Anticipatory postural adjustments associated with a loading perturbation in children with hemiplegic and diplegic cerebral palsy

Anticipatory postural adjustments (APAs) in preparation for predictable externally induced loading perturbation were studied in children with typically development (TD), hemiplegic (HEMI), and diplegic (DIPL) cerebral palsy. Twenty-seven children (n = 9 in each group) were asked to stand and catch a load dropped from a pre-specified height. Electrical activity of the leg and trunk muscles and center of pressure (COP) displacements were recorded to quantify the APAs. All groups were able to generate APAs prior to the perturbation, but the magnitude was smaller and the onset was delayed in the dorsal (agonist) postural muscles in both HEMI and DIPL as compared to TD. HEMI and DIPL also generated APAs in the antagonist postural muscles. Anticipatory backward COP displacement was significantly different from the baseline value only in the TD and HEMI. HEMI and DIPL displayed a different postural control strategy; HEMI showed no difference in background postural activity from TD, but with diminished APAs in the agonist postural muscles compared to TD, while DIPL showed a higher background postural activity and diminished APAs in the agonist postural muscles compared to TD. These differences are important to consider when designing rehabilitation programs to improve posture and movement control in children with hemiplegic and diplegic cerebral palsy.

Determination of short-chain fatty acids in rat and human feces by high-performance liquid chromatography with electrochemical detection

A simple method for determining short-chain fatty acids (SCFAs) in rat and human feces was developed using high-performance liquid chromatography with electrochemical detection (HPLC-ECD). A two-channel HPLC-ECD system was fabricated using an ion exclusion column and an electrochemical detector with a glassy carbon working electrode. Aqueous solutions of 0.1 mM HClO(4) and of ethanol containing 2-methyl-1,4-naphthoquinone served as a mobile phase and a quinone solution, respectively. Peak areas for lactic, acetic, propionic, butyric, isovaleric, and valeric acids at a detection potential of -0.9 V vs. an Ag/AgCl electrode showed a linear relationship with the acid amount in the range 0.1 to 40 nmol. Standard acids at 4 nmol were determined ten times with relative standard deviations (RSD) of less than 2.0%. The analytical results of healthy human feces were measured within 35 min. RSD (n = 5) in all SCFAs were less than 2.7%, and recoveries of SCFAs were more than 92%. The present method was characterized by reproducibility with the simple and rapid procedure without derivatization of analytes, and it has the potential for clinical and biomedical applications.

Enhancement of chemosensitivity toward peplomycin by calpastatin-stabilized NF-kappaB p65 in esophageal carcinoma cells: possible involvement of Fas/Fas-L synergism

Chemosensitivity to anticancer drugs was compared between two human esophageal carcinoma cell lines, T.Tn and YES-6 cells. T.Tn cells were more resistant than YES-6 cells to peplomycin (PEP) but not to the other anticancer drugs such as camptothecin, mitomycin C and cytosine arabinoside. Western blot analysis showed higher expression levels of m-calpain and activated mu-calpain in T.Tn cells than in YES-6 cells. On the other hand, YES-6 cells showed a high expression level of calpastatin, which is a calpain-specific endogenous inhibitor. To investigate whether calpain activity was involved in the chemosensitivity, T.Tn cells were transfected with calpastatin cDNA in an inducible expression vector. The induction of calpastatin was accompanied by increased chemosensitivity to PEP. The increases in calpastatin levels were followed by serial increases in the expression levels of NF-kappaB p65 and Fas. Since purified m- or mu-calpain degraded NF-kappaB p65 in vitro, it is possible that calpastatin suppressed calpain-mediated degradation of NF-kappaB p65. Fas ligand (Fas-L) protein levels increased after treatment of the parental T.Tn and calpastatin-transfected cells with PEP, suggesting the synergism between calpastatin-induced Fas and PEP-induced Fas-L. These results suggest that calpain/calpastatin expression levels are effective markers for predicting the sensitivity of human esophageal carcinoma cells to PEP.

Association of tannase-producing Staphylococcus lugdunensis with colon cancer and characterization of a novel tannase gene

BACKGROUND

The relationship between Streptococcus (St.) bovis endocarditis and colon cancer is well known. In St. bovis, the biotype I strain (formerly, St. gallolyticus) produces tannase that degrades tannins. The aim of this study was to investigate the association of tannase-producing bacteria with colon cancer, and to identify the major tannase-producing bacteria and the gene involved.

METHODS

Tannase-producing bacteria were isolated in tannic acid-treated selective agar medium from feces and rectal swabs of 357 patients who underwent colon endoscopy from 1999 to 2004.

RESULTS

Tannase-producing bacteria were isolated more frequently from the colon cancer group (24.3%) than from the adenoma or normal groups (14.4%; P < 0.05). S. gallolyticus, Staphylococcus (S.) lugdunensis, Lactobacillus (L.) plantarum, and L. pentosus were all identified as tannase-producing bacteria. Of these, S. lugdunensis was significantly isolated from the advanced-stage cancer group (22.2%; P < 0.001) more than from the early-stage cancer (8.6%) or adenoma (4.9%) groups. The gene (tanA) for tannase in S. lugdunensis was cloned and sequenced. The tanA gene was associated with all S. lugdunensis but not with other bacteria by Southern blotting and polymerase chain reaction.

CONCLUSIONS

Tannase-producing S. lugdunensis is associated with advanced-stage colon cancer, and the tanA gene is a useful marker for the detection of S. lugdunensis.

Concurrent chemoradiation for patients with squamous cell carcinoma of the cervical esophagus

Little is known concerning the role of concurrent chemoradiation (CCRT) in the management of carcinoma of the cervical esophagus. We retrospectively evaluated our treatment approach for patients with cervical esophageal cancer with special emphasis on CCRT with or without surgery. Medical records of 21 consecutive patients with cervical esophageal carcinoma treated mainly with CCRT (1997-2004) were reviewed, and factors that influenced patient survival were analyzed retrospectively. Nineteen received CCRT with cisplatin/5-fluorouracil and five underwent curative surgery. Two patients who were deemed unfit for CCRT received radiation therapy alone. All had three-dimensional treatment planning (median total dose, 40 Gy with surgery, 64 Gy without surgery). Of the 19 patients who received CCRT, 11 patients including five who underwent curative surgery achieved initial local control. Neither of the two patients who received radiation therapy alone achieved local control. Among 19 patients who underwent CCRT, 9/11 with T1-3 grade tumors achieved initial local control, but only 2/8 patients with T4 tumors (P = 0.011, chi(2) test) achieved initial local control. No patient without initial local control survived > 20 months compared with 2-year and 5-year survival rates of 60% and 40% in those who achieved initial local control (P = 0.038). No patient with T4 tumors survived > 18 months, whereas 2- and 5-year survival rates were 62% and 41%, respectively, in those with T1-3 tumors (P = 0.006). The significant effect of T-classification on survival was maintained when analyzed among 19 patients who received CCRT. CCRT shows promise for cervical esophageal carcinoma. T-classification and initial local control had significant impact on survival.

Neoadjuvant chemoradiotherapy followed by esophagectomy for initially resectable squamous cell carcinoma of the esophagus with multiple lymph node metastasis

Neoadjuvant chemoradiotherapy (CRT) was expected to improve surgical curability and prognosis for advanced esophageal cancer. However, the clinical efficacy of neoadjuvant CRT followed by esophagectomy with three-field lymphadenectomy (3FL) for initially resectable esophageal squamous cell carcinoma (SCC) remains unclear. Since 1998, we have defined the status of metastases to five or more nodes, or nodal metastases present in all three fields as multiple lymph node metastasis, which was previously shown to be associated with poor prognosis. Between 1998 and 2002, 83 patients with initially resectable esophageal SCC were prospectively allocated into two groups, according to the clinical status of nodal metastasis. Nineteen patients clinically accompanied by multiple lymph node metastasis initially underwent neoadjuvant CRT followed by curative esophagectomy with 3FL (CRT group). The other 64 patients clinically without multiple lymph node metastasis immediately received curative esophagectomy with 3FL (control group). Although the overall morbidity rate was significantly higher in the CRT group, no in-hospital death occurred in either group. Patients without pathologic multiple lymph node metastasis in the CRT group showed a significantly better disease-free survival rate than either patients pathologically with multiple lymph node metastasis in the control group or those in the CRT group. However, the differences in the overall survival rate among the groups were not significant. Thus, the significant survival benefit by neoadjuvant CRT in addition to esophagectomy with 3FL was not confirmed, although it may have been advantageous, without increase in mortality, to at least some patients who responded well to neoadjuvant CRT. Therefore, neoadjuvant CRT can be an initial treatment of choice for resectable esophageal SCC clinically with multiple lymph node metastasis. The prediction of response to CRT and the development of alternative treatment for hematogenous recurrence could achieve a further survival benefit of this trimodality treatment.

Development of less invasive surgical procedures for thoracic esophageal cancer

In order to minimize the invasiveness of the operative procedure for thoracic esophageal cancer, several procedures have been introduced since January 1997. They included: (i) perioperative use of steroids; (ii) muscle-sparing thoracotomy without costectomy; (iii) preparation of the gastric tube with preservation of sufficient blood supply; (iv) reconstruction of the alimentary tract via posterior-mediastinal route; and (v) formation of anastomosis between the remaining esophagus and the gastric tube at a location between the gastroepiploic arteries of the gastric greater curvature. Twenty-one patients who did not receive preoperative chemoradiotherapy underwent the newly developed procedure, and were compared with those receiving the original procedure. Hospital mortality was zero, and postoperative systemic inflammatory response syndrome was suppressed. The mean postoperative hospital stay was 21.5 days, and the actuarial 3-year survival rate was 76.2%. From the comparison with those receiving the original procedure, it can be concluded that the newly developed procedures were effective in minimizing surgical invasiveness and were sufficiently curative in terms of cancer treatment.

Comparison between in vivo and in vitro pharmacokinetics of succinylcholine in humans

PURPOSE

To compare the in vivo and in vitro pharmacokinetics of succinylcholine (SCh) in humans.

METHODS

A bolus of SCh 1 mg.kg(-1) (n = 7) or 2 mg.kg(-1) (n = 11) was given to 18 patients anesthetized with thiopental. Arterial blood samples for determination of in vivo SCh concentrations were collected every 30 s for 5 min. Another 20-ml blood sample was obtained before induction of anesthesia for determination of in vitro SCh. Concentrations of SCh were measured by high-performance liquid chromatography. In vivo and in vitro concentrations of SCh vs time data were analyzed by the one-compartment model.

RESULTS

The respective in vivo and in vitro pharmacokinetic parameters (SCh 1 mg.kg(-1) vs SCh 2 mg.kg(-1)) were as follows: Plasma clearance was 4.17 +/- 2.37 and 1.85 +/- 0.28 l.min(-1), P < 0.05, vs 2.91 +/- 2.01 and 1.27 +/- 0.43 l.min(-1), P < 0.05. Elimination half-life was 25.4 +/- 10.6 and 47.4 +/- 5.4 s, P < 0.002 vs 26.3 +/- 10.0 and 75.2 +/- 21.8 s, P < 0.00005.

CONCLUSION

These results suggest that the rapid disappearance of SCh from the circulation is due to diffusion out of the blood vessels rather than to enzymatic hydrolysis.

Immunosuppressant pharmacodynamics on peripheral-blood mononuclear cells from patients with ulcerative colitis

We investigated peripheral-blood mononuclear cell (PBMC) response to immunosuppressive drugs and its influence on glucocorticoid therapy in ulcerative colitis (UC). IC50s of immunosuppressive drugs on in vitro blastogenesis of PBMCs stimulated with concanavalin A were estimated in 76 UC and 146 healthy subjects. Individual differences in IC50s for prednisolone, methylprednisolone, cyclosporine, and tacrolimus on blastogenesis of PBMCs from UC patients were spread from 11.0 to 1000, 0.6 to 1000, 0.01 to 1000, and 0.001 to 4.6 ng/ml, respectively. Normal upper thresholds for IC50s of these drugs were estimated from the mean + 2 S.D. of the IC50s of healthy PBMCs, and the patients exhibiting IC50s over these levels were arbitrarily considered as resistant. The incidences of resistance to glucocorticoids and cyclosporine in UC were significantly higher than those in healthy subjects (p < 0.0005). In 14 UC patients, there was a significant correlation between amounts of prednisolone (p < 0.05) or period of prednisolone administration (p < 0.05) for UC treatment and prednisolone IC50. The results showed that large individual deviations in PBMC response to the drugs were observed in UC, and UC patients exhibiting low PBMC sensitivity to prednisolone required a high prednisolone amount as well as long period of prednisolone administration for treatment. Thus, the drug sensitivity tests could be informative to single out refractory patients to the immunosuppressive therapy.

Expression of angiogenic factors predicts response to chemoradiotherapy and prognosis of oesophageal squamous cell carcinoma

The ability to predict patients' responses to chemoradiotherapy by analyzing pre-treatment biopsy specimens would be valuable for managing oesophageal squamous-cell cancer. To this end, the expression of p53, thymidine phosphorylase and vascular endothelial cell growth factor was analyzed by immunohistochemistry in 52 patients with oesophageal squamous-cell cancer prior to chemoradiotherapy. Treatment consisted of radiotherapy (40 Gy) and 5 day-infusion of 5-Fluorouracil (500 mg m(-2) per day) combined with cisplatin (10 mg m(-2) per day). Following treatment, imaging and endoscopic reassessment was performed to establish treatment response. Thirty-one patients underwent radical surgery and 21 patients were treated with an additional 20 Gy of radiotherapy. Of the tumours studied, 58% were p53-positive, 40% thymidine phosphorylase-positive and 44% vascular endothelial cell growth factor-positive. A clinical response was observed in 36 patients (69%) and was negatively associated with thymidine phosphorylase expression (P=0.02) and vascular endothelial cell growth factor expression (P<0.001). However, the 5-year survival rate was significantly lower only in patients with vascular endothelial cell growth factor-positive tumours (P=0.037). Multivariate analysis identified vascular endothelial cell growth factor as a significant independent prognostic factor (P=0.0147). These results suggest that expression of angiogenic factors has predictive value for the treatment response and outcome of patients with oesophageal cancer.

Anticipatory postural adjustments during load catching by standing subjects

OBJECTIVES

(1) To study differences in the generation of anticipatory postural adjustments (APAs) in arm and trunk/leg muscles prior to catching a load released either by the subject him-/herself or by the experimenter. (2) To study the importance of different mechanical characteristics of the load at impact for the generation of APAs prior to load catching.

METHODS

Standing subjects were asked to catch loads dropped onto the left hand from different heights either by the experimenter or by the subject's right hand. The load mass and release height were manipulated to keep either the mass or the momentum of the load at impact constant. APAs were quantified with integral electromyographic indices.

RESULTS

APAs were observed in leg, trunk and arm muscles prior to load impact for both self- and experimenter-release trials. Kinetic energy showed higher correlations with the magnitude of APA than momentum, but only in experimenter-release trials.

CONCLUSIONS

Subjects can generate APAs in both arm and trunk/leg muscles in the absence of an explicit voluntary action. The relative importance of kinetic energy and momentum for defining the magnitude of APAs can reflect the difference in the sources of information used to prepare for the forthcoming perturbation during self- and experimenter-released load catch.

The role of action in postural preparation for loading and unloading in standing subjects

The main purpose of the present study has been to find an answer to the question: Can the subject generate anticipatory postural adjustments (APAs) when a predictable postural perturbation occurs in the absence of a voluntary action? Answering this question would allow us to distinguish between two competing hypotheses on the relation between APAs and voluntary movements. One hypothesis considers both APAsigma and voluntary "focal" movements different peripheral patterns associated with a single control process, while the alternative hypothesis considers them outcomes of two parallel control processes. Healthy subjects performed series of loading and unloading trials that included: (1) catching a falling load onto another load held in extended hands; (2) catching a falling load onto a tray attached to the trunk; (3) allowing a falling load to hit another load out of the extended hands, causing an unloading; and (4) releasing a load held in extended hands by a voluntary shoulder movement. In series 1, precautions were taken to avoid possible small hand movements prior to the impact of the falling load. Available visual information on the trajectory of the falling load was manipulated. In all conditions, except when the subject's eyes were closed, APAs were seen with patterns that were adequate for counteracting expected perturbations. Quantitative electromyographic indices of APAs depended on the availability of visual information and particular methods of introducing postural perturbations despite the fact that the magnitude of the perturbation was always the same. Our findings support a hypothesis that control processes resulting in APAs can be different from control processes associated with focal voluntary movements.

Analysis of kinematically redundant reaching movements using the equilibrium-point hypothesis

Six subjects performed a planar reaching arm movement to a target while unpredictable perturbations were applied to the endpoint; the perturbations consisted of pulling springs having different stiffness. Two conditions were applied; in the first, subjects had to reach for the target despite the perturbation, in the second condition, the subjects were asked to not correct the motion as a perturbation was applied. We analyzed the kinematics profiles of the three arm segments and, by means of inverse dynamics, calculated the joint torques. The framework of the equilibrium-point (EP) hypothesis, the lambda model, allowed the reconstruction of the control variables, the "equilibrium trajectories", in the "do not correct" condition for the wrist and the elbow joints as well as for the end point final position, while for the other condition, the reconstruction was less reliable. The findings support and extend to a multiple-joint planar movement, the paradigm of the EP hypothesis along with the "do not correct" instruction.

The roles of proximal and distal muscles in anticipatory postural adjustments under asymmetrical perturbations and during standing on rollerskates

OBJECTIVES

The study addresses two controversial issues surrounding the nature of anticipatory postural adjustments (APAs). The first deals with the reproducible APA patterns in proximal postural muscles and variable APA patterns reported for the muscles controlling the ankle joint (TA-SOL). We hypothesized that the TA-SOL muscles participate mainly in the compensation of lateral and rotational perturbations, in particular those associated with asymmetrical movements. The second issue deals with decreased APAs reported during both very stable and unstable standing. We hypothesized that APA changes during unstable standing might depend on the actual mechanical nature of instability.

METHODS

Eight healthy subjects were recruited who had had no prior experience with rollerskates. They performed series of bilateral and unilateral, flexion and extension movements during regular standing and bilateral movements during standing on rollerskates. EMG changes and shifts of the center of pressure were analyzed within a time window typical of APAs.

RESULTS

We found that APAs in proximal muscles were decreased during unilateral shoulder movements as compared to APAs during bilateral movements but did not show right-left differences. In contrast, the distal muscles (TA-SOL) showed little involvement during bilateral movements, while a clear right-left asymmetry was seen during unilateral movements. Bilateral movements performed while standing on rollerskates were accompanied by unchanged APAs in the proximal muscle pairs and increased APAs in the TA-SOL pair.

CONCLUSIONS

We conclude that the proximal muscles provide a general pattern counteracting expected perturbations in the anterior-posterior direction while the distal muscles deal with asymmetrical perturbations and the modulation of APAs in unusual conditions such as standing on rollerskates. There seems to be no unambiguous relation between the magnitude of APAs and the stability of standing: Depending on the exact mechanical nature of postural instability, it could be associated with qualitatively different changes in the APAs.

[Immunosuppressive treatment of ulcerative colitis]

5-aminosalicylic compounds and corticosteroids are standard drugs, which have been used for treatment of ulcerative colitis (UC). Although unusually we experience severe active UC, such as refractory cases to these drugs. Immunosuppressive agents are introduced and effective for these cases. In the treatment for UC, 6-mercaptopurine and azathioprine are effective, but it takes a few months until their optimum effect. So these drugs are not suitable for severe active UC which needs rapid treatment. On the other hand, newer immunosuppressive agents such as cyclosporin, tacrolimus have a rapid onset of action. These drugs are very effective, but have side effects. We will review immunosuppressive treatment strategy of UC.

Resistance of Fc receptor- deficient mice to fatal glomerulonephritis

Immune complex-mediated inflammation is a common mechanism of various autoimmune diseases. Glomerulonephritis (GN) is one of these diseases, and the main mechanism of the induction of GN has been unclear. We examined the contribution of Fc receptors in the induction of nephrotoxic GN by establishing and analyzing mice deficient in the Fc receptor gamma chain (FcRgamma). Whereas all wild-type mice died from severe glomerulonephritis with hypernitremia by administration of anti-glomerular basement membrane (GBM) antibodies, all FcRgamma-deficient mice survived. Histologically, wild-type mice showed glomerular hypercellularity and thrombotic changes, whereas the renal tissue in FcRgamma-deficient mice was almost intact. Deposition of anti-GBM antibody as well as complement components in the GBM were equally observed in both wild-type and knockout mice. These results demonstrate that the triggering of this type of glomerulonephritis is completely dependent on FcR+ cells.

A novel acyl-CoA thioesterase enhances its enzymatic activity by direct binding with HIV Nef

In addition to playing a crucial role in the pathogenesis of AIDS, HIV nef induces down-regulation of CD4 expression and TCR signaling and also regulates the sorting pathway in host T cells. To elucidate the Nef function in HIV progression, we searched for a cellular component which interacts with Nef. A human cDNA encoding a novel acyl-CoA thioesterase (hACTE-III) was isolated as an HIV nef-binding protein by yeast two-hybrid system. hACTE-III is homologous to E. coli thioesterase II but to none of the mammalian thioesterases and therefore belongs to a new type. hACTE-III exhibits enzymatic specificity for a broad range of fatty acyl-CoAs. The hACTE-III-binding region within Nef is localized in the central region (amino acids 109-152). hACTE-III greatly enhances its enzymatic activity upon direct binding to Nef. Considering that either Nef-overexpression or impaired fatty acid regulation induces alteration of subcellular morphology, the augmented hACTE-III function by Nef-binding might induce dysfunction of T cells.

Tyrosine phosphorylation controls internalization of CTLA-4 by regulating its interaction with clathrin-associated adaptor complex AP-2

CTLA-4 is a costimulation receptor that binds to the same ligands, CD80 and CD86, as CD28 with high affinity and is transiently expressed on the cell surface of activated T cells. CTLA-4 delivers an inhibitory signal through association of a phosphotyrosine-containing motif in the cytoplasmic domain with Syp tyrosine phosphatase. We now demonstrate that CTLA-4 interacts with the mu2 subunit of the plasma membrane-associated adaptor complex, AP-2, through the same motif involved in the interaction with Syp, except that the interaction with mu2 requires unphosphorylated tyrosine. The interaction with mu2 likely induces rapid internalization of CTLA-4 from the cell surface. Our results suggest that the phosphorylation state of a single tyrosine residue determines whether CTLA-4 delivers a negative signal or is internalized.

[Out line of measurement of gastric emptying using by radioisotope and its problems awaiting solution]

The radioisotopic technique has been recognized as the best method of measuring gastric emptying all over the world, but several problems which must be solved have remained in it. The first is the confusion in the choice of a standard meal of ordinary food labeled with radioisotope. A meal for use in this studies must be reproducible in quality, and radioisotope must be homogenously distributed in it. It is necessary to consider the efficiency of examination, and to release a examinee's agony, therefore a meal must leave the stomach within the tolerable limits of a patient who keeps himself unshaken during measurement. If a liquid meal is used, we can easily make use of foods on the market. But, if a solid meal, a practical difficulty stands in front of us; Who prepares to cook it? Unless this problem has been solved, the radioisotopic method is never found general acceptance as a clinical examination. The second is the confusion in the choice of a posture during measurement. We must select such posture that never alter a patient's characteristics of his gastric emptying. For example, it is difficult to prove rapid evacuation in a patient with dumping syndrome, if we examine him in supine position. A final problem is to re-examine what kinds of index are necessary to investigate the gastric emptying curve with many variations except of half-emptying time which has been used popularly as the index of the rate of it. We gave an out-line of the methods of measuring gastric emptying using radioisotope and a suggestion of its some problems awaiting solution.

Long-term results of pylorus-preserving gastrectomy for gastric ulcer

The postoperative results of pylorus-preserving gastrectomy (PPG) for gastric ulcer performed in 134 patients during the past 25 years (mean postoperative period, 16.6 years) were studied. The incidence of postoperative complications was low. Dumping syndrome occurred in only 4.4% and 0% of cases as assessed by questionnaire and interview, respectively. Four (5.4%) of 74 patients available for this study had ulcer recurrence. In one of these four patients concurrent gastroduodenal ulcer was suspected from preoperative gastric analysis. The site of recurrence was found in all cases to be the remnant antral gland area along the greater curvature between the proper gastric gland area and the duodenum. Basal and maximal acid outputs at the time of relapse were significantly higher in patients with recurrence than in patients without recurrence. The fasting and postprandial serum gastrin levels were high in one patient with recurrence, whose antrum was preserved as long as 3 cm proximal to the pyloric ring; this was longer than that described in our original method of PPG. In two other recurrent cases the serum gastrin levels were not different from those in nonrecurrent cases. Immunohistochemical examination of the residual antrum showed no increase in the G-cell density in patients either with or without recurrence. These results suggest that the long-term quality of life of patients treated with PPG remains favorable. Recurrence rate can be further reduced if PPG is strictly indicated for gastric ulcer only and carried out by meticulous surgical techniques. In the pathogenesis of the ulcer recurrence the role of gastrin release from the residual antral mucosa seems to be limited.

Electrotransformation of Thiobacillus ferrooxidans with plasmids containing a mer determinant

The mer operon from a strain of Thiobacillus ferrooxidans (C. Inoue, K. Sugawara, and T. Kusano, Mol. Microbiol. 5:2707-2718, 1991) consists of the regulatory gene merR and an operator-promoter region followed by merC and merA structural genes and differs from other known gram-negative mer operons. We have constructed four potential shuttle plasmids composed of a T. ferrooxidans-borne cryptic plasmid, a pUC18 plasmid, and the above-mentioned mer determinant as a selectable marker. Mercury ion-sensitive T. ferrooxidans strains were electroporated with constructed plasmids, and one strain, Y4-3 (of 30 independent strains tested), was found to have a transformation efficiency of 120 to 200 mercury-resistant colonies per microgram of plasmid DNA. This recipient strain was confirmed to be T. ferrooxidans by physiological, morphological, and chemotaxonomical data. The transformants carried a plasmid with no physical rearrangements through 25 passages under no selective pressure. Cell extracts showed mercury ion-dependent NADPH oxidation activity.

Molecular cloning of the gene encoding Thiobacillus ferrooxidans Fe(II) oxidase. High homology of the gene product with HiPIP

The amino-terminal sequence of Thiobacillus ferrooxidans Fe(II) oxidase (linked to cytochrome c552) was determined, and the iro gene that encodes this enzyme was cloned using degenerate oligonucleotides as a probe. The DNA sequence of a region (856 base pairs) which encompasses the iro gene revealed that the enzyme was encoded by a 273-base pair open reading frame and consists of 90 amino acids, including a possible 37-residue signal sequence. The iro gene seems to be transcribed independently of any other gene because the transcriptional products are 0.45 and 0.6 kilobases in size. Current protein databases revealed that the iro gene product is a new member of the high redox potential iron sulfur proteins, which generally function in electron transport but do not show enzymatic activity.

Renal 25-hydroxyvitamin D-1 alpha-hydroxylase activity and mitochondrial phosphate transport in Hyp mice

The Hyp mouse is a homologue of the X chromosome-linked human disease, familial hypophosphatemic rickets (FHR). In FHR, reduced renal tubular brush-border membrane transport of phosphate results in hypophosphatemia and rickets. Both humans with FHR and Hyp mice have abnormal regulation of 25-hydroxyvitamin D-1 alpha-hydroxylase (1 alpha-hydroxylase), a mitochondrial enzyme found in proximal renal tubular cell epithelia, the apparent site of defective brush-border membrane phosphate transport. No common pathophysiology for these defects has been demonstrated. We hypothesized that phosphate transport may be present in renal mitochondria from Hyp mice and that its regulation may be deranged in parallel with the mitochondrial 1 alpha-hydroxylase. Using inhibitor-stop techniques described for measurement of phosphate transport in liver mitochondria, we examined mitochondria in normal and Hyp mouse kidney and found them to be comparable. We performed manipulations known to alter 1 alpha-hydroxylase differentially in normal and Hyp mice, i.e., phosphorus deprivation and phosphorus loading, and found no effect on mitochondrial phosphate transport. We also subjected Hyp and normal mice to calcium and vitamin D deprivation; this maneuver resulted in no significant changes in mitochondrial phosphate transport in Hyp or normal mice but confirmed the earlier observation that 1 alpha-hydroxylase activity is stimulated to a greater degree in normal mice than Hyp mice after this diet. Furthermore, administration of 1,25-hydroxyvitamin D3 depresses 1 alpha-hydroxylase activity in mitochondria from both normal and Hyp mice but has no effect on mitochondrial phosphate transport. We conclude that the mechanism of abnormal vitamin D metabolism in Hyp mice is not related to a primary defect in renal mitochondrial phosphate transport.

[Experience of surgical therapy of pyothorax in the pleural fistula of the bronchi and esophagus due to esophageal cancer]

The esophagectomy and total left pneumonectomy were carried out in a 53-year-old male who had developed pyothorax in the pleural fistula of the bronchi and esophagus due to esophageal cancer, and then reconstruction of the esophagus by route of the anterior thoracic wall was performed using stomach tube biphasically. The postoperative course was favorable, and oral intake was possible, and his physical condition recovered as the patient could repeat stopping out from hospital while he died by pneumonia after 7 months. The remote metastasis or metastasis to the mediastinal lymph-node were not noted by autopsy. It is considered that there are cases having indication for active resection among A3-esophageal cancers.

Effect of parathyroid hormone-like peptides on 25-hydroxyvitamin D-1 alpha-hydroxylase activity in rodents

The role of vitamin D metabolism in the humoral hypercalcemia of malignancy syndrome (HHM) is unclear. We studied in vivo and in vitro effects of synthetic parathyroid hormone-like peptides (PTH-LPs) on rodent renal 25-OHD-1 alpha-hydroxylase activity. Infusion of mice with PTH-LP-(1-36) at 10 pmol/h for 12 and 24 h showed significant (429 +/- 139% and 937 +/- 413%, respectively) stimulation of control enzyme activity. Infusion for 36 h demonstrated diminution of activity to levels nearer to the unstimulated state (228 +/- 36% of control). In that maximal activity was observed after 24 h of infusion, we examined 1 alpha-hydroxylase activity after variable dosages of PTH-LP-(1-36) at this time point. Animals infused with PTH-LP-(1-36) at dosages of 2.5, 10, and 30 pmol/h for 24 h demonstrated 1 alpha-hydroxylase activities of 0.71 +/- 0.12, 4.74 +/- 2.09, and 9.91 +/- 1.01 ng.mg protein-1.20 min-1 (means +/- SD), respectively, all significantly greater than control activity (0.51 +/- 0.20 ng.mg protein-1.20 min-1). PTH-LP-(1-36) and PTH-LP-(1-74) were comparable in potency to bovine (b)PTH-(1-34) in stimulating 1 alpha-hydroxylase. Direct in vitro incubation of PTH-LP-(1-36) with renal slices resulted in stimulation of 1 alpha-hydroxylase activity up to 200% of control levels, comparable to that seen with equimolar concentrations of bPTH-(1-34).(ABSTRACT TRUNCATED AT 250 WORDS)

Nucleotide sequence of the Thiobacillus ferrooxidans chromosomal gene encoding mercuric reductase

The nucleotide sequence of the Thiobacillus ferrooxidans chromosomal mercuric-reductase-encoding gene (merA) has been determined. The merA gene contains 1635 bp, and shares 78.2% and 76.6% sequence homology with the transposon, Tn501, and plasmid R100 merA genes, respectively. From the sequence, a 545-amino acid (aa) polypeptide was deduced, and comparison with those of Tn501 and R100 revealed 80.6% and 80.0% homology, respectively, at the aa sequence level. Divergence among the three merA aa sequences was clustered within a specific region (aa positions 41-87). By analysis of codon usage frequency, it is speculated that the T. ferrooxidans merA gene originated from Tn501, R100, or a common ancestral gene, but not from T. ferrooxidans itself.

Cloning and expression of Thiobacillus ferrooxidans mercury ion resistance genes in Escherichia coli

A search of various domestic isolates of Thiobacillus ferrooxidans revealed that some were fairly resistant to mercury ion. A proportion of mercury-resistant clones were able to volatilize mercury, and their corresponding gene was localized not in the plasmid DNA but in chromosomal DNA. This mercury ion resistance gene was cloned in Escherichia coli. E. coli carrying the recombinant plasmid was able to grow in the presence of more than 40 micrograms of HgCl2 per ml. Deletion analysis of the recombinant plasmid showed that the entire coding sequence of the mercury ion resistance gene was located within a 2.3-kilobase fragment of the chromosomal DNA from strain E-15. At least two polypeptides (molecular mass, 56 and 16 kDa, respectively) were coded by this fragment.

Gastric emptying in patients with gastric and duodenal ulcer

Gastric emptying was measured in patients with proximal gastric, distal gastric and duodenal ulcers using a radioisotopic method. Gastric emptying was rapid in patients with proximal gastric ulcer, and was considered to be due to accelerated proximal evacuation. However, emptying was delayed in patients with distal gastric ulcer, and was considered to be due to reduced emptying in the antrum. On the other hand, rapid emptying seen in duodenal ulcer patients was considered to be due to accelerated emptying in both the proximal stomach and the antrum. Gastric emptying in the healing stage was closer to that in healthy subjects than in patients with active-stage ulcer.

A case of intestinal obstruction due to a hernia traversing the lesser sac

A case of a hernia traversing the lesser sac with a primary defect in the greater omentum and a secondary defect in the lesser omentum is reported herein. This type of internal hernia is extremely rare and we have found only three other reported cases apart from our case. All four cases in whom this type of hernia occurred were young people. The general manifestation resembles acute intestinal obstruction and a plain radiograph shows obstruction of the upper small intestine. An erect lateral view of the abdomen often shows the anatomical location more clearly. Bowel resection was performed in two cases and all of the four reported cases recovered uneventfully.

A case of hemangioendothelioma of the small intestine

An 81-year-old female was admitted to hospital with anemia and abdominal discomfort, however, various pre-operative diagnostic work-ups for the gastro-intestinal tract revealed no significant change. At the time of surgery, a small intestinal tumor was discovered by means of endoscopy and seven centimeters of ileum was radically resected. The tumor was subsequently diagnosed histopathologically as hemangioendothelioma. The patient recovered quickly and now, 6 years later, has had no sign of tumor recurrence. The incidence of this tumor is reportedly less than 3 per cent of all tumors found in the small intestine and the prognosis of this tumor in the small intestine is poor. A five-year-survival rate can be referred to only 33.3 per cent of the reported cases.

Brain eicosanoid levels in spontaneously hypertensive rats after ischemia with reperfusion: leukotriene C4 as a possible cause of cerebral edema

The relation of brain eicosanoids to progression of cerebral edema was studied in stroke-resistant spontaneously hypertensive rats subjected to incomplete global brain ischemia induced by bilateral occlusion of the common carotid arteries. Thromboxane B2 and 6-keto prostaglandin F1 alpha levels were significantly elevated 5 minutes after reperfusion but returned to control levels by 30 minutes. In contrast, leukotriene C4 levels increased 2 hours after bilateral common carotid artery occlusion and peaked 30 minutes after reperfusion, with higher levels persisting until 60 minutes after reperfusion. Cerebral ischemia was accompanied by cerebral edema early after reperfusion. The edema correlated with increased leukotriene C4 levels. That the increased brain water content was causally related to an increase in leukotriene C4 was supported by results obtained following administration of the 5-lipoxygenase inhibitors ONO-LP-016 and AA-861. Both inhibitors suppressed the increased leukotriene C4 and brain water contents after reperfusion. Our results indicate that leukotriene C4 is closely associated with an induction of ischemic cerebral edema.

Oncofetal expression of glutathione S-transferase placental form in human stomach carcinomas

The content of glutathione S-transferase placental form (GST-pi) was immunohistochemically analyzed in 100 cases of human stomach carcinoma of various histological types and compared with the content in the stomach mucosa of the human fetus, infant and adult. High levels of GST-pi content were demonstrated in all stomach carcinomas except for signet ring cell carcinomas. High levels were also present in surface mucous cells and glandular cells of the stomach from a fetus aged 18 weeks, whereas only the parietal cells of fundic glands in the adult stomach showed slight staining for GST-pi. These results indicate that the phenotypic expression of GST-pi in human stomach carcinoma is oncofetal in character.

New additional operation for the prevention of the gastric stasis after selective gastric vagotomy with antrectomy

In order to prevent postoperative gastric stasis, we devised and tested the following improvements in the selective gastric vagotomy with antrectomy. (1) The gastroduodenostomy was made so as to have an acute angle to the longitudinal axis of the remnant stomach, and (2) the downward traction being exerted on the remnant stomach by the transverse colon was eliminated by dissecting the greater omentum, and then (3) the posterior wall of the corpus on the lesser curvature side was fixed to the stump of the hepatogastric ligament, and the posterior wall of the corpus on the greater curvature side was fixed to the retroperitoneum inferior to the pancreas. By these procedures, the corpus was maintained in a position superior to the anastomosis. These operative procedures resulted in preventing the gastric stasis after the start of oral feeding. The two patients on whom this operation was performed have been followed up for 3 to 4 months since the operation, and neither of them has had any complaint of gastric stasis, such as anorexia or a feeling of heaviness of the stomach.

[A case of early primary adenosquamous carcinoma of the stomach]

Primary adenosquamous carcinoma of the stomach is rare. Most cases are advanced when detected since there are only two cases of the early stages of this type of cancer in the literature. The histogenesis of this type of stomach carcinoma is still under discussion. In this paper an early stage of adenosquamous carcinoma of the stomach in a 56-year-old female is reported. The localization and characteristics of two type of cancer cells, adeno and squamous cell carcinoma cells, were studied using cytokeratin and PAS stainings.