Stimulation of saphenous afferent nerve produces vasodilatation of the vasa nervorum via an axon reflex-like mechanism in the sciatic nerve of anesthetized rats

The present study was intended to examine the physiological relevance of peptidergic afferent vasodilative fibers in the regulation of blood flow in the vasa nervorum, with special reference to the axon reflex. The response of nerve blood flow (NBF) in the sciatic nerve to electrical stimulation of saphenous nerve afferents was examined using laser Doppler flowmetry in anesthetized rats whose lumbosacral afferents and efferents had been disconnected from the spinal cord. Repetitive electrical stimulation of unmyelinated fibers in the central cut end of the saphenous nerve produced an increase in NBF in the sciatic nerve ipsilateral to the stimulation, independent of changes in mean arterial blood pressure. This increase was abolished by topical application of a calcitonin gene-related peptide (CGRP) receptor antagonist, hCGRP (8-37). In conclusion, NBF in the sciatic nerve is regulated via an axon reflex-like mechanism by unmyelinated afferent CGRP containing vasodilators with collaterals in the saphenous nerve.

Expression of CD10/neutral endopeptidase in normal and malignant tissues of the human stomach and colon

The expression of common acute lymphoblastic leukemia antigen (CALLA; CD10), which is identical to neutral endopeptidase (NEP, EC3.424.11), was examined in the malignant and adjacent noninvaded tissues of the human stomach and colon (n = 27). All of 27 normal and 18 well or moderately differentiated adenocarcioma tissue specimens were positive for monoclonal antibody (mAb) NL-1 against CD10/NEP, whereas the expression level was clearly decreased in all of 9 specimens of poorly differentiated adenocarcinoma. In addition, all of 7 gastric or colorectal carcinoma cell lines tested showed decreased expression of CD10/NEP. Sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot analysis of the crude antigen J5 from the normal colon tissue lysate by mAb J5 detected a single band of approximately 100 kDa that was consistent with that of NALM-6 cells used as a positive control. These findings suggest that CD10/NEP is expressed in normal epithelial cells of the human stomach and colon, whereas the expression level is decreased in the poorly differentiated type of adenocarcinoma.

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.

[Two operated cases of synchronous double cancer of the lung and digestive tract in patients over 80 years old and genetical diagnosis]

Synchronous double cancer of the lung and gastrointestinal organ was successfully resected by an one-step approach in two aged patients over 80 years. An 81-year-old man was clinically diagnosed as having a right lung cancer (S3) along with a sigmoid colon cancer. The pathological cell types of these cancers were squamous cell carcinoma and adenocarcinoma respectively. Right upper lobectomy and sigmoidectomy were performed at the same time because he had no risks for the operation. An-80-year-old woman was diagnosed as having a left lung cancer (S8-9) along with a stomach cancer. The cell types of these cancers were both highly differentiated adenocarcinoma. Left lower lobectomy and subtotal gastrectomy were performed at the same time, too. We limited lymph nodes dissection to shorten the operation time and no postoperative complications occurred in both patients. It is suggested that simultaneous operation for double cancer in aged patients can be safely performed in selected cases. In the latter patient, pathological cell type of the lung cancer was similar to that of stomach cancer. So we applied polymerase chain reaction (PCR) for making a diagnosis of double cancer postoperatively, and it was proved that the lung and gastric cancers were different from each other in genetical natures. Application of the genetical technique to clinical field which greatly contribute to making a diagnosis of double cancer is expected.

A case of lymphocutaneous nocardiosis with a review of lymphocutaneous nocardiosis reported in Japan

An 82-year-old Japanese male developed nodules and ulcers along the lymphatics after a fall in the garden of his house resulting in injuries to the dorsum of his left hand which lasted for 3 months. Nocardia brasiliensis was isolated from a nodule, supporting a diagnosis of the lymphocutaneous type of nocardiosis. He had previously developed generalized bone metastasis from prostatic cancer, and his resulting depressed immunity might have played a part in the nocardiosis genesis. Sixteen cases of the lymphocutaneous type of nocardiosis reported in Japan were reviewed.

Timing of cancer chemotherapy based on circadian variations in tumor tissue blood flow

Blood flows of normal tissues (subcutis, liver, kidney cortex, bone marrow) and tumor tissues (SLC) were measured during a daytime period (3-9 HALO) and a nighttime period (15-21 HALO) by the hydrogen clearance technique. Rats were subjected to an artificial light-dark cycle with light from 7 A.M. to 7 P.M. In all normal tissues, there were no significant differences between average tissue blood flows in 2 different time zones, while tumor tissue blood flow increased significantly in the nighttime. Based on this functional characteristic of tumor microcirculation, anti-tumor effects were compared between a group in which ADM was administered at 4 HALO and a group in which it was administered at 16 HALO. The therapeutic effect of ADM on rats administered at 16 HALO was significantly greater, particularly in large tumors, than that on rats administered at 4 HALO. The main reason for this therapeutic improvement may be due to the selective increase in delivery of anti-cancer drugs to tumor tissues brought about by a circadian increase in tumor tissue blood flow.

Elevated circulating levels of tumor necrosis factor in patients with mitral valve disease and ventricular septum defect

Elevated levels of circulating tumor necrosis factor (TNF)-alpha have been reported in patients with decreased left ventricular ejection fraction. Also, TNF has been reported to depress myocardial contractility. In our previous study, no correlation was found between the plasma level of TNF and clinical parameters in patients with cardiomyopathy. In the present study, we detected elevated levels of circulating TNF-alpha in 5 out of 15 patients with mitral valve disease and in 1 patient with ventricular septal defect whose left ventricular ejection fraction was within the normal range. The levels of TNF-alpha were not correlated with any hemodynamic parameters. Further studies are necessary to clarify the mechanisms of the regulation and effects of TNF-alpha in patients with chronic heart failure.

Effects of octopine on the serum cholesterol level in rats

The effects of dietary octopine, which is one of the major extractive component of marine molluscs, on the level of serum and liver cholesterol of rats fed with cholesterol-enriched or cholesterol-free diets were investigated. Dietary supplementation with 1.5% octopine in a cholesterol-enriched diet significantly decreased the serum total- and VLDL+LDL-cholesterol levels and by contrary increased the serum HDL-cholesterol level in rats. The same tendency was observed in the rats fed with 1.5% octopine in a cholesterol-free diet.

Use of ultrasound-guided percutaneous needle biopsy in the diagnosis of mediastinal tumors

We herein report the usefulness of ultrasound-guided percutaneous needle biopsy for histological diagnosis in 18 patients with mediastinal tumors. Computed tomography revealed these tumors to be in contact with the chest wall. The preoperative diagnosis was thymoma in 7 patients, germinoma in 5, neurogenic tumor in 3, and "other" in 3. The most commonly encountered indication for an ultrasound-guided percutaneous needle biopsy was an anterior mediastinal lesion (78%; 14 of 18 patients). In 16 (89%) of the 18 patients, the biopsy diagnosis corresponded to the postoperative diagnosis. No complications were encountered in any of the patients. This new technique of ultrasound-guided percutaneous needle biopsy is both relatively simple and highly accurate and may thus be useful for outpatients. Preoperative ultrasound-guided percutaneous needle biopsy is thus considered to be a safe and reliable method for the histological diagnosis of mediastinal tumors, and a good alternative to traditional biopsy techniques such as mediastinoscopy or thoracotomy.

A variety of clinical applicabilities of immobilized dextran sulphate as lipoprotein adsorbent and avoidance of anaphylactoid (anion-blood contact) reaction in its use

Dyslipidemia including hyper-LDL(low density lipoprotein) cholesterol which is very often refractory to dietary/medical treatments is known to be a risk factor of many arteriosclerotic lesions. An extracorporeal procedure of plasma adsorption, LDL adsorption, utilizing dextran sulphate as a ligand immobilized on cellulose gel beads has been clinically applied in a variety of dyslipidemic conditions as listed below. Its usefulness in secure reduction of the serum LDL level and consequent symptomatic improvements has been confirmed. Familial hypercholesterolemia(FH): A regular repetition of the LDL adsorption ameliorates hyper-LDL cholesterolemia as resulting in regression of the multiple stenoses in the coronary arteries. Focal glomerulosclerosis(FGS): A seesion of the LDL adsorption improves kidney function and reduces a urinary protein excretion in FGS patients with dyslipidemia. Arteriosclerosis obliterans(ASO): More than 60 ASO patients with dyslipidemia have been treated by the LDL adsorption in our center. In over 80% of the patients, marked improvement in clinical symptoms such as leg pain/intermittent claudication has been brought out. Hemodialysis-relevant dyslipidemia(HDDL): HDDL which develops in the long-term HD patients has been treated. Transplantation-relevant dyslipidemia(TXDL): TXDL with deterioration of the transplanted kideny function has been treated by the LDL adsorption. Kidney function improves. Anaphylactoid reaction which is tentatively explained as a result of release of bradykinin in contact of blood with polyanionic material of the adsorbent, dextran sulphate, develops, in particular, while an angiotensin-converting enzyme inhibitor is administered as a depressant. However, it can be avoided in a use of nafmostat mesilate, a protease inhibitor, as an anticoagulant.

Reduced reticulization of palatine tonsils with IgA nephropathy

Tonsillar abnormalities have been observed in patients with IgA nephropathy (IgAN). In addition, it has been suggested that the reticulization of tonsillar crypt epithelium is important in tonsillar immunity. Therefore, we investigated reticulization of this area in patients with IgAN (10 cases) and compared results with those of control patients who exhibited recurrent tonsillitis or tonsillar hypertrophy (12 cases). Immunohistochemical staining of anti-keratin antibody PKK1 was employed to visualize reticulization. Tonsils of controls showed well developed reticular crypt epithelia with lymphoepithelial symbiosis, and the non-reticulated area was less than 7% (mean 1.9%, range 0-6.3%) of the total crypt epithelia per overall section. In IgAN tonsils, however, non-reticulated crypt epithelium was frequently observed and, in the advanced stage of IgAN, exceeded 50% (mean 62%, range 50-69%) of total crypt epithelia. The extent of glomerular damage in IgAN patients correlated significantly with the percentage of the area of non-reticulated crypt epithelia in palatine tonsils with a correlation coefficient of 0.91. Considering together with our finding that PKK1-positive epithelial reticular cells strongly expressed HLA-DR antigens in normal tonsils, the low level of reticulization in IgAN patients may induce the unusual immunity responsible for the pathogenesis of IgAN.

[Epidemiology of pertussis and studies on culture positive pertussis cases in Japan]

The number of pertussis patients has decreased steadily in the late 1960s and was extremely small in early 1970s. During 1973-74 the first national survey on pertussis cases confirmed by culture was conducted, when whole cell pertussis vaccine was used. The study revealed that 33.3% of culture positive cases had 2-4 doses of DT combined with whole cell pertussis vaccine. Acellular pertussis vaccine was introduced in 1981 and for the last several years the number of pertussis patients became low for the second time. During 1988-92 exactly the same study was conducted as the previous one. Among 2501 pertussis cases diagnosed clinically 403 were culture positive. Most of the patients were below 1 year of age. Most of the patients were below 1 year of age. Clinical symptoms of those infants were more serious than those of older children. Only 7 out of 403 (1.8%) had a history of 2-4 doses of DT combined with acellular pertussis vaccine. This proved that the acellular pertussis vaccine is by far more effective than the whole cell pertussis vaccine. Serotypes of 377 Bordetella pertussis were identified and 370/377 (98.1%) were serotype 1-3 group.

MRI artifact cancellation due to rigid motion in the imaging plane

A post-processing technique has been developed to suppress the magnetic resonance imaging (MRI) artifact arising from object planar rigid motion. In two-dimensional Fourier transform (2-DFT) MRI, rotational and translational motions of the target during magnetic resonance magnetic resonance (MR) scan respectively impose nonuniform sampling and a phase error an the collected MRI signal. The artifact correction method introduced considers the following three conditions: (1) for planar rigid motion with known parameters, a reconstruction algorithm based on bilinear interpolation and the super-position method is employed to remove the MRI artifact, (2) for planar rigid motion with known rotation angle and unknown translational motion (including an unknown rotation center), first, a super-position bilinear interpolation algorithm is used to eliminate artifact due to rotation about the center of the imaging plane, following which a phase correction algorithm is applied to reduce the remaining phase error of the MRI signal, and (3) to estimate unknown parameters of a rigid motion, a minimum energy method is proposed which utilizes the fact that planar rigid motion increases the measured energy of an ideal MR image outside the boundary of the imaging object; by using this property all unknown parameters of a typical rigid motion are accurately estimated in the presence of noise. To confirm the feasibility of employing the proposed method in a clinical setting, the technique was used to reduce unknown rigid motion artifact arising from the head movements of two volunteers.

IgA nephropathy with poorly developed lymphoepithelial symbiosis of the palatine tonsils

Tonsillar abnormalities have been observed in patients with IgA nephropathy (IgAN). In addition, it has been suggested that reticulization of tonsillar crypt epithelium is important in tonsillar immunity. Therefore, we investigated reticulization of this area in patients with IgAN (14 cases) and compared results with those of control patients who exhibited recurrent tonsillitis or tonsillar hypertrophy (12 cases). Immunohistochemical staining of antikeratin antibody PKK1 was employed to visualize reticulization. Tonsils of controls showed well developed reticular crypt epithelia with lymphoepithelial symbiosis and the nonreticulated area was less than 7% of the total crypt epithelia per overall section. In IgAN tonsils, however, nonreticulated crypt epithelium was frequently observed and, in the advanced stage of IgAN, exceeded 50% of total crypt epithelia. The extent of glomerular damage in IgAN patients correlated significantly with the percentage of the area of nonreticulated crypt in palatine tonsils with a correlation coefficient of 0.91. Considered together with our finding that PKK1-positive epithelial reticular cells strongly expressed HLA-DR antigens in normal tonsils, the low level of reticulization in IgAN patients may induce the unusual immunity responsible for the pathogenesis of IgAN.

The nitric oxide synthase inhibitor L-NAME reduces inhibitory components of somato-vesical parasympathetic reflexes in the rat

Reflex discharges of pelvic postganglionic parasympathetic efferent fibers on the bladder surface induced by afferent volleys in the hindlimb nerve have been recorded in anesthetized rats, and the effects of the nitric oxide synthase inhibitor, N omega-nitro-L-arginine methyl ester (L-NAME) on the reflex discharges have been investigated. Single electrical stimulation of the tibial nerve at intensities supramaximal for excitation of A- and C-afferents evoked a reflex discharge in the postganglionic parasympathetic efferents with four distinct components, i.e., two inhibitory components with latencies of 49 and 203 ms, respectively, and two excitatory components with latencies of 126 and 308 ms, respectively. These reflexes could be observed when the bladder was expanded, but not markedly when the bladder was empty. Intravenous administration of L-NAME resulted in (a) a reduction in the level of resting discharge, (b) a reduction in the size of the first inhibitory component, (c) the disappearance of the second inhibitory component and (d) the exaggeration of the late excitatory component. Intracisternal injection of L-NAME caused changes similar to those observed following intravenous injection. The results suggest that inhibitory components of the somato-pelvic parasympathetic reflex are mediated by pathways that utilize nitric oxide as a neurotransmitter or neuromodulator at the level of the brainstem.

Clinical significance of DNA ploidy pattern in stage III gastric cancer

Nuclear DNA contents from stage III gastric cancers of 216 patients undergoing curative resection from 1972 to 1987 were measured by flow cytometry using paraffin-embedded materials. To determine the clinical significance of the DNA ploidy pattern, the correlation between it and conventional clinicopathologic findings was studied and a prognostic factor for gastric cancer was investigated by both univariate and multivariate analysis. Survivals were compared for diploidy and aneuploidy patterns in subclasses of stage III gastric cancer as well. The grade of each clinicopathologic factor showed no differences between diploidy and aneuploidy patients. The multivariate analysis revealed that the p value and Hazard ratio of the DNA ploidy patterns were 0.001 and 2.099, respectively. Consequently, it was a valuable independent prognostic factor that could be used in addition to lymph node metastasis and depth of invasion. For the most advanced subclass of stage III gastric cancer the 5-year survival rate of patients with a diploid tumor was significantly higher than that for those with aneuploid tumor. No difference was observed for the other subclasses. These results indicate that the DNA ploidy pattern is a valuable independent prognostic factor for gastric cancer, and that it is more useful for evaluating the prognosis of patients with more advanced lesions undergoing "curative resection."

Lack of immunoreactivity for myoglobin in skeletal muscle of acute stroke patients

Sternothyroid muscle biopsy specimens, obtained during tracheostomies from 15 patients with acute stroke and respiratory failure, were examined immunohistochemically to immunoreactivity to myoglobin (Mb). A marked decrease or lack of Mb immunoreactivity in association with hyaline degeneration was observed in 0.8 to 44.4% of the muscle fibers on both the paretic and non-paretic sides of all patients. The percentages of negative staining for Mb were less than 3.1% in 5 patients with acute respiratory failure due to causes other than stroke. The pattern and incidence of attenuated Mb immunoreactivity in the muscle fibers was found to be distinctively different in the two patients groups. In one group of 5 patients, a large number of muscle fibers (24.8 +/- 15.6%) had no Mb staining and were clearly bordered and grouped. In another 10-patient group, only a limited number of muscle fibers (3.3 +/- 2.5%) had no staining for Mb and these fibers were scattered. Four patients in the former group had catastrophic outcomes, while all the patients in the latter group survived. Ischemia, produced by an increase in catecholamines, and the consequent vasoconstriction, rather than hypoxemia seemed to be the cause of the negative immunoreactivity for Mb in the group pattern. In contrast, hypoxemia may have caused the scattered pattern of negative Mb immunoreactivity. It was concluded that negative immunostaining for Mb in muscle fibers represents a common and characteristic complication in acute stroke patients.

Morphological and histochemical study of nonhemiplegic muscle in acute stroke patients manifesting respiratory failure

There is little information on skeletal muscle changes in patients with acute stroke. We performed morphological and histochemical examinations of nonhemiplegic sternothyroid muscles biopsied at the time of tracheostomy from 13 patients with acute stroke manifesting acute respiratory failure. Degenerating and regenerating fibers were observed in all 13 specimens. Following characteristic myopathic changes suggestive of mitochondrial abnormalities were also demonstrated in a majority of patients. Namely, ragged-red fibers, focal increase in NADH-TR activity in subsarcolemmal areas and increases in acid phosphate activity were found. The changes were similar but extremely slight in control patients with acute respiratory failure due to causes other than stroke and were absent in the other control patients with adenomatous thyroid tumor. The severity and extent of the histopathological changes in the muscle fibers in patients with acute stroke were closely correlated with the duration of hypoxemia but not with such items as type of stroke, site of cerebral lesion, consciousness level, days of biopsy after the stroke, clinical outcome, levels of serum creatine kinase, myoglobin and PaO2. This acute nonhemiplegic muscle involvement was considered to be a very common complication in severe stroke patients.

Effects of 19-oxygenated lanosterol derivatives on 3-hydroxy-3-methylglutaryl coenzyme a reductase activity and lanosterol demethylase activity

The effects of 19-oxygenated lanosterol derivatives on lanosterol 14 alpha-demethylase (P-450(14DM)) and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity were studied. 3 beta-Hydroxylanost-9(11)-en-19-oic acid (6) was found to be an effective inhibitor (IC50:0.5 microM) of P-450(14DM) in the reconstituted system using purified pig liver P-450(14DM) and was most active in inhibiting HMG-CoA reductase activity (IC50:1.0 microM) in mouse L cells. In [2-14C]acetate incorporation studies using mouse L cells, 6 was found to reduce the incorporation of acetate into C27-sterol (desmosterol) with a concomitant increase in radiolabeled C30-sterols. These results demonstrate that 6 is a dual-action inhibitor of cholesterol biosynthesis.

Development of osteopenia in the hemiplegic finger in patients with stroke

Previous studies have demonstrated that hip fractures in stroke patients occurred almost exclusively on the hemiplegic side. We examined the bone changes in the second metacarpal of the hemiplegic side in terms of microdensitometric indices in 93 stroke patients with hemiplegia. All six indices indicated a significant decrease in bone mass on the hemiplegic side compared with the contralateral side. Differences in the indices between the hemiplegic and contralateral sides were correlated well with the duration of the illness and Brunstrom's stage for finger, arm, and leg. The same degree of osteopenia occurred in both small capsular and large hemispheric lesions. The same osteopenia was demonstrated in paralyzed and immobilized patients with myopathy. Thus a combination of weakness and immobilization is thought to be responsible for the osteopenia in the hemiplegic metacarpal bone. The osteopenia noted in the second metacarpal in the affected limb may account for the fact that hip fractures in stroke patients occur almost exclusively on the hemiplegic side.

Afferent projections to the Bötzinger complex from the upper cervical cord and other respiratory related structures in the brainstem in cats: retrograde WGA-HRP tracing

Following injection of WGA-HRP (30-60 nl, 5%) into the Bötzinger complex (Böt.c), a group of expiratory neurons in the vicinity of the retrofacial nucleus, a number of labeled neurons were observed, predominantly ipsilaterally, in the intermediate zone of the upper cervical cord at the C1 and C2 segments, the retrotrapezoid nucleus (RTN) in the ventrolateral medulla and the parabrachial-Kölliker-Fuse nuclear complex in the rostral pons. In addition, clusters of labeled cells were also observed in and around the solitary tract nucleus, nuclei ambiguus and retroambiguus, and nucleus raphe magnus. Control injections into the magnocellular tegmental field adjacent to the Böt.c resulted in a diffuse distribution of labeled neurons in the reticular formation. These results demonstrate that the Böt.c receives convergent monosynaptic axonal projections from the upper cervical spinal cord, the pontine pneumotaxic area, the RTN and several other respiratory related structures in the medulla.

Expression of nm23-H1 and nm23-H2 protein in endometrial carcinoma

nm23 gene expression has been shown to be inversely correlated with tumour metastatic potential in some cancers but not in others. Examination was made of the expression of nm23-H1 and nm23-H2 gene products by immunohistochemistry and immunoblotting in 28 endometrial carcinomas. Immunohistochemistry indicated the cytoplasm of cancer cells to be positive, and myometrium and endometrial stromal cells negative, for nm23-H1 and -H2 protein. The staining intensity for these proteins was significantly stronger in well-differentiated adenocarcinomas (G1) than in those moderately differentiated (G2) (P < 0.05). nm23-H1 and -H2 proteins were shown by immunoblotting to be present at significantly higher levels in G1 than in G2 tumours (P < 0.05). Two of eight cases expressed high nm23-H1 and -H2 protein in poorly differentiated adenocarcinomas (G3). In G3 tumours, nm23 expression may be diverse. In this study, the expression of nm23-H1 and -H2 was not correlated with stage, metastasis, tumour size, myometrial invasion, oestrogen receptor, progesterone receptor or menopause. It follows from the findings presented above that the high expression of nm23-H1 and -H2 is positively correlated with histological differentiation.