SARC-F Validation and SARC-F+EBM Derivation in Musculoskeletal Disease: The SPSS-OK Study

OBJECTIVES

To validate the SARC-F questionnaire for sarcopenia screening in musculoskeletal disease setting, and to assess improvements in diagnostic accuracy by adding "EBM" (elderly and body mass index information) to the SARC-F.

DESIGN

Diagnostic accuracy study.

SETTING AND PARTICIPANTS

The center involved in this study was located in an urban area of Kobe City, Japan. People with musculoskeletal disease in the knee, hip, or spine who were scheduled for surgical treatment were included.

MEASUREMENTS

Sarcopenia was evaluated using the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP2), which included bioimpedance, handgrip strength, and gait speed. Patients answered the SARC-F questionnaire and their body mass index was measured. SARC-F and "EBM" information were combined into an original score. The sensitivities, specificities, and areas under the receiver operating characteristic curve (AUC) were estimated and compared to identify sarcopenia.

RESULTS

A total of 959 patients were included. Sarcopenia by AWGS criteria was identified in 36 (3.8%) patients. SARC-F had a sensitivity of 41.7% and specificity of 68.5%. SARC-F+EBM had a sensitivity of 77.8% and specificity of 69.6%, with substantial improvement in sensitivity (P<0.001). The AUCs for SARC-F and SARC-F+EBM were 0.557 (95% confidence interval [CI] 0.452-0.662) and 0.824 (95% CI 0.762-0.886), respectively (P<0.001). Similar results were obtained when EWGSOP2 criteria were used as the reference standard.

CONCLUSION

The SARC-F alone is not adequate for finding cases in musculoskeletal disease settings. SARC-F+EBM significantly improved the sensitivity and overall diagnostic accuracy of the SARC-F for screening sarcopenia. SARC-F+EBM is potentially useful for screening sarcopenia in different ethnic and disease settings.

Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength

INTRODUCTION

There is a growing interest in the use of patient-reported outcomes to provide a more patient-centered view on treatment. Forgetting the artificial joint can be regarded as the goal in joint arthroplasty. The goals of the study were to describe changes in joint awareness in the artificial joint after total knee arthroplasty (TKA), and to determine which factors among pain, knee range of motion (ROM), quadriceps strength, and functional ability affect joint awareness after TKA.

HYPOTHESIS

Patients undergoing TKA demonstrate changes in joint awareness and joint awareness is associated with pain, knee ROM, quadriceps strength, and functional ability.

PATIENTS AND METHODS

This prospective cohort study comprised 63 individuals undergoing TKA, evaluated at 1, 6, and 12 months postoperatively. Outcomes included joint awareness assessed using the Forgotten Joint Score (FJS), pain score, knee ROM, quadriceps strength, and functional ability.

RESULTS

Fifty-eight individuals completed all postoperative assessments. All measures except for knee extension ROM improved from 1 to 6 months. However, there were no differences in any measures from 6 to 12 months. FJS was affected most greatly by pain at 1 month and by quadriceps strength at 6 and 12 months.

DISCUSSION

Patients following TKA demonstrate improvements in joint awareness and function within 6 months after surgery, but reach a plateau from 6 to 12 months. Quadriceps strength could contribute to this plateau of joint awareness.

LEVEL OF EVIDENCE

Prospective cohort study, IV.

Structural and Electrical Characterization of Undoped Poly-Si Oxides

We evaluated structural and electrical characteristics of undoped poly-Si oxide films. Poly-Si films made by solid phase crystallization at 600-900°C from undoped amorphous Si films were oxidized to form oxide layers of 140nm thickness. We observed protuberances on the surface of poly-Si layers after oxidation. Poly-Si oxide layers also generated protuberances above the protuberances of poly-Si films. The number of protuberances per unit area is larger in the case of high temperature crystallization. The measurement of current through the poly-Si oxide films shows that the conductivity of poly-Si oxide films depends on crystallization temperature of poly-Si films in the case of positive gate bias. When the gate is biased negatively, current through the poly-Si oxide films remained almost constant regardless of crystallization temperature. We find that poly-Si crystallized at lower temperatures offers poly-Si oxide films of lower leakage current in the case of electron injection from undoped poly-Si layers. The lower leakage current is due to highness of energy barrier for electron at undoped poly-Si/poly-Si oxide interface.

Quantitative evaluation of blood flow distribution to exercising and resting skeletal muscles in patients with cardiac dysfunction using whole-body thallium-201 scintigraphy

BACKGROUND AND HYPOTHESIS

Decreased blood flow to working muscles makes an important contribution to exercise intolerance in patients with chronic heart failure. This study was undertaken to examine whether maldistribution of skeletal muscle blood flow is closely related to exercise intolerance in patients with cardiac dysfunction.

METHODS

Whole-body thallium scintigraphy was performed during one-leg exercise in 11 patients with left ventricular (LV) dysfunction (LV ejection fraction < 45%). Blood flow distribution to the exercising and resting legs was quantified by expressing regional thallium counts as a percentage of the whole-body counts at rest, at the level of anaerobic threshold, and at peak exercise.

RESULTS

At anaerobic threshold, the thallium activity of exercising muscle increased from 4.2 +/- 0.7 to 14.0 +/- 2.5% (p < 0.05) in the thigh and from 1.7 +/- 0.3 to 4.1 +/- 0.9% (p < 0.05) in the calf, compared with the resting value. Consequently, the ratio of thallium activity between exercising and resting legs increased to 2.7 +/- 0.7 (p < 0.05) in the thigh and to 2.3 +/- 0.7 (p < 0.05) in the calf. When plotted as a function of anaerobic threshold, thallium activity of the exercising thigh (r = 0.78, p < 0.05) and the thallium ratio between exercising and resting thigh (r = 0.69, p < 0.05) declined with the reduction of exercise tolerance. These correlations were not observed in calves.

CONCLUSION

Whole-body thallium scintigraphy demonstrated a maldistribution of leg blood flow in patients with reduced aerobic exercise capacity, suggesting that this abnormality could play an important role in exercising intolerance in these patients.

Zn deficiency aggravates hypertension in spontaneously hypertensive rats: possible role of Cu/Zn-superoxide dismutase

Using spontaneously hypertensive rats (SHR) fed a standard or a Zn-deficient diet for 4 weeks, we examined whether Zn deficiency affects systemic blood pressure (BP) levels in a genetically hypertensive state through a fall in the activity of Cu/Zn-superoxide dismutase (SOD). SHR fed a Zn-deficient diet had a progressive increase in systolic BP during the dietary conditioning. Consequently, SHR fed a Zn-deficient diet exhibited significantly increased levels of systolic BP by 2 weeks after the start of dietary treatment when compared with SHR fed a standard diet. Similarly, levels of basal mean arterial pressure (MAP) observed at the end of dietary treatment were SHR fed a Zn-deficient diet > SHR fed a standard diet. Administration of the nitric oxide synthase (NOS) inhibitor, L-NAME, caused an increase in MAP levels in the two groups of rats, demonstrating the involvement of the vasodilator, nitric oxide (NO), in the regulation of systemic BP in a genetically hypertensive state. The expression of endothelial (e) NOS mRNA and protein in the thoracic aorta paralleled basal MAP levels in the two groups of rats, suggesting the counter-regulation of eNOS against the developed hypertensive state in SHR fed a Zn-deficient diet. On the other hand, administration of the superoxide scavenger, tempol (a SOD mimetic compound), led to a decrease in MAP levels in the two groups of rats, indicating the participation of the oxygen free radical, superoxide, in an increase in systemic BP in a genetically hypertensive state. As reported recently, the mechanism involved is due likely to a decrease in the action of the vasodilator, NO, based on the formation of peroxynitrite coming from the non-enzymatic reaction of superoxide and NO. In addition, tempol treatment completely restored MAP levels in SHR fed a Zn-deficient diet to levels comparable to those observed in SHR fed a standard diet, indicating that a further increase in systemic BP levels seen in SHR fed a Zn-deficient vs. a standard diet is presumably brought by a reduction in the action of the vasodilator, NO, resulting from an increase in the action of superoxide. The activity of the superoxide scavenger, Cu/Zn-SOD, in the thoracic aorta was significantly decreased in SHR fed a Zn-deficient diet relative to SHR fed a standard diet. It appears that a decrease in the activity of Cu/Zn-SOD observed in the thoracic aorta of SHR fed a Zn-deficient diet at least in part plays a role in an increase in the action of superoxide in this model. Thus, Zn deficiency may be a factor to develop genetic hypertension presumably through the oxidative stress caused by superoxide.

Effects of gonadotropin-releasing hormone analog treatment on skin condition

The skin is a target organ of estrogens. Thus, theoretically, a hypoestrogenic state induced by gonadotropin-releasing hormone analog (GnRHa) treatment may have effects on skin condition. The aim of this study was to evaluate skin condition during GnRHa treatment. Sixteen premenopausal women undergoing GnRHa treatment for 16 weeks, as a presurgical treatment for uterine leiomyomas, were studied. Measurement of serum estradiol levels and epidermal hydration, and evaluation of subjective findings on skin condition using a questionnaire, were performed every 4 weeks during the treatment period. Serum estradiol levels were significantly suppressed at 4 weeks of treatment, and remained low afterwards. Epidermal hydration measured by corneometer did not show any significant difference at any time point examined, compared with that before treatment. No particular subjective findings relating to the skin (dryness, wrinkling, roughness, pigmentation, itching, formication, reaction to cosmetics) were reported during treatment, whereas complaints about hot flushes and sweating were notable. The results of this preliminary study support the notion that GnRHa treatment for 16 weeks is unassociated with apparent changes in skin condition.

The tamoxifen-responsive estrogen receptor alpha mutant D351Y shows reduced tamoxifen-dependent interaction with corepressor complexes

The effects of estrogen and anti-estrogen are mediated through the estrogen receptors ERalpha and beta, which function as ligand-induced transcriptional factors. The nonsteroidal anti-estrogen tamoxifen is the most commonly used endocrine in the treatment of all stages of breast cancer in both pre- and postmenopausal women. Several lines of evidence have indicated that tamoxifen promotes association between ERalpha and corepressors N-CoR or silencing mediator for retinoid and thyroid hormone receptor (SMRT). Our results indicate that N-CoR/SMRT recognize and interact with helices H3 and H5 of the ERalpha ligand-binding domain in a 4-hydroxy tamoxifen-dependent manner. The mutant ERalpha(D351Y), derived from a tamoxifen-stimulated tumor and containing an amino acid substitution at position 351 within H3, showed reduced interaction with N-CoR/SMRT and high tamoxifen-induced activation function-1 (AF-1) activity. While the estradiol-dependent transcriptional activity of ERalpha(D351Y) was almost equal to that of wild-type ERalpha, the mutant exhibited higher levels of transcriptional activity in the presence of both E2 and 4-hydroxy tamoxifen compared with wild-type ERalpha. These results may explain the observation that the growth of tumor cells expressing ERalpha(D351Y) can be stimulated by tamoxifen, E2, or both.

Increased apoptosis in a variety of tissues of zinc-deficient rats

Zinc deficient rats were prepared to investigate histopathological changes in thymus, testis, skin, esophagus, kidney and liver and the relationship between these changes and apoptosis. Seven-week-old male SD rats were given a Zn deficient diet (0% Zn diet) or a standard diet (0.02% Zn diet). The above-mentioned organs were excised 1, 2, 3, 4, 5, 10, 13, and 34 weeks after initiating diet administration. Then, these organs were examined morphologically, and apoptotic changes were analyzed by either the TdT- mediated dUTP - biotin nick end labeling (TUNEL) or electrophoresis. Significant morphological changes were seen only in rats on the 0% Zn diet. After 4 weeks, atrophy of the thymus was seen. After 5 weeks, oligospemia was observed, and after 10 weeks, testicular atrophy accompanied by the loss of sperm cells and spermatocytes was confirmed. In addition, after 10 weeks, thickening of epithelia was seen in the skin and esophagus of rats on the 0% diet. During the observation period, no marked morphological changes were observed in the liver or kidney. In the thymus and testis of rats on the 0% Zn diet, prior to detecting any morphological changes, increases in apoptosis were confirmed at 1 and 3 weeks after initiating diet administration, respectively. In the kidney and liver, TUNEL positive cells appeared after 13 and 34 weeks, respectively. These observations suggest that the functional and morphological changes in the thymus and testis of rats on the 0% Zn diet are caused by increased apoptosis, and that even when the supply of Zn is terminated for only a short period of time, immunocytes and germ cells can not survive or regenerate sufficiently. Again, the fact that even in the liver and kidney, apoptosis was observed when administration of the 0% Zn diet was prolonged suggests that the appearance of apoptosis is dependent on the amount of Zn in tissues. In addition, the fact that increases in apoptosis were confirmed in the skin of rats on the 0% Zn diet, but not in the esophagus of these rats suggests that apoptosis does not directly cause thickening of stratified squamous epithelium in Zn deficient rats.

Stable inversion method for a polarized-lidar: analysis and simulation

A new inversion inhomogeneous atmosphere (IA) method that is more stable than Fernald's method for two-component (molecule and aerosol) scattering analysis of polarized Mie lidar signals is proposed and examined. The backscattering coefficient and the extinction-to-backscattering ratio (EBR) can be calculated for specified regions at which the depolarization ratio is less than that of molecule without further assumptions. The inversion procedure can be extended to both inward stepwise and outward stepwise integration algorithms. Simulation results indicate that a higher precision was achieved with the IA method than with Fernald's method in terms of error and random noise in estimating boundary value and EBR. Experimental results were also better with the IA method than with Fernald's method.

Effects of dietary protein on eicosanoid production in rat renal tubules

The effects of dietary protein on the in vitro production of prostaglandin (PG) E2, 6-keto PGF1alpha, and thromboxane B2 (TxB2) were examined in cortical and medullary tubules from rats fed a low (6% casein) or a high (40% casein) protein diet for approximately 8 weeks. PGE2 was a major eicosanoid produced by rat renal tubules (PGE2 > TxB2 > 6-keto PGF1alpha). Medullary tubules produced significantly greater amounts of PGE2, 6-keto PGF1alpha, and TxB2 than cortical tubules. The activity of phospholipase (PL) A2 and PLC and the levels of cyclooxygenase (COX) were significantly greater in medullary tubules than in cortical tubules. The production of eicosanoids may be increased in medullary versus cortical tubules via the greater activity of these enzymes involved in eicosanoid formation. Although there were no substantial differences in the production of PGE2, 6-keto PGF1alpha, and TxB2 between cortical tubules from rats fed a low- or a high-protein diet, significant increases in the synthesis of the three eicosanoids were observed in medullary tubules from rats fed a high- versus a low-protein diet. The activity of membrane-bound PLA2 and PLC and the levels of COX were not also substantially different between cortical tubules from rats fed a low- or a high-protein diet. However, medullary tubules had significantly greater activity of membrane-associated PLA2 and COX in rats fed a high-protein diet than in those fed a low-protein diet. The activity of PLC was comparable in medullary tubules from rats fed a low- or a high-protein diet. We conclude that a high protein intake selectively enhances eicosanoid production in rat medullary tubules probably via activation of the PLA2-COX pathway.

Zinc deficiency further increases the enhanced expression of endothelin-1 in glomeruli of the obstructed kidney

BACKGROUND

Zinc (Zn) is an essential trace element in humans and animals. We have recently documented that Zn deficiency may aggravate tubulointerstitial nephropathy seen in the obstructed kidney (OK) of 72 hours duration through a further increase in the activity of endogenous angiotensin II in the OK. Also, it is known that the vasoconstrictors angiotensin II and endothelin (ET)-1 may be implicated in the deterioration of glomerular hemodynamics caused in the OK. We therefore designed the present study to examine the effect of Zn deficiency on the expression of ET-1 and a potential role of endogenous angiotensin II in the expression of ET-1 in glomeruli of the OK of 72 hours duration.

METHODS

Using reverse transcription-polymerase chain reaction and immunohistochemistry, the expression of prepro-ET-1 mRNA and ET-1 was examined in glomeruli of the contralateral, non-obstructed control kidney (CLK) and the OK from rats with unilateral ureteral obstruction (UUO) of 72 hours duration fed a standard or a Zn-deficient diet for approximately 50 days. The rats in each group were treated with saline alone or the angiotensin-converting enzyme inhibitor enalapril before and after ureteral obstruction.

RESULTS

The expression of prepro-ET-1 mRNA and ET-1 was markedly greater in the OK than in the CLK in the standard and the Zn-deficient diet groups. However, the expression of prepro-ET-1 mRNA and ET-1 was substantially increased in the OK of the Zn-deficient diet group relative to the OK of the standard diet group. There were no significant differences in the expression of prepro-ET-1 mRNA and ET-1 between the CLK of the two diet groups. Administration of enalapril restored the expression of prepro-ET-1 mRNA and ET-1 in the OK to levels seen in the CLK in the standard and the Zn-deficient diet groups. Enalapril produced no effects on the expression of prepro-ET-1 mRNA and ET-1 in the CLK of the two diet groups.

CONCLUSIONS

UUO of 72 hours duration may increase the expression of prepro-ET-1 mRNA and ET-1 in glomeruli of the OK through an increment in the biological action of endogenous angiotensin II in the OK. Moreover, Zn deficiency may enhance the expression of prepro-ET-1 mRNA and ET-1 in glomeruli of the OK through a further increment in the biological action of endogenous angiotensin II in the OK. Zn deficiency appears to be a factor to worsen glomerular hemodynamics in the OK of the UUO setting of 72 hours duration through an increment in the biological action of the vasoconstrictors angiotensin II and ET-1.

Effect of age on the relationship between gastric cancer and Helicobacter pylori. Tokyo Research Group of Prevention for Gastric Cancer

Helicobacter pylori is thought to be involved in the pathogenesis of gastric cancer, but the time point at which it produces its effects (critical time) is unknown. We measured the serum level of H. pylori antibody in 787 gastric cancer patients and 1007 controls aged 20 to 69. Odds ratios for different gastric cancer types and stages were determined for each 10-year age class. The overall odds ratio for gastric cancer decreased with age, being 7.0 for those aged 20 - 29, 14.5 for those aged 30 - 39, 9.1 for those aged 40 - 49, 3.5 for those aged 50 - 59, and 1.5 for those aged 60 - 69 (trend in odds ratios: P < 0.01). However, there was no such age-dependent trend for early diffuse-type cancer; the odds ratios were 12.6, 4.0, 7.2, 6.5, and 18.5 respectively (P = 0.29). Early cancer tended to show higher seroprevalence than advanced cancer, especially in older subjects. No significant difference in seroprevalence was observed between diffuse and intestinal cancers within each age-class. Seroreversion must have occurred in the time interval between the critical time and the diagnosis of the cancer, especially in older patients. The age-dependent relationship between H. pylori and gastric cancer may be due to seroreversion, which itself may be independent of age. This age-independence indicates that prolonged exposure to H. pylori does not increase the magnitude of its influence on gastric carcinogenesis. Possible mechanisms through which H. pylori exerts pathogenic effects are continuous inflammation in adulthood and / or irreversible damage to gastric mucosa in childhood or the teenage years.

L-Arginine treatment may prevent tubulointerstitial nephropathy caused by germanium dioxide

BACKGROUND

Long-term oral ingestion of germanium dioxide (GeO2) causes progressive renal failure derived from tubulointerstitial nephropathy in humans and animals. The characteristic of GeO2-induced nephropathy is the renal tissue injury persisting for a long time, even after cessation of GeO2 ingestion. However, a treatment that can suppress the long-lasting renal tissue injury has not yet been established.

METHODS

Using the methods of immunohistochemistry and reverse transcription-polymerase chain reaction, we examined the expression of ED1-positive cells (macrophages/monocytes), transforming growth factor (TGF)-beta1 mRNA and protein and collagen type IV mRNA and protein in the kidneys of rats with GeO2-induced nephropathy. Concomitantly, the effects of L-arginine treatment on their expression was explored in the kidneys of rats with GeO2-induced nephropathy.

RESULTS

Chronic administration of GeO2 caused tubulointerstitial nephropathy characterized by leukocyte invasion into the enlarged tubulointerstitial space in rats. The expression of ED1-positive cells, TGF-beta1 protein and collagen type IV protein was markedly increased in the tubulointerstitium of the renal cortex from rats with GeO2-induced nephropathy. Similarly, TGF-beta1 and collagen type IV mRNA were significantly enhanced in the renal cortex of rats with GeO2-induced nephropathy. A small number of tubulointerstitial cells expressing TGF-beta1 protein were also observed in the renal cortex of rats with GeO2-induced nephropathy. However, L-arginine treatment led to a parallel decrease in the expression of ED1-positive cells, TGF-beta1 mRNA and collagen type IV mRNA and protein in rats with GeO2-induced nephropathy.

CONCLUSIONS

In general, collagen synthesis is driven by TGF-beta1 in the fibrotic process associated with a variety of renal disorders. TGF-beta1 is secreted by TGF-beta1 producing cells such as macrophages, fibroblasts and myofibroblasts. Thus, the present study indicates that the expression of collagen type IV may be mediated by TGF-beta1 released from invading macrophages and, to a lesser extent, released from tubulointerstitial cells, presumably fibroblasts and/or myofibroblasts in GeO2-induced nephropathy. L-Arginine treatment inhibits collagen type IV synthesis possibly by suppressing macrophage invasion and the resultant TGF-beta1 expression in this nephropathy. L-Arginine treatment may be beneficial in the prevention of tubulointerstitial fibrosis, which is considered to be the terminal stage of GeO2-induced nephropathy.

Long-term effect of Helicobacter pylori infection on serum pepsinogens

Serum pepsinogen values are markers of gastric mucosal status and of gastric cancer risk. The effect of Helicobacter pylori infection and sibship size on change of serum pepsinogen values over a seven-year span was investigated. Data from 2584 subjects with phlebotomy were analyzed both in 1989 and in 1996. The subjects were classified by H. pylori serology and sibship size (1 - 3 vs. 4 and more). Pepsinogen I (PG I) to II (PG II) ratio in '96 minus that in '89 was defined as DeltaPG I / II and compared among the groups. DeltaPG I / II was lower and decrease of PG I / II was more frequent among H. pylori-positive subjects than among negative subjects. The difference was owing to a decrease of PG I in all subjects and owing to an increase of PG II in those not younger than 30 years in '89. In H. pylori-positive subjects, those with a larger sibship size showed lower DeltaPG I / II and higher frequency of PG I / II decline. H. pylori infection exerts a reducing effect on PG I / II during the seven-year span. The effect of H. pylori is stronger among those with a larger sibship size, who are expected to have been infected with H. pylori in childhood. Inducing atrophy of gastric mucosa, which is reflected by a decline of PG I / II, may be one of the mechanisms through which H. pylori elevates the risk of gastric cancer.

Enhanced expression of vsmNOS mRNA in glomeruli from rats with unilateral ureteral obstruction

BACKGROUND

The vasodilatory/cytotoxic gas, nitric oxide (NO), is associated with an alteration in glomerular hemodynamics seen after the induction of ureteral ligation. As yet the type of nitric oxide synthase (NOS) protein involved in the mechanism has not been clearly established in the unilateral ureteral obstruction (UUO) model.

METHODS

Using reverse transcription (RT)-polymerase chain reaction (PCR), the expression and localization of vascular smooth muscle-derived nitric oxide synthase (vsmNOS) mRNA were examined in glomeruli from sham-operated control (SOC) rats and rats with UUO of three hours duration. Moreover, the effect of endogenous angiotensin II on the expression of vsmNOS mRNA in glomeruli was explored using SOC rats and rats with UUO that were pretreated or not with enalapril, an angiotensin-converting enzyme inhibitor.

RESULTS

The expression of vsmNOS mRNA was significantly greater in glomeruli of rats with UUO than in those of SOC rats. In rats with UUO, the expression of vsmNOS mRNA was substantially increased in glomeruli of the obstructed kidney (OK) compared to the contralateral, nonobstructed kidney (CLK). Suppression of angiotensin II production in vivo with enalapril restored the expression of vsmNOS mRNA in glomeruli of the CLK and OK from rats with UUO to levels comparable to that seen in glomeruli from SOC rats. In addition, the in situ RT-PCR analysis, a novel method for mRNA identification in cells and tissue, revealed that vsmNOS mRNA was expressed in the cytoplasm of glomerular mesangial and epithelial cells in SOC rats and rats with UUO.

CONCLUSIONS

An increase in vsmNOS mRNA expression in glomeruli of the CLK and OK from rats with UUO may be mediated by increased action of endogenous angiotensin II that occurs after the onset of ureteral obstruction. Enhanced expression of vsmNOS mRNA in glomeruli of the OK compared to the CLK may be due to differences in levels of angiotensin II acting on the two kidneys in vivo. Additionally, the expression of vsmNOS mRNA in glomeruli originates in mesangial and epithelial cells in SOC rats and rats with UUO.

Effects of Fish Oil Diet and Age on the Fatty Acid Composition and the Endogenous Lipase Activity in Mouse Brain

The influences of a fish oil diet and aging on the fatty acid composition in mouse brain, and the release of polyunsaturated fatty acids from brain membranes by endogenous lipase were studied. The changes in brain fatty acid composition with aging were determined in 5-weeks, 5-months and 19-months old mice fed on a commercial chow. Mice of different ages were also fed a fish oil or lard diet for 30 days, and the influence of the diets on brain fatty acid composition and endogenous lipase activity was analyzed. In aged mice fed on a commercial chow brain arachidonic acid and docosahexaenoic acid (%) decreased significantly, whereas blood arachidonic acid (%) increased and docosahexaenoic acid (%) did not change. The percentages of brain docosahexaenoic acid were significantly higher but those of arachidonic acid were lower in the fish oil diet group than in the lard diet group. However, there were no significant differences in the endogenous lipase activity between the different age or dietary groups. The release of arachidonic acid showed a tendency to decrease and docosahexaenoic acid to increase in mice fed on the fish oil diet. These results suggest that dietary lipids affect the percentages of arachidonic and docosahexaenoic acids which are released by the endogenous lipase in brain although the decreases in brain polyunsaturated fatty acid content with aging are not due to the enzyme activation, and dietary lipids do not influence the enzyme activity.

A case report: pregnancy complicated by blue rubber-bleb nevus syndrome

Blue rubber-bleb nevus (BRBN) syndrome, first reported in 1958 by Bean, manifests with multiple hemangiomas located in the skin and gastarointestinal tract. Characteristic laboratory data include chronic anemia with iron deficiency and consumption coagulopathy. We describe herein a pregnancy complicated by BRBN syndrome resulting in the delivery of a male infant by cesarean section.

Role of angiotensin II, endothelin-1, and nitric oxide in HgCl2-induced acute renal failure

To elucidate the mechanisms underlying the development of HgCl2-induced acute renal failure (ARF), we examined the expression of endothelin (ET)-1, endothelial (e) nitric oxide synthase (NOS) and inducible (i) NOS, and a role of angiotensin II (ANG II) and tumor necrosis factor (TNF) in glomeruli and cortices from rats at 20 h after exposure of HgCl2. Prepro-ET-1 and iNOS mRNA were significantly increased in glomeruli and cortices from rats with HgCl2-induced ARF. However, eNOS mRNA was markedly decreased in glomeruli of rats with HgCl2-induced ARF. Blockade of the action of endogenous ANG II with TCV-116, an ANG II receptor type 1 antagonist, or prior administration of TNF antibody (Ab) neutralizing TNF bioactivity or aminoguanidine, an iNOS inhibitor, substantially suppressed the increase in the expression of prepro-ET-1 or iNOS mRNA seen in rats with HgCl2-induced ARF. Both TCV-116 and TNF Ab had no effects on the expression of eNOS mRNA. The abundance of ET-1, iNOS, and eNOS proteins was paralleled by the magnitude of each mRNA expression. Additionally, the aggravation of blood urea nitrogen and serum Cr observed in rats with HgCl2-induced ARF were significantly ameliorated together with the alleviation of proximal tubule epithelial cell injury when the expression of prepro-ET-1 or iNOS mRNA was blunted by prior administration of TCV-116 or prior injection of TNF Ab or aminoguanidine. These observations indicate that ANG II, ET-1, and NO may play an important role in the progression of HgCl2-induced ARF through the acceleration of proximal tubule epithelial cell injury and the deterioration of glomerular hemodynamics. In HgCl2-induced ARF, the gene expression of ET-1 or iNOS is at least in part up-regulated at the transcription level by endogenous ANG II or TNF.

Inducible nitric oxide synthase expression in mercury chloride-induced acute tubular necrosis

To examine the mechanisms involved in the progression of mercury chloride (HgCl2)-induced acute tubular necrosis (ATN), we investigated the histopathological changes and the expression of inducible nitric oxide synthase (iNOS) mRNA and protein in renal cortices of rats at 20 hours after exposure to HgCl2. The expression of iNOS mRNA was significantly augmented in renal cortices of rats with HgCl2-induced acute renal failure (ARF). Likewise, the induction of iNOS protein was observed in damaged proximal tubule epithelial cells of rats with HgCl2-induced ARF. Pretreatment of rats with iNOS inhibitor aminoguanidine, however, suppressed the development of proximal tubule epithelial cell injury and prevented an increase in blood urea nitrogen and serum creatinine as well as resulting in a marked fall in iNOS mRNA and protein in rats with HgCl2-induced ARF. These observations indicate that the induction of iNOS may play a role in the progression of HgCl2-induced ATN through the exacerbation of proximal tubule epithelial cell damage.

Zinc deficiency aggravates tubulointerstitial nephropathy caused by ureteral obstruction

Ureteral ligation causes tubulointerstitial nephropathy characterized by the tubular dilatation, the interstitial expansion, and a leukocyte infiltration into the tubulointerstitium. The present study was designed to explore whether zinc (Zn) deficiency affects the development of unilateral ureteral obstruction (UUO)-induced tubulointerstitial nephropathy. Compared to rats fed a standard diet, rats fed a Zn-deficient diet exhibited a greater influx of leukocytes into the tubulointerstitium of the cortex of the obstructed kidney 3 d following UUO. Furthermore, rats fed a Zn-deficient diet showed a slight invasion of leukocytes into the tubulointerstitium of the cortex of the contralateral nonobstructed kidney (CLK), although there was no infiltration of leukocytes into the CLK of rats fed a standard diet. These histological changes, however, were ameliorated by administration of enalapril, an angiotensin (ANG) I-converting enzyme inhibitor. Thus, it is suggested that Zn deficiency aggravates UUO-induced tubulointerstitial nephropathy via an increase in the action of ANG II.

Altered expression of endothelin-1 and endothelial nitric oxide synthase in the juxtaglomerular apparatus of rats with HgCl2-induced acute renal failure

A progressive fall in glomerular capillary plasma flow (QA) is observed in mercury chloride (HgCl2)-induced acute renal failure (ARF) although the site of the main lesion of this ARF is the proximal tubule. To elucidate this mechanism, we examined the expression of endothelin (ET)-1 and endothelial nitric oxide synthase (eNOS) protein at the glomerulus level in the kidneys of control rats and rats with HgCl2-induced ARF. Both ET-1 and eNOS protein were detected in the juxtaglomerular cells of afferent arterioles. The expression of ET-1 was significantly increased in ARF rats when compared to control rats. Inversely, the expression of eNOS protein was markedly reduced in ARF rats as opposed to control rats. These observations suggest the participation of the vasoconstrictor, ET-1 and the vasodilator, NO in a reduction in QA observed in HgCl2-induced ARF.

Ultrashort-pulse-controlled all-optical modulation by interband and intersubband transitions in doped quantum wells

The optimum condition for achieving highly efficient ultrafast all-optical pulse modulation by modification of the absorption of a pulsed interband light field by ultrasubband control-light pulses in a doped quantum well is investigated. The modulation efficiency in the femtosecond domain can be maximized by an intersubband control light with a pulse width (200 fs) that is comparable with the phase-relaxation time of the system and an intensity that is close to the intersubband saturation intensity.

Ureteral obstruction enhances eicosanoid production in cortical and medullary tubules of rat kidneys

We examined prostaglandin (PG) E2, 6-keto PGF1alpha, and thromboxane B2 (TxB2) production in cortical and medullary tubules from sham-operated control (SOC) rats and rats with bilateral ureteral obstruction (BUO) of 24 h duration. In SOC rats medullary tubules produced significantly greater amounts of the three eicosanoids than cortical tubules. Again, the production of PGE2, 6-keto PGF1alpha, and TxB2 by cortical and medullary tubules was significantly greater in BUO rats than in SOC rats. To elucidate the mechanisms involved, we examined the activity of phospholipase A2 (PLA2) reactive against phosphatidylcholine or phosphatidylethanolamine (PE), the activity of phospholipase C (PLC), and the levels of cyclooxygenase (COX) in cortical and medullary tubules from SOC and BUO rats. In SOC rats the activity of phosphatidylcholine-PLA2 and PE-PLA2, the activity of PLC, and the mass of COX were significantly greater in medullary tubules than in cortical tubules. On the other hand, the activity of PLC in membranes of cortical tubules and the activity of PE-PLA2 and PLC in membranes of medullary tubules, which were in active location, were significantly greater in BUO rats than in SOC rats. COX levels were also significantly greater in cortical and medullary tubules of BUO rats than in those of SOC rats. Thus, we indicate that medullary tubules from SOC rats have greater production of eicosanoids through increased activity of the PLA2 and PLC-COX pathway than cortical tubules from the same group of rats. Again, in rats with BUO, the tubular eicosanoid production may be enhanced via activation of the PLC-COX pathway in cortical tubules or through activation of the PE-PLA2 and PLC-COX pathway in medullary tubules. The enhanced production of tubular eicosanoids observed in rats with BUO may affect tubular function, particularly sodium and water reabsorption.

Lithium deficiency reduces thymus weight and alters differential blood count in rats

Effects of lithium (Li) deficiency and/or immobilization stress on the thymus weight and differential blood count of rats were studied. The thymus weight of the rats fed a low Li diet were lighter than those of rats fed a Li supplemented diet, whether the rats were exposed to stress or not. Of the rats not exposed to stress, those in the low Li diet group showed a significant decrease in the ratios of neutrophils and T helper lymphocytes. However, there was an increase in the total number of lymphocytes in the low Li dietary group. It was shown that Li deficiency altered the responses to stress in rats.

Research on the estimate of safety and toxicity of p-nitrophenol sodium with a physiologically based pharmacokinetics model

The safety and toxicity of chemicals given first to animals and finally to humans are generally estimated with a method of safe coefficient, which is scientifically a way lack of grounds. To make a change of the old method, we designed a Physiologically-Based Pharmacokinetics Model for the estimate of safety and toxicity of chemicals. As an example, p-nitrophenol sodium (PNP-Na) is used in the research work. Studies of the PNP-Na pharmacokinetics in bodies of rat as well as humans are made, and possibilities of making use of the Model in the estimate of safety and toxicity of chemicals are discussed.

Rapid incorporation of docosahexaenoic acid from dietary sources into brain microsomal, synaptosomal and mitochondrial membranes in adult mice

This study examined the incorporation of docosahexaenoic acid (DHA) from several dietary sources into the brain tissue and intracellular organelles in mice which had been fed a 5% palm oil (low n-3 fatty acid level) diet for 8 or 11 weeks. The percentages of DHA in the tissues of mice fed 5% representative oils for 30 days or 5% purified n-3 fatty acid diets for 6 days were analyzed using gas chromatography. The percentage of DHA in the brain was ranked in the following order: the salmon oil diet group > the sardine oil diet group > > the perilla oil diet group > > the lard and palm oil diet groups for the 30 day feeding trial; and the DHA diet group > > the eicosapentaenoic acid and alpha-linolenic acid diet groups for the 6 day feeding trial. The percentage of arachidonic acid showed a more dramatic decrease than that of docosapentaenoic acid. These results reflected the plasma fatty acid concentrations, but were not as pronounced as the changes observed in the plasma. The majority of the DHA incorporated into the brain was recovered in microsomal, synaptosomal, and mitochondrial fractions separated by density gradient centrifugation. These membrane fractions took up DHA within several days. These results suggest that the intake of DHA itself increases the DHA level of brain membranes more rapidly than intake of the precursors in animals fed a low n-3 fatty acid level diet.

[Estimation of safety and toxicity of rho-nitrophenol sodium with a physiologically based pharmacokinetics model]

The safety and toxicity of chemicals given first to animals and finally to humans are generally estimated with a method of safe coefficient, which lacks scientific ground. To change the traditional method, we designed a physiologically based pharmacokinetics model (PBPK) for the estimation of safety and toxicity of chemicals. For example, rho-nitrophenol sodium (PNP-Na) was used. The PNP-Na pharmacokinetics in bodies of rat as well as humans were studied, and possibilities of making use of the model in the estimation of safety and toxicity of chemicals were also discussed.

Parabolic mirror optics for collimation of a crescent blue laser beam radiated from channel waveguide Čerenkov second-harmonic generation

Parabolic mirror optics to collimate the crescent-shaped blue laser beam that radiates from Čerenkov second-harmonic generation (SHG) in a channel waveguide configuration is proposed. Mirror collimation optics has a large tolerance to the variations of SHG element parameters, such as the laser source wavelength, as well as to mirror displacement. The anisotropy of a nonlinear crystal in which the waveguide is fabricated has been taken into account. The optimum mirror alignment to obtain a collimated blue laser beam is evaluated in terms of Marechal's criterion. The minimum wave-front aberration with beam intensity weighted is 0.054 λSH. The convergence of the collimated beam is less than 1.6 mrad, and, by using an objective lens, the collimated beam can be focused to a diameter of less than 1 µm, which is 1.27 times the diffraction-limited focusing point.

[Intracavitary bacillus Calmette-Guerin therapy for upper tract transitional cell carcinoma]

Four patients with upper urinary tract transitional cell carcinoma were treated with bacillus Calmette-Guerin (BCG) via a percutaneous nephrostomy tube or a retrograde ureteral catheter. A 68-year-old female and an 80-year-old male had carcinoma in situ (CIS) in the left upper urinary tract (cases 1 and 2). A man aged 47 had CIS in the left upper urinary tract, bladder, and prostatic urethra (case 3). CIS in the left upper urinary tract was identified in a woman aged 63 with chronic renal insufficiency (case 4). Two patients (cases 1 and 2) responded to this therapy. In the other two patients nephrectomy was performed due to residual tumor. There were extensive tuberculous granulomas in the kidneys. In one resected kidney (case 4) carcinoma had invaded the renal parenchyma. The reviewed literature showed that BCG perfusion therapy was effective in 71% (27 of 38 renal units) for the upper urinary tract tumors and that there were 5 cases of severe complication, including sepsis in 2, high fever in 2, and ureteral stricture in 1. Based on the fact that the kidney receives a profuse blood supply and that the renal pelvis and ureter have a thin wall, careful management is mandatory to prevent severe adverse effects and insidious tumor progression.

Association between family history and gastric carcinoma among young adults

The relationship between family history of gastric carcinoma and gastric carcinoma in Japanese under 40 years of age was analyzed. The subjects were 108 gastric carcinoma patients (86% were diffuse type) at 9 hospitals in the Kanto area of Japan. Firstly, incidence of gastric carcinoma among the parents of the subjects were compared with that in the general population. Observed/expected (O/E) ratios (P-value) were 1.8 (0.06) for all subjects, 1.3 (0.62) for male subjects, 2.1 (0.04) for female subjects, 0.5 (0.41) for early carcinoma, 2.6 (P<0.01) for advanced carcinoma, 2.3 (0.22) for intestinal-type carcinoma and 1.7 (0.13) for diffuse-type carcinoma. Association between gastric carcinoma and parents' history of gastric carcinoma was strong among women and regarding advanced carcinoma, and the difference in O/E ratios between early and advanced carcinoma was remarkable. Secondly, factors related to advanced-stage gastric carcinoma were analyzed. Histological type (diffuse and intestinal types) was not related, but family history of gastric carcinoma among parents and grandparents was related to advanced stage, and the relationship was independent of other factors. The odds ratio (95% confidence interval) was 3.3 (1.1-9.9). Family history may be related to stage of gastric carcinoma through its relationship to the manner or speed of the tumor's progression. We hypothesis that some genetic factor exists which is involved both in progression from early to advanced stage and in occurrence of gastric carcinoma.

[Trace elements and their physiological roles]

Of 95 naturally occurring elements of the periodic table, no less than 25 perform essential functions in the human body. Eight of these, namely zinc, copper, selenium, cobalt, chromium, molybdenum, manganese and iodine, are required in small amounts and each comprises less than 0.01% of the body weight and termed essential trace elements. In the body, they function in a similar way; most of them are at the active site of enzymes or of physiologically active substances of the body. Dietary deficiency causes a variety of clinical features, which are consistent with the decreased activity of these active substances. Recent topics are the resemblance of these features and their background pathophysiology with those of aging.

Loading sequence plays an important role in enhanced load sensitivity of left ventricular relaxation in conscious dogs with tachycardia-induced cardiomyopathy

BACKGROUND

Left ventricular relaxation rate in the failing heart depends more on the systolic load than in the normal heart. To elucidate the mechanisms for the enhanced load sensitivity of left ventricular relaxation in heart failure, we examined the relative contributions of changes in end-systolic volume and loading sequence to the left ventricular relaxation rate.

METHODS AND RESULTS

In seven conscious dogs, the time constant (Td) of left ventricular pressure decay, end-systolic volume, systolic circumferential force, and time to peak force during caval occlusion were compared before and after development of tachycardia-induced heart failure. Rapid ventricular pacing decreased the slope of the end-systolic pressure-volume relation from 4.5 to 2.8 mm Hg/mL (P < .01) and prolonged Td from 33 to 49 ms (P < .01). In normal conditions, caval occlusion reduced end-systolic force (-580 g, P < .01) and end-systolic volume (-7 mL, P < .01) but did not change Td or time to peak force. In heart failure, however, caval occlusion shortened Td (-11 ms, P < .01), with a concomitant decrease in the time to peak force (-30 ms, P < .01), while end-systolic volume and force declined slightly. Consequently, for a comparable reduction in end-systolic force, Td decreased more in heart failure than in normal hearts, suggesting enhanced load sensitivity. Moreover, changes in Td correlated well with those in the time to peak force (r = .79, P < .01) but not with those in end-systolic volume.

CONCLUSIONS

Loading sequence rather than elastic recoil seems to play the predominant role in the enhanced load sensitivity of left ventricular relaxation in heart failure.

[Clinical statistics on outpatients during a ten-year period (1983, 10-1993, 12) at Department of Urology, Fukui Medical School]

A clinical statistic survey was carried out on the patients and disease experienced at the outpatient clinic of our Department of Urology, between 1983 and 1993. Although the number of newly diagnosed patients was rather constant, the total number of outpatients gradually increased every year, and the average and median age of newly diagnosed patients became higher. The major disease categories were infectious and neoplastic disorders.

Whole-body 201Tl scintigraphy during one-leg exercise and at rest in normal subjects: estimation of regional blood flow changes

To determine the effect of exercise intensity on regional blood flow in exercising and resting leg muscles and organs, we assessed relative changes in the regional distribution of 201Tl during one-leg ergometer exercise and at rest by whole-body scintigraphy as an estimate of regional blood flow changes in 10 healthy males. The regional 201Tl activity was expressed as a percentage of the whole-body activity, and relative changes in each region were compared to those at the anaerobic threshold (AT) and at peak exercise. In the legs, the distribution of 201Tl in the exercising thigh and calf increased significantly at the AT to 390.7 and 219.2% respectively of resting levels (both P < 0.01), but remained unchanged the resting thigh from rest to peak exercise. Conversely its distribution in the resting calf decreased significantly at the AT to 60.0% of the resting level (P < 0.01). However, there were no significant differences between AT and peak exercise. In the organs, the distribution of 201Tl in the lung, liver, spleen and kidneys decreased significantly at the AT to 88.4 +/- 10.4%, 67.0 +/- 11.5%, 62.4 +/- 11.8% and 67.0 +/- 8.6% respectively of resting levels (all P < 0.01). Redistribution of blood flow to the exercising leg occurs predominantly during mild to moderate exercise. Therefore, blood flow in the leg during strenuous exercise depends primarily upon an increase in cardiac output. The splanchnic organs are the major sources of redistribution.

Serum anti-Helicobacter pylori antibody and gastric carcinoma among young adults. Research Group on Prevention of Gastric Carcinoma among Young Adults

BACKGROUND

Helicobacter pylori is recognized as one of the possible causes of gastric carcinoma. There have been few studies on the relationship between H. pylori and gastric carcinoma in patients younger than 40 years.

METHODS

Data and sera were collected from the cases (105 hospitalized patients younger than 40 years with gastric carcinoma from 9 hospitals in the Kanto-Shin-Etsu Area in Japan) and controls (102 hospitalized control subjects and 101 screening control subjects) whose sex and age (within 4 years) were matched. The serum anti-H. pylori immunoglobulin G antibody was measured, and the odds ratio (OR) for the association between seropositivity and gastric carcinoma was calculated.

RESULTS

The OR (95% confidence interval) was 13.3 (5.3-35.6). For women, the OR was 32.8, whereas for men it was 6.8. The OR for patients with early gastric carcinoma was 20.8, and for patients with advanced disease, it was 10.8. The OR for intestinal-type carcinoma was 18.0, and for diffuse-type carcinoma, it was 12.8. The OR for proximal carcinoma was 11.3, and for distal carcinoma it was 14.8.

CONCLUSION

The OR for these young subjects was considerably larger than that for the older subjects in previously published studies. Among those younger than 40 years of age, early stage carcinoma has a stronger association with H. pylori than advanced carcinoma, and intestinal- and diffuse-type carcinomas have an association with H. pylori.

Serum anti-Helicobacter pylori antibody and gastric carcinoma among young adults. Research Group on Prevention of Gastric Carcinoma among Young Adults

BACKGROUND

Helicobacter pylori is recognized as one of the possible causes of gastric carcinoma. There have been few studies on the relationship between H. pylori and gastric carcinoma in patients younger than 40 years.

METHODS

Data and sera were collected from the cases (105 hospitalized patients younger than 40 years with gastric carcinoma from 9 hospitals in the Kanto-Shin-Etsu Area in Japan) and controls (102 hospitalized control subjects and 101 screening control subjects) whose sex and age (within 4 years) were matched. The serum anti-H. pylori immunoglobulin G antibody was measured, and the odds ratio (OR) for the association between seropositivity and gastric carcinoma was calculated.

RESULTS

The OR (95% confidence interval) was 13.3 (5.3-35.6). For women, the OR was 32.8, whereas for men it was 6.8. The OR for patients with early gastric carcinoma was 20.8, and for patients with advanced disease, it was 10.8. The OR for intestinal-type carcinoma was 18.0, and for diffuse-type carcinoma, it was 12.8. The OR for proximal carcinoma was 11.3, and for distal carcinoma it was 14.8.

CONCLUSION

The OR for these young subjects was considerably larger than that for the older subjects in previously published studies. Among those younger than 40 years of age, early stage carcinoma has a stronger association with H. pylori than advanced carcinoma, and intestinal- and diffuse-type carcinomas have an association with H. pylori.

Serum anti-Helicobacter pylori antibody and gastric carcinoma among young adults. Research Group on Prevention of Gastric Carcinoma among Young Adults

BACKGROUND

Helicobacter pylori is recognized as one of the possible causes of gastric carcinoma. There have been few studies on the relationship between H. pylori and gastric carcinoma in patients younger than 40 years.

METHODS

Data and sera were collected from the cases (105 hospitalized patients younger than 40 years with gastric carcinoma from 9 hospitals in the Kanto-Shin-Etsu Area in Japan) and controls (102 hospitalized control subjects and 101 screening control subjects) whose sex and age (within 4 years) were matched. The serum anti-H. pylori immunoglobulin G antibody was measured, and the odds ratio (OR) for the association between seropositivity and gastric carcinoma was calculated.

RESULTS

The OR (95% confidence interval) was 13.3 (5.3-35.6). For women, the OR was 32.8, whereas for men it was 6.8. The OR for patients with early gastric carcinoma was 20.8, and for patients with advanced disease, it was 10.8. The OR for intestinal-type carcinoma was 18.0, and for diffuse-type carcinoma, it was 12.8. The OR for proximal carcinoma was 11.3, and for distal carcinoma it was 14.8.

CONCLUSION

The OR for these young subjects was considerably larger than that for the older subjects in previously published studies. Among those younger than 40 years of age, early stage carcinoma has a stronger association with H. pylori than advanced carcinoma, and intestinal- and diffuse-type carcinomas have an association with H. pylori.

Serum anti-Helicobacter pylori antibody and gastric carcinoma among young adults. Research Group on Prevention of Gastric Carcinoma among Young Adults

BACKGROUND

Helicobacter pylori is recognized as one of the possible causes of gastric carcinoma. There have been few studies on the relationship between H. pylori and gastric carcinoma in patients younger than 40 years.

METHODS

Data and sera were collected from the cases (105 hospitalized patients younger than 40 years with gastric carcinoma from 9 hospitals in the Kanto-Shin-Etsu Area in Japan) and controls (102 hospitalized control subjects and 101 screening control subjects) whose sex and age (within 4 years) were matched. The serum anti-H. pylori immunoglobulin G antibody was measured, and the odds ratio (OR) for the association between seropositivity and gastric carcinoma was calculated.

RESULTS

The OR (95% confidence interval) was 13.3 (5.3-35.6). For women, the OR was 32.8, whereas for men it was 6.8. The OR for patients with early gastric carcinoma was 20.8, and for patients with advanced disease, it was 10.8. The OR for intestinal-type carcinoma was 18.0, and for diffuse-type carcinoma, it was 12.8. The OR for proximal carcinoma was 11.3, and for distal carcinoma it was 14.8.

CONCLUSION

The OR for these young subjects was considerably larger than that for the older subjects in previously published studies. Among those younger than 40 years of age, early stage carcinoma has a stronger association with H. pylori than advanced carcinoma, and intestinal- and diffuse-type carcinomas have an association with H. pylori.

The association of smoking and drinking habits with serum pepsinogens

BACKGROUND

The influence of smoking on serum pepsinogen I has been assessed. However, still to be assessed are the influences of smoking on pepsinogen II and drinking on serum pepsinogens.

METHODS

Data were collected from 13,381 employees by questionnaire and serum tests. Multiple regression analyses were done with logarithms of serum pepsinogen I (LPI), pepsinogen II (LPII) or pepsinogen I/II ratio (LI/II) as a criterion variable and as categorized explanatory variables, sex, age, subjective symptoms in the stomach, past history of peptic ulcer, current smoking dose, past smoking amount, drinking habit and current drinking dose.

RESULTS

Current smoking dose showed dose-dependent positive associations with LPI and LI/II: Past smoking amount yielded weakly dose-dependent negative associations with LPI and LI/II: Current drinking dose showed dose-dependent negative associations with LPI and LPII.

CONCLUSION

Current smoking elevates pepsinogen I and the I/II ratio, and it may be necessary to consider the effect of smoking when pepsinogens are used as markers for gastric cancer. Drinking reduced pepsinogen I and II, but the effect was not so large.

Interaction of atrial natriuretic peptide with its receptors in bovine lung membranes

In bovine lung membranes, atrial natriuretic peptide (ANP) showed temperature-dependent binding to guanylate cyclase-natriuretic peptide receptor (NPR-GC). Photoaffinity labeling of the receptors with 4-azidobenzoyl (AZB)-125I-ANP and competitive binding studies with 125I-ANP, ANP, and atriopeptin I (API) revealed that NPR-GC was detected as the predominant ANP-binding protein at 0 degrees C, whereas at 37 degrees C natriuretic peptide clearance receptor (NPR-C) was detected as the predominant protein. The ratio of NPR-GC and NPR-C was 89:11 at 0 degrees C for 40 min, respectively, whereas 6:94 at 37 degrees C. AZB-125I-ANP bound to NPR-GC dissociated from the binding site within 5 min at 37 degrees C but not at 0 degrees C, whereas ANP bound to NPR-C did not dissociate from the binding site at 0 and 37 degrees C. The dissociated AZB-125I-ANP rapidly rebound to NPR-GC at 37 degrees C but not to NPR-C, and the dissociated NPR-GC was capable of binding. Some AZB-125I-ANP was hydrolyzed by a membrane-bound proteinase(s). Phosphoramidon inhibited the hydrolysis of AZB-125I-ANP. Thus, the dissociated AZB-125I-ANP rebound to NPR-GC and NPR-C. These results suggest that usually intact ANP repeatedly binds to NPR-GC until hydrolysis. Furthermore, the majority of ANP bind to NPR-GC before binding to NPR-C under physiological temperature.

N-Methyl-beta-carboline-3-carboxamide (FG 7142): An anxiogenic agent in cigarette smoke condensate and its mechanism of formation

beta-Carboline-3-carboxylic acid methylamide (FG 7142), an anxiogenic agent has been found in cigarette smoke condensate, but not in the cigarette itself. When a cigarette, except its filter portion, was immersed in 20 ml of potassium phosphate buffer, pH 7.4, then heated at 60 degrees C for 2 days with or without presence of methylamine, FG 7142 was detected only in the mixture containing methylamine. Furthermore, when the mixtures of beta-carboline derivatives and various amounts of methylamine hydrochloride were heated at 60 degrees C for 5 days, FG 7142 was formed only in the mixtures containing methylamine and 1-methyl-1,2,3,4-tetrahydro-beta-carboline-3-caroxylic acid (MTCA) or 1,2,3,4-tetrahydro-beta-carboline-3-carboxylic acid (TCCA). FG 7142 was also produced in the mixture of glucose, l-tryptophan and methylamine when heated at 200 degrees C in a dry condition. These observations suggest that FG 7142 is formed through the smoking process and that methylamine in cigarette smoke may play an important role in the formation of FG 7142.

Effects of dietary protein on glomerular eicosanoid production in rats with bilateral ureteral obstruction

Greater protein intake increases glomerular eicosanoid production in rats. Bilateral ureteral obstruction (BUO) also enhances glomerular eicosanoid production in experimental animals. To examine the effects of dietary protein intake on glomerular eicosanoid production in ureteral obstruction, we measured the in vitro production of the vasodilatory prostaglandins, PGE2, and 6-keto PGF1 alpha, and the vasoconstrictor, TxB2, and the mass of cyclooxygenase in glomeruli of sham-operated control (SOC) rats and rats with BUO of 24 hr duration fed a low- (6% casein) or a high- (40% casein) protein diet for approximately 4 weeks. The animals were pretreated or not with the angiotensin converting enzyme inhibitor, enalaprilat, prior to sham-operation or ureteral obstruction. Glomeruli from SOC rats fed a high-protein diet produced significantly greater amounts of PGE2, 6-keto PGF1 alpha, and TxB2, and had substantially increased mass of cyclooxygenase when compared with glomeruli from SOC rats fed a low-protein diet. Pretreatment of animals with enalaprilat prior to sham operation prevented the increase in glomerular eicosanoid production and cyclooxygenase content in SOC rats fed a high-protein diet and the levels observed were similar to those in SOC rats fed a low-protein diet. Both eicosanoid production and cyclooxygenase mass were further increased in glomeruli from rats with BUO fed a high-protein diet when compared with glomeruli of SOC rats fed the same diet. The increased levels of these measurements in BUO rats fed a high-protein diet fell markedly when the rats were pretreated with enalaprilat in vivo. The values were essentially comparable to those of SOC rats fed a low-protein diet. By contrast, there was no substantial increase in the production of PGE2, 6-keto PGF1 alpha, and TxB2 and in the mass of cycloxygenase in glomeruli of BUO versus SOC rats fed a low-protein diet. Enalaprilat did not affect glomerular eicosanoid production or cyclooxygenase content in SOC and BUO rats fed a low-protein diet. Taken together, the present study indicates that dietary protein affects BUO-induced increases in glomerular eicosanoid production by altering the activity of the cyclooxygenase pathway mainly via the reninangiotensin system. Thus, protein content in a diet may modify an alteration in renal hemodynamics caused by BUO by changing the glomerular production of eicosanoids and the activity of the renin-angiotensin system.