Comparison of Surgical and Oncological Outcomes of Laparoscopic and Open Gastrectomy for Pathologically Serosa-Invasive (pT4a) Advanced Gastric Cancer-Retrospective Propensity Score-Matched Analysis

Background: We aimed to clarify the operative feasibility and oncological efficacy of a laparoscopic gastrectomy (LG) for pT4a gastric cancer through comparison with open gastrectomy (OG). Materials and Methods: We compared surgical and oncological outcomes in 178 patients with pT4a gastric cancer who underwent LG or OG between 2002 and 2016; the background was adjusted using propensity score matching. Results: After score matching, 45 patients were included in each group. The LG group had a significantly longer operation time (277 minutes versus 175 minutes, P < .001) and lower estimated blood loss (50 mL versus 280 mL, P < .001). The total number of dissected lymph nodes did not differ between groups (46 versus 38, P = .119); however, the number of dissected suprapancreatic lymph nodes was significantly higher in the LG group (11 versus 7.5, P = .011). Postoperative morbidity rates did not differ between groups. Postoperative hospitalization was significantly shorter in the LG group (7 days versus 13 days, P < .01), whereas overall survival, disease-free survival, and cancer recurrence rates and patterns were similar between groups. Conclusions: LG for pT4a gastric cancer has feasible and acceptable outcomes compared with OG.

Outcomes of elderly patients following thoracoscopic esophagectomy for esophageal cancer

PURPOSE

Thoracoscopic esophagectomy (TE) is widely used for esophageal cancer treatment. However, the short- and long-term outcomes of TE in older patients remain unknown. Thus, we investigated those outcomes as well as the effectivity of TE in this patient cohort.

METHODS

A total of 228 consecutive patients who underwent TE for esophageal cancer from 2002 to 2015 were included in the study and categorized into the elderly (≥ 75 years) and non-elderly (< 75 years) groups. The background was adjusted by propensity score matching. The short- and long-term outcomes were then compared between the two groups.

RESULTS

There was no difference in the short-term outcomes between the two groups. The elderly group had significantly lower overall survival (OS) and relapse-free survival (RFS) than the non-elderly group. When pulmonary complications occurred, the OS and RFS were significantly decreased in the elderly group but not in the non-elderly group. Without pulmonary complications, the OS and RFS in the elderly group did not differ from those in the non-elderly group. The multivariate analysis showed that pulmonary complications were independent poor prognostic factors for OS and RFS in the elderly group but not in the non-elderly group.

CONCLUSION

TE is safe and feasible for older patients. However, the OS and RFS of the elderly group were significantly worse than those of the non-elderly group, especially when pulmonary complications occurred. Therefore, perioperative management to prevent pulmonary complications is essential to improve the long-term outcomes of older patients receiving TE.

[A Case of Suspected Lynch Syndrome Due to Radical Resection for Descending Colon Cancer and Renal Pelvic Cancer]

A 60-year-old woman was admitted on account of presenting with bloody stools. She had a history of endometrial cancer surgery. Family history revealed 3 colorectal cancer cases among the first or second relatives. Colonoscopy and contrast- enhanced computed tomography revealed descending colon cancer and left renal pelvic cancer. We performed partial resection of the descending/transverse colon with D3 lymph node dissection and total resection of the left kidney and ureter with curative intent. Postoperative pathological diagnosis revealed descending colon cancer(pT4bN0M1c, pStage Ⅳc)and left renal pelvic cancer (T1N0M0, Stage Ⅰ). In this case, Lynch syndrome was suspected based on the family history and medical history. The clinical findings were consistent with Amsterdam Criteria Ⅱ. The microsatellite instability(MSI)test result was MSI-H and the BRAF genetic test result showed a wild type. Immunohistochemical staining of descending colon cancer tissue showed loss of expression of MSH2 and MSH6 proteins. Genetic counseling was provided because Lynch syndrome was strongly suspected. Capecitabine plus oxaliplatin therapy was performed for 6 months for descending colon cancer. Nine months postoperatively, the patient remained recurrence-free for both colon cancer and renal pelvic cancer. We report a case of suspected Lynch syndrome triggered by double cancer of the descending colon and renal pelvis.

Laparoscopic transabdominal preperitoneal hernioplasty for bilateral obturator hernias and left inguinal hernia with emaciation caused by anorexia nervosa: A case report

A 55-year-old woman receiving treatment for anorexia nervosa presented with abdominal pain and right thigh pain. Her body mass index was 12.9 kg/m² . Computed tomography showed fluid storage in the distal side of the right obturator foramen and revealed a dilated small bowel without a starting point of obstruction. We diagnosed a naturally reduced incarcerated right obturator hernia and performed elective surgery with a laparoscopic approach for hernia repair the next day. Intraperitoneal observation revealed bilateral obturator hernias and a left direct-type inguinal hernia. Transabdominal preperitoneal hernioplasty was performed using two self-gripping polyester meshes for bilateral obturator hernia repair and a lightweight 3D-shaped mesh for left inguinal hernia repair. Women with emaciation caused by anorexia nervosa may be more likely to have complex hernias, including obturator hernia, and laparoscopic approaches may be useful for preoperatively diagnosed nonstrangulated obturator hernias.

[A Case of Umbilical Metastasis from Pancreatic Cancer after Surgery]

The patient was a 63-year-old woman with diagnosis of pancreatic cancer. Abdominal CT showed pancreatic head tumor and paraaortic lymph node metastasis. We performed chemotherapy with nab-paclitaxel plus gemcitabine. After 5 courses of chemotherapy, the tumor reduced in size. Pancreaticoduodenectomy followed by adjuvant chemotherapy with S-1 was performed. Fourteen months after surgery, umbilical metastasis(Sister Mary Joseph's nodule: SMJN)was found in the umbilicus near the abdominal incisional hernia. There was no evidence of metastasis except in the umbilicus, we performed the umbilical tumor resection and abdominal incisional hernia repair. Pathological diagnosis was pancreatic cancer metastasis. Although following chemotherapy, multiple skin metastases was found in the lower abdomen 3 months after umbilical resection. We performed skin metastases resection to relieve pain and symptoms of bleeding. But she died 29 months after the initial therapy(7 months after umbilical resection).

Clinical Utility of ypTNM Stage Grouping in the 8th Edition of the American Joint Committee on Cancer TNM Staging System for Esophageal Squamous Cell Carcinoma

BACKGROUND

The 8th edition of the American Joint Committee on Cancer (AJCC) TNM staging system provided a specific 'ypTNM' stage grouping for patients with esophageal cancer.

OBJECTIVE

This study aimed to evaluate the clinical utility of the AJCC 8th edition ypTNM stage grouping for patients with esophageal squamous cell carcinoma (ESCC).

METHODS

We enrolled 152 patients with ESCC who underwent surgery after neoadjuvant cisplatin plus 5-fluorouracil (CF) therapy between June 2005 and December 2011. ypStage was evaluated according to the AJCC 7th and 8th editions. Predictive performance for disease-specific survival (DSS) and overall survival (OS) was compared between both editions. The prognostic significance of ypTNM stage grouping was evaluated using univariate and multivariate analyses.

RESULTS

Revision of the AJCC 7th edition to the 8th edition was associated with a change in ypStage in 96 patients (63.2%). The AJCC 8th edition revealed a better predictive performance than the 7th edition in terms of DSS (Akaike's information criterion [AIC] 499 vs. 513; Bayesian information criterion [BIC] 505 versus 519; concordance index [C-index] 0.725 versus 0.679) and OS (AIC 662 vs. 674; BIC 669 vs. 681; C-index 0.662 vs. 0.622). On univariate and multivariate analyses, ypStage in the 8th edition was an independent prognostic factor for both DSS and OS.

CONCLUSIONS

ypTNM stage grouping in the AJCC 8th edition provided a better predictive performance for DSS and OS than that in the 7th edition. ypStage in the 8th edition was the most reliable prognostic factor for ESCC patients who underwent surgery after neoadjuvant CF therapy.

[Chemoresistance in Microsatellite Instability-High Gastric Cancer-A Case Report]

A 74-year-old woman with cT4aN2M0, cStage ⅢB gastric cancer underwent neoadjuvant chemotherapy comprising 2 courses of S-1 plus cisplatin, and the clinical response was determined as non-CR/non-PD according to RECIST ver 1.1. Although distal gastrectomy with D2 lymphadenectomy was planned, the tumor was considered as unresectable with peritoneal metastases during laparotomy. After the subsequent chemotherapy with 1 course of capecitabine plus cisplatin, tumor bleeding, and obstruction due to rapid tumor progression occurred. We performed palliative distal gastrectomy; however, the patient died 17 days after gastrectomy. A comprehensive genomic analysis using cancer-gene panel identified the tumor as a microsatellite instability-high(MSI-H). Recently post hoc analysis of the large-scale clinical trials showed no clinical benefit of perioperative chemotherapy in MSI-H gastric cancer. MSI status has a potential to optimize the perioperative treatment strategy in gastric cancer.

[Staged Laparoscopy-Assisted Surgery Including Hand-Assisted Laparoscopic Surgery for Rectal Cancer with Synchronous Liver Metastases-A Case Report]

Here, we reported a case of a 39-year-old woman having rectal cancer with multiple liver metastases who underwent staged laparoscopic resection. She was diagnosed with low rectal cancer and multiple liver metastases; thus, she underwent low anterior resection and diverting colostomy. Following the neoadjuvant chemotherapy, she underwent colostomy closure and subsequent hand-assisted laparoscopic partial hepatectomy using the operative site during the colostomy closure. The postoperative course was uneventful, and adjuvant chemotherapy with CapeOX was performed 3 weeks post-surgery. Minimally invasive surgery was performed using hand-assisted laparoscopy.

A change in objective sleep duration is associated with a change in the serum adiponectin level of women with overweight or obesity undergoing weight loss intervention

BACKGROUND

Although the serum adiponectin level is inversely correlated to body mass index and closely associated with obesity and related diseases, neither the impact of weight loss on the adiponectin level nor other factors that might influence the adiponectin level during weight loss intervention are well documented.

OBJECTIVE

The objective of the study is to assess the change in the serum adiponectin level during weight loss intervention and to determine if sleep parameters affect the serum adiponectin level.

METHODS

Ninety women with overweight or obesity aged 25 to 65 years completed a 7-month cognitive behavioural therapy based weight loss intervention that included dieting, exercise and stress management. Serum adiponectin level, body fat percent, symptoms of depression and anxiety and objective sleep parameters, assessed by actigraphy, were measured at baseline and at the end of the intervention.

RESULTS

The serum adiponectin level was significantly increased after the weight loss intervention (P < 0.001). In a multiple regression analysis, the change of the adiponectin level was positively associated with the magnitude of body fat loss (β = -0.317, P < 0.001) and an increase of sleep minutes (β = 0.210, P = 0.043).

CONCLUSION

An increase in objective sleep duration was related to a significantly increased serum adiponectin level independently of the change of body fat during the weight loss intervention.

[A Case of Solitary Paraaortic Lymph Node Recurrence after Surgical Resection for Combined Hepatocellular and Cholangiocarcinoma]

A 46-year-old woman underwent right hemihepatectomy, cholecystectomy, and sampling of the hilar lymph nodes for combined hepatocellular and cholangiocarcinoma. She received oral S-1 after hepatectomy. However, her serum level of carcinoembryonic antigen gradually increased, and solitary paraaortic lymph node recurrence was detected on positron emission tomography-computed tomography 12 months after hepatectomy. The patient underwent paraaortic lymph node dissection. Histologic examination revealed solitary paraaortic lymph node metastasis composed of hepatocellular carcinoma. After paraaortic lymph node dissection, she was administered sorafenib, and she remains alive and healthy with no evidence of disease 17 months after the initial resection.

Higher sleep fragmentation predicts a lower magnitude of weight loss in overweight and obese women participating in a weight-loss intervention

Background:

Sleep has been identified as having an influence on the success of weight-loss interventions; however, knowledge of the mechanisms and the extent to which sleep disturbances affect the magnitude of weight reduction is inconclusive.

Objective:

To determine if sleep duration and quality can predict the magnitude of weight reduction in a weight-loss intervention program for overweight and obese women.

Methods:

Ninety overweight and obese women aged 25–65 years completed the 7-month weight-loss phase of our weight-loss intervention. Sleep duration and quality were evaluated before the intervention by the Pittsburg Sleep Quality Index (PSQI), a self-report questionnaire, and by actigraphy. Serum levels of ghrelin, leptin, cortisol and insulin also were measured at baseline. Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR).

Results:

The mean reduction rate of body mass index (BMI) after the intervention was 13.6%. Multiple linear regression revealed that the number of wake episodes (WEs) per night had a significant relationship with the reduction of BMI even after adjusting for other clinical variables (β=−0.341, P=0.001). The participants with five or more WEs per night (high-WE group) had a significantly lower reduction in BMI compared with those with fewer than five (normal-WE group), after adjusting for confounding variables. In contrast, the PSQI-assessed parameters, reflecting the subjective assessments of sleep quality and duration, failed to detect an association with the reduction in BMI. Baseline HOMA-IR was significantly higher in the high-WE group than in the normal-WE group after adjusting for confounding variables.

Conclusions:

Higher sleep fragmentation, as manifested by the increased number of WEs, predicts a lower magnitude of weight reduction in persons participating in weight-loss programs.

Distribution of Fos-immunoreactive cells in rat forebrain and midbrain following social defeat stress and diazepam treatment

The anxiolytic diazepam selectively inhibits psychological stress-induced autonomic and behavioral responses without causing noticeable suppression of other central performances. This pharmacological property of diazepam led us to the idea that neurons that exhibit diazepam-sensitive, psychological stress-induced activation are potentially those recruited for stress responses. To obtain neuroanatomical clues for the central stress circuitries, we examined the effects of diazepam on psychological stress-induced neuronal activation in broad brain regions. Rats were exposed to a social defeat stress, which caused an abrupt increase in body temperature by up to 2°C. Pretreatment with diazepam (4mg/kg, i.p.) attenuated the stress-induced hyperthermia, confirming an inhibitory physiological effect of diazepam on the autonomic stress response. Subsequently, the distribution of cells expressing Fos, a marker of neuronal activation, was examined in 113 forebrain and midbrain regions of these rats after the stress exposure and diazepam treatment. The stress following vehicle treatment markedly increased Fos-immunoreactive (IR) cells in most regions of the cerebral cortex, limbic system, thalamus, hypothalamus and midbrain, which included parts of the autonomic, neuroendocrine, emotional and arousal systems. The diazepam treatment significantly reduced the stress-induced Fos expression in many brain regions including the prefrontal, sensory and motor cortices, septum, medial amygdaloid nucleus, medial and lateral preoptic areas, parvicellular paraventricular hypothalamic nucleus, dorsomedial hypothalamus, perifornical nucleus, tuberomammillary nucleus, association, midline and intralaminar thalami, and median and dorsal raphe nuclei. In contrast, diazepam increased Fos-IR cells in the central amygdaloid nucleus, medial habenular nucleus, ventromedial hypothalamic nucleus and magnocellular lateral hypothalamus. These results provide important information for elucidating the neural circuitries that mediate the autonomic and behavioral responses to psychosocial stressors.

Commensal microbiota modulate murine behaviors in a strictly contamination-free environment confirmed by culture-based methods

BACKGROUND

There is increasing evidence suggesting the existence of an interaction between commensal microbiota, the gut and the brain. The aim of this study was to examine the influence of commensal microbiota on the host behaviors in a contamination-free environment, which was verified by culture-based methods.

METHODS

Open-field and marble-burying tests were used to analyze anxiety-like behaviors and locomotor activity in gnotobiotic BALB/c mice with a common genetic background in a sterile isolator. The monoamine levels in several regions of the brain were measured in germfree (GF) mice and commensal fecal microbiota-associated mice (EX-GF).

KEY RESULTS

A 24-h exposure to the environment outside the sterile isolators rendered GF mice less anxious than those not contaminated, while there was no change in the locomotion. EX-GF mice, the gnotobiotic mice with normal specific pathogen-free microbiota, were less anxious and active than GF mice using open-field and marble-burying tests. The norepinephrine, dopamine, and serotonin turnover rates were higher in the EX-GF mice than in the GF mice in most regions of the brain, suggesting that monoaminergic neurotransmission might increase in the EX-GF mice comparing the GF mice. Monoassociation with Brautia coccoides reduced the anxiety level, but it did not affect the locomotor activity. In contrast, colonization with Bifidobacterium infantis decreased the locomotor activity, while having little effect on the anxiety level.

CONCLUSIONS & INFERENCES

These results strongly support the current view that gut microorganisms modulate brain development and behavior.

Bile duct stone formation around a nylon suture after gastrectomy: a case report

BACKGROUND

Many cases of choledocholiths formed around sutures and clips used during cholecystectomy have been reported. We describe a case of gallstone formation around a nylon suture after non-biliary surgery. To the best of our knowledge, this is the first report of such a case.

CASE PRESENTATION

A 75-year-old Japanese man, who had undergone distal gastrectomy for gastric cancer and reconstruction with the Billroth II method 8 years earlier, presented with gastric discomfort. Abdominal ultrasonography was conducted and we diagnosed cholecysto-choledocholithiasis with dilatation of the intrahepatic bile duct. He underwent cholecystectomy and cholangioduodenostomy for choledocholith removal. Gallstones, which had formed around a nylon suture used during the previous gastrectomy, were found in the bile duct. Sutures of the same material had also been placed on the duodenum. Chemical analysis revealed that the stones were composed of calcium bilirubinate. The patient was discharged on postoperative day 19, and choledocholithiasis has not recurred thus far.

CONCLUSION

The findings from this case suggest that standard, non-resorbable sutures used in gastrectomy may be associated with the formation of bile duct stones; therefore, absorbable suture material may be required to avert gallstone formation even in the case of gastrectomy.

The outcome of Japanese anorexia nervosa patients treated with an inpatient therapy in an internal medicine unit

OBJECTIVE

To investigate the outcome of Japanese anorexia nervosa (AN) patients who were treated with the standard Japanese inpatient therapy.

METHOD

Of the 88 female AN patients treated with our inpatient therapy between January 1997 and December 2002, 67 (76.1%) who agreed to cooperate in this study were assessed by the Global Clinical Score (GCS) at admission and follow-up, 6.3±1.8 years after discharge. Their clinical characteristics at admission and discharge were also examined.

RESULTS

Four (6.0%) patients had died before follow-up. BMI was significantly increased during inpatient therapy. At follow-up, excellent, much improved, symptomatic, and poor outcomes on GCS were 57.1%, 14.3%, 14.3% and 14.3%, respectively. Younger age at admission and larger BMI at discharge were significantly associated with a better outcome.

DISCUSSION

This study shows the potential for the use of this method for the treatment of AN patients in countries without specialized eating disorder units.

Real-time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging: preliminary results of a prospective study

BACKGROUND

Recently, a highly sensitive fluorescent imaging technique was developed for the real-time identification of hepatic tumors. The authors applied this procedure for the intraoperative detection of radiographically occult hepatic micrometastases from pancreatic cancer.

METHODS

Forty-nine consecutive patients with pancreatic cancer who underwent surgical intervention were examined. Preoperative clinical images had not revealed any hepatic metastases. On the day before surgery, indocyanine green was injected intravenously. During the operation, the liver was observed with a near-infrared camera system, and abnormal fluorescent foci were examined by frozen-section histology. The patients with hepatic micrometastases were judged to have unresectable disease and underwent only palliative surgery followed by systemic chemotherapy using gemcitabine.

RESULTS

Abnormal hepatic fluorescence at least 1.5 mm in greatest dimension without any apparent tumor was observed in 13 patients. Among them, histologic examination confirmed micrometastases in 8 of 49 patients (16%). All patients with hepatic micrometastases had clinical T3 or T4 disease and high serum CA19-9 levels (P = .042). On follow-up computed tomography images that were obtained within 6 months after surgery, the patients with hepatic micrometastases manifested hepatic overt metastases (7 of 8 patients; 88%) more frequently than the patients without hepatic micrometastases (4 of 41 patients; 10%; P < .001). Regardless of histologic confirmation, the positive predictive value of abnormal fluorescence for the manifestation of hepatic relapse within 6 months was 77% (10 of 13 patients), and the negative predictive value was 97% (35 of 36 patients).

CONCLUSIONS

Indocyanine green-fluorescent imaging can detect hepatic micrometastases of pancreatic cancer during surgery. The hepatic micrometastases seem to have an adverse clinical impact identical to that of evident distant metastases.

Predictors of menstrual resumption by patients with anorexia nervosa

OBJECTIVE

To investigate which factors predict the resumption of menstruation by patients with anorexia nervosa (AN).

METHODS

Participants were AN patients who, even after weight recovery by inpatient treatment, had prolonged amenorrhea (N=11), AN patients who resumed menstruation after weight recovery (N=9), and age-matched healthy controls (N=12). Anthropometric data and the serum levels of leptin, insulin-like growth factor I (IGF-1), cortisol, luteinizing hormone (LH), estradiol (E2), and other hormones were measured at the beginning of the inpatient treatment and after weight recovery.

RESULTS

Of the baseline anthropometric and hormonal factors, logistic regression analysis extracted a high serum cortisol level as a predictor of the inhibition of the resumption of menstruation. After weight recovery, the E2 and leptin levels were significantly higher for eumenorrheic patients than for amenorrheic patients.

CONCLUSION

The baseline serum cortisol level was a predictor of the prolonged inhibition of menstrual recovery.

Barriers to compliance with the Daily Food Guide for Children among first-grade pupils in a rural area in the Philippine Island of Mindanao

BACKGROUND/OBJECTIVE

To identify and address caregivers' perceived barriers to compliance with dietary guidelines for children.

SUBJECTS/METHODS

Information on family socioeconomic status, child's consumption frequency of nine food items, and caregiver's attitudes and behaviors regarding meal preparation were collected through structured interviews with caregivers (70 mothers, four grandmothers and one father) of first-grade children (39 boys and 36 girls) living in five barangays of New Corella, Mindanao Island, Philippines. If the child's intake did not reach the level recommended in the dietary guidelines, the reasons were investigated from the economic, social, cultural and environmental viewpoints.

RESULTS

Their diet relied heavily on rice and others. The percentages of children who did not consume each of the food items on a daily basis were 77.3% for eggs; 57.3% for milk; 41.3% for fish/meat/poultry/dried beans/nuts (FMPDBN); 42.7% for fruits; 17.4% for green, leafy and yellow (GLY) vegetables; and 38.5% for other vegetables. The most reported reasons for the infrequent consumption of FMPDBN (87.1%), milk (81.4%) and eggs (36.2%) were 'no money to buy,' that of fruits (59.4%) was 'out of season' and that of GLY (61.5%) and other vegetables (55.2%) was 'child's dislike.'

CONCLUSIONS

The expansion of homestead food production and the national feeding program contribute to increased animal food consumption. Nutrition education aimed at overcoming food preferences and increasing the awareness of micronutrient intake are perhaps the most effective means to promote vegetable intake.

Insulin-like growth factor-I (IGF-I) system during follicle development in the bovine ovary: relationship among IGF-I, type 1 IGF receptor (IGFR-1) and pregnancy-associated plasma protein-A (PAPP-A)

Insulin-like growth factor-I (IGF-I) system that is exerted mainly through the type 1 IGF receptor (IGFR-1) and releasing of free IGF-I is regulated by the proteases of IGF-binding proteins (IGFBPs), an important factor in follicle development of bovine ovary. The aims of the present study were to examine the mRNA expressions of IGF-I, IGFR-1 and pregnancy-associated plasma protein-A (PAPP-A) in granulosa cells and theca tissues during bovine follicular development and the effects of follicle-stimulating hormone (FSH) and estradiol (E2) on the expression of these genes in cultured bovine granulosa cells. Follicles were classified into four groups such as small follicle (SF), estrogen inactive dominant follicle (EID), estrogen active dominant follicle (EAD) and preovulatory follicle (POF). The concentration of free IGF-I in follicular fluid of POF was significantly higher than those in EID, whereas the total IGF-I in follicular fluid did not change at all developmental stages. The expression of IGF-I mRNA was not detected in the granulosa cells at all at any developmental stages but the expression was detected in the theca tissues. The amount of IGFR-1 mRNA in granulosa cell showed the constant level at all developmental stages except EID. The expressions of IGFR-1 and PAPP-A in cultured bovine granulosa cells were stimulated with FSH but not with E2. The PAPP-A mRNA expression was stimulated by FSH in presence of 1 ng/ml E2. These results indicate that IGF-I in follicular fluid is mainly derived from the circulation and that FSH is an inducer for the expression of IGFR-1 and PAPP-A genes in granulosa cells. Therefore, we suggest that PAPP-A stimulated with FSH play a crucial role for IGF-I system in bovine follicular development.

252 THE ROLE OF INSULIN-LIKE GROWTH FACTOR 1 (IGF-1) IN DEVELOPMENT OF AN ESTROGEN-ACTIVE DOMINANT FOLLICLE DURING THE FIRST FOLLICULAR WAVE POSTPARTUM IN DAIRY COWS

Recent studies have shown that IGF-1 is a crucial factor for ovarian follicular development in mammals. In postpartum (pp) dairy cows, plasma IGF-1 and estradiol (E2) levels in ovulatory cows at the first follicular wave pp are higher than in anovulatory cows. However, the plasma IGF-1 profile in an ovulatory or anovulatory dominant follicle (DF), which have different E2 production, at the first follicular wave pp have not yet been elucidated. Thus, we investigated the changing profile of plasma IGF-1 levels during first follicular wave pp. In 22 multiparous Holstein cows, blood samples were obtained 2 times/week from 4 weeks prepartum to 3 weeks pp, and the first follicular wave was monitored by ultrasound 2 times/week from 7 days pp to ovulatory phase. Detailed IGF-1 profiles in blood were determined during DF growth and maturation 4 times/day from 10 days pp to 7 days after the first ovulation in 5 ovulatory cows and to 20 days pp in 4 anovulatory cows; the data were analyzed by repeated measures ANOVA, and Student&apos;s t-test. There was no interaction between groups and time within the prepartum or the pp period. The ovulatory cows (n = 13/22) with an estrogen-active dominant (EAD: high plasma E2 level with peak) follicle showed higher IGF-1 levels than anovulatory cows (n = 9/22) with an estrogen-inactive dominant (EID: low plasma E2 level without peak) follicle during the prepartum (117 � 8 vs. 91 � 5 ng mL-1; P &lt; 0.05) and the pp (91 � 4 vs. 64 � 4 ng mL-1; P &lt; 0.001) period. Especially noteworthy, during the first follicular wave pp in ovulatory cows, the plasma IGF-1 levels were maintained at a high level until E2 levels increased, followed by an LH surge. We observed that the EAD follicle in ovulatory cows ovulated. To further examine the IGF-1 system in the intra-follicular environment, we used the EAD and EID follicles from ovaries of dairy cows obtained at a slaughterhouse. The EAD and EID follicles were classified on the basis of follicle diameter and E2 concentrations in follicular fluid (FF). The significant differences of factors between EAD and EID were analyzed by Student&apos;s t-test. The expression of IGF-1 mRNA was not detected in follicular cells in either EAD and EID, suggesting that IGF-1 in FF is mainly derived from liver. The free IGF-1 levels in FF in EAD (4.8 � 0.5 ng mL-1) were higher than those in EID (2.7 � 0.1 ng mL-1; P &lt; 0.05). In addition, the expression of type 1 IGF receptor (IGFR-1) mRNA in EAD was higher than hat in EID (P &lt; 0.0001). From the results of the present study, it is apparent that the EAD follicle during the first follicular wave pp in ovulatory cows sufficiently expressed IGFR-1, and a liver-derived IGF-1 stimulates E2 production in the follicle to ovulate. In conclusion, our data suggest that a high concentration of IGF-1, secreted from the liver, during the peripartum period may be one of important factors for the appearance of an ovulatory follicle during the first follicular wave pp cows.

Gender differences in dietary intake among adults of Hindu communities in lowland Nepal: assessment of portion sizes and food consumption frequencies

OBJECTIVE

To elucidate gender differences in dietary intake among adults in lowland Nepalese communities.

SUBJECTS AND METHODS

For 122 male and 195 female subjects aged 20 years and over from 94 randomly selected households, interviews using a 19-item food frequency questionnaire were conducted. To determine the portion sizes of these foods, the samples consumed by 56 subjects in a full 1-day period were weighed. Energy expenditure was estimated by time spent on daily activities.

RESULTS

Gender differences in per-day energy and protein intakes were related to sex differences in body size and energy expenditure. Apparent gender differences in the crude intakes disappeared when they were expressed by nutrient density (mg or microg/MJ) since micronutrient intakes were significantly correlated with energy intake. However, males' iron intake was larger even after adjustment for energy intake, attributing to their larger portion sizes of commonly consumed staple foods and higher frequencies of consuming luxury foods (fish and tea).

CONCLUSION

The intrahousehold unequal distribution of food incurs risk of iron deficiency among female subjects.

SPONSORSHIP

This study was financially supported by the Ajinomoto Foundation for Dietary Culture and the Alliance for Global Sustainability Program.

The hepatic sympathetic nerve plays a critical role in preventing Fas induced liver injury in mice

BACKGROUND

Although previous studies have shown that the hepatic sympathetic nerve controls various physiological functions in the liver, the role of this nerve in liver injury has yet to be clarified.

AIMS

The purpose of this study was to elucidate the role of this nerve, based on our newly developed technique for selectively removing the activities of the hepatic sympathetic nerve.

SUBJECTS AND METHODS

Male C57BL/6 mice were operated on for hepatic sympathetic denervation. Thereafter, mice were intravenously administered 0.25 or 0.35 microg/g weight of the Fas agonist antibody, Jo-2, after which mortality by fulminant hepatitis was evaluated. Apoptosis in the liver was also examined by both terminal deoxynucleotidyl transferase mediated dUTP nick end labelling and caspase-3 assay.

RESULTS

Mortality in sympathectomised mice was significantly higher than that in sham operated mice following administration of Jo-2. This result was also supported by apoptosis data in which sympathectomised livers exhibited a significant elevation in the number of apoptotic hepatocytes and caspase-3 activity after Jo-2 treatment compared with sham operated livers. Moreover, pretreatment with norepinephrine dose dependently inhibited the hepatic sympathectomy induced increase in mortality after Jo-2 injection. Antiapoptotic protein levels of FLICE inhibitory protein, Bcl-xL, and Bcl-2 in the liver were significantly lower in sympathectomised mice at one and two hours following Jo-2 treatment than in sham operated animals. In addition, interleukin 6 supplementation dose dependently suppressed the hepatic sympathectomy induced increase in mortality after Jo-2 treatment.

CONCLUSIONS

These results suggest that norepinephrine released from the hepatic sympathetic nerve plays a critical role in protecting the liver from Fas mediated fulminant hepatitis, possibly via mechanisms including antiapoptotic proteins and interleukin 6.

An oral introduction of intestinal bacteria prevents the development of a long-term Th2-skewed immunological memory induced by neonatal antibiotic treatment in mice

BACKGROUND

Recent epidemiological studies indicate that antibiotic use in infancy may be associated with an increased risk of developing atopy. Our previous work on animals demonstrated that kanamycin use during infancy promotes a shift in the Th1/Th2 balance towards a Th2-dominant immunity.

OBJECTIVE

The first purpose of this study is to clarify whether or not the supplementation of intestinal bacteria can reverse such a Th2-skewed response induced by neonatal antibiotic use. The second objective is to elucidate the contribution of genetic factors to antibiotic-induced immune-deviation.

METHODS

BALB/c or C57BL/6 mice at 3 weeks of age were orally administered 600 microg/day of kanamycin sulphate for seven consecutive days. Thereafter, the mice were inoculated with one type of intestinal bacterial species: Enterococcus faecalis, Lactobacillus acidophilus or Bacteroides vulgatus. Blood samples were collected 10 weeks after the cessation of kanamycin treatment, and the effect of the kanamycin treatment on Th1/Th2 balance was evaluated based on in vivo antibody levels.

RESULTS

A kanamycin-induced elevation of the serum IgE levels was reversed by the supplementation with Enterococcus faecalis, and to a lesser extent by that with Lactobacillus acidophilus. The IgE/IgG2a ratio in the mice supplemented with Enterococcus faecalis significantly decreased in comparison with that in the kanamycin-treated mice without any bacterial supplementation, while such a ratio was enhanced in the mice inoculated with Bacteroides vulgatus. No antibiotic-induced Th2-skewed response was seen in C57BL/6 mice that are genetically biased towards Th1-dominant immunity.

CONCLUSION

These results suggest that adequate probiotic intervention after antibiotic treatment may improve the intestinal ecosystem, and thereby prevent the Th2-shifted immunity induced by neonatal antibiotic use. In addition, the difference of genetic backgrounds also contributes to such an antibiotic-induced Th2-skewed response.

Dehydroepiandrosterone attenuates the spontaneous elevation of serum IgE level in NC/Nga mice

Dehydroepiandrosterone (DHEA) and its sulfate derivatives are known to affect host immune function; however if such hormones influence the development of atopic dermatitis has not yet been clarified. In this study, we examined the effects of DHEA on the allergic process using NC/Nga mouse, a model animal of human atopic dermatitis. The administration of DHEA profoundly suppressed the spontaneous elevation of both serum IgE and interleukin-6 levels in NC/Nga mice during the observation period. These results indicate that DHEA promotes a shift in Thl/Th2 balance toward Th1-dominant immunity, and thus may be one of the effective alternatives in treating atopic dermatitis.

Lung cancer, myocardial infarction, and the Grossarth-Maticek personality types: a case-control study in Fukuoka, Japan

Grossarth-Maticek and colleagues have shown, in their prospective studies, a strong relationship of their personality types, Types 1 and 2, to cancer and coronary heart disease (CHD), respectively. Relevant information is limited from replication studies, and little is known about psychosocial factors in relation to cancer or CHD in Japan. Subjects included 95 cases of lung cancer (LC), 94 cases of myocardial infarction (MI) and 596 controls. The controls were men and women who visited a clinic for a health checkup. The Grossarth-Maticek personality types, Types 1 to 6, were assessed using the Short Interpersonal Reactions Inventory. The distributions of the 6 personality types were compared between the case and control groups, adjusting for sex and age class. The relation of each of the 6 types to LC and MI were examined in terms of odds ratio, using a logistic regression model controlling for age, sex, job status, education level, and smoking status. As regards the distribution analysis, Types 1 and 2 in the LC and MI groups each were not more prevalent than the controls, respectively. High score of the Type 1 scale was associated with a statistically nonsignificant decrease in LC risk. MI risk was significantly, positively associated with the Type 2 and 5 scales, and unexpectedly, positively related to the Type 3 scale. The present findings partly supported the Grossarth-Maticek theory, but there remain some conflicting issues to be confirmed in future studies.

Nutrient intake among female shift workers in a computer factory in Japan

Based on a 4-day questionnaire survey for all meals and snacks consumed by female workers in a computer factory in Japan, consisting of 44 daytime workers and 93 weekly-rotating shift workers (of whom 47 and 46 were engaged in, respectively, early-shift work and late-shift work during the survey week), the present study aimed to clarify the effects of shift work on their nutrient intakes in association with food consumption patterns. Their dietary intakes for 3 working days and an off day were assessed by self-registered food consumption records with the aid of a photographic method, and intakes of energy, protein, fat, carbohydrate, calcium and iron were estimated. The inter-group differences were prominent in the working days. The shift workers, particularly the late-shift workers, took smaller amounts of energy and nutrients than the daytime workers, implying that the former group's nutritional status has been worsened, judged from the recommended dietary allowance for Japanese. Their inadequate nutrient intake was due to lower meal frequency and poor meal quality, both of which were conditioned by shift work.

Central and peripheral catecholamines regulate the exercise-induced elevation of plasma interleukin 6 in rats

Several recent reports indicate that exercise elevates the plasma interleukin 6 levels; however, the precise regulation of such an elevation still remains to be clarified. In this study, in order to clarify the requirements of central and peripheral catecholaminergic system for this exercise-induced interleukin 6 elevation, rats were either intraperitoneally or intracerebroventricularly injected with 6-hydroxydopamine which depletes the catecholamine in the central or peripheral tissues. As a result, our exercise protocol elevated the plasma interleukin 6, ACTH, and corticosterone levels in response to exercise. All such exercise-induced increases in the interleukin 6, ACTH, and corticosterone levels were significantly inhibited by pretreatment with an intracerebroventricular injection of 6-hydroxydopamine. In the intraperitoneal 6-hydroxydopamine-treated animals, the exercise-induced interleukin 6 elevation was significantly suppressed compared with the vehicle-treated animals, although no significant difference was found in either the ACTH level or the corticosterone level between both groups of animals. These results thus suggest that central and peripheral catecholamines are involved in the regulation of the exercise-induced interleukin 6 elevation.

Restraint stress elevates the plasma interleukin-6 levels in germ-free mice

Several recent reports demonstrated that restraint stress elevates plasma IL-6 levels; however, the precise mechanism whereby stress stimuli trigger the production of IL-6 remains to be clarified. In this study, in order to elucidate whether or not the intestinal microflora contribute to the stress-induced IL-6 elevation, the plasma IL-6 response of germ-free (GF) mice, which are indeed devoid of indigenous microflora, was compared to that of specific pathogen-free (SPF) mice. The plasma IL-6 level increased after 1 h of restraint stress and thereafter gradually decreased in GF mice as well as in SPF mice. In addition, such a stress-induced IL-6 elevation was also found in the mice reconstituted with SPF feces. The expression levels of IL-6 mRNA in the liver increased after 1 h of stress in both GF and SPF mice based on the findings of a semiquantitative RT-PCR method, although no such increase was observed in the spleen and kidney of both groups of mice. These results thus indicate that restraint stress is capable of elevating the plasma IL-6 levels independently of the intestinal microflora and the liver is one of the main sources responsible for the increased plasma IL-6 during stress.

Restraint stress-induced elevation of endogenous glucocorticoids decreases Peyer's patch cell numbers via mechanisms that are either dependent or independent on apoptotic cell death

In this study, we investigated whether restraint stress induces either apoptotic cell death or lymphocyte migration in Peyer's patches. Exposure to stress induced a striking decrease in the number of CD3+CD4+, CD3+CD8+ and B220+ cells. Such decreases were accompanied by the enhanced induction of apoptosis in Peyer's patches. The apoptosis of Peyer's patch cells was completely reversed by pretreatment with either high or low doses of RU-486, a glucocorticoid receptor antagonist. In contrast, the stress-induced lymphopenia was little affected by administration of low doses of RU-486, although such lymphopenia was perfectly inhibited by treatment with high doses of RU-486. Taken together, these results suggest that the stress-induced lymphopenia in Peyer's patches is partly due to apoptotic cell death, although other systems such as lymphocyte migration, may contribute to such a reduction in the number of Peyer's patch cells.

Antibiotic use during infancy promotes a shift in the T(H)1/T(H)2 balance toward T(H)2-dominant immunity in mice

BACKGROUND

Recent epidemiologic studies indicate that antibiotic use in infancy may be associated with an increased risk of development of atopy; however, its precise mechanism remains to be elucidated.

OBJECTIVE

The purpose of this study is to clarify whether one such antibiotic, kanamycin, affects the T(H)1/T(H)2 balance.

METHODS

BALB/c mice at 3 and 52 weeks of age were orally administered 600 mg/d kanamycin sulfate for 7 consecutive days. Blood samples were collected on weeks 0, 10, 18, and 26 after the cessation of kanamycin treatment, and the effect of the kanamycin treatment on the T(H)1/T(H)2 balance was evaluated on the basis of both the in vivo antibody levels and the in vitro splenocyte cytokine secretion pattern.

RESULTS

The administration of kanamycin increased the serum levels of total IgG1 and IgE while decreasing the serum IgG2a levels. Moreover, when spleen cells were stimulated with immobilized anti-CD3 antibody in vitro, such kanamycin treatment enhanced the in vitro IL-4 secretion while reducing the in vitro IFN-gamma secretion. The basal IL-12 p70 secretion levels of splenic dendritic cells in the kanamycin-treated mice were lower than those in the control mice, although no significant difference was seen in IL-12 p40 levels between either group of mice.

CONCLUSION

These results suggested that antibiotic use during infancy may indeed quantitatively disturb, qualitatively disturb, or both the intestinal microflora and thereby prevent postnatal T(H)1 cell maturation, thus resulting in a T(H)2-polarized immune deviation.

Dietary nucleic acids promote a shift in Th1/Th2 balance toward Th1-dominant immunity

BACKGROUND

Dietary sources of nucleic acids and their relative components are known to affect host immune function; however, it has not yet been clarified whether such dietary nucleic acids influence the pathogenesis of allergic reaction.

OBJECTIVE

The purpose of this study is to elucidate the effect of dietary nucleic acids on Th1/Th2 balance.

METHODS

Both human flora-associated and specific pathogen-free BALB/c mice were maintained on either nucleic acid-free, or -supplemented diets. The effects of nucleic acids on both in vivo antibody levels and in vitro splenocyte cytokine production were compared using these mice.

RESULTS

Supplementation of nucleic acids caused a reduction in the serum antibody levels of total IgM, IgG, IgG1, and IgE in the human flora-associated mice without affecting the composition of intestinal flora. In contrast, there was no significant difference of the serum IgG2a levels between nucleic acid-free and -supplemented mice. Such a phenomenon as that, the supplementation of dietary nucleic acids reduces the serum IgE or IgG1 levels, but not the IgG2a level, was also seen in the specific pathogen free mice. Moreover, when the mice were systematically challenged with ovalbumin, the supplementation of nucleic acids also suppressed the serum ovalbumin-specific IgE and IgG1 antibody levels as well as in vitro IL-4 and IL-10 secretion, while enhancing both the serum ovalbumin-specific IgG2a antibody levels and in vitro IFN gamma secretion.

CONCLUSION

These results suggested that dietary nucleic acids may play an important role in promoting a shift in Th1/Th2 balance toward Th1-dominant immunity.

Sleep patterns and sleep disorders among female shift workers in a computer factory of Japan

Using a repeated questionnaire survey for female workers in a computer factory of Japan, consisting of 45 daytime workers and 84 weekly rotating shift workers (of whom 40 and 44 were respectively engaged in early-shift work and late-shift work during the survey week), the present study aimed to clarify the effects of shift work on their sleep patterns and sleep disorders. The time of retiring, time of rising, duration of sleep, and self-evaluated sleep quality based on four sleep-related problems were investigated for four days (Sunday-Monday, Tuesday-Wednesday, Thursday-Friday, and Saturday-Sunday) in a week. The intergroup comparison revealed that the earlier the rising time and the shorter the duration of sleep, the lower the sleep quality; the lowest sleep quality was observed in the early-shift workers.

The restraint stress-induced elevation in plasma interleukin-6 negatively regulates the plasma TNF-alpha level

Although a considerable amount of evidence has shown that physical and psychological stress elevates the plasma interleukin 6 (IL-6) levels, the physiological significance of such an elevation remains to be elucidated. In this study, in order to determine whether the restraint stress-induced elevation of plasma IL-6 contributes to the activation of the hypothalamic-pituitary-adrenal axis, and whether or not such elevation can affect the inflammatory processes, the plasma levels of ACTH, corticosterone, interleukin-1 (IL-1), and tumor necrosis factor-alpha (TNF-alpha) in mice pretreated with anti-IL-6 antibody (MP5-20F3 monoclonal antibody) were compared with those in mice pretreated with rat IgG (control antibody) both during and after stress. Both the anti-IL-6-antibody- and control-antibody-pretreated mice showed the same extent of plasma ACTH and corticosterone increases during stress, and no significant difference was found between the two groups of animals. On the other hand, the level of plasma TNF-alpha in the anti-IL-6-treated animals was also significantly higher than that in the control animals both immediately after cessation of stress and 60 min after the cessation of the 120-min period of restraint. Plasma IL-1 activity, however, did not reach a detectable level in either group of animals at any time point examined. These results thus indicate that the restraint-stress-induced elevation of plasma IL-6 negatively regulates the plasma TNF-alpha levels and may thus contribute to the maintenance of homeostasis.

The restraint stress-induced reduction in lymphocyte cell number in lymphoid organs correlates with the suppression of in vivo antibody production

In this study, we examined the effects of restraint stress on some immune parameters such as the in vivo antibody levels, cytokine production, and lymphocyte cell number in the spleen or mesenteric lymph node (MLN). BALB/c mice were thus injected intraperitoneally 2-times with OVA absorbed into alum on days 0 and 21. Before the first injection, the animals were either restrained for 12 h (stress group) or returned to their home cage (control group). Exposure to stress resulted in a reduction in the serum levels of anti-OVA IgE, IgG1, and IgG2a. In addition, stress also caused a decrease in the IL-4 and IFN-gamma levels in the spleen or mesenteric lymph node cell culture supernatants. Furthermore, exposure to stress resulted in a decrease in the splenic and mesenteric lymphocyte cell number when examined immediately after the cessation of stress. This decrease persisted for at least 12 h after the termination of stress and thereafter disappeared 24 h after stress. The stress-induced reductions in antibody and cytokine production occurred only when antigen was given either immediately or 6 h after stress, but not when antigen was given 24 h post stress. These results thus suggest that the restraint stress-induced change in lymphocyte cell number in the spleen or MLN closely correlates with the altered antibody and cytokine levels.

The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction

The role of intestinal bacterial flora in oral tolerance induction to the IgE response was investigated using germfree (GF) mice. When GF mice were orally administered 20 mg of OVA as tolerogen before a systemic challenge with OVA, the Th1-mediated responses, such as the production of IgG2a and IFN-gamma, were abrogated, while the Th2-mediated immune responses, such as the production of IgE, IgG1, and IL-4, were maintained. Moreover, the basal level of IL-4 production in vitro was significantly higher in the GF mice than that of IL-4 in specific pathogen-free mice when challenged systemically with OVA. On the other hand, both Th1 and Th2 responses were fully sensitive to such tolerance induction in specific pathogen-free mice. The reconstitution of intestinal flora of GF mice with Bifidobacterium infantis, one of the predominant bacteria in the intestinal flora, restored the susceptibility of these Th2 responses to oral tolerance induction; however, this was only effective when such reconstitution was performed in neonates, but not in mice at an older age. These results thus suggested that intestinal bacterial flora play a crucial role in generating a Th2 cell population whose size and response are adequately regulated and, consequently, fully susceptible to oral tolerance induction, probably by affecting the development of gut-associated lymphoid tissue at the neonatal stage.

The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction

The role of intestinal bacterial flora in oral tolerance induction to the IgE response was investigated using germfree (GF) mice. When GF mice were orally administered 20 mg of OVA as tolerogen before a systemic challenge with OVA, the Th1-mediated responses, such as the production of IgG2a and IFN-gamma, were abrogated, while the Th2-mediated immune responses, such as the production of IgE, IgG1, and IL-4, were maintained. Moreover, the basal level of IL-4 production in vitro was significantly higher in the GF mice than that of IL-4 in specific pathogen-free mice when challenged systemically with OVA. On the other hand, both Th1 and Th2 responses were fully sensitive to such tolerance induction in specific pathogen-free mice. The reconstitution of intestinal flora of GF mice with Bifidobacterium infantis, one of the predominant bacteria in the intestinal flora, restored the susceptibility of these Th2 responses to oral tolerance induction; however, this was only effective when such reconstitution was performed in neonates, but not in mice at an older age. These results thus suggested that intestinal bacterial flora play a crucial role in generating a Th2 cell population whose size and response are adequately regulated and, consequently, fully susceptible to oral tolerance induction, probably by affecting the development of gut-associated lymphoid tissue at the neonatal stage.

Augmented Ca2+ influx is involved in the mechanism of enhanced proliferation of cultured vascular smooth muscle cells from spontaneously diabetic Goto-Kakizaki rats

To investigate whether augmented calcium influx is involved in the mechanism of the enhanced proliferation of vascular smooth muscle cells (VSMCs) in diabetes, we studied the association between proliferation and cytosolic free calcium concentration ([Ca2+]i) in cultured aortic VSMCs from spontaneously diabetic Goto-Kakizaki (GK) and Wistar rats. Serum, angiotensin II and Bay K 8644, a voltage-dependent Ca2+ channel (VDC) agonist, stimulated the proliferation of VSMCs; the magnitude was greater in VSMCs from GK than Wistar rats. VDC blockers, verapamil and nicardipine, inhibited Bay K 8644-induced cell proliferation, and the difference in the proliferation of VSMCs between GK and Wistar rats disappeared. Angiotensin II-induced proliferation was only partially inhibited by VDC blockers, and enhanced proliferation of GK-VSMCs was still observed. Bay K 8644 and angiotensin II increased [Ca2+]i, and the increase was augmented in GK-VSMCs. Bay K 8644-induced [Ca2+]i increase was completely inhibited by pretreatment with verapamil or removal of extracellular Ca2+, suggesting that VDC is associated with this increase. Although angiotensin II-induced [Ca2+]i increase was not affected by verapamil, removal of extracellular Ca2+ slightly but significantly attenuated angiotensin II-induced [Ca2+]i increase, suggesting that VDC blocker-insensitive receptor-activated Ca2+ influx is involved. These results indicate that augmented Ca2+ influx via VDC and a receptor-activated pathway may be involved in the mechanism of the enhanced proliferation of VSMCs from GK rats.

Restraint stress causes tissue-specific changes in the immune cell distribution

In this study, the effect of restraint stress on alterations in the immune cell distribution was examined in bone marrow, liver, thymus, and spleen. In bone marrow, stress induced a striking increase in both the proportion and number of CD3+CD4+, CD3+CD8+, B220brightIgM+, CD3-IL-2R beta + and CD3intIL-2R beta + cells. Such an increase was partially reversed by pretreatment with RU-486, a steroid receptor antagonist, while it was profoundly enhanced by either sympathectomy with 6-hydroxydopamine hydrobromide or by a beta-adrenergic blockade with propranolol, a beta-adrenergic receptor antagonist; this suggests that corticosteroids and catecholamines may act in opposition with regard to such an immune-cell accumulation in bone marrow. In the liver, stress decreased the proportions of CD3intIL-2R beta +, CD3-IL-2R beta +, and B220brightIgM+ cells, while it increased the proportion of CD3brightIL-2R beta-cells, thus demonstrating that different subpopulations were differentially affected. In the thymus and spleen, stress only slightly affected the proportions of lymphocyte subpopulations, although both tissues showed a drastic reduction in the number of lymphocytes. Taken together, these results suggest that restraint stress induces tissue-specific changes in the immune-cell distribution.

Multivariate analysis of prognostic factors in patients with ovarian cancer stage I and II

OBJECTIVE

To evaluate prognostic factors such as surface capsular invasion, rupture of the capsule and intraperitoneal cytology in patients with stage I or II ovarian cancer.

METHOD

Multivariate analysis was performed using 11 clinicopathologic prognostic factors obtained from 183 cases of stage I and II ovarian cancer, which had been surgically treated between 1983 and 1993.

RESULTS

Significant prognostic factors determined by the Kaplan-Meier method were rupture and invasion of the capsule in stage II ovarian cancer. Multivariate analysis showed that spontaneous rupture of the capsule was the only significant factor, and intrapelvic cytology was an important factor without significance. Although capsular rupture caused by the surgeon showed poor prognosis by the Kaplan-Meier method, no significance was observed for this factor by multivariate analysis.

CONCLUSION

Multivariate analysis showed that capsular rupture caused by the surgeon did not affect the prognosis in stage I and II ovarian cancer.

[Use of a micturition-monitoring device in elderly inpatients]

More than 100,000 people suffer from functional urinary incontinence in Japan. To improve the quality of life of these people, we tested a device for monitoring micturition by means of a thin-layer membrane sensor in a diaper. The device was tested in elderly inpatients, and associated changes in the wordload of the nursing staff were also recorded. The device was beneficial because the precise micturition time was easily obtained and thus the daily pattern of micturition became obvious. With the use of this device, the time during which the patients wore wet diapers was shorter than with the conventional system of scheduled changes. However, the increase in the frequency of diaper changed doubled the workload of the nursing staff. In conclusion, improving the quality of life with regard to urinary incontinence entails an increase in the workload of the nursing staff; efficient distribution of that work may require some staff members to devote all their time to changing diapers.

Extracellular ATP activates mast cells via a mechanism that is different from the activation induced by the cross-linking of Fc receptors

In this study, the extracellular ATP (ATPo)-induced biochemical events were elucidated by comparing them with either the Fc epsilon RI- or Fc gamma R-induced events in the mouse mast cell line MC9. The omission of extracellular Ca2+ almost completely abolished the elevation of intracellular Ca2+ ([Ca2+]i) in the ATPo-stimulated cells, but only suppressed the second phase of the increase of [Ca2+]i in FcR-stimulated cells, thus suggesting that the ATPo-induced elevation of [Ca2+]i is totally dependent on the entry of extracellular Ca2+. Pretreatment with genistein, which inhibits protein kinases, especially protein tyrosine kinase, inhibited the FcR-triggered increase of [Ca2+]i, but not the ATPo-triggered one; however, such pretreatment did suppress both ATPo- and FcR-mediated beta-hexosaminidase release. An immunoblot analysis revealed that both ATPo and the cross-linking of FcRs led to tyrosine phosphorylation of 44- and 110-kDa proteins, which thus suggested that these tyrosine-phosphorylated proteins are involved in a modulation of the degranulation process following an elevation of [Ca2+]i. Pretreatment with PMA inhibited the FcR-induced [Ca2+]i increase, while not inhibiting the ATPo-induced one, thus suggesting that ATPo can mobilize [Ca2+]i even when protein kinase C (PKC) has already been activated. Pretreatment of calphostin C, a specific PKC inhibitor, had little effect on the ATPo-mediated beta-hexosaminidase secretion, thus indicating that the ATPo-induced degranulation is not mediated by PKC. Taken together, these results demonstrate that ATPo activates MC9 mast cells by a mechanism that is different from the activation induced by the cross-linking of FcRs.

Extracellular ATP activates mast cells via a mechanism that is different from the activation induced by the cross-linking of Fc receptors

In this study, the extracellular ATP (ATPo)-induced biochemical events were elucidated by comparing them with either the Fc epsilon RI- or Fc gamma R-induced events in the mouse mast cell line MC9. The omission of extracellular Ca2+ almost completely abolished the elevation of intracellular Ca2+ ([Ca2+]i) in the ATPo-stimulated cells, but only suppressed the second phase of the increase of [Ca2+]i in FcR-stimulated cells, thus suggesting that the ATPo-induced elevation of [Ca2+]i is totally dependent on the entry of extracellular Ca2+. Pretreatment with genistein, which inhibits protein kinases, especially protein tyrosine kinase, inhibited the FcR-triggered increase of [Ca2+]i, but not the ATPo-triggered one; however, such pretreatment did suppress both ATPo- and FcR-mediated beta-hexosaminidase release. An immunoblot analysis revealed that both ATPo and the cross-linking of FcRs led to tyrosine phosphorylation of 44- and 110-kDa proteins, which thus suggested that these tyrosine-phosphorylated proteins are involved in a modulation of the degranulation process following an elevation of [Ca2+]i. Pretreatment with PMA inhibited the FcR-induced [Ca2+]i increase, while not inhibiting the ATPo-induced one, thus suggesting that ATPo can mobilize [Ca2+]i even when protein kinase C (PKC) has already been activated. Pretreatment of calphostin C, a specific PKC inhibitor, had little effect on the ATPo-mediated beta-hexosaminidase secretion, thus indicating that the ATPo-induced degranulation is not mediated by PKC. Taken together, these results demonstrate that ATPo activates MC9 mast cells by a mechanism that is different from the activation induced by the cross-linking of FcRs.