Atelocollagen Sponge as a Stem Cell Implantation Scaffold for the Treatment of Scarred Vocal Folds

Objectives

Treatment of vocal fold scarring remains a therapeutic challenge. Our group previously reported the efficacy of treating injured vocal folds by implantation of bone marrow–derived stromal cells containing mesenchymal stem cells. Appropriate scaffolding is necessary for the stem cell implant to achieve optimal results. Terudermis is an atelocollagen sponge derived from calf dermis. It has large pores that permit cellular entry and is degraded in vivo. These characteristics suggest that this material may be a good candidate for use as scaffolding for implantation of cells. The present in vitro study investigated the feasibility of using Terudermis as such a scaffold.

Methods

Bone marrow–derived stromal cells were obtained from GFP (green fluorescent protein) mouse femurs. The cells were seeded into Terudermis and incubated for 5 days. Their survival, proliferation, and expression of extracellular matrix were examined.

Results

Bone marrow–derived stromal cells adhered to Terudermis and underwent significant proliferation. Immunohistochemical examination demonstrated that adherent cells were positive for expression of vimentin, desmin, fibronectin, and fsp1 and negative for beta III tubulin. These findings indicate that these cells were mesodermal cells and attached to the atelocollagen fibers biologically.

Conclusions

The data suggest that Terudermis may have potential as stem cell implantation scaffolding for the treatment of scarred vocal folds.

Drug Delivery System of Hepatocyte Growth Factor for the Treatment of Vocal Fold Scarring in a Canine Model

Objectives:

Vocal fold scarring remains a therapeutic challenge. Previous studies have indicated that hepatocyte growth factor (HGF), a strong antifibrotic element, has therapeutic potential for restoring scarred vocal folds. To enhance the effect of HGF in vivo, we developed a novel drug delivery system (DDS) in which HGF is embedded in gelatin hydrogel and continuously released over a period of 2 weeks. In the present study we investigated the therapeutic efficacy of the HGF DDS on vocal fold scarring by using a canine model.

Methods:

The vocal folds of 8 beagles were unilaterally scarred by stripping the entire layer of the lamina propria. The contralateral vocal folds were kept intact as normal controls. One month after the procedure, hydrogels (0.5 mL) containing 1 μg of HGF were injected into the scarred vocal folds of 4 dogs (HGF-treated group), whereas hydrogels containing saline solution were injected in the other 4 dogs (sham group). Histologic and vibratory examinations were completed for each group 6 months after the initial surgery.

Results:

The excised larynx experiments showed significantly better vibration in terms of mucosal wave amplitude and glottal closure in the HGF-treated group compared to the sham group. Histologic evaluation of the vocal folds indicated remarkable reduction in collagen deposition and tissue contraction, with favorable restoration of hyaluronic acid and elastin in the HGF-treated group.

Conclusions:

The present findings suggest that the novel HGF DDS may provide favorable effects in restoring the vibratory properties of scarred vocal folds.

Improvement of eustachian tube function by tissue-engineered regeneration of mastoid air cells

Objectives/Hypothesis

Most cases of chronic otitis media (OMC) are associated with poor development of the mastoid air cells (MACs) and poor Eustachian tube (ET) function. We have previously reported that MAC regeneration can effectively eliminate intractable OMC. In this study, we assessed the ability of regenerated MACs to restore normal gas exchange function and contribute to improved ET function.

Study Design

Clinical trial with control.

Setting

General hospitals.

Materials and Methods

Seventy-six patients with OMC, including cholesteatoma and adhesive otitis media, received tympanoplasty and MAC regeneration therapy. At the first-stage of tympanoplasty, artificial pneumatic bones and/or autologous bone fragments were implanted into the opened mastoid cavity. At the 2nd-stage operation, a nitrous oxide (N2O) gas study was performed in 10 patients to measure middle ear pressure (MEP). For the control group, MEP was measured in five patients with good MAC development during cochlear implantation or facial nerve decompression. ET function was measured twice in each patient, once before the 1st operation and 6 months after the second operation.

Results

At the 2nd-stage operation, in all cases with regenerated MACs and in the normal control group, MEP changed after administration of N2O. In contrast, no change in MEP was observed in cases with unregenerated MACs. In 70% (n = 37/53) of the regenerated MAC group, ET function was improved, whereas improvement of ET function was observed in only 13% (n = 3/23) of the unregenerated MAC group.

Conclusions

Tissue-engineered regeneration of MACs improves ET function and gas exchange in the middle ear. Laryngoscope, 2012

Level of Evidence

3b

Laryngeal regeneration using tissue engineering techniques in a canine model

OBJECTIVES

We previously reported that polypropylene mesh covered with collagen sponge is a useful material for the regeneration of the trachea and the cricoid cartilage. The aim of this study was to regenerate larynges after partial hemilaryngectomy with this new biomaterial.

METHODS

A left partial hemilaryngectomy was performed on 12 adult beagles. The defect size was about 1.8 x 1.0 cm. Both sides of polypropylene mesh were coated with either 1% or 3% collagen sponge. This scaffold was wrapped in fascia lata harvested from the left thigh and then fixed in place over the defect. Endoscopic examinations were performed periodically. Six months after treatment, 3-dimensional computed tomographic scanning was performed. Vibratory examinations were also performed with excised larynges.

RESULTS

In the 1% collagen group, exposure or dislocation of the mesh was found in 3 of 6 cases, but in the 3% group, no exposure of the mesh was seen. The morphological findings in the vocal fold were better in the 3% group than in the 1% group, but a difference in the vertical levels of the vocal folds was found in both groups.

CONCLUSIONS

This study suggests that 3% collagen-coated polypropylene mesh wrapped with autologous fascia is a useful material for laryngeal regeneration.

A tissue-engineering approach for stenosis of the trachea and/or cricoid

CONCLUSION

This new regenerative therapy shows great potential for the treatment of stenosis of the trachea and/or cricoids (STC).

OBJECTIVES

To estimate the potential of tissue-engineered artificial trachea (AT) for treatment of STC in clinical applications. We previously reported that AT was a useful material for implantation into a tracheal defect after resection of cancer. There are many causes of stenosis of the respiratory tract and STC is particularly difficult to treat.

METHODS

The AT was a spiral stent composed of Marlex mesh made of polypropylene and covered with collagen sponge made from porcine skin. Three patients with STC were treated by this tissue-engineering method. All of them suffered from STC caused by long endotracheal intubations. They underwent a two-stage operation. In the first operation, after resection of the stenotic regions, the edge of the tracheal cartilage was sutured to the edge of the skin. The tracheal lumen was exposed and a T-shaped cannula was inserted into the large tracheostoma. At 3 weeks to 2 months after the first operation, the trachea and skin were separated. The trimmed AT with venous blood and basic fibroblast growth factor (b-FGF) was then implanted into the cartilage defect.

RESULTS

Postoperatively, all patients were able to breathe easily and had no discomfort in their daily activities. Six months after the second operation, we observed enough air space in the trachea and cricoid by computed tomography (CT) imaging and fiber endoscopy.

Atelocollagen Sponge as a Stem Cell Implantation Scaffold for the Treatment of Scarred Vocal Folds

Objectives:

Treatment of vocal fold scarring remains a therapeutic challenge. Our group previously reported the efficacy of treating injured vocal folds by implantation of bone marrow—derived stromal cells containing mesenchymal stem cells. Appropriate scaffolding is necessary for the stem cell implant to achieve optimal results. Terudermis is an atelocollagen sponge derived from calf dermis. It has large pores that permit cellular entry and is degraded in vivo. These characteristics suggest that this material may be a good candidate for use as scaffolding for implantation of cells. The present in vitro study investigated the feasibility of using Terudermis as such a scaffold.

Methods:

Bone marrow—derived stromal cells were obtained from GFP (green fluorescent protein) mouse femurs. The cells were seeded into Terudermis and incubated for 5 days. Their survival, proliferation, and expression of extracellular matrix were examined.

Results:

Bone marrow—derived stromal cells adhered to Terudermis and underwent significant proliferation. Immunohistochemical examination demonstrated that adherent cells were positive for expression of vimentin, desmin, fibronectin, and fsp1 and negative for beta III tubulin. These findings indicate that these cells were mesodermal cells and attached to the atelocollagen fibers biologically.

Conclusions:

The data suggest that Terudermis may have potential as stem cell implantation scaffolding for the treatment of scarred vocal folds.

Protective effect of hedgehog signaling on cytokine-induced cytotoxicity in pancreatic beta-cells

BACKGROUND

Hedgehog (Hh) signaling plays an important role in pancreas development. However, its role in the developed endocrine pancreas remains to be elucidated. To clarify whether Hh signaling participates in beta-cell survival, we investigated the role of Hh signaling in cytokine-induced apoptosis in pancreatic beta-cells.

METHODS

Insulin-producing INS-1E cells were transfected with Sonic Hh (Shh) expression vector or siRNA against Indian Hh (siIhh). The Hh signal inhibitor cyclopamine were pretreated in INS-1E cells and rat islets. The cells were exposed to 200 U/ml IL-1β and 200 U/ml IFN-γ for 48 h. Apoptosis was estimated by flow cytometory and immunofluorescence staining for cleaved caspase-3. Nitric oxide generation was measured by Griess reaction.

RESULTS

We found that exposure to proinflammatory cytokines increased Ihh expression in rat islets and INS-1E cells. Overexpression of Shh reduced cytokine-induced apoptosis. By contrast, treatment with cyclopamine increased cytokine-induced apoptosis in INS-1E cells and rat islets. Treatment with the siIhh showed same results in INS-1E cells. Forced expression of Shh suppressed cytokine-induced nuclear factor-κB promoter activity, leading to attenuation of nitric oxide synthase 2 expression and nitric oxide production, while Ihh knockdown enhanced this pathway in INS-1E cells.

CONCLUSION

Our findings suggest that Hh signaling is implicated in protecting beta-cells from cytokine-induced cytotoxicity.

Glottal reconstruction with a tissue engineering technique using polypropylene mesh: a canine experiment

OBJECTIVES

The larynx must be resected in some cases of cancer or stenosis, and various techniques are generally employed to fill the resulting defect. No ideal way, however, has been established to restore vocal function after this form of insult. The aim of this preliminary feasibility study in a canine model was to investigate the effectiveness of a polypropylene-based tissue engineering approach to repair a partial glottal defect.

METHODS

Eight dogs were used in this study. A laryngeal defect involving resection of the left vocal fold was created through a thyroid cartilage window. A scaffold made of polypropylene and collagen was preclotted and wrapped with autologous fascia lata, inserted through the window, and sutured to the laryngeal defect in 5 dogs. The defect was reconstructed with an adjacent sternohyoid muscle flap in 3 control dogs. The surgical site was evaluated 3 months after operation by fiberscopic examination, computed tomographic imaging, histologic evaluation, and study of excised larynges.

RESULTS

On fiberscopic examination, the experimental group implants were completely covered with regenerated mucosa in all cases, and a favorable vocal fold contour was found in 4 of the 5 cases. One case was characterized by a concave vocal fold shape and red granulation. In the control group, the muscle flap was replaced by scarred mucosa with a concave vocal fold contour in 2 cases, and there was soft white granulation at the anterior resected edge in the third case. The histologic data revealed the regeneration of lined epithelium, subepithelial tissue, and muscle structure in both groups. The excised larynx phonatory data revealed reduced vibratory amplitude in the experimental group compared with the control group; however, excised phonation was not achieved in 2 of the 3 cases in the control group.

CONCLUSIONS

This polypropylene-based tissue engineering technique appears to be a viable tool for glottal reconstruction; however, additional refinement is required to maximize long-term phonatory function.

In situ tissue engineering of canine skull with guided bone regeneration

CONCLUSION

Calcium alginate (CA) membrane prevents excessive fibrous tissue intrusion and/or dislocation of a bone scaffold. However, CA membrane did not always accelerate cranial bone regeneration.

OBJECTIVE

We previously reported skull regeneration using a bone substitute material (BSM), which consisted of collagen-coated beta-tricalcium phosphate and autologous bone fragments, and bone marrow-derived stromal cells (BSCs). However, excessive fibrous tissue intrusion or dislocation of the BSM occasionally interrupted bone regeneration. To avoid such problems, we examined CA membrane, which is useful for guided bone regeneration (GBR), to investigate whether this material maintains the bone regenerative space.

MATERIALS AND METHODS

Bone defects (2x2 cm) were created in the skulls of 12 adult beagle dogs using the same clinical procedure. Four experimental models were tested with or without BSM plus BSCs or CA membrane. In group I, the original free bone flap was replaced at the defect. In group II, after replacing the bone flap, the defect was covered with CA membrane. In group III, BSM plus BSCs were used as a gap filler. In group IV, BSM plus BSCs and CA membrane were applied. Histological examinations were performed 3 and 6 months after the operation.

RESULTS

In groups I and II, bone regeneration was not observed but fibrous tissue intrusion was prevented in group II. Bone neogenesis was more observed in group III than in group IV at 3 months (p<0.05). At 6 months, the regenerated areas were larger than those observed at 3 months, but the differences between groups III and IV were not statistically significant.

Atelocollagen sponge as a stem cell implantation scaffold for the treatment of scarred vocal folds

OBJECTIVES

Treatment of vocal fold scarring remains a therapeutic challenge. Our group previously reported the efficacy of treating injured vocal folds by implantation of bone marrow-derived stromal cells containing mesenchymal stem cells. Appropriate scaffolding is necessary for the stem cell implant to achieve optimal results. Terudermis is an atelocollagen sponge derived from calf dermis. It has large pores that permit cellular entry and is degraded in vivo. These characteristics suggest that this material may be a good candidate for use as scaffolding for implantation of cells. The present in vitro study investigated the feasibility of using Terudermis as such a scaffold.

METHODS

Bone marrow-derived stromal cells were obtained from GFP (green fluorescent protein) mouse femurs. The cells were seeded into Terudermis and incubated for 5 days. Their survival, proliferation, and expression of extracellular matrix were examined.

RESULTS

Bone marrow-derived stromal cells adhered to Terudermis and underwent significant proliferation. Immunohistochemical examination demonstrated that adherent cells were positive for expression of vimentin, desmin, fibronectin, and fspl and negative for beta III tubulin. These findings indicate that these cells were mesodermal cells and attached to the atelocollagen fibers biologically.

CONCLUSIONS

The data suggest that Terudermis may have potential as stem cell implantation scaffolding for the treatment of scarred vocal folds.

Bone Regeneration of Canine Skull Using Bone Marrow-Derived Stromal Cells and β-Tricalcium Phosphate

OBJECTIVE

The aim of this study was to regenerate high-quality cranial bone using tissue engineering techniques, with subsequent extension to clinical application. Our previous study with a 3-month observation period indicated that a composite scaffold composed primarily of beta-tricalcium phosphate (TCP) had the potential for cranial bone regeneration. In this study, we investigated whether bone marrow derived stromal cells (BSCs) could promote the regeneration of cranial bone as determined after 3 and 6 months.

STUDY DESIGN

The pilot study was conducted with 14 adult beagle dogs.

MATERIALS AND METHODS

Craniotomy was performed in the same manner used clinically. The bone defect (2 x 2 cm) was created at each canine temporoparietal region. The test animals were divided into three groups. In group I, the bone defect was closed by replacing the original free bone flap without filling the residual gaps. In group II, the gap was filled with a composite scaffold consisting of collagen coated beta-TCP and autologous bone fragments with fibrin glue. In group III, autologous cultured BSCs and the composite scaffold were used to fill the gap. The sites of craniotomy were analyzed with three-dimensional computed tomography and histologic examination 3 and 6 months after the operation.

RESULTS

Bone regeneration was observed in groups II and III, with more extensive formation in group III than in group II. In group I, bone regeneration was not observed.

CONCLUSION

This study showed that BSCs have the potential to promote cranial bone regeneration and confirmed the efficacy of a composite scaffold made of beta-TCP and autologous bone fragments with fibrin glue.

Expression of extracellular matrix proteins in the vocal folds and bone marrow derived stromal cells of rats

Vocal fold scarring remains a therapeutic challenge. Our research group has indicated that bone marrow-derived stromal cells (BSCs) may have therapeutic potential in restoration of injured vocal folds. However, it is still unclear how BSCs restore the viscoelasticity of vocal fold mucosa. Since a feature of vocal fold scarring is the disorganization of the extracellular matrix (ECM), it is important to understand how BSCs produce ECM. The present study aimed to clarify ECM gene expression in BSCs, and also examined the effects of hepatocyte growth factor (HGF) on this expression. BSCs obtained from the femurs of four Sprague-Dawley rats were cultured with or without HGF. The mRNA expression of ECM components (type I procollagen, decorin, Has2, CD44, MMP-1, and GAPDH) were examined in cultured BSCs and the vocal fold mucosa by the reverse transcription-polymerase chain reaction (RT-PCR). The mRNA expression of Has2 and MMP-1 was significantly stronger in BSCs than in the vocal folds (P < 0.05). Expression of Has2 in BSCs was significantly increased by the administration of HGF (P < 0.05). There was no significant difference in the gene expression of other ECM molecules between BSCs and vocal fold mucosa. Increased expression of Has2 and MMP-1 genes from BSCs may have a positive potential in the treatment of vocal fold scarring.

Tranilast inhibits glucose-induced insulin secretion from pancreatic beta-cells

Tranilast, N-(3,4-demethoxycinnamoyl)-anthranilic acid, is an anti-allergic agent identified as an inhibitor of mast cell degranulation. Recently, tranilast was shown to decrease albuminuria in a rat model of diabetic nephropathy and to ameliorate vascular hypertrophy in diabetic rats, suggesting that it may be clinically useful in the treatment of diabetic complications. However, the effects of tranilast on glucose tolerance have not been elucidated. Thus, the aim of this study is to investigate the effect of tranilast on insulin secretion in pancreatic beta-cells. Treatment with tranilast significantly suppressed insulin secretion in INS-1E cells and rat islets induced by 16.7 mmol/l glucose. Furthermore, tranilast inhibited tolbutamide-induced insulin secretion. Treatment with tranilast increased (86)Rb (+) efflux from COS-1 cells in which pancreatic beta-cell-type ATP-sensitive K (+) (K (ATP)) channels were reconstructed and suppressed the cytosolic ATP/ADP ratio in INS-1E cells. Interestingly, treatment with tranilast enhanced glucose uptake in INS-1E cells. In the present study, we demonstrated that tranilast inhibited glucose- and tolbutamide-induced insulin secretion through the activation of K (ATP) channels in pancreatic beta-cells.

A case of floppy epiglottis in adult: a simple surgical remedy

A new operative technique for the treatment of floppy epiglottis is introduced in this report. Though its diagnosis is not so difficult by close observations using a flexible fiberscope, it is likely to be treated as an asthma attack or a paradoxical vocal cord movement. In previous reports of upper airway obstruction caused by adult floppy epiglottis: epiglottis prolapse during inspiration, the cause of this condition has been divided broadly into two categories: idiopathic cases and secondary cases. Partial or total epiglottectomy has been usually reported for the treatment of the relief of airway obstruction caused by a floppy epiglottis. It is very difficult to decide adequately how much volume of epiglottis to cut without postoperative sequelae. A V-shaped partial epiglottidectomy is described for its treatment. This technique is very easy, simple, and effective.

Experimental regeneration of canine larynx: a trial with tissue engineering techniques

CONCLUSION

Since this tissue engineering technique is cost-effective and is less invasive to patients, it may replace conventional approaches in laryngeal reconstructive surgeries.

OBJECTIVE

Laryngeal cancer is one of the most prevalent cancers in the head and neck region, and frequently requires surgical resection. Although there are many ways to reconstruct the larynx after resection, donor tissue is usually required. Recently, tissue engineering techniques have become widely accepted in clinical medicine and have already been applied to some organs. This animal experiment was designed to elucidate the efficacy of laryngeal regeneration using tissue engineering technique.

MATERIALS AND METHODS

A bioartificial scaffold was designed from a replica of a canine larynx. A dental cast was used to replicate the intricate inside shape of the larynx. After copying its shape on a polypropylene mesh sheet, this sheet was coated with spongy collagen from porcine skin. A hemilaryngectomy was performed on beagle dogs under general anesthesia. Then the scaffold, preclotted with a mixture of peripheral blood and bone marrow-derived stromal cells, was implanted and fixed. The postoperative status was examined fiberscopically.

RESULTS

On the eighth day after the operation, the surface of the implant was covered with soft tissue. Finally, the implant was completely covered with regenerated mucosa.

Evidence for nucleosynthesis in the supernova gamma process: universal scaling for p nuclei

Analyzing the solar system abundance, we find two universal scaling laws concerning the p and s nuclei. They indicate that the gamma process in supernova (SN) explosions is the most probable origin of the p nuclei that has been discussed with many possible nuclear reactions and sites in about 50 years. In addition, the scalings lead to new concepts: a universality of the gamma process and a new nuclear cosmochronometer. We carry out gamma-process nucleosynthesis calculations for typical core-collapse SN explosion models, and the results satisfy the observed scalings.

[Neurinoma of tympanic plexus: a case report]

We report a unique case of neurinoma originating from the tympanic plexus. A 23-year-old man reparting hearing impairment was found in otoscopic examination to have a tumor contour identified through the ear drum. Computed tomography showed that the tumor extended from the hypotympanum to the mesotympanum, eroding the promontory. A small specimen obtained after myringotomy indicated neurinoma. The man did not report facial weakness or taste disturbance. When we operated to remove the tumor, we found the long crus of Incus had disappeared and the stapes superstructure was dislocated upward due to the tumor expanse. Pathologically, the extirpated tumor was neurinoma of Antoni A. A postoperative salivary gland function test using Tc showed hypofunction at the lesion side of the parotid gland. We surmise that neurinoma originated from the tympanic plexus because of its location and its lack of a relationship to the chorda tympanic nerve or facial nerve.

High-performance liquid chromatographic quantification of allysine as bis-p-cresol derivative in elastin

The first step in normal cross-linking in elastin is the formation of alpha-aminoadipic-delta-semialdehyde, allysine, through oxidative deamination of specific peptidyl lysine by the enzyme lysyl oxidase (EC 1.4.3.13). For the analysis of allysine, allysine was derivatized with p-cresol. The derivatization was carried out by acid hydrolysis (6N HCl containing 5% (w/v) p-cresol at 110 degrees C for 48 h) accompanied with the hydrolysis of elastin. A bis-p-cresol derivative of allysine was isolated from bovine ligamentum nuchae elastin hydrolysates, and was characterized by UV, FAB-MS and NMR. This derivative was identified as 2-amino-6,6-bis(2-hydroxy-5-methylphenyl)hexanoic acid. A rapid, sensitive reverse-phase high-performance liquid chromatographic method with UV detection was developed for the quantitative determination of allysine as its bis-p-cresol derivative. The lower limit of detection of the bis-p-cresol derivative was 58 pmol in the standard sample with a 20-microl injection at a signal-to-noise ratio of 3. This method was applied to the determination of allysine in bovine ligamentum nuchae, aorta, lung, and rat aorta elastin. The allysine content in rat aorta elastin dramatically increased from 1 week to 2 weeks of age.

Oxodesmosine and isooxodesmosine, candidates of oxidative metabolic intermediates of pyridinium cross-links in elastin

We isolated two new dihydrooxopyridine cross-links, oxodesmosine (OXD) and isooxodesmosine (IOXD) from the acid hydrolysates of the bovine aortic elastin. OXD and IOXD were identified to have N-substituted 1,2-dihydro-2-oxopyridine and N-substituted 1,4-dihydro-4-oxopyridine skeletons, respectively, with three alpha-amino acid groups and mass of 495 (C23H37N5O7). These structures and distribution indicated that OXD and IOXD are oxidative metabolites generated from desmosine (DES) and isodesmosine (IDE), respectively, by reactive oxygen species (ROS). Effects of ROS derived from divalent metal (Fe2+, Cu2+)/H2O2 on DES, IDE, OXD, and IOXD in elastin were investigated. Changes in the contents of these cross-links in elastin were observed by using reverse-phase HPLC with UV detection. The time- and pH-dependent formation of OXD and reduction of DES and IDE in elastin by Cu2+/H2O2 and Fe2+/H2O2 were observed. OXD was found to be formed from DES by Fe2+/H2O2. No formation of IOXD was observed under the conditions of oxidation examined. By using a model compound of IDE, however, we found that 4-pyridone could be formed by Fe2+/H2O2. Elastin incubated in Cu2+/H2O2 was also solubilized dependent on solution pH and the concentration of H2O2. These results suggest that oxidative degradation of elastin with cross-links results in its weakening, followed by its solubilization. Pyridinium cross-links, such as DES and IDE, may be oxidatively metabolized by ROS, further changing to dihydrooxopyridine cross-links such as OXD and IOXD, respectively.

Two new elastin cross-links having pyridine skeleton. Implication of ammonia in elastin cross-linking in vivo

Isolation and structure analysis of two amino acids from bovine ligamentum nuchae elastin hydrolysates revealed the presence of pyridine cross-links in elastin. The structures of these amino acids were determined to have 3,4,5- and 2,3,5-trisubstituted pyridine skeletons both with three carboxylic acids and a mass of 396 (C(18)H(28)N(4)0(6)) identified as 4-(4-amino-4-carboxybutyl)-3,5-di-(3-amino-3-carboxypropyl)-pyridine and 2-(4-amino-4-carboxybutyl)-3,5-di-(3-amino-3-carboxypropyl)-pyridine. We have named these pyridine cross-links desmopyridine (DESP) and isodesmopyridine (IDP), respectively. Structure analysis of these pyridine cross-links implied that the formation of these cross-links involved the condensation reaction between ammonia and allysine. The elastin incubated with ammonium chloride showed that DESP and IDP levels increased as the allysine content decreased. DESP and IDP were measured by high pressure liquid chromatography (HPLC) with UV detection and were found in a variety of bovine tissues. The DESP/desmosine (DES) and IDP/isodesmosine (IDE) ratios in aorta elastin were higher than in other tissues. DESP and IDP contents in human aorta elastin were found to be gradually increased with age. The concentration of IDP was significantly elevated in aorta elastin of rat with chronic liver cirrhosis induced by carbon tetrachloride (mean +/- S.D.; 11.1 +/- 0.9 nmol/mg elastin) when compared with normal rats (5.9 +/- 1.5 nmol/mg elastin). Although DESP and IDP are present at only trace concentrations in the tissue elastin, these pyridine cross-links may be useful biomarkers for the aortic elastin damaged by ammonia.

Impacts of the Detection of Cassiopeia A Point Source

Very recently the Chandra first light observation discovered a point-like source in the Cassiopeia A supernova remnant. This detection was subsequently confirmed by the analyses of the archival data from both ROSAT and Einstein observations. Here we compare the results from these observations with the scenarios involving both black holes (BHs) and neutron stars (NSs). If this point source is a BH, we offer as a promising model a disk-corona type model with a low accretion rate in which a soft photon source at approximately 0.1 keV is Comptonized by higher energy electrons in the corona. If it is an NS, the dominant radiation observed by Chandra most likely originates from smaller, hotter regions of the stellar surface, but we argue that it is still worthwhile to compare the cooler component from the rest of the surface with cooling theories. We emphasize that the detection of this point source itself should potentially provide enormous impacts on the theories of supernova explosion, progenitor scenario, compact remnant formation, accretion to compact objects, and NS thermal evolution.

The Ejection of Relativistic Bullets from Supernovae and the Generation of Gamma-Ray Bursts

It is generally believed that cosmological gamma-ray bursts (GRBs) are produced by the deceleration of relativistic objects with Gamma greater, similar100. We study the possibility that some GRBs are produced along with relativistic matter ejected from supernovae. In this model, it is quite likely that the matter has to travel through the progenitor's thick envelope before generating GRBs. Under the assumption that the ejected matter is described as a single collective piece of matter, we obtain constraints on the matter having Gamma greater, similar100 at the breakout of the progenitor. One advantage of considering this type of model is that the expected GRB energy is sufficiently large, in contrast to the GRB-generation model of the shock breakout in the energetic supernova explosion. We find that, in general, the cross section of the matter has to be very small compared with the progenitor's radius, and thus the matter has to be bullet-like (or jetlike) rather than shell-like.

Effects of intravenous administration of high dose-diethylstilbestrol diphosphate on serum hormonal levels in patients with hormone-refractory prostate cancer

The objective of this study was to elucidate the mechanism underlying the further suppression of serum testosterone (T) by diethylstilbestrol diphosphate (DES-DP) in patients with prostate cancer refractory to hormonal treatment. These patients received an LHRH agonist with or without a non-steroidal androgen-receptor blocker or a gestagen before DES-DP. We measured serum levels of total and free T, dihydrotestosterone (DHT), estradiol (E2), dehydroepiandrosterone sulfate (DHEA-S), dehydroepiandrosterone (DHEA), androstenedione, cortisol, aldosterone before and during intravenous administration of high doses of DES-DP (500 or 1000 mg/day). DES-DP administration suppressed the serum levels of FSH (p=0.04) and total T (p=0.02), and eliminated free T (p=0.04) and E2 (p=0.04) from serum, while reducing serum DHEA-S to approximately two-thirds of the pretreatment level (p=0.03). In contrast, serum levels of SHBG (p=0.02) and cortisol (p=0.02) were markedly increased after DES-DP administration. The latter had no significant effect on serum levels of LH, DHT, ACTH, 17alpha-hydroxypregnenolone, 17alpha-hydroxyprogesterone, DHEA, androstenedione, or aldosterone. The results suggest that the potent suppression of circulating total T by DES-DP is caused, in part, by the inhibitory effect of DES-DP on serum DHEA-S level. In most patients, high-dose DES-DP treatment completely suppressed the serum level of free T, while possibly elevating serum SHBG and decreasing serum total T. The mechanisms that maintain the serum level of serum DHT during DES-DP treatment require further elucidation.

Alterations of asparagine-linked sugar chains of N-acetyl beta-D-hexosaminidase during human renal oncogenesis: a preliminary study using serial lectin affinity chromatography

Enzymatic properties and asparagine (Asn)-linked sugar-chain structures of N-acetyl beta-D-hexosaminidase A (Hex A) were compared in human tissues between normal renal cortex and renal cell carcinoma (RCC). No significant differences between the two Hex A preparations were observed with respect to enzymatic properties such as molecular mass, Michaelis-Menten value or optimal pH. With RCC preparations, relatively more Hex A passed through the concanavalin A (Con A) column, bound weakly to Con A, or bound strongly to Con A and also to the wheat germ agglutinin (WGA) column, than with preparations from normal renal cortex. In contrast, relatively less Hex A bound strongly to the Con A column, but passed through the WGA column with RCC preparations than with those from normal renal cortex. Asn-linked sugar-chain structures might apparently be altered during human renal oncogenesis.

Neonatal hyperbilirubinemia and mutation of the bilirubin uridine diphosphate-glucuronosyltransferase gene: a common missense mutation among Japanese, Koreans and Chinese

We analyzed the bilirubin uridine diphosphate-glucuronosyltransferase (B-UGT) gene in 42 Japanese newborns with hyperbilirubinemia and determined that 21 infants were heterozygous while 3 was homozygous for Gly71Arg. Allele frequency of Gly71Arg was 0.32 in newborns with hyperbilirubinemia, which was significantly higher than 0.13 in healthy Japanese controls. This mutant allele is also prevalent among Korean and Chinese healthy controls with a frequency of 0.23 in both populations. However, this mutation was not detected in 50 healthy German controls. These data suggest that the high frequency of the Gly71Arg mutation of the B-UGT gene is associated with high incidence of neonatal hyperbilirubinemia in Japanese, Korean and Chinese populations.

[Studies of type I collagen related substances as bone metastatic markers of prostate carcinoma with special regard to serum carboxyterminal propeptide of type. I. Procollagen (PICP), cross-linked carboxyterminal telopeptide of type I collagen (ICTP) and Urinary deoxypyridinoline levels]

BACKGROUND

To investigate if serum levels of carboxyterminal propeptide of type I procollagen (PICP), cross-linked carboxyterminal telopeptide of type I collagen (ICTP) and urinary levels of deoxypyridinoline (D-Pyr) are useful markers of bone metastasis in patients with prostate carcinoma, we measured these markers in patients with untreated benign prostatic hyperplasia (BPH) and untreated prostate carcinoma (PCA).

METHODS

Serum PICP, ICTP and urinary D-Pyr levels were determined in 53 patients; 16 patients with BPH, 15 patients with PCA without bone metastasis (stage A, B, C and D1) and 22 patients with PCA with bone metastasis (stage D2). At the same time correlations among these markers and serum total alkaline phosphatase (ALP) activity were studied.

RESULTS

Serum PICP, ICTP and urinary D-Pyr levels in the PCA patients with bone metastasis were significantly higher than those of BPH. The serum levels of PICP in patients with PCA with bone metastasis group were significantly higher than those of without bone metastasis group. The serum levels of ICTP in patients with PCA without bone metastasis group were significantly higher than those of BPH group, while no significant difference was observed between PCA group with and without bone metastasis. In the PCA patients with bone metastasis, serum PICP and serum total alkaline phosphatase (ALP) activity were significantly correlated (r = 0.80). In these patients, serum ICTP and urinary D-Pyr levels were also significantly correlated (r = 0.70).

CONCLUSION

These results suggest that serum PIPC, ICTP and urinary D-Pyr are the useful markers to quantitate bone metastasis in the patients with PCA. Moreover, the determination of serum ICTP levels may be significant for detecting occult bone metastasis in the patients with PCA.

Response regulators implicated in His-to-Asp phosphotransfer signaling in Arabidopsis

The His to Asp phosphotransfer signal transduction mechanism involves three common signaling domains: the transmitter (or His-kinase), the receiver, and the histidine-containing phototransfer (HPt) domain. Typically, a sensor kinase has a His-kinase domain and a response regulator has a receiver domain containing a phosphoaccepting aspartate, whereas a histidine-containing phototransfer domain serves as a mediator of the histidine-to-aspartate phosphotransfer. This signal transduction mechanism was thought to be restricted to prokaryotes. However, many examples have been discovered in diverse eukaryotic species including higher plants. In Arabidopsis, three sensor kinases have been characterized, namely, ETR1, ERS, and CKI1, which were suggested to be involved in ethylene- and cytokinin-dependent signal transduction pathways, respectively. To date, no response regulator has been discovered in higher plants. We identify five distinct Arabidopsis response regulator genes, each encoding a protein containing a receiver-like domain. In vivo and in vitro evidence that ARRs can function as phosphoaccepting response regulators was obtained by employing the Escherichia coli His-Asp phosphotransfer signaling system.

[A case of polyorchidism with embryonal carcinoma]

Polyorchidism is a rare anomaly with approximately 70 cases reported in the literature. We reported a case of polyorchidism with embryonal carcinoma, the first case, in one of 4 testes. Polyorchidism with malignancy had been reported in 5 cases and bilateral polyorchidism in 3 cases. Authors have not been clarified whether the incidence of malignancy in polyorchidism is high or low. But we have to treat the patients with polyorchidism carefully, because polyorchidism is highly associated with cryptorchidism.

[Studies of prostate-specific antigen (PSA) immunoassays--differences in characteristic of immunoreactivity and reference materials among the kits]

PURPOSE

We conducted this study to examine differences in characteristics of immunoreactivity for free PSA and alpha(1)-antichymotrypsin complex PSA (ACT-PSA) as well as in compositions and concentrations of PSA reference materials among commercially available PSA kits.

METHODS

Fractionated serum samples using a Sephacryl S-200 column were measured by Tandem-R, Delfia-PSA, Ab bead PSA, ACS-PSA, Markit-M and gamma-seminoprotein (gamma-Sm) kits. The calibrators of Tandem-R, Delfia-PSA, Ab bead PSA and Markit-M were fractionated by the same method and measured by Tandem-R. The calibrators of Delfia-PSA, Ab bead PSA and Markit-M and control serums of ACS-PSA were measured by Tandem-R.

RESULTS

Although the characteristic of immunoreactivity of Tandem-R, Delfia-PSA, and Ab bead PSA were found to be similar, they were not shown identical. ACS-PSA was proved to recognize free PSA greater than above three PSA kits, while Markit-M could scarcely detect free PSA. gamma-Sm recognized only free PSA. The calibrators of Tandem-R, Delfia-PSA, Ab bead PSA and Markit-M were proved to be only free PSA. The linear correlation was obtained between Tandem-R and Delfia-PSA or Ab bead PSA or Markit-M. The ratio of Delfia-PSA to Tandem-R, Ab bead PSA to Tandem-R and Markit-M to Tandem-R was 0.66, 0.93 and 2.2, respectively. With regard to relation of ACS-PSA and Tandem-R, two ratios of 0.22 and 0.25 were obtained between the two kits according to the different concentrations of control sera.

CONCLUSION

The present studies suggest that the difference in PSA values among the commercial PSA kits results from (1) different characteristics of immunoreactivity for ACT-PSA and free PSA among PSA kits, (2) compositions of PSA calibrators among the kits, and (3) different concentrations of PSA calibrators among the kits.

Serum concentration of type I collagen metabolites as a quantitative marker of bone metastases in patients with prostate carcinoma

BACKGROUND

Bone scans, widely used for the detection of bone metastases from prostate carcinoma, can neither quantitate metastatic lesions nor detect osteolytic lesions.

METHODS

Serum concentrations of the carboxyterminal propeptide of Type I procollagen (PICP), the carboxyterminal pyridinoline cross-linked telopeptide of Type I collagen (ICTP), and prostate specific antigen (PSA) were measured by radioimmunoassays in 48 patients with benign prostatic hyperplasia (BPH), 25 patients with prostate carcinoma (PCA) without bone metastases, and 36 patients with PCA and bone metastases.

RESULTS

Serum concentrations of PICP were significantly higher in patients with PCA with bone metastases than in patients with BPH or PCA without bone metastases. No significant differences were observed between patients with BPH and those with PCA without bone metastases. Serum ICTP concentrations were significantly higher in patients with PCA than in patients with BPH regardless of the presence or absence of bone metastases. Serum concentrations of PICP, ICTP, and PSA correlated significantly with Soloway's grading system for bone scans. The serum concentrations of PICP and ICTP in patients without bone metastases showed a significant downward trend in response to antiandrogen therapy.

CONCLUSIONS

These observations suggest that the serum concentrations of PICP and ICTP are quantitative markers of bone metastases from PCA when followed serially in individual patients.

[Transurethral balloon laser thermotherapy for benign prostatic hyperplasia]

Between April 1994 and March 1995, transurethral balloon laser thermotherapy (TUBAL-T) using Prostalase was performed on 53 patients with benign prostatic hyperplasia. Clinical efficacy was evaluated at 3 months after TUBAL-T. The mean international prostate symptom score (I-PSS) decreased from 21.5 at baseline to 11.3 after 3 months (p < 0.0001). Irritative (the sum of items 1, 2, 4 and 7 of I-PSS) decreased by 55%, while obstructive symptoms (the sum of items 3, 5 and 6 of I-PSS) by 45%. However, other objective parameters such as maximum flow rate, voided volume, percent postvoid residual volume and prostate volume showed no significant change (7.8 to 7.2 ml/s, 130 to 147 ml, 33 to 28% and 39.7 to 41.0 ml, respectively). In conclusion, significant improvement after TUBAL-T was observed for subjective symptoms, especially irritative symptoms, but not for objective parameters.

[A case of concurrent bilateral adrenocortical adenoma causing Cushing's syndrome]

A 43-year-old woman presented with obesity and lumbago. Endocrinological examinations revealed normal plasma cortisol levels and a suppressed serum adrenocorticotropic hormone (ACTH) level. On venous sampling, markedly elevated plasma cortisol levels were observed for bilateral adrenal veins (243 and 62.3 micrograms/dl on the right and left sides, respectively). Although the computed tomogram revealed bilaterally enlarged adrenal glands, 131I-adosterol scintigram showed a strong uptake only on the right side. Right adrenalectomy successfully relieved Cushing's syndrome. Pathological diagnosis was adrenocortical adenoma, 3.5 cm in diameter. Cushing's syndrome recurred in 9 years. At that time, she underwent left subtotal adrenalectomy including a 3-cm adrenocortical adenoma. Postoperative convalescence has been uneventful with oral steroid supplementation. All 14 previously reported cases of bilateral adrenocortical adenoma (BAA) causing Cushing's syndrome as well as the present case were concurrent and dominant in females of reproductive age. This suggests that some cofactors other than ACTH, such as estrogen, contribute to the pathogenesis of BAA.

[Studies on changes in the ratio of free to total PSA after endocrine treatment of prostate carcinoma]

The post-diagnostic changes in the free to total PSA ratio in the serum of patients with prostate carcinoma, after the initiation of endocrine treatment were examined. Two-week pretreatment with either chlormadinone acetate (100 mg/day) or flutamide (375 ng/day) was administered orally to 14 patients with newly diagnosed advanced prostate carcinoma (clinical stage was C in 2, Dl in 1 and D2 in 11). Then the LH-RH analogue was injected. Total and free PSA in the serum of these patients were measured every 4 weeks by the Ab bead PSA (Eiken) and the recently developed assay for free PSA by Eiken, respectively. The follow-up period ranged from 3 to 9 months with a median of 6 months. Levels of both total and free PSAs decreased significantly following the endocrine treatment, while free to total PSA ratio at 4 to 16 weeks after the start of LH-RH analogue was increased significantly compared to the pretreatment level (p < 0.05). These findings suggest that the rate of decrease of complex PSA during the first 4 months after the beginning of treatment may exceed that of free PSA in the serum of patients with advanced prostate carcinoma initially treated with endocrine therapy.

SomA, a novel gene that encodes a major outer-membrane protein of Synechococcus sp. PCC 7942

The outer membrane of a cyanobacterium (Synechococcus sp. strain PCC 7942) contains only a few major proteins. A gene encoding one of them, somA, was cloned and characterized. Based on the nucleotide sequence, SomA was predicted to comprise 531 amino acids with a calculated molecular mass of 57,136 Da. The deduced amino acid sequence of SomA shares similarities with two bacterial cell-surface proteins, the S-layer protein of Thermus thermophilus and the flagellin of Campylobacter coli. The predicted amino acid sequence of SomA revealed also that it contains a signal peptide-like sequence at its N terminus. This signal peptide-like sequence was capable of mediating protein translocation across the cytoplasmic membrane into the outer membrane of Escherichia coli, provided that this sequence was fused to the E. coli outer-membrane protein, OmpF. The signal peptide-like sequence was cleaved upon the translocation of the SomA::OmpF protein. We suggest that SomA is synthesized as a precursor and that its N-terminal 24 amino acid sequence is a cleavable signal peptide involved in protein targeting into the outer membrane. To our knowledge, this is the first example of cleavable signal peptides for proteins transported into the outer membrane of cyanobacteria.

[The significance of free-type PSA and complex-type PSA in patients with prostatic carcinoma--the characteristics of ACS-PSA method compared with that of Delfia- and Eiken-PSA method]

We studied the clinical significance of free-type prostate specific antigen (PSA) and bound-type PSA in serum of the patients with prostatic carcinoma and benign prostatic hypertrophy. The levels of PSA, gamma-seminoprotein and prostatic acid phosphatase (PAP) in 17 healthy adult males, 20 patients with benign prostatic hypertrophy and 23 patients with prostatic carcinoma were measured by ACS-PSA, Delfia and Eiken-PSA method. The levels of PSA in serum from prostatic carcinoma patients was significantly elevated as compared with that from benign prostatic hypertrophy. Linear regression analysis of the data showed that, although overall correlations were well, different assays gave different PSA concentrations. We have studied the forms of PSA in serum by gel filtration technique and measured PSA levels in each fractions using three methods. Moreover, the characteristics of ACS-PSA method was compared with that of Delfia and Eiken-PSA method. Two peaks of PSA were detected on the elution profiles from three prostatic carcinoma patients sera. Those were estimated complex-type PSA (90kDa) and free-type PSA (30kDa). The complex-type PSA fractions detected by ACS-PSA method were almost identical with that detected by Delfia-PSA method, while free-type PSA fractions detected by ACS-PSA method were greater quantity than those by Delfia and Eiken method. Many factors were contributory to the difference between the assay kits on serum complex-type PSA and free-type PSA levels. The present results suggest that there are some quantitative differences in the immunorecognition of complex-type PSA and free-type PSA between the assay kits.