxygenase (5-LO) metabolism in rat basophilic leukemia cells (RBL-1 cells) was examined. Saiboku-To significantly inhibited calcium ionophore-stimulated synthesis of cysteinyl leukotrienes (cLTs) and leukotriene B4 (LTB4). Inhibition appeared 10 min after addition of the substance and reached a maximal value after 3 h. Saiboku-To did not inhibit the release of [3H]arachidonic acid (AA) from cell membrane by calcium ionophore stimulation, or the production of cLTs and LTB4 when LTA4-free acid was used as the substrate. However, it significantly inhibited the production of cLTs and LTB4 when free AA was used as the substrate. The production of thromboxane A2 (TXA2). a cyclooxygenase metabolite, was not inhibited when AA was used as the substrate in cell free study. These results indicate that Saiboku-To selectively inhibits 5-LO activity in the metabolic pathway of AA.

Six cases of microscopic polyarteritis exhibiting acute interstitial pneumonia

Out of 21 autopsy cases of microscopic polyarteritis (MPA), six cases that died of acute respiratory failure are described. All of these six cases exhibited pauci-immune necrotizing glomerulonephritis. Of these six cases, systemic vasculitis and respiratory failure occurred almost simultaneously in two, whereas respiratory failure developed when vasculitis recurred in the other four. Pathologically, pulmonary changes were diffuse and almost uniform in each case. Interstitial inflammatory cells (alveolitis), hyaline membrane, restructuring, and fibrosis were observed. The degrees of these changes differed from case to case; four cases showed predominantly exudative changes and two cases exhibited proliferative or organizing ones. Clinical and pathological features were consistent with acute interstitial pneumonia (AIP). Immunofluorescent and ultrastructural studies did not suggest deposition of immune complexes at the lesions of alveolitis. An etiologic agent could not be identified in these cases. Some lung lesions including pulmonary hemorrhage have been described in association with MPA; however, cases such as those presented here have rarely been reported. It was considered that AIP could be one of the pulmonary disorders in MPA. Furthermore, the possible pathogenetic role of antineutrophil cytoplasmic antibodies (ANCA) in the evolution of present lung lesion is discussed. Although ANCA were not examined in the present cases, these antibodies should be investigated in future cases.

Evaluation of DNA probes for specific detection of Vibrio cholerae O139 Bengal

Two DNA probes, 2R1 and 2R3, prepared from a region in the chromosome specific for the lipopolysaccharide O side chains of Vibrio cholerae O139 (M.K. Waldor and J.J. Mekalanos, Lancet 343:1366, 1994) were examined for their specificity and sensitivity. Both probes did not hybridize with any strain of V. cholerae belonging to serogroups other than O139 and to any of the other species examined belonging to the family Vibrionaceae. Among the 126 strains of V. cholerae O139 examined, probe 2R1 hybridized with 125 strains while probe 2R3 hybridized with all 126 strains. Both probes were found to be highly specific and sensitive and can be used for the specific identification of V. cholerae O139.

Spontaneous spinal subarachnoid hematoma--case report

BACKGROUND

Spinal subarachnoid hemorrhage is unusual, and rarely results in spinal subarachnoid hematoma because the cerebrospinal fluid tends to dilute the blood and prevent the formation of clots. We describe a patient with spinal subarachnoid hematoma of unusual spontaneous origin.

CASE

A 66-year-old female presented with sudden onset of intense back pain with paraplegia. Magnetic resonance imaging demonstrated a mass lesion between T2 and T6, compressing the spinal cord anteriorly. Emergency osteoplastic laminotomy exposed a hematoma in the subarachnoid space from T2 to T6, but no source of the hemorrhage was found. The patient was able to walk by herself about 20 days after the operation.

CONCLUSION

The outcome is significantly influenced by the duration between onset and operation, preoperative neurologic status, and rapidity of symptom progression. Therefore, we emphasize the importance of early diagnosis, and rapid and complete operative removal of spinal subarachnoid hematoma in order to achieve the best outcome.

Control of thymus-independent intestinal intraepithelial lymphocytes by beta 2-microglobulin

Murine intestinal intraepithelial lymphocytes (i-IEL) comprise thymus-dependent cells such as T cell receptor (TcR) alpha/beta CD8 alpha/beta+ i-IEL, as well as thymus-independent ones such as TcR alpha/beta CD8 alpha/alpha+ and TcR gamma/delta CD8 alpha/alpha+ i-IEL. Whilst the development of the CD8 alpha/beta expressing i-IEL is strictly contingent on major histocompatibility complex (MHC) class I surface expression, that of CD8 alpha/alpha i-IEL appears largely MHC class I independent. We have used beta 2-microglobulin (beta 2m)-/- mutant mice lacking surface-expressed MHC class I and TcR alpha/beta CD8 alpha/beta+ i-IEL to analyze the potential impact of MHC class I on regional activation of thymus-independent i-IEL. To analyze the role of TcR gamma/delta i-IEL in regional cell interactions, these mice were treated with the anti-TcR gamma/delta mAb, GL3. Whilst numbers of TcR alpha/beta CD8 alpha/alpha i-IEL were markedly reduced in beta 2m-/- mice, those of TcR gamma/delta i-IEL were elevated. Administration of GL3 in vivo caused TcR down-modulation and functional inactivation of TcR gamma/delta i-IEL in beta 2m+/- mice. In contrast, TcR expression and functional activities of TcR gamma/delta i-IEL from beta 2m-/- mice were not impaired by GL3 treatment. The TcR alpha/beta CD8 beta- i-IEL from beta 2m-/- mice were expanded and functionally activated as a consequence of TcR gamma/delta engagement. The TcR gamma/delta i-IEL and TcR alpha/beta CD8 alpha/alpha+ i-IEL from athymic nu/nu mice which express MHC class I, but lack TcR alpha/beta CD8 alpha/beta+ i-IEL, responded to TcR gamma/delta engagement as those from the beta 2m+/- controls. In addition, the TcR gamma/delta i-IEL from TcR beta-/- and TCR beta+/- mutants were equally affected by GL3. We conclude that the absence of beta 2m renders TcR gamma/delta i-IEL resistant to TcR-mediated inactivation and promotes activation of TcR alpha/beta CD8 beta- i-IEL. The activation of TcR gamma/delta i-IEL seems to be directly controlled by beta 2m/MHC class I expression and independent from TcR alpha/beta CD8 beta+ i-IEL. Regulation of self-reactive thymus-independent i-IEL through beta 2m/ MHC class I may contribute to control of autoreactive immune responses in the intestine.

Structure-activity relationship study of TXA2 receptor antagonists. 4-[2-(4-substituted phenylsulfonylamino)ethylthio]phenoxyacetic acids and related compounds

We have recently reported that 4-[2-(4-substituted phenylsulfonylamino) ethylthio]phenoxyacetic acids and related compounds showed potent thromboxane A2 (TXA2) receptor antagonist activity. To understand how substituents affect the biological activity, the quantitative structure-activity relationship (QSAR) was analyzed by using the Hansch-Fujita method for 36 compounds, including newly synthesized compounds. The positive coefficient for pi R and FR in the results of the QSAR study suggested that a hydrophobic an sigma electron-withdrawing substituent R at the para-position of the phenylsulfonyl moiety is required to improve the activity. Further, a substituent R which is long and moderately wide, was suggested to be preferable for the activity. The positive coefficients for pi X,Y,W-COOH and sigma Q(1)-(6) may indicate that the introduction of a hydrophobic and electron-withdrawing group on the benzene ring of the phenoxy acetic acid moiety enhances the activity. The length of the W-COOH moiety may also be important. On the other hand, the effect of the presence of methylene (n = 1) was not clear.

Intercostal nerve transfer to restore upper extremity functions after brachial plexus injury

We report the efficacy of intercostal nerve transfer to restore elbow flexion, shoulder functions, and hand functions. One hundred and twelve patients with loss of elbow flexion were treated with intercostal nerve transfer to the musculocutaneous nerve and 97 (87%) of them regained grade 3 or 4 elbow flexion. Seven patients with loss of shoulder functions were treated with combined intercostal nerve transfer to the axillary nerve and phrenic nerve transfer to the suprascapular nerve, and 4 (57%) of them regained more than 80 degrees abduction and 5 (71%) regained more than 50 degrees external rotation starting with the forearm against the chest. To restore hand functions, intercostal nerves were sutured to the radial nerve or one of its branches in 40 patients and to the median nerve in 10 patients. Motor recovery was poor in both nerve transfers, but protective sensation was regained in the fingers innervated by the median nerve in 9 (90%) of the 10 patients. We conclude that intercostal nerve transfer after brachial plexus injury was a useful procedure to restore elbow flexion and shoulder functions, and for restoring a protective sensation in the fingers.

Enzyme-linked immunosorbent assay of pro-gastrin-releasing peptide for small cell lung cancer patients in comparison with neuron-specific enolase measurement

Our previous study demonstrated that pro-gastrin-releasing peptide(31-98), or ProGRP, is a specific tumor marker in patients with small cell lung carcinoma (SCLC). Using a newly developed, highly sensitive enzyme-linked immunosorbent assay (ELISA) for ProGRP, we analyzed 1,446 samples including those obtained from 478 lung cancer patients to evaluate the clinical usefulness of this ELISA. Several properties indicated that ProGRP is a useful tumor marker for SCLC. First, ProGRP was specifically elevated in SCLC patients. In non-SCLC patients and patients with non-tumorous lung diseases, its serum level was very rarely elevated. Secondly, ProGRP was a reliable marker, in terms of the marked elevation of serum ProGRP levels in SCLC patients. Thirdly, serum ProGRP levels were elevated in SCLC patients even at a relatively early stage of this disease. Fourthly, changes in the serum ProGRP level showed an excellent correlation with the therapeutic responses in SCLC patients. Neuron-specific enolase (NSE) is accepted as a tumor marker of SCLC patients. With the aim of comparing ProGRP and NSE as tumor markers for SCLC patients, we measured serum NSE levels in all samples collected in the present study. We found that ProGRP was superior to NSE in terms of sensitivity, specificity and reliability. Therefore, we consider that ProGRP can play a major role as a clinical tumor marker for SCLC patients.

Epitheloid granuloma formation in type C chronic hepatitis: report of two cases

Two cases of type C chronic hepatitis with the presence of epitheloid granulomas were reported. Case 1 was a 44-year-old man who presented with a moderate increase in serum ALT and positive anti-HCV. Histological examination of percutaneous liver biopsy specimens showed dense portal inflammation with piecemeal necrosis. Lobular inflammation was present mederately and a large well-organized epitheloid granuloma was found within a liver lobule. Case 2 was a 55-year-old woman, who was presented because of a slight increase in serum ALT and positive anti-HCV. Histologically, liver biopsy specimens showed lymphoid aggregates in the portal area and slight piecemeal necrosis. Moderate steatosis were noted and an epitheloid granuloma was present in the hepatic lobule. Acid-fast stains were negative for both cases and serum ACE and lysozyme were within normal range. These granulomas were composed of epitheloid cells surrounded by lymphocytes. They were not present within the portal tracts, but were found in the hepatic lobule. The incidence of the appearance of epitheloid granuloma in liver biopsy specimens of type C chronic hepatitis was 2 out of 273 cases (0.73%). The role of HCV infection in the genesis of epitheloid granulomatosis is of much interest and should be investigated.

The presence of phorbol ester responsive and non-responsive forms of the zeta isozyme of protein kinase C in mouse epidermal cells

The possible involvement of zeta isozyme of protein kinase C (PKC zeta) in phorbol ester-induced signal transduction was investigated in mouse epidermal cells. Western blot analysis of RESOURCE Q column chromatography eluates obtained from 105,000 g supernatants and particulate fractions of epidermal cells was performed using anti-PKC zeta specific antibody. Anti-PKC zeta antibody recognised proteins in low salt range corresponding to 25-125 mM NaCl (low salt-eluted PKC zeta; 1-PKC zeta) as well as high salt range corresponding to 175-300 mM NaCl (high salt-eluted PKC zeta; h-PKC zeta) in both subcellular fractions. 1-PKC zeta and h-PKC zeta were detected as a doublet protein of 79,000 and 85,000 M(r) in 105,000 g supernatants, but as a 79,000 M(r) protein in particulate fractions. Immunoprecipitated 1-PKC zeta and h-PKC zeta with anti-PKC zeta specific antibody possessed phosphatidylserine (PS)-dependent protein kinase activity, but neither 1-PKC zeta nor h-PKC zeta were further activated by 40 nM phorbol 12-myristate 13-acetate (PMA) in the presence of PS. Furthermore, 1-PKC zeta and h-PKC zeta can be autophosphorylated, indicating that both 1-PKC zeta and h-PKC zeta are PKC zeta. Treatment of intact epidermal cells with PMA or other PKC activators caused the apparent shift of 79,000 M(r) 1-PKC zeta to the 85,000 M(r) from in particulate fractions. Prolonged treatment of the cells with PMA induced the downregulation of both forms of 1-PKC zeta in particulate fractions. Under the same condition, 1-PKC zeta in 105,000 g supernatants and h-PKC zeta in both fractions did not respond to PMA. This apparent shift was reversible and the content ratio of 85,000 to 75,000 M(r) 1-PKC zeta was decreased by acid phosphatase treatment, indicating that the apparent shift results at least in part from phosphorylation of 79,000 M(r) 1-PKC zeta. Total activity of 1-PKC zeta was increased in association with the apparent shift from the 79,000 to 85,000 M(r) form in response to PMA treatment of intact epidermal cells. All of these results indicate that PKC zeta is present as multiple forms in mouse epidermal cells, and that especially 1-PKC zeta in particulate fractions play a significant role(s) in PMA-induced signal transduction in mouse epidermal cells.

Successful utilization of a video-assisted thoracic approach to repair Morgagni's hernia: report of a case

We describe herein the successful utilization of a video-assisted thoracic surgical approach to repair Morgagni's hernia. The patient was a 62-year-old woman in whom a routine chest X-ray had revealed an asymptomatic mass, which was presumed to be a pericardial lipoma or Morgagni's hernia. The video-assisted thoracic surgical approach was combined with a right submammary minithoracotomy to successfully repair the hernia without performing a laparotomy. The patient's postoperative course was uneventful and she was discharged 14 days after surgery. Thus, we believe that video-assisted thoracic surgery may be a useful and effective method for repairing Morgagni's hernia.

Characterization of arachidonate 12-lipoxygenase found in the liver of mongrel dog and its immunohistochemical localization in neutrophils

The cytosol fraction of non-parenchymal cells isolated from the liver of adult mongrel dogs converted arachidonic acid to 12S-hydroxy-5,8,10,14-eicosatetraenoic acid. The arachidonate 12-lipoxygenase enzyme reacted with linoleic and alpha- and gamma-linolenic acids as well as arachidonic acid. The enzyme was immunoprecipitable with an antibody against the leukocyte 12-lipoxygenase, but not with an antibody against the platelet 12-lipoxygenase. By immunohistochemical observation with anti-leukocyte 12-lipoxygenase antiserum, hepatocytes, Kupffer cells and sinusoidal endothelial cells were not immunostained, but a large number of neutrophils located in sinusoidal cavities were positively stained. The 12-lipoxygenase activity thus detected may be attributed predominantly to the neutrophils appearing in sinusoidal cavities rather than the non-parenchymal cells in the liver of mongrel dog upon infection. In agreement with this finding there was essentially no neutrophil accumulation in the liver of Beagle dog which had no bacterial and parasitic infection.

Minimal deviation adenocarcinoma of endometrioid type may arise in the isthmus: clinicopathological and immunohistochemical study of two cases

Clinicopathological and immunohistochemical features of minimal deviation adenocarcinoma (MDA) of endometrioid type which may have arisen in the isthmus are presented. Hysterectomy specimens from two women, one 39 years of age and the other 64 years of age, showed the presence of endometrioid-type adenocarcinoma with minimal atypia and without back-to-back arrangement of the glands, which was consistent with a histological diagnosis of endometrioid MDA. However, the tumorous glands were most abundant in the isthmus, and extensively infiltrated into the cervical stroma, vagina, parametrium, and corpus in one case, and the tumor was confined to the isthmus in the other. Immunohistochemically, the tumorous glands were CEA-positive and vimentin-negative in both cases. p53 protein expression was found in one case. Histogenetic origin of MDA of endometrioid type is discussed.

Anatomy of the sinus node, AV node, and His bundle of the heart of the sperm whale (Physeter macrocephalus), with a note on the absence of an os cordis

BACKGROUND

Atrioventricular (AV) conduction time in large whales is only slightly greater than in smaller mammals even though their hearts are enormously larger. Little is known of the detailed histology or cytology of the conduction system of large whales. Such knowledge could be useful in defining the nature of cardiac rhythm and conduction of the whale as well as smaller mammals including humans.

METHODS

We studied hearts from seven sperm whales. After fixation in formaldehyde and later dissection, specimens were prepared for histological examination.

RESULTS

Cell size, histological organization, and innervation of the sperm whale's sinus node, AV node, and His bundle are similar to most mammalian hearts, except the sinus node is substantially larger. There is no central fibrous body between the atrial and ventricular septa, and the whale has no os cordis. Only the upper quarter of the interventricular septum is fully formed; below that there is only a thin layer of fatty connective tissue between the two ventricles.

CONCLUSIONS

Given our morphological findings, we believe that the whale's comparatively short AV conduction time may be best explained by the sinus node and AV node functioning as coupled relaxation oscillators. Absence of an os cordis or central fibrous body or strong attachment between the two ventricles may pose both electrophysiological and hemodynamic hazards when the whale is no longer in its normally buoyant aquatic environment.

m-calpain in rat growth plate chondrocyte cultures: its involvement in the matrix mineralization process

m-Calpain, a Ca(2+)-dependent neutral cysteine proteinase (EC 3.4.22.17), has been demonstrated to be present in the lower hypertrophic zone of the rat growth plate. Using the pelleted culture system as an in vitro model of rat epiphyseal chondrocyte differentiation, we studied m-calpain contents and activities in pelleted cultures during chondrocyte differentiation and the role of m-calpain in the mineralization process. m-Calpain was demonstrated immunohistochemically in epiphyseal chondrocytes, and immunoreactive m-calpain content in cells increased with terminal differentiation into hypertrophic cells. Immunoblotting also showed the association of the increase in m-calpain in cell pellets and in cell culture medium with development of the culture. Ca(2+)-dependent caseinolytic activities of m-calpain extracted from cell pellets and from the medium increased with chondrocyte differentiation, coincident with the increase in enzyme content. The inhibition of m-calpain by the addition of calpastatin, a specific inhibitor of calpain, caused suppression of matrix mineralization in pelleted cultures; the addition of E-64c, a specific inhibitor of cysteine proteinases, during the mineralization stage also caused a significant inhibition of the matrix mineralization. The addition of E-64c resulted in altered composition of proteoglycan monomers and aggregates in cell pellets and in suppression of mineral growth. These findings support an important role of cysteine proteinases, especially m-calpain, in the regulation of the cartilage mineralization process through proteoglycan degradation.