Reduced renal clearance of furancarboxylic acid, a major albumin-bound organic acid, in undialyzed uremic patients

3-Carboxy-4-methyl-5-propyl-2-furanpropionic acid (CMPF) is accumulated in uremic serum as a major albumin-bound organic acid. We determined both serum and urine levels of total CMPF to calculate renal clearance of CMPF in healthy subjects and undialyzed uremic patients. Urinary excretion of CMPF and renal clearance were significantly decreased in the uremic patients. The relative clearance ratios of CMPF to creatinine were as low as 0.43% in healthy subjects and 0.45% in uremic patients, indicating that only the protein-unbound, free form of serum CMPF (about 0.4%) is ultrafiltrated in the glomeruli and then excreted into urine. In conclusion, CMPF is accumulated in uremic serum as a consequence of its reduced renal clearance. Urinary excretion of CMPF may be explained only by glomerular filtration of free CMPF in the blood.

[Normal cerebral perfusion of 99mTc-ECD brain SPECT--evaluation by an anatomical standardization technique]

A single photon emitter labeled tracer, 99mTc-ethyl cysteinate dimer (99mTc-ECD), has now been used for rCBF studies with SPECT. However, normal distribution pattern of this agent in the brain still remains unclear. Therefore, the specific purpose of this study was to investigate the normal distribution pattern of 99mTc-ECD SPECT image. Regional cerebral distribution was measured with SPECT and 984 +/- 17 MBq of 99mTc-ECD in ten normal subjects. During the SPECT measurement, subjects were placed comfortably in a supine position with their eyes closed. Each SPECT image was anatomically standardized using a computerized brain atlas system of Roland et al. (HBA: Human Brain Atlas) and X-CT image. Anatomically standardized SPECT images were globally normalized to 100 count/voxel. Then, the mean and SD images of brain SPECT were calculated voxel-by-voxel basis. The highest radioactivity was found in the medial aspect of the occipital lobe. The results indicate that the normal distribution pattern of 99mTc-ECD in the human brain may be not simply reflect the regional cerebral blood flow.

Cerebral blood flow measurement with iodine-123-IMP SPECT, calibrated standard input function and venous blood sampling

We previously reported simple methods for measuring cerebral blood flow (CBF) with 123l-labeled N-isopropyl-p-iodoamphetamine (IMP) and SPECT: table look-up method and autoradiography. With these methods, the arterial input function is obtained by calibrating the standard input function using one-point arterial blood sampling 10 min after IMP infusion. In this study, we sought to determine if these approaches can be as successful when used with venous blood sampling.

METHODS

After IMP infusion, simultaneous arterial and venous blood samples were drawn from 30 subjects without heart or lung disease.

RESULTS

The activity ratios of venous whole blood from the cubital vein to arterial blood were 0.75 +/- 0.09, 0.77 +/- 0.10, 0.78 +/- 0.03 and 0.83 +/- 0.11, respectively, at 10, 20, 30 and 50 min after IMP infusion. Venous blood activities were always 20% lower than the artery values over 50 min. When blood was sampled from the dorsal hand vein, however, the respective ratios were 0.92 +/- 0.03, 0.93 +/- 0.05, 0.97 +/- 0.04 and 0.98 +/- 0.08 after 10, 20, 30 and 50 min. Furthermore, when the palm was exposed to heat during the sampling period, blood activity levels increased to 0.92 +/- 0.04, 0.96 +/- 0.04, 0.99 +/- 0.05 and 0.98 +/- 0.03. Thus, venous blood activities were consistent with arterial activity, presumably because of the numerous arteriovenous anastomoses in the palm. Optimal times for venous blood sampling, with and without palm heating, were determined by error analysis to be 15 and 20 min, respectively, after IMP infusion.

CONCLUSION

Venous blood sampling from the dorsal hand can be substituted for arterial blood sampling in IMP-CBF studies.

Overexpressed tau protein in cultured cells is phosphorylated without formation of PHF: implication of phosphoprotein phosphatase involvement

Pyramidal neurons in affected regions of Alzheimer's disease (AD) brain contain neurofibrillary tangles (NFT), aggregates of paired helical filaments (PHF) composed mainly of phosphorylated microtubule-associated protein tau. To explore the role of tau phosphorylation in the aggregation of tau into PHF, we constructed mammalian cell culture systems producing high levels of intracellular phosphorylated tau. COS-1 fibroblast-like cells were transiently transfected to simultaneously express tau, MAP kinase (MAPK), and MAP kinase kinase (MAPKK), or alternatively to express tau and glycogen synthase kinase 3 (GSK3). B103 neuron-like cells (which contain MAPK but little tau or GSK3) were stably transfected to express tau or tau and GSK3. In both systems, GSK3-transfected cells contained tau AT8/M (defined by AT8 staining and tau PHF-like mobility), but MAPK-transfected cells required phosphatase inhibitors, such as okadaic acid (OKA) or calyculin (CAL), to produce tau AT8/M. In vitro, the same concentrations of CAL and OKA inhibit phosphatases 1 and 2A (PP1 and PP2A), except that 100-1000 times as much OKA is needed to inhibit PP1. Inducing tau phosphorylation at the AT8 site in MAPK-transfected cells required 2-10 times more OKA than CAL, suggesting both PP1 and PP2A helped block the phosphorylation. Though levels of tau AT8/M reached 2-8% of total cellular proteins in COS-1 cells, the ratio of particulate to supernatant tau levels did not increase, and no tangles were observed; perhaps post-translational modifications or co-aggregating proteins are needed to induce PHF.

A Method for Purification of Clostridium perfringens Phospholipase C from Recombinant Bacillus subtilis Cells

We developed a method to purify Clostridium perfringens phospholipase C from a culture of recombinant Bacillus subtilis cells. This method consists of three purification steps, and it allowed us to obtain 6.2 mg of pure phospholipase C from 800 ml of culture.

Production of platelet-activating factor by porcine brain microvascular endothelial cells in culture

Endothelial cells produce platelet-activating factor (PAF), which is the key process in the interactions between the vascular wall and blood cells. To examine the production of PAF in brain microvasculature we have cultured brain endothelial cells and performed a comparative study with aortic endothelial cells. Fresh porcine brain was homogenized, and microvascular endothelial cells were separated by enzyme digestion. The cells were cultured in medium containing epidermal growth factor and bovine brain extract. Endothelial cells from the aorta of the same animal were cultured in a similar manner. Production of PAF was assessed by [3H]acetate incorporation into phospholipids or by radioimmunoassay. Prostacyclin was measured by radioimmunoassay of 6-ketoprostaglandin F 1 alpha. The cells produced 1760 +/- 403 and 2892 +/- 347 dpm/10(6) cells (n = 4) of PAF when stimulated with bradykinin and calcium ionophore A23187, each at 1 microM, respectively. Aortic endothelial cells produced 3911 +/- 2006 and 8052 +/- 2270 dpm/10(6) cells (n = 4), respectively, and these values were significantly higher than those in brain endothelial cells (p < 0.01, U-test). Prostacyclin production was also higher in aortic cells as compared to brain microvascular endothelial cells. In aortic endothelial cells both Ca ionophore A23187 and bradykinin significantly stimulated PMN adherence whereas in brain microvascular cells only Ca ionophore enhanced the adherence. Brain microvascular endothelial cells produce smaller amount of PAF and prostacyclin as compared to aortic endothelial cells, and this fact may imply that the functional integrity of the brain microvascular endothelium is maintained at a low level.

Regulation of classical HLA class I genes in human choriocarcinoma cells by nuclear proteins binding to MHC class I regulatory elements

PROBLEM

The regulation of classical HLA class I genes in choriocarcinoma have been reported.

METHODS

We determined whether four choriocarcinoma cell lines expressed classical HLA class I or HLA-G by a reverse transcription-polymerase chain reaction (RT-PCR) and studied the regulatory mechanism of classical class I using a gel mobility shift assay.

RESULTS

NUC1 and SCH expressed classical class I but not HLA-G. GCH1 and Jar did neither. Nuclear protein binding to the class I regulatory element (CRE) was detected in NUC1 and SCH. Interferon-gamma augmented both classical class I expression and the DNA-protein complex in NUC1. The DNA-protein complex was not observed in GCH1, and Jar showed a CRE-binding protein with different electrophoretic mobility and binding affinity from that of SCH and NUC1.

CONCLUSION

The CRE is one of the regulatory elements of classical HLA class I genes in choriocarcinoma cells.

Intussusception of the appendix: a report of three cases with different clinical and pathologic features

Three cases of intussusception of the appendix (IA) with distinctive pathologic changes were reported. All patients were women with different clinical presentations. Grossly, a complete intussusception was found in one case (case 1), while the others (cases 2 and 3) showed a partial intussusception. In case 1, almost the total segment of the appendix bearing the villous adenoma with focal malignant transformation became completely telescoped into the cecum. In case 2, no underlying appendiceal lesion was disclosed. In case 3, appendiceal endometriosis was found as the point of traction. Awareness of such a rare complication associated with various appendiceal lesions provides a clue for making an accurate diagnosis and selecting appropriate surgical management.

Effects on health of dietary supplementation with 100 mg d-alpha-tocopheryl acetate, daily for 6 years

To evaluate the clinical antioxidant effects of vitamin E, 161 healthy volunteers aged 39 to 56 years, were given 100 or 3 mg of d-alpha-tocopheryl acetate orally daily for 6 years using a randomized, double-blind design. Among the 147 volunteers who qualified for the analysis, seven of the 73 volunteers receiving 3 mg d-alpha-tocopheryl acetate daily and none of the 74 volunteers receiving 100 mg had coronary disorders including myocardial damage (P < 0.02). ST or T wave abnormalities on electrocardiograms were considered to indicate coronary disorders (four volunteers). The mean serum total tocopherol (TOC) concentration in the 100-mg group was significantly higher than that in the 3-mg group 6 months after the start of the study, and this raised value was maintained throughout the study; the level in the 3-mg group did not change significantly from the baseline value. The low-density lipoprotein cholesterol/total TOC ratio, a parameter of the inhibition of peroxidation of low-density lipoprotein cholesterol, was the only serum lipid parameter that was significantly different, at baseline, in the volunteers with coronary disorders compared with the others. These findings indicate that long-term supplementation with 100 mg tocopheryl acetate daily may prevent the early stages of coronary atherosclerosis by decreasing peroxidation of low-density lipoprotein cholesterol.

The novel variants of mb-1 and B29 transcripts generated by alternative mRNA splicing

The Ig-alpha/Ig-beta heterodimers encoded by mb-1 and B29 genes, respectively, are crucial for the constitution of the B-cell receptor (BCR). We report here novel variants of mb-1 and B29 transcripts produced by alternative mRNA splicing. The proteins encoded by these variants are predicted to conserve transmembrane and cytoplasmic portions of Ig-alpha and Ig-beta but lack a part of the extracellular portions containing cysteine residues which are required for intramolecular and intermolecular S-S bonds. Transfection studies revealed that the variant mb-1 and B29 did not contribute to the BCR expression on cell surfaces. Although peripheral B cells contain small amounts of the variant mb-1 and B29 transcripts, treatment with an anti-IgM antibody, LPS or IL-4 induces a significant increase in amounts of the variant transcripts. These observations suggest that B-cell activation induces alternative splicing of mb-1 and B29 transcripts which encode proteins unable to constitute the BCR.

[Normal cerebral perfusion of 99mTc-HMPAO brain SPECT--evaluation by ananatomical standardization technique]

Single photon labeled tracer 99mTc-hexamethylpropylene amine oxime (HMPAO) has been used for rCBF studies by SPECT. However, normal perfusion pattern of this agent still remains unclear. The purpose of this study was to investigate normal 99mTc-HMPAO SPECT image voxel by voxel. Eighteen male subjects without any prior or present history of medical illness participated in this study. All SPECT images were globally normalized to 100 count/voxel. Each subject had an X-ray CT scan at the same day of SPECT measurement. All subjects had normal X-ray CT scans. The standard anatomical structures of the computerized brain atlas of Roland et al. were fitted to X-ray CT images of a subject by linear and non-linear parameters. These parameters were subsequently used to transform SPECT images of the subject. After the anatomical standardization, mean and SD images of eight standardized images were calculated voxel-by-voxel basis. In the mean image, following structures showed relatively higher radioactivity; the putamen, the cerebellum, and the frontal lobe. In addition, the occipital lobe, parietal lobe, frontal lobe, and the putamen showed large degree of SD. Anatomical standardization of SPECT images may be useful as a reference to diagnose and evaluate various brain disorders.

Surgical treatment of mesenteric infarction, thoracoabdominal aortic aneurysm, and proper hepatic aneurysm in a middle-aged woman with Takayasu's arteritis

Although Takayasu's arteritis may present a wide variety of signs and symptoms depending on the vessel affected, it is rarely associated with acute abdomen requiring emergency laparotomy. We report a case of Takayasu's arteritis that required several surgical interventions for mesenteric infarction, thoracoabdominal aneurysm, and proper hepatic artery aneurysm, all of which were noted in succession within a 1-year period. This is also the first report, to our knowledge, of a hepatic artery aneurysm caused by Takayasu's arteritis.

[A new 3-dimensional head fixation device for brain imaging]

We have developed a new head fixation device for studies of brain function. This device was designed to immobilize subject's heads during image scanning and to precisely reproduce the head position for two different imaging modalities such as MRI and PET. The device consists of a plastic frame, a pillow filled with beads of styrene foam, and a face mask of thermoplastic resin which was originally intended for application in radiotherapy. A bridge for biting was incorporated into the mask for stable fixation. The device enables immobilization of subject's heads with good reproducibility of position at the practical level. Our results indicate that this head fixation system is useful for fixation of head during activation studies using PET.

Leukemia inhibitory factor (LIF) enhances trophoblast differentiation mediated by human chorionic gonadotropin (hCG)

We investigated the effect of LIF on the differentiation of trophoblasts. Isolated cytotrophoblasts were cultured with and without LIF and cell smears were immunocytochemically analyzed, using anti-hCG antibody. The percentage of differentiated trophoblasts stimulated by 10ng/ml of LIF was about 2.5-fold that in the control culture. The effect of LIF in inducing the differentiation of cytotrophoblasts to syncytiotrophoblasts was dose-dependent. The same effect was shown when hCG was added to the medium. This enhancing effect of LIF on trophoblast differentiation was blocked by adding anti-hCG antibody to the culture system. These results indicate that LIF enhanced trophoblast differentiation by stimulating hCG production in trophoblasts, and not by exerting a direct effect on the trophoblasts.

Non-X histiocytoma, similar to fibrous histiocytoma, in an infant

A case is presented of a female infant with an atypical histiocytoma. A gradually enlarging brown lesion was noted on the left side of the chest at the age of 2 weeks. Microscopic study of a biopsy revealed an ill-defined infiltration of spindle cells with indented nuclei. The tumor cells were positive for CD14, HLA-DR, lysozyme, alpha-1-antitrypsin and alpha-1-antichymotrypsin, and negative for CD1, CD3, CD8, CD10, CD19, CD68 and S-100 by immunohistochemistry. Electron microscopy demonstrated no distinct Birbeck's granules, but aberrant granules were seen in a small number of cells. At 7 months of age, a nodule with similar histologic features was noted in the nuchal region, but was incompletely resected. The patient remains recurrence-free at 36 months of age. This case is thought to be a benign form of non-X histiocytoma.

Interleukin-1 receptor antagonist expression in epithelial cells of human endometrium

OBJECTIVE

To examine the expression of interleukin-1 (IL-1) and IL-1 receptor antagonist (IL-1ra) in the human endometrium in the follicular and luteal phases.

METHODS

The concentrations of IL-1alpha and IL-1beta in the culture supernatants of endometrial cells were determined by enzyme-linked immunosorbent assay. Transcription of the IL-1ra gene in the endometrium was investigated by reverse polymerase chain reaction (PCR). Human endometrium was immunohistochemically stained using a monoclonal antibody specific to IL-1ra.

RESULTS

The concentrations of IL-1alpha and IL-1beta in the culture supernatants were 11 and 55 pg/ml, respectively, in the follicular phase, and 10 and 40 pg/ml, respectively, in the luteal phase. The concentration of IL-1ra was 465 pg/ml in the follicular phase and 1710 pg/ml in the luteal phase. Densitometric analysis of the reverse PCR products showed that the expression of IL-1ra mRNA was increased in endometrial cells in the luteal phase. Immunohistochemical staining revealed that epithelial cells were the main source of IL-1ra in human endometrium.

CONCLUSIONS

Human endometrial cells produce IL-1 (mainly IL-1beta) and IL-1ra. The level of IL-1ra production in human endometrial epithelial cells was greater in the luteal phase than in the follicular phase due to the increased transcription of the IL-1ra gene.

[Usefulness of adjuvant chemotherapy with antimetabolites for cervical invasive cancer]

A series of 584 patients with cervical invasive cancer were included in the retrospective study on the efficacy of long-term oral maintenance chemotherapy with antimetabolites (Fluorouracil or Tegaful). The patients were histologically classified into the squamous cell carcinoma (SCC) group and the adenocarcinoma (AD) group. In the SCC group (n = 518), 163 patients were given more than 300 mg/day of antimetabolite tablets for one year or more after the main therapy (hysterectomy or pelvic irradiation). In the AD group (n = 66), 36 patients were treated with the same dose of antimetabolites. The Kaplan-Meier overall and cancer specific survival analysis estimates that the chronic administration of antimetabolites did not improve the cumulative 5-year survival in the SCC group. In contrast, the cumulative 5-year survival rate in the AD group treated with antimetabolites (88%) was significantly higher than that without chemotherapy (64%) by Kaplan-Meier analysis. This significant improvement in the survival rate in the AD group due to antimetabolites was notable in patients in FIGO stage I or II treated with radical or semiradical hysterectomy, these results indicate that oral adjuvant chemotherapy with antimetabolites is useful for cervical adenocarcinoma, but not for squamous cell carcinoma.

Activity in the human primary motor cortex related to arm and finger movements

With the purpose of mapping representations of the finger and proximal arm in the human primary motor cortex (MI), we measured regional cerebral blood flow (rCBF) in eight right-handed normal volunteers during self-paced finger and proximal arm movements. Each movement activated two different fields in MI, one located deep in the anterior lip of the central sulcus and the other relatively close to the surface of the precentral gyrus. Arm fields were located higher than finger fields. A superficial arm field and a deep finger field partially, overlapped. The results indicate that there are two spatially separate motor representations of the finger and proximal arm in the human MI.

[Clinical usefulness of 201Tl-chloride scintigraphy for the diagnosis of bone metastases]

Fifty-five patients with bone lesions underwent 201Tl-chloride (201TlCl) scintigraphy to evaluate its findings and usefulness for the diagnosis of bone metastases. 201TlCl scintigraphy was performed 15 minutes (early scan) and 2 hours (delayed scan) after intravenous administration of 5.55 MBq/kg of 201Tl-chloride. To evaluate the degree of tracer retention at the lesions, we calculated retention index after setting regions of interest in each lesions demonstrated tracer uptake in both early and delayed scans. Among 118 lesions of pathologically and/or clinically confirmed bone metastases, 201TlCl planar images disclosed 90 (76.3%) and 88% (74.6%) lesions on early and delayed scans, respectively. SPECT images were preferable for the evaluation of the lesions in the spine, the thoracic cage and pelvis. Correlation of tumor size with findings on 201TlCl images demonstrated 90.5% sensitivity for the metastases more than 7 cm3. No correlational difference was seen in the sensitivity depending on primary cancers. The overall retention index of bone metastases was -21.4 +/- 47.1. Bone metastases of pulmonary adenocarcinomas and small cell carcinomas demonstrated higher retention index than those of pulmonary squamous cell carcinomas and breast cancers. On 201TlCl images, no abnormal tracer uptakes were seen in benign lesions detected by 99mTc-hydroxymethylene diphosphonate (99mTc-HMDP) images except 5 lesions. The retention index of these benign lesions demonstrated abnormal uptakes on 201TlCl images was -48.3 +/- 15.0, which found no significant difference between that of metastases. In cases of vertebral compression fractures, abnormal tracer uptakes were demonstrated in 9 of the 12 pathologic fractures against 2 of the 10 benign ones. Those 2 benign fractures proved to be vertebral tuberculosis.(ABSTRACT TRUNCATED AT 250 WORDS)

[A correlative study of the aluminum content and aging changes of the brain in non-demented elderly subjects]

The interrelation of the aluminum content and aging change of the nerve cells was studied with special reference to the neurofibrillary tangle (NFT) and occurrence of senile plaque (SP), in 15 autopsied brains (cerebrum) of non-demented elderly subjects varying in age from 75 to 101 years old and 10 cases of non-demented non-elderly adult subjects. 1) In the brain of non-demented non-elderly adult subjects, the aluminum content of the hippocampus was 14.4 +/- 1.39 ppb and that of the cortex of the frontal lobe was 20.4 +/- 2.54 ppb. In the brain of the non-demented elderly subjects, the aluminum content of the hippocampus was 401.7 +/- 60.05 ppb and that of the cortex of the frontal lobe was 373.29 +/- 72.35 ppb. Comparison of the two groups showed obviously higher levels in the latter group, being 28 times in the hippocampus and 19 times in the cortex of the frontal lobe. 2) The histochemical demonstration of the aluminum localization by the Morin method disclosed the positive fluorescence reaction along the part of the disintegrating neurofibrillary tangle and amyloid core in the senile plaques of non-demented elderly subjects. In the normal brain tissue, positive fluorescence reaction was observed in the wall of the capillary vessels of the blood brain barrier, perivascular glial supporting tissues, the nuclei of the astrocytes and nuclei, nucleoli of the nerve cells partially. No fluorescence reaction was observed in the non-demented adult subjects. 3) Morphologically, the appearance of the neurofibrillary tangle was noted in some cases of non-demented elderly group with higher aluminum levels. Classical and diffuse type senile plaques were dispersed in the 1st to 4th zone of the cortex of the frontal lobe. However, diffuse type senile plaques in the hippocampus appeared to a lesser extent. Neurofibrillary tangles were slightly noted in the cortex of the frontal lobe, however marked increase was confirmed in the CA1 to CA3 zones of the hippocampus. Ultrastructurally, paired helical filaments (PHF) were noted in the neurofibrillary tangle constituent and the increase of amyloid fibrils in senile plaques was confirmed. In this study, high levels of the aluminum content of the brain were confirmed in the non-demented elderly subjects. Moreover, the histochemical demonstration of aluminum localization by the Morin method disclosed a positive fluorescence reaction along the sites of neurofibrillary tangles and amyloid core in the senile plaques of non-demented elderly subjects.(ABSTRACT TRUNCATED AT 400 WORDS)