Histologic grade and cellular proliferation at the deepest invasive portion correlate with the high malignancy of submucosal invasive gastric carcinoma

To establish appropriate indications for endoscopic treatment of submucosal invasive gastric carcinoma, we investigated clinicopathologic features and proliferating cell nuclear antigen (PCNA) expression at the deepest invasive portion of 192 differentiated submucosal invasive gastric carcinomas that had been surgically resected. Lymph node metastasis was demonstrated in 30 (15.6%) of 192 lesions. Histologic heterogeneity (based on differentiation at the deepest invasive portion) was demonstrated in 36 (18.8%) of the 192 lesions. In 159 lesions, excluding 33 undifferentiated lesions at the deepest invasive portion, the depth of invasion, histologic grade, lymph vessel involvement, infiltrative growth pattern (INF) and existence of an ulceration were all significantly correlated with the incidence of lymph node metastasis. The lesions with both well-differentiated adenocarcinoma (WELL) and minimal submucosal invasion (sm1) showed no lymph node metastasis. PCNA expression was estimated in 59 good stained lesions. The mean PCNA labeling index (LI) was 50.9 +/- 7.2% in lesions with lymph node metastasis and 43.7 +/- 9.3% in those without lymph node metastasis (p < 0.05). In addition, PCNA-LI also correlated significantly with the histologic grade, depth of invasion, INF and lymph vessel involvement. These results indicate that the submucosal invasive gastric carcinoma with both WELL and sm1, which shows no other risk factors, can be considered as the appropriate indication for curative endoscopic treatment. The PCNA-LI at the deepest invasive portion is useful in understanding the biology of lymph node metastasis in submucosal invasive gastric carcinoma.

A new inherited muscular disorder in Japanese quails (Coturnix coturnix japonica)

Thirteen adult mutant (LWC strain) Japanese quails (Coturnix coturnix japonica), between the ages of 8 and 60 weeks were examined for a progressive muscular disorder. The disorder, inherited as an autosomal dominant trait, was clinically apparent as early as 28 days of age; it was characterized by generalized myotonia, muscle stiffness, and muscle weakness. Affected birds were identified by their inability to lift their wings vertically upward and by their inability to right themselves when placed on their dorsum. Electromyographic studies in two mutant quails showed high-frequency repetitive discharges comparable to those of myotonic runs. These discharges persisted after nerve resection. The distinctive histopathologic changes in the various muscles examined were ring fibers, sarcoplasmic masses, and internal migration of sarcolemmal nuclei. A slight decrease in the size of type IIB muscle fibers and a slight increase in the size of type IIA fibers were observed in the M. pectoralis thoracicus of affected quails. In older affected birds, inter- and intrafascicular fatty infiltration with replacement of type IIB fibers by fat cells was seen in the pectoral muscles. Single fiber necrosis, nonspecific lymphorrages, and variations in the muscle fiber size and shape were also noted. The typical muscle lesions and multisystem involvement, which was manifested by testicular degeneration and atrophy in the male LWC specimens and bilateral lenticular cataracts in 6 of 13 affected mutant quails, suggest resemblance of this new inherited muscular disorder to myotonic dystrophy in man.

Ultrastructural and morphometrical analyses of Leydig and Sertoli cells in the testes of rats with hereditary polydactylism

Rats of the polydactylous (PD) strain carry an autosomal recessive gene pd that causes polydactylism in homozygotes (pd/pd). Male homozygotes are sterile owing to an abnormality of spermatogenesis. In the present study, Leydig and Sertoli cells of 12-week-old pd/pd male rats were examined for ultrastructural alterations in an attempt to clarify the cause of the abnormal spermatogenesis. The relative volumes of the organelles were also determined with morphometry. Phenotypically normal pd/+ males served as controls. No morphological or morphometrical abnormalities were noted in the Leydig cells. However, two different types of Sertoli cell were evident: light cells and dark cells. The incidence of the dark Sertoli cells in pd/pd males was high (27%) compared with that in pd/+ males (6%). These dark cells contained quantities of lipid droplets in the cytoplasm and exhibited a significant increase in the relative volume of lipid droplets compared with the value for the light cells. The nuclei of the dark Sertoli cells were irregular in shape and were invaginated. These results suggest that dark Sertoli cells may have lower lipid metabolism, and in pd/pd males, the high number of these dark Sertoli cells may be related to abnormal spermatogenesis.

Bulbar morphology and expression of bulbar dopamine and parvalbumin in experimentally-induced anosmic rats

Morphological study was carried out in rats with olfactory dysfunction induced by deafferentation of serotonergic fibers in the olfactory bulb. With a computer capable of area measurements, olfactory bulbs of the anosmic rats were found to be decreased in size to 61% of control bulbs, and all bulbar layers were involved in the bulbar shrinkage. Given areas of each bulbar layer in control bulbs to be 100%, percentages of each bulbar layer in the anosmic rats were 23% in the olfactory nerve layer, 54% in the glomerular layer, 63% in the external plexiform layer, 83% in the internal plexiform layer and 81% in the granule cell layer. Dopamine-and parvalbumin-containing neurons were examined immunohistochemically in the experimentally-induced anosmic rats. As a result, immunoreactive neurons for these two chemical substances were significantly decreased in number (dopamine, 33% of control value; parvalbumin, 46% of control value). The present study, using an animal model of anosmia, provided quantitative data on the bulbar atrophy and showed effects of anosmia on expression of dopamine and parvalbumin in the bulb.

A case of glycogen storage disease type III (glycogen debranching enzyme deficiency) with liver cirrhosis and hypertrophic cardiomyopathy

We present a 26-year-old woman with glycogen storage disease type III (debranching enzyme deficiency) complicated with liver cirrhosis and hypertrophic cardiomyopathy. Glycogen debranching enzyme has two catalytic sites, oligo-1,4,-1,4- glucantransferase (EC 2.4.1.25) and amylo-1,6-glucosidase (EC 3.2.1.33). Variability in the clinical phenotype could be a function of the involvement of one or other catalytic site, or differences in tissue expression of the defective enzyme, or both. We hypothesize that some subtypes of glycogen storage disease (GSD) type III may cause liver cirrhosis as seen in GSD type IV due to the accumulation of glycogen of abnormal structure.

Vocal function in patients with unilateral vocal fold paralysis before and after silicone injection

A total of 240 patients with unilateral vocal fold paralysis (UVFP) underwent transcutaneous intrafold silicone injection (TCIFSI) for the purpose of vocal rehabilitation during the period from 1983 to 1993 in the Kurume University Hospital. Their vocal function was evaluated and the effects of TCIFSI upon the vocal function were investigated. The patients with UVFP presented with an increase in airflow during phonation; a decrease in maximum phonation time and fundamental frequency (F0) range and sound pressure level (SPL) range of phonation; and an increase in pitch perturbation quotient, amplitude perturbation quotient and normalized noise energy in the voice signal. TCIFSI resulted in a decrease in airflow, an increase in phonation time and F0 and SPL range of phonation, and a decrease in pitch and amplitude perturbation and noise in the voice signal. Patient's own subjective evaluation presented with an improvement of his/her voice after TCIFSI.

Successful prophylaxis of wheat-dependent exercise-induced anaphylaxis with terfenadine

A 20-year-old female was brought to our emergency unit with generalized erythema and discomfort induced by running after having eaten wheat bread. The laboratory examinations, including eosinophils, total IgE, RAST score to wheat, heat challenge test and methacholine inhalation test were within normal limits. No anaphylactoid responses occurred after provocation tests of wheat bread intake or exercise alone. However, on provocation exercise test after eating pancakes, she developed hypotension, generalized itching and urticaria associated with an elevation of plasma histamine levels. These findings suggested wheat-dependent exercise-induced anaphylaxis. This was completely prevented by daily administration of terfenadine 120 mg p.o. without side effects such as fatigue or drowsiness.

Thoracoscopic resection of a solitary pulmonary lymphangioma: report of a case

We present herein the rare case of a young man who was found to have a solitary tumor in the right upper lobe of his lung by a routine chest X-ray. The tumor was removed by thoracoscopic surgery, and pathological examinations confirmed the diagnosis of a primary lymphangioma of the lung. A brief review of the available literature on this extremely rare type of benign tumor follows the case report.

[Evaluation of internal thoracic artery bypass grafting with perfusion contrast echocardiography]

Intraoperative perfusion contrast echocardiography (PCE) is a new method to evaluate regional myocardial perfusion using Albunx (air encapsulated albumin microspheres-Molecular Biosystems, Inc.) and has been employed by direct individual injection into human saphenous vein coronary bypass grafts. Because this is not an appropriate technique for assessing left internal thoracic artery (LITA) graft, we tested the hypothesis that PCE can be performed with a single aortic root injection and, thereby, provide regional perfusion data for LITA and native coronary flow. CABG (LITA to the left anterior descending artery (LAD) was performed in adult swine. PCE was performed in each of the following conditions: 1) LITA occluded, LAD 100% flow; 2) LITA 100% flow, LAD occluded; 3) LITA 50% flow, LAD occluded; and 4) LITA and LAD occluded. Time-intensity curves were constructed to assess the time to initial appearance of myocardial enhancement (TIA), peak contrast intensity (PI), and area under the enhancement curve (AUC). In 12/14 cases, (85.7%), adequate enhancement was achieved. LITA perfusion, when compared to perfusion through the native LAD, showed delayed appearance (TIA 0.4 +/- 0.1 vs 1.9 +/- 0.2 secs), reduced PI (43 +/- 3 vs 28 +/- 3 AU) and reduced AUC (247 +/- 115 +/- 19 AU) (p < 0.01) when LITA flow was reduced 50%, TIA was prolonged (1.7 +/- 0.2 vs 2.4 +/- 0.2 secs) and AUC was reduced (152 +/- 18 vs 88 +/- 20 AU) (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Development of a new endotoxin sensor with intermittent injection of limulus reagent for continuous monitoring of dialysate fluid

This report describes a method of continuously, stably, and inexpensively measuring endotoxin (ET) concentrations in dialysate fluid using an ET sensor with intermittent injection of limulus reagent. An ET solution simulating dialysate fluid was sampled in a single tube at a flow rate of 260 microliters/min and mixed with 30 microliters of limulus reagent intermittently injected into the tube. The absorbance of the solution was measured after the limulus reaction at 313 or 318 degrees K at 26 min. A good linear relationship (r = 0.98) between peak area of absorbance and ET concentration at ET concentrations ranging from 0 to 0.12 endotoxin unit (EU)/ml was obtained, using a spectrophotometer with a cell volume of 8 microliter. The baseline rose after the measurements were taken because the cell volume was so small that the cell was stuffed with gel. A good linear relationship (r = 1.00) at ET concentration of 0.1-0.25 EU/ml was also obtained, and the baseline was unchanged after measurements, using a metal free spectrophotometer with a cell volume of 420 microliters. In conclusion, to measure ET concentrations below 0.1 EU/ml, the cell volume of a metal free spectrophotometer should be minimal.

Effects of thromboxane A2 analogue on vascular resistance distribution and permeability in isolated blood-perfused dog lungs

This study was designed to determine the effects of thromboxane A2 (TxA2) on the distribution of vascular resistance, lung weight, and microvascular permeability in isolated dog lungs perfused at a constant pressure with autologous blood. The stable TxA2 analogue (STA2; 30 micrograms, n = 5) caused an increase in pulmonary capillary pressure (Pc) assessed as double-occlusion pressure to 14.0 +/- 0.4 mmHg from the baseline of 7.9 +/- 0.3 mmHg with progressive lung weight gain. Pulmonary vascular resistance increased threefold exclusively due to pulmonary venoconstriction. Pulmonary venoconstriction was confirmed in lungs perfused in a reverse direction from the pulmonary vein to the artery (n = 5), as evidenced by marked precapillary vasoconstriction and a sustained lung weight loss. Furthermore, in lungs perfused at a constant blood flow (n = 5), STA2 also caused selective pulmonary venoconstriction. Vascular permeability measured by the capillary filtration coefficient and the isogravimetric Pc at 30 and 60 min after STA2 infusion did not change significantly from baseline in any lungs studied. Moreover, elevation of Pc by raising the venous reservoir of the intact lobes (n = 5) to the same level as the STA2 lungs caused a greater or similar weight gain compared with the STA2 lungs. Thus, we conclude that TxA2 constricts selectively the pulmonary vein resulting in an increase in Pc and lung weight gain without significant changes in vascular permeability in isolated blood-perfused dog lungs.

Tyrosine phosphorylation and translocation of the c-cbl protein after activation of tyrosine kinase signaling pathways

The c-cbl protooncogene product (c-Cbl) is a 120-kDa protein that has been shown to bind to the Src homology 3 domains of various proteins, suggesting its involvement in signal transduction pathways. We identified one of the most prominent tyrosine-phosphorylated proteins in Fc gamma receptor (Fc gamma R)-stimulated macrophages to be c-Cbl. Tyrosine phosphorylation of c-Cbl occurred within 20 s after stimulation and reached maximum levels within 3-5 min. c-Cbl was also tyrosine-phosphorylated in epidermal growth factor (EGF) receptor-overexpressing cells upon EGF stimulation, in macrophages in response to CSF-1 treatment, and in v-src transformed cells. Furthermore, we found that c-Cbl associated with these kinases in vivo. In vitro, c-Cbl bound to the Src homology 3 domains of Src, Fyn, and Lyn in both unstimulated and Fc gamma R-stimulated macrophages. Examination of cells by immunofluorescence revealed that c-Cbl is diffusely distributed in the cytoplasm in both unstimulated macrophages and EGF receptor-overexpressing cells and translocated to a more specific compartment of the cell, consistent with the trans-Golgi region, following Fc gamma R clustering and EGF stimulation, respectively. These results suggest that c-Cbl is involved in the signaling pathways utilized by different types of tyrosine kinases.

Comparative study of vasodilator effects of the potassium channel openers NIP-121 and levcromakalim in dogs and rats

The effects of potassium channel openers NIP-121 ((+)-7,8-dihydro-6,6-dimethyl-7-hydroxy-8-(2-oxo-piperidine-1-yl)-6H- pyrano[2,3-ss]benz-2,1,3-oxadiazole) and levcromakalim were examined in vitro and in vivo. In isolated canine vascular beds, NIP-121 (3 x 10(-9) to 10(-7) M) and levcromakalim (3 x 10(-8) to 10(-6) M) produced a concentration-dependent reduction in the vasoconstrictor responses to U46619. The effects were antagonized by glibenclamide, an ATP-sensitive potassium channel blocker. The maximal relaxation was more than 70% of the maximal vasodilation induced by papaverine (10(-4) M), except in the basilar artery. These compounds had very potent effects on the coronary and cranial mesenteric arteries and saphenous vein. In the coronary perfused rat heart, both compounds (10(-7) M) also increased coronary perfusion flow. The effects were also inhibited by glibenclamide (10(-6) M). In anesthetized dogs, NIP-121 (1 to 10 micrograms/kg (3.2 to 32 nmol/kg), i.v.) and levcromakalim (3 to 30 micrograms/kg (10.5 to 105 nmol/kg), i.v.) dose-dependently increased coronary and renal blood flow. NIP-121 and levcromakalim at higher doses produced the greatest increase in coronary blood flow among the blood vessels examined, in spite of the hypotensive effect. In conclusion, NIP-121 and levcromakalim were similarly selective vasodilators on the canine isolated coronary and cranial mesenteric arteries and saphenous vein, and they selectively increased coronary blood flow in vivo. With respect to increasing the coronary blood flow, NIP-121 had a fourfold greater potency than levcromakalim. This effect might be related to the glibenclamide-sensitive potassium channels.

Height reduction among prenatally exposed atomic-bomb survivors: a longitudinal study of growth

Using a random coefficient regression model, sex-specific longitudinal analyses of height were made on 801 (392 male and 409 female) atomic-bomb survivors exposed in utero to detect dose effects on standing height. The data set resulted from repeated measurements of standing height of adolescents (age 10-18 y). The dose effect, if any, was assumed to be linear. Gestational ages at the time of radiation exposure were divided into trimesters. Since an earlier longitudinal data analysis has demonstrated radiation effects on height, the emphasis in this paper is on the interaction between dose and gestational age at exposure and radiation effects on the age of occurrence of the adolescent growth spurt. For males, a cubic polynomial growth-curve model applied to the data was affected significantly by radiation. The dose by trimester interaction effect was not significant. The onset of adolescent growth spurt was estimated at about 13 y at 0 Gy. There was no effect of radiation on the adolescent growth spurt. For females, a quadratic polynomial growth-curve model was fitted to the data. The dose effect was significant, while the dose by trimester interaction was again not significant.

Liver with hypoechoic nodular pattern as a risk factor for hepatocellular carcinoma

BACKGROUND/AIMS

Ultrasonography should be used for screening of hepatocellular carcinoma, but there are few reports on the relationship between liver ultrasonographic findings and the development of hepatocellular carcinoma (HCC). Using prospective follow-up studies, we examined the role of liver with a hypoechoic nodular pattern as a high-risk factor in HCC.

METHODS

The study was performed by follow-up on 593 patients with chronic liver disease recorded at our hospital. The ultrasonographic pattern of the liver parenchyma was classified either as a small or large hypoechoic nodular pattern or as a nonnodular pattern. Patients were followed up from the time of initial ultrasonographic examination (1985-1987) until January 1, 1991.

RESULTS

During the follow-up period (average, 4.2 years, range, 0.3-6.0 years), 62 patients were found to have HCC (12%). Patients whose livers showed small or large hypoechoic nodular pattern had a significantly higher risk of HCC than did patients whose livers showed a nonnodular pattern (rate ratios were 14.0 and 20.0, respectively, adjusted for age, sex, hepatitis virus markers, ICG R15, alpha-fetoprotein concentration, and ultrasonographic pattern of the liver).

CONCLUSIONS

Liver showing a hypoechoic nodular pattern is a major risk factor in HCC.

Effect of lysyl hydroxylase inhibitor, minoxidil, on ultrastructure and behavior of cultured rabbit subconjunctival fibroblasts

BACKGROUND

Minoxidil is an inhibitor of lysyl hydroxylase, an enzyme involved in collagen production, and decreases collagen production in vitro. We investigated the in vitro effects of minoxidil on behavior such as proliferation and migration of rabbit subconjunctival fibroblasts (SCFs). The ultrastructural effect of the drug on SCFs was also examined.

METHODS

Proliferation of SCFs and closure of the defect produced in monolayer cultures in the presence or absence of minoxidil was studied. The ultrastructure of SCFs treated with minoxidil was also examined.

RESULTS

Minoxidil inhibited SCF proliferation and the closure of the defect produced in monolayer cell sheets. Ultrastructural observations revealed extensive areas of irregularly dilated endoplasmic reticulum in cells treated with minoxidil, indicating the accumulation of protein, probably underhydroxylated collagen precursors, in the cisternae of endoplasmic reticulum.

CONCLUSIONS

The results indicated that minoxidil attenuated cellular activities of SCFs such as proliferation and migration in vitro. The exact mechanism of the inhibitory effects of minoxidil on these cellular activities is unknown. The findings suggest that the drug might help to prevent bleb scarring after glaucoma filtering surgery.

Aromatase in bone cell: association with osteoporosis in postmenopausal women

To clarify the possible action of adrenal androgen on bone cell, the existence, characteristics and regulation of aromatase in human osteoblast-like osteosarcoma cells (HOS) and primary cultured osteoblast-like cells from normal human bones (HO) were examined in this study. Significant positive correlation between bone mineral density (BMD) and serum dehydroepiandrosterone sulfate (DHEA-S) was found in 120 postmenopausal women (51-99 years old) but no correlation was seen between BMD and serum estradiol (E2). In subset analysis, strongly positive correlation of serum DHEA-S and estrone (E1) with BMD was observed in postmenopausal women aged less than 69 years old. Administration of DHEA to ovariectomized rat significantly increased BMD and decreased relative osteoid volume in femur. These in vivo findings strongly suggested that serum adrenal androgen may be converted to estrogen in peripheral organ, especially, osteoblast and be important steroids to maintain BMD. [3H]DHEA was converted to [3H]androstenedione and [3H]androstenedione to [3H]estrone in primary cultured human osteoblast. Osteoblast-like cells showed aromatase activity, and an apparent Km and the Vmax were 4.74 +/- 0.78 nM (mean +/- SD, n = 3) and 0.83 +/- 0.79 fmol/mg protein/h for HOS, and 4.6 +/- 2.9 nM and 279 +/- 299 fmol/mg protein/h (mean +/- SD, n = 19) for HO, respectively. The aromatase activity was significantly increased by dexamethasone in a dose-dependent manner. Reverse transcription-polymerase chain reaction analysis revealed that dexamethasone increased the transcript of P450AROM gene. Osteoblast-specific promoters were also determined. Dexamethasone and 1 alpha,25-dihydroxyvitamin D3 synergistically enhanced aromatase activity and P450AROM mRNA expression. These results demonstrate that adrenal androgen, DHEA, is converted to E1 in osteoblast by P450AROM which is positively regulated by glucocorticoid and 1 alpha,25-dihydroxyvitamin D3 and important to maintain BMD in the 6 to 7th decade, after menopause.

Alteration of gamma-ray-induced chromosome aberration by 0.5 M NaCl in Chinese hamster cells

Hypertonic treatment (0.5 M NaCl in phosphate-buffered saline, pH 7.2) at 37 degrees C for 20 min slightly delayed the mitotic frequency for non-irradiated cells in G1 and G2 phases. The mitotic frequency for irradiated cells in G2 was delayed by hypertonic treatment, and that in G1 was slightly delayed by hypertonic treatment. Hypertonic treatment in non-irradiated cells did not induce any chromosomal or chromatid aberrations in either G1 or G2. Chromosomal aberrations caused by gamma-irradiation were slightly enhanced by hypertonic treatment, and chromatid aberrations were markedly enhanced by hypertonic treatment. The enhancement ratio of gamma-irradiation-induced chromatid breaks and exchanges was 1.4 and 3.0, respectively. This cell cycle dependency of chromosome aberrations induced by postirradiation hypertonic treatment was the same as that of cell survival. These findings suggested that hypertonic treatment modifies the rejoining of DNA strand breaks in G2, but slightly modifies that in G1.

Dissection of GLUT4 recycling pathway into exocytosis and endocytosis in rat adipocytes. Evidence that GTP-binding proteins are involved in both processes

The effects of guanine nucleotides on either exocytosis or endocytosis of GLUT4 were examined in electrically permeabilized rat adipocytes by using Dk-(62-85), a major histocompatibility complex class I-derived peptide. Reversal of glucose transport activity that had been stimulated with insulin was completely blocked by Dk-(62-85). Likewise, endocytosis of the trypsin-cleaved 35-kDa fragment of GLUT4 was almost completely inhibited by the peptide. Insulin-stimulated glucose transport activity was enhanced about 50% by Dk-(62-85), whereas the basal transport activity was stimulated only slightly. Although guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S) augmented glucose transport to the same extent as insulin in the absence of the peptide, glucose transport stimulated by GTP gamma S was only 60% of the insulin effect in the presence of the peptide; the effect of insulin was markedly enhanced by Dk-(62-85), whereas GTP gamma S-induced glucose transport was not affected, suggesting that GTP gamma S has an effect similar to that of the peptide. In fact, endocytosis of the 35-kDa fragment of GLUT4 was markedly inhibited by GTP gamma S. Additionally, GLUT4 endocytosis was accelerated by GTP but was inhibited by guanosine 5'-O-(2-thiodiphosphate). These results indicate that GTP gamma S induces translocation of GLUT4 by both stimulating exocytosis and inhibiting endocytosis. With respect to the dependence on GTP hydrolysis, distinct types of GTP-binding proteins are involved in exocytosis and endocytosis of GLUT4.