Activation of mitochondrial K(ATP) channel elicits late preconditioning against myocardial infarction via protein kinase C signaling pathway

Activation of mitochondrial K(ATP) (mitoK(ATP)) channel induces acute ischemic preconditioning (PC) against ischemic injury. The ability of this channel to elicit late PC remains unknown. The present study tests the hypothesis that stimulation of mitoK(ATP) channel induces late PC via the protein kinase C (PKC) signaling pathway. Rats were subjected to 30 minutes of regional ischemia and 120 minutes of reperfusion (I/R). In other groups, rats were pretreated with diazoxide, a specific opener of the mitoK(ATP) channel (7 mg/kg, IV), 12, 24, 48, and 72 hours before they were subjected to I/R. A maximum reduction in infarct size was observed after 24 hours (33.3+/-2.2% versus I/R group, 62.1 +/-2.4%). Pretreatment with diazoxide did not reduce the infarct size significantly after 12, 48, and 72 hours (50.2+/-4.3%, 50.5+/-4.6%, and 58.2+/-4.9%) compared with the I/R group. The protection was blocked with 5-hydroxydecanoic acid (5-HD, 5 mg/kg IV), a relatively selective mitoK(ATP) channel blocker (56.5+/-2.7%), and chelerythrine (5 mg/kg IV), an effective PKC inhibitor (57.1+/-3.4%) administered either on the first day before diazoxide pretreatment or 10 minutes before I/R on the second day. Cell necrosis was decreased by approximately 50% in the diazoxide preconditioned hearts compared with control I/R hearts. Cell death by apoptosis was also significantly decreased in diazoxide pretreated hearts (3.2%) as compared with I/R (11.3%). In conclusion, activation of mitoK(ATP) channel with diazoxide produces late PC against reperfusion injury. The effect of mitoK(ATP) channel appears to be dependent on the PKC-mediated signal pathway.

Prediction and probability of neonatal outcome in isolated congenital diaphragmatic hernia using multiple ultrasound parameters

OBJECTIVES

To evaluate the accuracy and probabilities of different fetal ultrasound parameters to predict neonatal outcome in isolated congenital diaphragmatic hernia (CDH).

METHODS

Between January 2004 and December 2010, we evaluated prospectively 108 fetuses with isolated CDH (82 left-sided and 26 right-sided). The following parameters were evaluated: gestational age at diagnosis, side of the diaphragmatic defect, presence of polyhydramnios, presence of liver herniated into the fetal thorax (liver-up), lung-to-head ratio (LHR) and observed/expected LHR (o/e-LHR), observed/expected contralateral and total fetal lung volume (o/e-ContFLV and o/e-TotFLV) ratios, ultrasonographic fetal lung volume/fetal weight ratio (US-FLW), observed/expected contralateral and main pulmonary artery diameter (o/e-ContPA and o/e-MPA) ratios and the contralateral vascularization index (Cont-VI). The outcomes were neonatal death and severe postnatal pulmonary arterial hypertension (PAH).

RESULTS

Neonatal mortality was 64.8% (70/108). Severe PAH was diagnosed in 68 (63.0%) cases, of which 63 died neonatally (92.6%) (P < 0.001). Gestational age at diagnosis, side of the defect and polyhydramnios were not associated with poor outcome (P > 0.05). LHR, o/e-LHR, liver-up, o/e-ContFLV, o/e-TotFLV, US-FLW, o/e-ContPA, o/e-MPA and Cont-VI were associated with both neonatal death and severe postnatal PAH (P < 0.001). Receiver-operating characteristics curves indicated that measuring total lung volumes (o/e-TotFLV and US-FLW) was more accurate than was considering only the contralateral lung sizes (LHR, o/e-LHR and o/e-ContFLV; P < 0.05), and Cont-VI was the most accurate ultrasound parameter to predict neonatal death and severe PAH (P < 0.001).

CONCLUSIONS

Evaluating total lung volumes is more accurate than is measuring only the contralateral lung size. Evaluating pulmonary vascularization (Cont-VI) is the most accurate predictor of neonatal outcome. Estimating the probability of survival and severe PAH allows classification of cases according to prognosis.

Downregulation of protein kinase C inhibits activation of mitochondrial K(ATP) channels by diazoxide

BACKGROUND

The mitochondrial K(ATP) (mitoK(ATP)) channel has been shown to confer short- and long-term cardioprotection against prolonged ischemia via protein kinase C (PKC) signaling pathways. However, the exact association between PKC or its isoforms and mitoK(ATP) channels has not yet been clarified. The present study tested the hypothesis that the activity and translocation of PKC to the mitochondria are important for cardiac protection elicited by mitoK(ATP) channels. Methods and Results-PKC was downregulated by prolonged (24-hour) treatment with phorbol 12-myristate 13-acetate (4 microgram/kg body weight) before subsequent experiments in rats. Langendorff-perfused rat hearts were subjected to 40 minutes of ischemia followed by 30 minutes of reperfusion. Effects of PKC downregulation on the activation of mitoK(ATP) channels and other interventions on hemodynamic, biochemical, and pathological changes were assessed. Subcellular localization of PKC isoforms by Western blot analysis and immunocytochemistry demonstrated that PKC-alpha and PKC-delta were translocated to the sarcolemma and that PKC-delta was translocated to the mitochondria after diazoxide treatment. In hearts treated with diazoxide (80 micromol/L), a significant improvement in cardiac function and an attenuation of cell injury were observed. In PKC-downregulated hearts, protection was abolished because mitoK(ATP) channels could not be activated by diazoxide.

CONCLUSIONS

These data suggest that PKC activation is required for the opening of mitoK(ATP) channels during protection against ischemia and that this effect is linked to isoform-specific translocation of PKC-delta to the mitochondria.

Pathologic assessment of myocardial cell necrosis and apoptosis after ischemia and reperfusion with molecular and morphological markers

The present work illustrates the critical subcellular changes in the rat heart after 10-30 min of left coronary artery (LCA) occlusion and 120 min of reperfusion with a combination of several staining techniques. Triphenyltetrazolium chloride (TTC) to detect non-injured myocytes, horseradish peroxidase (HRP) and terminal deoxynucleotide nick-end labeling (TUNEL) to detect necrotic and apoptotic cells were employed and electron microscopy (EM) was used to validate these changes. After 20 min of LCA occlusion, myocytes began to undergo necrosis whilst after 10 min occlusion, no myocyte underwent irreversible cell injury in the risk area. After 30 min of LCA occlusion and 120 min reperfusion, 36.3, 26.6 and 25% cells were normal, necrotic, and reversibly injured, respectively; the remaining 12.8% cells were apoptotic. Necrotic cells were strongly positive with HRP and negative for TTC and TUNEL. TUNEL-positive or apoptotic cells were slightly HRP-positive, indicating altered cell membrane permeability. Reversibly-injured myocytes were TTC-, HRP- and TUNEL-negative. These changes were more accurately defined in the 100- microm thick sections than in the traditional slices. It is concluded that: (1) TTC-staining of 100- microm thick sections is far superior and accurate for the detection of ischemic changes with shorter period of ischemia (10 min); (2) the combination of TTC-staining, HRP reaction and TUNEL method is excellent for demarcation of early ischemic changes; (3) TTC-negativity in ischemia less than 20 min does not indicate necrosis but only represents reversible changes; (4) the apoptosis is absent in early ischemia of 20 min with or without reperfusion at a time when sufficient ATP is present, and appears only after 30 min of coronary ligation and reperfusion; and (5) the apoptotic cells lose membrane integrity accompanied by decreased glycocalyx thickness and cell swelling as opposed to commonly known characteristics of apoptotic cells.

Expression and Localization of Lumican in the Ischemic and Reperfused Rat Heart

Lumican belongs to the small leucine-rich proteoglycan family and has an important role in the regulation of corneal and dermal collagen fiber assembly. Recently, lumican mRNA was found in the heart and its high expression was reported during wound healing of the cornea. In the present study, the expression and role of lumican in fibrosis of an ischemic and reperfused rat heart were examined. The expression level of lumican mRNA increased in the ischemic and reperfused rat heart and was highest on the fourth week. Lumican protein existed in the forms of core protein and proteoglycan in the control rat heart. The amount of lumican in the form of proteoglycan increased, and that as the form glycoprotein was newly detected in the ischemic and reperfused rat heart on the fourth week. In the control heart, lumican was weakly expressed in the collagen fibers of the perivascular area, but it was expressed strongly in many capillary endothelial cells in the ischemic lesion on day 1. After 3 days, lumican was localized in collagen fibers and in the fibroblasts of fibrotic lesions. A few myocardial cells close to the ischemic lesion expressed lumican mRNA. Lumican is considered to play an important role in the fibrillogenesis of the ischemic and reperfused rat heart.

Changes in Somatosensory Evoked Potentials and Hoffmann Reflexes during Fast Isometric Contraction of Foot Plantarflexor in Humans

In the present study, the extent to which the early component of somatosensory evoked potentials (SEPs) and the Hoffmann (H-) reflex induced by stimulation of the posterior tibial nerve are altered during the ascending and descending phases of fast plantarflexion was investigated. SEPSs and H-reflex of the soleus following tibial nerve stimulation were examined during fast plantarflexion when performed by nine normal subjects. The analyses focused on differences in amplitude modulation of the P30-P40 component of SEP and the H-reflex between the ascending and descending phases of full-wave rectified and averaged soleus electromyographic (EMG) activity. The H-reflex amplitude was significantly increased and decreased during the ascending and descending phases more than under resting control conditions, respectively. The reduction of SEP amplitude was 49% for the ascending phase and 83% for the descending phases with respect to the resting situation. Modulation of SEP during the ascending and descending phases was robustly retained even during ischemic nerve blockade of large diameter afferent fibers. These findings suggest that the transmission of afferent inputs from muscle spindles to motoneurons and to the somatosensory cortex during fast isometric contraction of the plantar flexor is regulated in a time-dependent fashion by descending commands.

Prenatal diagnosis of posterior mediastinal lymphangioma by two- and three-dimensional ultrasonography

Lymphangioma is a rare benign tumor characterized by proliferating lymph vessels and composed of large cyst spaces with endothelium-lined channels of varying dimensions. The incidence of lymphangioma is approximately one in 6000 pregnancies. Less than 1% of lymphangiomas are purely mediastinal. The great majority of cases are of cystic lymphangioma, but very rarely there is a mixed lesion consisting of multiple cysts of dilated capillary and lymph vessels. We report a case of posterior mediastinal lymphangioma diagnosed at 28 weeks' gestation, in which three-dimensional ultrasonography was helpful in determining the precise location of the tumor. A Cesarean section was performed at 39 weeks and the tumor was resected on the 5(th) day postdelivery; histological examination revealed a mixed cystic lymphangioma.

Morphological characteristics and clinical significance of nerve distribution in pancreatic cancers

Macroscopic and immunohistochemical observations were made to clarify the innervation of normal pancreatic tissues, and the clinicopathological and electron-microscopic findings of 33 cases of pancreatic cancer were obtained. The results showed that the innervation of both the head and the body of the pancreas mainly consisted of nerve fibers separated from the right celiac neuroganglion and the right half of the superior mesenteric arterial plexus. The pancreas was full of nerve fibers ending at acinar lobules, among which the adrenergic nerves commonly control the walls of blood vessels. Pancreatic cancer tends to be accompanied by invasion and metastasis along intra or extra-pancreatic nerves, and we found that the positive rates for invasion and metastasis were 73.33% and 60.00%, respectively. The follow-up study revealed that the nerve-invasion group had worse prognosis than the non-invasion group (P < 0.05). The approaches of the invasions of the nerves were as follows: (1) through the vessels of the perineurium; (2) through the perineurium; and (3) through the synaptic membrane of nerve endings. The invasion were a continuous process, often resulting in the destruction or even the disappearance of the normal structure of the nerve fibers. The above results suggest that there are plentiful vegetative nerves inside or outside the pancreas and that pancreatic cancers have a tendency of invading and metastasizing along or around nerves.

[The role of the heat shock protein in human breast cancer]

OBJECTIVE

To study the role of heat shock proteins (HSP) in the cell cycle and various processes of carcinogenesis.

METHODS

Immunohistochemical SP methods, electron microscopy, in situ hybridization and RT-PCR were used to evaluate the expression of HSP, mainly HSP90, ubiquitin and HSP70 in breast cancer tissues.

RESULTS

HSP90 mRNA was expressed at much higher levels in cancerous tissue than in non-cancerous tissues. In addition, a close relation between HSP90 mRNA expression and proliferating cell nuclear antigen labelling index (PCNA L. I.) was observed in cancerous tissue. These findings suggest that increased expression of HPS90 isoform may play a role in cell proliferation. On the other hand, HSP90 mRNA was expressed in the more poorly differentiated carcinomas of the breast. The intracellular localization of HSP70 was consistent with that of ubiquitin. The PCNA L. I. was significantly higher in specimens showing HSP70 in nucleus. HSP73 mRNA, a member of HSP70 family, was also expressed at higher levels in cancerous tissues associated with a high PCNA L. I. than in non-cancerous tissues.

CONCLUSION

These results suggest that HSP90 may play a role in cancer cell proliferation and that HSP90 may contribute to cell differentiation and structural constitution. In addition, HSP70, especially HSP73, is related to ubiquetin and seems to be a marker for cancer proliferation.