Metacarpal bone mass in normal and osteoporotic Japanese women using computed X-ray densitometry

The metacarpal bone mineral density (BMD) and metacarpal index (MCI) of the second metacarpal bone were measured by computed X-ray densitometry (CXD) (Teijin Ltd., Tokyo), which we have established with the development of microdensitometry of radiographs. In this study, we evaluated the basic attributes of this CXD method and determined the age-related changes in both metacarpal measurements in normal Japanese women. The precision in vivo was measured in eight subjects. The precision errors [coefficient of variation (CV)] were 0.2-1.2% CV for metacarpal BMD and 0.4-2.0% CV for MCI, respectively. We have obtained low precision error and more rapid analysis, within 3 minutes respectively, compared with the previous methods. Age-related changes in the metacarpal measurements were evaluated in 1438 normal women. Both measurements showed the most significant decrease in the sixth decade of life. The rate of decrease in the sixth decade was 1.6%/year for metacarpal BMD and 1.5%/year for MCI. On comparison between metacarpal BMD by CXD and spine BMD using dual energy X-ray absorptiometry (DXA) in 248 normal women with and without menstruation, the two measurements were found to be similarly decreased in the subjects within 5 years after menopause. There was also no significant difference in the Z-score between metacarpal BMD and spine BMD within 5 years after menopause. These results indicate that early postmenopausal bone loss occurs not only in the spine but also in the metacarpal bone.(ABSTRACT TRUNCATED AT 250 WORDS)

[Non-MHC susceptibility genes in Japanese subjects with insulin-dependent diabetes mellitus (IDDM)]

Genetic factors clearly contribute to the development of autoimmune destruction of pancreatic beta cell in IDDM. The HLA class II genes have an important role in the pathogenesis of Japanese IDDM as they do in Caucasians. Particular HLA class II alleles and haplotypes contribute to the IDDM susceptibility/resistance in Japanese. In the 5' insulin gene polymorphism, the shorter insertion (class 1 allele) is predominant in Japanese, and thus is not associated with IDDM. Subdivision of the class 1 alleles also failed to show an association with Japanese IDDM. The insulin gene region appears not to be a valuable genetic marker for IDDM in Japanese. Recently, we found an association of polymorphism in the IFN-gamma gene with Japanese IDDM.

Hypertrophic pulmonary osteoarthropathy in a raccoon dog (Nyctereutes procyonoides) with chronic pulmonary inflammatory lesions

A female raccoon dog (Nyctereutes procyonoides) captured September 1992 in Nara prefecture, Japan, suffering from swollen joints of all four limbs was necropsied. Radiographically, there was a shadow in the right pulmonary caudal lobe and periosteal bone formation around several joints. Microscopically, there was extensive edema, along with one large and many small pyogranulomatous nodules and purulent bronchitis in the right lobe and left caudal lobe of the lungs. There were intermingled branching filamentous bacteria in the lesion, which stained positively with Warthin-Starry, Grocott, and Gram stains, and partially with periodic acid Schiff and Ziehl-Neelsen stains. Extensive exostosis with coralloid trabeculation had developed bilaterally at the carpal, stifle and hock joints in the surrounding well vascularized loose connective tissue. Degeneration of articular cartilage and villous proliferation of synovial membranes were apparent. This is the first report of hypertrophic pulmonary osteoarthropathy in the raccoon dog.

Lack of association of the insulin gene region with type 1 (insulin-dependent) diabetes mellitus in Japanese subjects

Although the insulin gene region is implicated in susceptibility to Type 1 (insulin-dependent) diabetes mellitus in Caucasians, significance of this region to Type 1 diabetes in Japanese remains unclear because the class 1 alleles (shorter insertion) of the variable number of tandem repeat in the 5' region of the insulin gene are predominant in both diabetic and non-diabetic subjects. The 5' insulin gene polymorphism was analysed in 75 Japanese patients and 69 control subjects with a precise method using PvuII and a polymorphism specific probe, which enabled us to divide class 1 alleles into four subclasses. Allelic frequencies were not significantly different between Type 1 diabetic patients and control subjects. The polymorphism in the 3' untranslated region of the insulin gene (1127/PstI) was also analysed and found to be tightly linked to the 5' insulin gene polymorphism, and thus was not associated with diabetes. Interaction between HLA-DR and the insulin gene region, which was reported in the French study, was not observed in Japanese. These results suggest that the insulin gene region is not a valuable genetic risk factor for Type 1 diabetes in Japanese.

Effects of hysterectomy on ovulation and related ovarian functions in regular estrous cycle rats

The number of ovulation was significantly higher in hysterectomized rats with regular estrous cycles than in sham-operated rats at the estrous stage 20-24 days after operations (13.2 +/- 0.33 vs. 11.8 +/- 0.41, P < 0.05). This finding suggests that hysterectomy facilitates the follicular maturation in rats. To examine the mechanism of facilitation on follicular maturation in hysterectomized rats, plasma FSH level, ovarian estradiol-17 beta (E2) and ovarian aromatase activity were measured 20 days after hysterectomy. Hysterectomy had no effect on plasma FSH levels at any of the estrous stages. Ovarian E2 level and aromatase activity (AA) were significantly increased by hysterectomy only at diestrus-2 stage of the estrous cycle (E2; 3.76 +/- 0.49 vs. 1.48 +/- 0.49 ng/g ovarian tissue, P < 0.05, AA; 1.36 +/- 0.15 vs. 0.83 +/- 0.11 pmol/h. mg ovarian tissue, P < 0.05), but ovarian testosterone level was not affected by the operation. These results support the hypothesis that in rats hysterectomy facilitates follicular maturation. This may be due to an increase in ovarian E2 level at the diestrus-2 stage, caused by heightened ovarian aromatase activity.

Formation and property of mixed vesicles of phosphatidylcholine and MDP derivatives

The aggregation form of mixtures of phosphatidylcholine and MDP derivatives was studied. The mixed vesicles containing less than 40% of B30-MDP were unilamellar, and over 40% B30-MDP aggregates of mixed vesicles or oligolammellar vesicles appeared. The mixed vesicles containing less than 20% of DV-7401 were unilamellar, and over 20% of it fibriform structures appeared.

Predictive value of screening tests for persistent hepatitis C virus infection evidenced by viraemia. Japanese experience

In November 1989, Japanese Red Cross Blood Centres started screening for hepatitis C virus (HCV) with enzyme-linked immunosorbent assay (Elisa) for the C100-3 viral peptide as the first such nationwide programme in the world. Thereafter post-transfusion non-A non-B hepatitis (PTNANBH) was reduced by 61-80%, but this was not as complete a success as our programme to prevent post-transfusion hepatitis B by screening for high titer hepatitis B core antibody, which we began in the same period. In order to acquire more effective control of PTNANBH, the HCV core-related antigen (GOR, N14) and second-generation Elisa (Ortho2, Abbott2) and second-generation antigen agglutination (PA, PHA) tests have been employed. Among 16,500 donors in 11 blood centers, 365 were serologically positive by at least one of these tests. Among these, HCV RNA was detected in 138 units and the remaining 227 were HCV RNA negatives. The effectiveness of these serological tests to detect HCV RNA-positive status were analyzed. Passive haemagglutination and particle agglutination (PHA and PA) tests were highly effective to predict HCV viraemia among blood donors. Also, these tests can easily determine antibody titre. By either PHA or PA, all units with > or = 2(12) agglutination titre (120 and 122 units) were HCV RNA positive and all agglutination-positive units with serum alanine aminotransferase level higher than 35 Karmen units were HCV RNA positive.(ABSTRACT TRUNCATED AT 250 WORDS)

[The influence of target blurring and simulated opacity of the ocular media on automated perimetric thresholds]

The influence of target blurring and simulated opacity of the ocular media on the sensitivity of the central visual field in quantitative static perimetry was studied using a SARGON program of the automated perimeter Octopus 201. Ten eyes of 10 normal subjects aged from 21 to 35 were examined with target sizes 1, 3, and 5; 4 spherical plus lenses of +1.0D, +2.0D, +3.0D, and +5.0D; 5 kinds of occlusion diffusers which corresponded to the visual acuities of 1.0, 0.8, 0.6, 0.4, and 0.1; and 4 neutral density filters of 0.1, 0.3, 0.6, and 1.0 log units. The studies suggested that there was little difference between the sensitivity for target size 1 and that for target size 3 in spite of slight blurring of the target and simulated opacity of the ocular media. We concluded that target size 1 was as useful as target size 3 in quantitative static perimetry.

Low temperature dependent IgG3 subclass antibody with low avidity to C100-3 antigen derived from hepatitis C virus in voluntary blood donors

The presence of an antibody which reacts strongly at lower temperatures to C100-3 antigen derived from the hepatitis C virus (HCV) was demonstrated in blood donors' sera. These sera reacted with the antigen most strongly at 4 C and most weakly at 37 C and are termed 'cold antibody group'. The cold antibody group reaction was specifically inhibited with soluble C100-3 antigen. Cold antibody bound to C100-3 antigen at 4 C was dissociated at 37 C and was isolated in this manner. Low temperature-dependent anti C100-3 antibody was shown to be predominantly IgG3 subclass by ELISA using anti-human IgG subclass antibody. This IgG3 antibody was dissociated from antigen with 6M urea, demonstrating its low avidity. HCV-RNA was demonstrated in two of five samples. Therefore, to achieve more effective prevention of post-transfusion hepatitis C, we propose the incorporation of programs to detect low temperature-dependent low-avidity antibody against HCV-related antigen.

Presence of lower temperature-dependent antibody with low avidity to C100-3 (HCV) antigen in voluntary blood donors

Serum samples with lower temperature-dependent antibody with low avidity to C100-3 (HCV) antigen were found in 0.19% of 23,197 voluntary blood donors at this blood center. They showed positive C100-3 antibody activity at 24 C but not at 37 C. The antibody activity bound to C100-3 antigen at lower temperature disappeared after incubation for 60 min at 37 C or treatment with 8 M urea. Other markers of hepatitis C virus infection, especially the presence of HCV-RNA were demonstrated in some of these serum samples and the importance of this phenomenon is discussed with regard to virus screening of blood donors for hepatitis C.

[Systemic lytic state as marker of therapeutic success after rt-PA in bolus in myocardial infarction]

PURPOSE

Evaluate the lytic state (LS) expressed by the level of plasmatic fibrinogen (PF) after rt-PA "in bolus" infusion for acute myocardial infarction (MI) and its relation to coronary reperfusion.

PATIENTS AND METHODS

Fifty-one patients (38 men, mean age of 53.0 +/- 9.8 years) with demonstrated occlusion of the infarct related artery (IRA) received an intravenous bolus infusion of 70 mg of rt-PA, PF was assessed before and 90 minutes after the treatment and the levels were compared in patients with (group 1) and without (group 2) reperfusion of the IRA.

RESULTS

Basal levels of PF were within the normal range in all patients. There was a decrement of 35.1% in the PF dosed at 90 minutes, from 276.8 +/- 55.5 mg/dl to 168.0 +/- 68.2 mg/dl. Both groups were similar in the levels of PF 90 after treatment (145.1 +/- 95.7 mg/dl in group 1 versus 187.0 +/- 53.7 mg/dl in group 2).

CONCLUSION

"In bolus" rt-PA treatment for MI significantly reduces the PF, but the LS obtained was similar in patients with or without reperfusion of the IRA.

Healing and recurrence of active duodenal ulcer with nizatidine

Nizatidine, a new H2-receptor antagonist for treatment of duodenal ulcer disease, was evaluated in a unique two-phase, placebo-controlled, randomized, double-blind, multicenter clinical trial. Patients received either 150 mg nizatidine twice daily or placebo for 4 weeks (phase I). If ulcer healing did not occur during phase I, patients were randomly reallocated to receive either 150 mg nizatidine twice daily or placebo for an additional 4 weeks (phase II). Patients with a healed ulcer continued on the same therapy. All patients were endoscoped at week 8. Healing rates at week 2 were 93 of 265 (35%) nizatidine-treated patients and 55 of 260 (21%) placebo-treated patients (p less than 0.001); at week 4, healing rates were 198 of 259 (76%) nizatidine-treated patients and 95 of 243 (39%) placebo-treated patients (p less than 0.001). In phase II, ulcer healing occurred in 46 of 86 (53%) nizatidine-treated patients and in 23 of 90 (26%) placebo-treated patients (p = 0.002). In patients who had a healed ulcer at previous endoscopies, 18 of 178 (10%) nizatidine-treated patients and 10 of 81 (12%) placebo-treated patients had a recurrence of duodenal ulcer. Smokers who had histories of previous ulcers were more likely to have an early recurrence.

Pharmacokinetics and pharmacodynamics of oral nizatidine

Nizatidine was studied in six high-acid-secretor (basal secretion, greater than or equal to 5 mEq/hr) male volunteers in a randomized, double-blind, nonbalanced, cross-over, placebo and standard drug-controlled study. Doses of 75 mg, 150 mg, and 300 mg bid were compared with placebo and cimetidine 300 mg qid. Nocturnal acid output was significantly reduced (P less than .01) by all doses of nizatidine (36 +/- 22, 36 +/- 31, and 26 +/- 20 mEq) with 75 mg, 150 mg and 300 mg, respectively, and also by cimetidine (43 +/- 39 mEq) as compared with placebo (101 +/- 61 mEq). Nizatidine also significantly reduced meal-stimulated acid secretion at breakfast (14 +/- 9, 9 +/- 7, and 5 +/- 6 mEq/2 hours with 75 mg, 150 mg, and 300 mg, respectively, P less than .01), at lunch (50 +/- 22, 57 +/- 22 and 50 +/- 35 mEq/2 hours, P less than .05) but did not have any effect at dinner (65 +/- 16, 78 +/- 24, and 71 +/- 17 mEq/2 hours) whereas cimetidine, given every 6 hours, significantly (P less than .01) reduced meal-stimulated acid secretion (25 +/- 16, 27 +/- 20 and 31 +/- 15 mEq/2 hours, breakfast, lunch, and dinner, respectively) as compared with placebo (81 +/- 30, 76 +/- 25, and 66 +/- 16 mEq/2 hours, breakfast, lunch, and dinner, respectively). Both drugs have a similar pharmacokinetic profile. Nizatidine seems to be a promising H2 antagonist, more potent than cimetidine (on an mg/mg basis), and efficacy studies on gastric acid disorders should be performed.

Nizatidine as maintenance therapy of duodenal ulcer disease in remission

A new H2-receptor antagonist, nizatidine (150 mg h.s.), was compared with placebo as maintenance therapy in a randomized, parallel, double-blind, one-year study of 513 patients with recently healed duodenal ulcer. Endoscopies were performed at 0, 3, 6, and 12 months and at unscheduled times if symptoms of active peptic ulcer disease were present. Cumulative ulcer recurrence rates for nizatidine and placebo were 13 versus 40% at 3 months, 24 versus 57% at 6 months, and 34 versus 64% at 12 months. The differences were significant (p less than 0.001) at each treatment period. Smokers in both treatment groups had significantly greater recurrence rates than non-smokers. Symptoms of peptic ulcer disease were significantly less in nizatidine-treated patients in the first 3 months of treatment. Adverse events, including those related to peptic ulcer disease, occurred more frequently in placebo-treated patients. Nizatidine proved to be safe and effective in preventing recurrences of duodenal ulcer.

[Superovulation-induced transient hyperprolactinemia in human in vitro fertilization and embryo transfer]

To examine the effects of transient hyperprolactinemia on in vitro fertilization and embryo transfer, 61 cycles in 50 euprolactinemic ovulatory women with irreparable tubal diseases were stimulated with clomiphene (CC) alone or CC and human menopausal gonadotropin followed by human chorionic gonadotropin (hCG). Serum prolactin (PRL) increased after hCG administration with peak values of 45.4 +/- 4.2 ng/ml on the day of laparoscopic oocyte aspiration. The highest serum estradiol (E2) concentration was found on the day before PRL peak and serum progesterone (P) began to increase after hCG injection concomitant with the PRL rise. The group having 50 ng/ml or more of PRL (34 cycles) had significantly higher levels of E2 during preovulatory and early luteal phase compared to those of the group having less than 50 ng/ml of PRL (27 cycles) but there was no significant difference between the P levels in the two groups. In the higher PRL group 72 (62.1%) of 116 collected oocytes were fertilized and 6 (20.0%) conceived. In the lower PRL group 45 oocytes (58.4%) of 77 were fertilized and 3 (12.5%) became pregnant. These data suggest that elevated serum PRL concentrations may have no effect on fertilization of oocytes in vitro or embryonic development.

Treatment of duodenal ulceration in the United States

Nizatidine, a new H2-receptor antagonist for the treatment of duodenal ulcer disease, was compared with placebo in a dose-response, double-blind, parallel, multicenter clinical trial. Patients were randomly allocated to receive either nizatidine (25 mg b.i.d., 150 mg b.i.d., or 300 mg at bedtime) or placebo. At the end of 4 weeks, patients whose ulcer had not healed were randomly reallocated to receive either the nizatidine 150 mg b.i.d. dosage regime or placebo for an additional 4 weeks. Nizatidine doses of 300 mg at bedtime and 150 mg b.i.d. demonstrated similar healing frequencies. Both of these doses were statistically significantly superior in ulcer healing to the nizatidine 25 mg b.i.d. dose and to placebo at the end of 4 weeks. Patients randomly reallocated to receive nizatidine had significantly greater healing rates than patients randomly reallocated to receive placebo. In summary, nizatidine given as a single evening dose of 300 mg or as 150 mg b.i.d. proved to be equally safe and effective in the healing of active duodenal ulcers.

[Clomiphene-HMG ovarian stimulation in human in vitro fertilization and embryo transfer]

In a program for in vitro fertilization and embryo transfer, laparoscopies for oocyte aspiration were performed in 40 cycles in 36 normally menstruating women with irreparable tubal diseases (IVF patients) who received clomiphene citrate (CC) and human menopausal gonadotropin (hMG). An intramuscular injection of human chorionic gonadotropin (hCG) was given to all patients after completion of follicular maturation. Fourteen cycles in 13 spontaneously ovulating women (control patients), also stimulated with CC and hMG, were adequately monitored to identify the appearance of the spontaneous luteinizing hormone (LH) surge. The follicular maturation was followed by daily ovarian ultrasonographic examination and serum estradiol estimations. Just before the LH surge the diameter of the leading follicle was 20.2 +/- 0.7 (mean +/- S.E.) mm and the serum estradiol concentration per follicle was 384.1 +/- 16.3pg/ml in the control patients. In the IVF patients the former was 20.6 +/- 0.3mm and the latter was 305.8 +/- 13.3pg/ml prior to hCG administration. When the relationship of follicular size to the rates of oocytes recovery, maturation, fertilization and cleavage was examined, larger follicles (3ml less than or equal to follicular fluid volume) showed good results. Of the 152 oocytes that were recovered from these IVF patients, 96 (63.2%) were fertilized and 79 (52.0%) cleaved. Three pregnancies resulted from 35 embryo transfers.

A sensitive assay method for the measurement of S-adenosylmethionine in tissue

An assay method has been developed for the measurement of tissue levels of S-adenosylmethionine based upon the ability of this compound to activate tripolyphosphatase associated with S-adenosylmethionine synthetase beta prepared from rat liver. The method has been used to measure S-adenosylmethionine levels in rat liver after feeding rats on various concentrations of methionine in the diet. The results obtained by this method agree well with those measured by the spectrophotometric method. The limit of sensitivity of the assay was about 0.1 nmol of S-adenosylmethionine in an incubation volume of 0.1 ml (10(-6) M).

The alpha-form of S-adenosylmethionine synthetase isozymes from liver is principally functional

Treatment of rats with an ethionine plus adenine or a methionine diet leads not only to a marked increase of the alpha-form isozyme of S-adenosylmethionine synthetase in liver, but also to the accumulation of comparable amounts of S-adenosylethionine and S-adenosylmethionine in liver. Transplantation of ascites tumor cells into mice leads to a marked increase only of the beta-form isozyme in the host liver, but the levels of S-adenosylmethionine do not significantly change in liver.

Changes in the activities of S-adenosylmethionine synthetase isozymes from rat liver with dietary methionine

The activities of S-adenosylmethionine synthetase isozymes in liver were measured after rats received a diet containing excess methionine. The activity of the alpha-form increased with increasing methionine content in the diet, and reached 4-5 fold after 6 days on a 3% methionine diet. However, the activity of the beta-form showed only a 1.5 fold increase. The activity of the gamma-form in kidney showed no significance change.