TCR in Fas-sensitive T cells from labial salivary glands of patients with Sjögren's syndrome

Apoptosis is found in labial salivary glands of patients with Sjogren's syndrome (SS). To analyze the pathogenesis of apoptosis in labial salivary glands of SS patients, we examined the expression of Fas Ag and Fas ligand (FasL) and TCR on T cells susceptible to anti-Fas mAbs (CH-11). Fas Ag is expressed on epithelial cells and mononuclear cells in the salivary glands as observed by an immunohistochemical method. FasL is over-expressed specifically on T cells infiltrating into the labial salivary glands as seen by an reverse transcription-PCR method. These results suggest that apoptosis in SS lips is mediated by a Fas/FasL pathway. PCR single-strand conformation polymorphism (SSCP) clearly demonstrated that more than 40% of the T cells accumulated in labial salivary glands are deleted by incubation with CH-11 for 24 h in vitro, indicating that these expanded cells are Fas sensitive. junctional sequence analysis showed that the same conserved amino acid motifs (LAGG, RLA, SLG, QGPG, PGG, GGE, RGR, KPG, AGD, and MLG) in complementarity determining region 3 (CDR3) are found in Fas-sensitive T cell clones, whereas they are not detected in Fas-resistant clones, suggesting that Fas-sensitive T cells recognize restricted T cell epitopes on autoantigens. In conclusion, the findings suggest that Fas-sensitive T cells in labial salivary glands of SS patients are generated by Ag stimulation and might function as autoreactive T cells.

Propofol or halothane anaesthesia for children with asthma: effects on respiratory mechanics

Propofol may cause histamine release and alter airway tone and reactivity. Although its use has been reported to be safe in asthmatics, there is a lack of information on its effect on lung function in children with asthma. We measured respiratory mechanics after i.v. or inhalation anaesthesia in 60 children, aged 2-12 yr, with or without asthma. Anaesthesia was induced with propofol 3 mg kg-1, fentanyl 1 microgram kg-1 and atracurium 0.5 mg kg-1 and maintained with an infusion of propofol 10 mg kg-1h-1 and 50% nitrous oxide in oxygen. Halothane was administered subsequently at a concentration of 1 MAC. Respiratory mechanics were measured by applying a single-compartment model using multi-linear regression analysis to calculate dynamic compliance (Crs,dyn) and respiratory system resistance (Rrs), based on: Pao = V/Crs,dyn + V Rrs + PA,EE, where Pao = airway opening pressure, PA,EE = alveolar pressure, V = volume and V = flow. The two groups were comparable in age, weight and ventilation variables (tidal volume and peak pressure). Respiratory mechanics during propofol anaesthesia were comparable in normal and asthmatic children (Rrs = 20.5 X 10(-4) (SD 5.2 X 10(-4)) vs 21.5 X 10(-4) (5.7 X 10(-4)) kPa ml-1 S-1 (ns) and Crs,dyn = 247.5 (76.51 vs 235.1 (63.8) ml kPa-1 (ns)). Halothane produced a minimal decrease in Rrs and a minimal increase in tidal volume in both groups without changes in Crs,dyn. In conclusion, respiratory mechanics were comparable after propofol anaesthesia in both children with and without asthma. Changes in Rrs after halothane administration were not clinically relevant.

Gas chromatographic-mass spectrometric metabolic profiling of patients with fatal infantile mitochondrial myopathy with de Toni-Fanconi-Debré syndrome

The metabolic profiles of three patients with fatal infantile mitochondrial myopathy with de Toni-Fanconi-Debré syndrome were studied by simultaneous analysis, after urease treatment of urinary organic acids, carbohydrates, polyols and amino acids using gas chromatography/mass spectrometry (GC/MS). All three patients persistently showed lactic aciduria, phosphaturia, glucosuria and generalized amino aciduria. This abnormal urinary metabolic profile was observed before the onset of any clinical symptoms, indicating that chemical diagnosis may be done presymptomatically. In one patient, the concentration of lactate increased in parallel with the severity of the clinical condition, whereas the urinary levels of 3-hydroxybutyrate, amino acids and glucose fluctuated and showed only a general tendency to increase with the clinical course. The above results suggest that simultaneous GC/MS analyses, without fractionation, of urinary metabolites facilitate not only the early chemical diagnosis either before or after the first onset, but also follow-up studies, providing an important index for the evaluation of the severity and clinical course in patients with this disorder.

Decreased severity of ethanol withdrawal behaviors in kainic acid-treated rats

The involvement of kainate (KA)-sensitive regions in ethanol withdrawal behaviors was investigated in male Wistar rats given three intraperitoneal (IP) injections of KA (12 mg/kg) or saline each followed by recovery at 4 degrees C for 5 h and room temperature for 3 days and a final KA or saline injection at room temperature. Some animals received MK-801 (1 mg/kg, IP) 30 min after each injection and one group received saline only. The saline/saline, saline/MK-801, and KA/MK-801 groups displayed typical ethanol withdrawal behaviors 8-12 h after ethanol withdrawal. These behaviors were attenuated in the KA/saline group. Audiogenic seizures could be induced in all treatment groups 12 h after withdrawal. There was severe neuronal degeneration in the hippocampal CA region and the piriform cortex of the KA/saline-treated animals that was reduced by MK-801 treatment. The inferior colliculus remained intact. These results suggest that the N-methyl-D-aspartate receptor mediates KA-induced damage in limbic structures and that these regions may play an important role in typical, but not audiogenically induced ethanol-withdrawal behaviors.

Porcine vitronectin, the most compact form of single-chain vitronectin: the smallest molecular mass among vitronectins was ascribed to deletion and substitution of base pairs, and proteolytic trimming of the peptide

Vitronectin is a multifunctional glycoprotein regulating the fibrinolysis, complement, and coagulation systems in plasma, besides exhibiting cell-spreading activity. Porcine vitronectin has an unusually small molecular mass among the vitronectins hitherto found, which seems to make it hard for it to retain all the known activities. In this study, the complete primary structure of porcine vitronectin was elucidated by cloned cDNA and glycoprotein analyses. A coding sequence of 459 amino acids including a signal peptide of 19 amino acids was deduced from the cDNA. The coding sequence showed 70.3% homology with that of human vitronectin, but porcine vitronectin lacked 22 amino acids in the connecting region. One amino acid substitution resulted in the loss of a potential glycosylation site in accordance with the finding on glycopeptide analyses that porcine vitronectin contained two kinds of glycosylated sequences, while human vitronectin contained three. C-Terminal analysis of porcine vitronectin indicated that an 80 amino acid fragment was completely removed from the C-terminal end on proteolytic processing. Thus, porcine vitronectin only exists in a truncated single-chain form representing the most compact functional form of vitronectin, which suggests the lack of functional necessity of the truncated C-terminal fragment.

Mild form of beta-ketothiolase deficiency (mitochondrial acetoacetyl-CoA thiolase deficiency) in two Japanese siblings: identification of detectable residual activity and cross-reactive material in EB-transformed lymphocytes

Mitochondrial acetoacetyl-CoA thiolase (T2) deficiency is an inherited metabolic disorder of isoleucine and ketone body catabolism. We report the cases of two siblings who showed clinically mild forms of this disorder. They did not excrete tiglylglycine in urine. Their EB-transformed lymphocytes contained residual T2 activity, which was confirmed by immunotitration analysis. In immunoblot analysis, the bands corresponding to T2 in the samples of the cell lines from two patients were the most intensely detected among those from 19 T2-deficient cell lines tested.

[Studies on serum protein fractions of patients with maxillary sinus cancer undergoing a combination of radiotherapy and chemotherapy: II. Relationship between changes in serum protein fractions and prognosis]

We examined the correlations between changes in serum protein fractions and the prognosis of the patients. The levels of 21 protein components of the sera of 36 patients with maxillary sinus cancer were determined by a single radial immunodiffusion method before and after radiation therapy. The patients with maxillary sinus cancer were treated with combined intra-arterial infusion of bleomycin and external irradiation of 60 Co gamma-rays, and were concurrently treated with 5-fluorouracil at 200 mg/day p.o. The levels of the same protein components were also measured in 34 normal adult as a control. All patients were observed 5 years and 12 years after radiation therapy. In patients who had survived at least 5 years after radiation therapy, the Alb, Tf, Hx, IgG and IgM levels measured before radiation therapy were elevated significantly compared with those who had died within 5 years. In those who had survived at least 5 years, the Alb, Tf, Hx, IgG, IgM, IgA and I alpha I levels measured after radiation therapy were elevated significantly compared with those who had died within 5 years, and AT III was reduced. In cases of maxillary sinus cancer following a period of 5 to 12 years after radiation therapy, multiple regression analysis was used to determine whether increased concentrations of serum protein fractions were associated with good prognosis for the original disease, alpha 2HS. IgM, HX, alpha 1AT and alpha 1X before radiation therapy were positively correlated with survival, whereas AT III, Pmg, Cp, IgA, and alpha 1AG showed negative correlations. After radiation therapy, Pmg, Hx, Cp, Cl inh and Fib were found to be positive factors of survival rate, whereas alpha 2M, alpha 2Pl, I alpha 1, IgA, alpha 1AG and C3 were negative factors.

Structures and contribution to the antigenicity of oligosaccharides of Japanese cedar (Cryptomeria japonica) pollen allergen Cry j I: relationship between the structures and antigenic epitopes of plant N-linked complex-type glycans

The oligosaccharide structures of Cry j I, a major allergenic glycoprotein of Cryptomeria japonica (Japanese cedar, sugi), were analysed by 400 MHz 1H-NMR and two-dimensional sugar mapping analyses. The four major fractions comprised a series of biantennary complex type N-linked oligosaccharides that share a fucose/xylose-containing core and glucosamine branches including a novel structure with a nongalactosylated fucosylglucosamine branch. Rabbit polyclonal anti-Cry j I IgG antibodies cross-reacted with three different plant glycoproteins having the same or shorter N-linked oligosaccharides as Cry j I. ELISA and ELISA inhibition studies with intact glycoproteins, glycopeptides and peptides indicated that both anti-Cry j I IgGs and anti-Sophora japonica bark lectin II (B-SJA-II) IgGs included oligosaccharide-specific antibodies with different specificities, and that the epitopic structures against anti-Cry j I IgGs include a branch containing alpha 1-6 linked fucose and a core containing fucose/xylose, while those against anti-B-SJA-II IgGs include nonreducing terminal mannose residues. The cross-reactivities of human allergic sera to miraculin and Clerodendron Trichotomum lectin (CTA) were low, and inhibition studies suggested that the oligosaccharides on Cry j I contribute little or only conformationally to the reactivity of specific IgE antibodies.

The influence of breathhold on peak expiratory flow in normal and asthmatic children

We have previously demonstrated a 10% reduction in peak expiratory flow (PEF) in healthy adults following a breathhold at total lung capacity (TLC). This fall was attributed to dissipation of airway wall viscoelasticity, increasing airway wall compliance (Caw). To investigate this phenomenon in children and to determine whether the effect of breathhold would be greater in asthmatics than in normal children, 15 asthmatics and 14 normal children (aged 10-15 yrs) performed maximal post expirations (MFE) with and without a 5 s breathhold at TLC. The entire study was repeated following the inhalation of salbutamol (800 micrograms) to relax the airway smooth muscle (and to increase Caw). Breathhold at TLC resulted in a significant decrease in PEF both in the asthmatics (group mean fall 5.8%; p < 0.01) and normal children (group mean fall 10.3%; p < 0.05). Salbutamol diminished this fall, becoming nonsignificant in the normal children. Similar patterns were also seen in forced expiratory volume in one second (FEV1) and in maximal expiratory flow at 50% vital capacity (V'50). These data are consistent with the proposal that breathhold at total lung capacity dissipated viscoelastic energy (increasing airway compliance) and decreased maximal expiratory flows both in normal and asthmatic children. They also demonstrate the need to standardize the forced vital capacity manoeuvre to decrease the variability in the flows recorded during the subsequent forced expiration.

[Pre-emptive analgesia from intravenous administration of opioid: no effect with pentazocine]

The influence of timing of administration of preoperative pentazocine on pain and analgesic requirements after surgery was studied in 46 patients undergoing total abdominal hysterectomy. Twenty-three patients received thiamylal 5 mg.kg-1 on induction of anesthesia, followed by pentazocine 30 mg or 60 mg before surgical incision (group A). Twenty-three control patients received pentazocine 30 mg or 60 mg, 5 min after abdominal incision (group B). The visual analogue scales for pain 24 h after operation were 6.0 cm at 30 mg dose in group A or 5.3 cm at 60 mg dose in group A and 5.7 cm at 30 mg dose in group B or 4.7 cm at 60 mg dose in group B. There were no differences in the visual analogues scales. Pentazocine consumption in the first 24 h after surgery was 67.5 mg at 30 mg dose in group A or 52.5 mg at 60 mg dose in group A and 70.9 mg at 30 mg dose in group B or 51.8 mg at 60 mg dose in group B. We conclude that postoperative pentazocine consumption and pain scores are no different when pentazocine is given before or after skin incision for abdominal hysterectomy and that there is no clinically useful pre-emptive analgesic effect with these doses of pentazocine.

Induction of immediate-early, ornithine decarboxylase and antizyme gene expression in the rat small intestine after transient ischaemia

The expression of the immediate early genes (IEG)s c-fos, c-jun and zif/268, and the genes coding for ornithine decarboxylase (ODC) and its regulatory protein antizyme (AZ), was studied in rat small intestine following transient ischemia. The ischemic stimulus for 10 min alone did not alter the expression of these genes. A rapid and transitory induction of all IEG mRNAs occurred in a coordinated manner peaking at 30 min following recirculation and returned to basal levels 3 hr after recirculation. Protein products of the IEGs accumulated in the smooth muscle layer of the intestine by 2-3 hr after recirculation. Expression of both ODC and AZ mRNAs initially decreased to 70% of control levels 1 hr after recirculation but markedly increased at 2 to 4 hr after recirculation. The functional significance of these changes in gene expression in relation to tissue integrity and function after the ischaemia/reperfusion is discussed.

Common T cell receptor clonotype in lacrimal glands and labial salivary glands from patients with Sjögren's syndrome

Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration into lacrimal and salivary glands leading to symptomatic dry eyes and mouth. Immunohistological studies have clarified that the majority of infiltrating lymphocytes around the lacrimal glands and labial salivary glands are CD4 positive alphabeta T cells. To analyze the pathogenesis of T cells infiltrating into lacrimal and labial salivary glands, we examined T cell clonotype of these cells in both glands from four SS patients using PCR-single-strand conformation polymorphism (SSCP) and a sequencing method. SSCP analysis showed that some infiltrating T cells in both glands expand clonally, suggesting that the cells proliferate by antigen-driven stimulation. Intriguingly, six to sixteen identical T cell receptor (TCR) Vbeta genes were commonly found in lacrimal glands and labial salivary glands from individual patients. This indicates that some T cells infiltrating into both glands recognize the shared epitopes on autoantigens. Moreover, highly conserved amino acid sequence motifs were found in the TCR CDR3 region bearing the same TCR Vbeta family gene from four SS patients, supporting the notion that the shared epitopes on antigens are limited. In conclusion, these findings suggest that some autoreactive T cells infiltrating into the lips and eyes recognized restricted epitopes of a common autoantigen in patients with SS.

[Intralobar pulmonary sequestration with an aberrant artery originating from the celiac artery and communicating with the pulmonary artery]

A 13-year-old boy underwent a right lower lobectomy for removal of an intralobar pulmonary sequestrum with a very rare type of aberrant artery. The aberrant artery originated from the celiac artery and communicated with the pulmonary artery. Angiographic and histologic findings led us to the following hypothesis regarding the origin of the sequestrum in this patient: There was a hypoplastic bronchus and an aberrant artery that originated from the celiac artery. Infection caused obstruction of the hypoplastic bronchus, which resulted in formation of the sequestrum. Another possibility is that high systemic pressure in the aberrant artery caused destruction of alveoli and led to the formation of cysts in the lung and to sequestration. Finally, the aberrant artery and the pulmonary artery communicated due to chronic inflammation in the sequestrum.

Characterization of carbohydrate-binding protein p33/41: relation with annexin IV, molecular basis of the doublet forms (p33 and p41), and modulation of the carbohydrate binding activity by phospholipids

A protein, p33/41, expressed in bovine kidney and many other tissues was identified as a lectin which binds to sialoglycoproteins and glycosaminoglycans in a calcium-dependent manner. Partial amino acid sequences of p33/41 are highly homologous to those of calcium/phospholipid-binding annexin protein, annexin IV (endonexin), p33/41 exhibited similar calcium/phospholipid-binding activity (Kojima, K., Ogawa, H., Seno, N., Yamamoto, K., Irimura, T., Osawa, T., and Matsumoto, I. (1993) J. Biol. Chem. 267, 20536-20539). To further characterize p33/41, we cloned the p33/41 cDNA and characterized the recombinant protein encoded by this cDNA. Oligonucleotide probes were synthesized based on partial amino acid sequences of p33/41 and used for screening. A p33/41 cDNA clone was isolated encoding a protein of 319 amino acids with a calculated molecular mass of 35,769 Da. The deduced amino acid sequence was identical to that of bovine annexin IV except for one amino acid substitution. The recombinant protein gave two 33-kDa (p33) and 41-kDa (p41) bands on SDS-polyacrylamide gel electrophoresis under non-reducing conditions, and only one 33-kDa band under reducing conditions, as did the native protein. Mass spectrometric analysis combined with site-directed mutagenesis of each of the four cysteine residues of the recombinant protein revealed that p41 is a dimer of p33 cross-linked at Cys-198 via a disulfide bond. The recombinant protein bound to columns of heparin and fetuin glycopeptides in a calcium dependent manner and to phospholipid vesicles composed of phosphatidylserine (PS)/phosphatidylcholine (PC), phosphatidylethanolamine (PE)/PC or phosphatidylinositol (PI)/PC. Furthermore, concurrent binding assays showed that the binding of the recombinant protein to phospholipid vesicles was not affected by heparin, whereas that to heparin was influenced by the phospholipid composition of the vesicles; the highest binding was observed with vesicles composed of PE/PC. These results suggest that p33/41 binds two types of ligands via different sites and that phospholipids modulate the carbohydrate binding activity of p33/41.

Differing patterns of mechanical response to direct fetal hormone treatment

A single combined intramuscular dose of betamethasone and l-thyroxine (T4) or placebo was injected into the shoulder of fetal lambs 48 hours prior to delivery at days 121 (n = 14), 128 (n = 25) or 135 (n = 20) of gestation. Respiratory mechanics were calculated using multiple linear regression analysis. Both respiratory system resistance (RRS) and elastance (ERS) decreased approximately 4 fold between gestational days 121 (D121) and 135 (D135). Both variables were also reduced by hormone treatment. Reduction in ERS was due to a reduction in both lung (EL) and chest wall (EW) components. In absolute terms EW decreased with gestational age; however, EW as a proportion of total elastance (% EW) increased. Inclusion of a volume-dependent elastance term in the multiple linear regression model enabled us to separate total elastance into volume-independent (E1) and volume-dependent (E2V) components. E1 decreased almost 8-fold compared with only a 2.5-fold fall in E2V between D121 and D135. %E2, the proportion of ERS which is volume-dependent and which provides an index of overventilation, doubled over this time period. Hormone treatment affected E1 and E2V components equally hence %E2 was not altered. Both excised lung volume and end expiratory alveolar volume increased with gestational age and with treatment. The response to treatment was qualitatively similar at each of the gestational ages examined, however, for all mechanics variables, except resistance and E1, the magnitude of response to treatment was significantly smaller in D135 animals compared with other age groups.

Somatization in adolescence with reference to dysmorphophobia

An adolescent male obtained a position in a large business with assistance from others. Initially he had tension headaches due to maladjustment. He then showed signs of dysmorphophobic symptoms, expressed as a dissatisfaction with his nose. Subsequently, he had cosmetic rhinoplasty twice for esthetic reasons. After a few years, he presented with a psychosis. During treatment his symptoms developed into headache and fever that disappeared upon recovery. He was therefore able to seek employment independently. This transition of symptoms assumes an aspect of adolescent mentality and presents a trial and error approach to establishing a social identity. In general, somatization is assumed to be an immature defense mechanism of individual psychopathology. However, somatization may be a sign of an improvement in one's health. Somatization in adolescence may also be a sign of the beginning of a reintegration into society and have a bridging functional aspect that induces socialization in adulthood.

Expression of carbohydrate-binding protein p33/41 in human tumor cell lines

We previously reported a new type of lectin, p33/41 (annexin IV), which was isolated from a bovine tissue extract [Kojima, K. et al. (1992) J. Biol. Chem. 267, 20536-20539]. When the expression of p33/41 (annexin IV) was surveyed in the lysates of 39 human tumor cell lines by SDS-PAGE, followed by Western blot analysis with polyclonal anti-bovine p33/41 and monoclonal anti-annexin IV (Z016, Zymed) antibodies, 21 cell lines were found to be reactive with the polyclonal antibody, whereas all 39 cell lines were stained with Z016. These results together with those obtained with standard proteins, annexins IV and V, suggested that the monoclonal antibody, Z016, recognizes annexin V, but not p33/41 (annexin IV). Therefore, we performed cDNA cloning of human p33/41 (annexin IV) to prepare a recombinant protein and raised monoclonal antibodies against the protein. Northern blot analysis with the cDNA as a probe showed that a human colon cancer cell line, HT29, contains p33/41 (annexin IV) mRNA of two sizes, 2.0 and 3.0 kb. The two monoclonal antibodies, AS11 and AS17, against the recombinant protein generated were useful for flow cytometric analysis, ELISA, Western blot analysis and immunoprecipitation. Flow cytometric analysis with AS17 showed that p33/41 (annexin IV) is located in the cytoplasm of HT29 cells, but not on the cell surface. However, one of the cell surface proteins first labeled with biotin and then solubilized with a detergent was immunoprecipitated with AS17. The results suggest the existence of a membrane spanning form of p33/41 (annexin IV).

A new chemical diagnostic method for inborn errors of metabolism by mass spectrometry-rapid, practical, and simultaneous urinary metabolites analysis

In most developed countries, neonatal mass screening programs for the early diagnosis of inborn errors of metabolism (IEM) have been implemented and have been found to be effective for the prevention or significant reduction of clinical symptoms such as mental retardation. These programs rely primarily on simple bacterial inhibition assays (the "Guthrie tests"). We developed a new method for screening IEM using GC/MS, which enables accurate chemical diagnoses through urinary analyses with a simple practical procedure. The urine sample preparation for GC/MS takes one hour for one sample or three hours for a batch of 30 samples (will be fully automated shortly), and the following GC/MS measurement is completed within 15 min per sample. This method allows the simultaneous analyses of amino acids, organic acids, sugars, sugar alcohols, sugar acids, and nucleic acid bases. Therefore, a large number of metabolic disorders can be simultaneously tested by this chemical diagnostic procedure. This method is quite comprehensive and different from conventional GC/MS organic acidemia screening procedures, which are not well-suited to detect metabolic disorders except organic acidurias. Sample preparation includes urease treatment, deproteinization, and derivatization. The method has also been applied to neonate urine specimens that are absorbed into filter paper. The air-dried samples were mailed to the analytical laboratory and eluted with water. The eluate (0.1 mL) was incubated with urease, followed by deproteinization with alcohol, evaporation to dryness of the supernatant, and trimethylsilylation; the samples were applied to GC/MS. A pilot study of the application of this diagnostic procedure to the neonatal mass screening of 22 disorders was started in Japan on February 1, 1995 in cooperation with four medical institutes. This program is supported by the Japanese Society for Biomedical Mass Spectrometry and the Japanese Mass Screening Society. The initial twenty-two target metabolic diseases are: methylmalonic acidemia; propionic acidemia; isovaleric acidemia; maple syrup urine disease; β-ketothiolase deficiency; galactosemia; phenylketonuria; hyperphenylalaninemia; homocystinuria; alkaptonuria; multiple carboxylase deficiency; nonketotic hyperglycinemia; lysinuria; cystinuria; tyrosinemia; glutaric aciduria type I; β-hydroxy-β-methylglutaric acidemia; β-methylcrotonylglycinuria; α-aminoadipic-α-ketoadipic aciduria; ornitine transcarbamylase deficiency (four urea cycle disorders can be screened); glutaric aciduria type II; and neuroblastoma. Neuroblastoma is not an IEM, and is examined at ca. 6 months of age. The twenty-two target diseases will be reconsidered during the pilot study. An accurate chemical diagnosis and hence early treatment of not only organic acidemias but also amino acidemias, and sugar-, polyol-, and nucleic acid base-accumulating metabolic disorders can be made at a very early stage of life. This procedure is also applicable to metabolic profiling of other body fluids that are potentially informative for the study and characterization of a wide range of inherited and acquired metabolic disorders. © 1997 John Wiley & Sons, Inc.

FOS and JUN as markers for ethanol-sensitive pathways in the rat brain

The expression of proteins coded by the immediate early genes of the fos family and c-jun was used to study the effect of acute ethanol administration on convulsant-induced neuronal activity in rat brain. Immunoreactivity for both types of protein was induced by either SC injection of pentylenetetrazole or by IP injection of N-methyl-D-aspartic acid. Both agents elicited distinct patterns of behaviour and a high level of FOS-immunoreactivity in the cerebral cortex and hippocampus. Acute IP doses of ethanol (1.0-3.0 g/kg) significantly reduced the behaviours and FOS-immunoreactivity induced in the cerebral cortex by both pentylenetetrazole and N-methyl-D-aspartic acid. Pentylenetetrazole-induced FOS-immunoreactivity in the hippocampus was also inhibited by ethanol. In contrast, N-methyl-D-aspartic acid-induced FOS-immunoreactivity in the hippocampus was not inhibited by any dose of ethanol. c-JUN immunoreactivity showed a distinct pattern of induction in the hippocampus after injection of N-methyl-D-aspartic acid. Ethanol (3.0 g/kg) inhibited N-methyl-D-aspartic acid-induced c-JUN-immunoreactivity in the hippocampus and cerebral cortex. The differences in inhibition of immunoreactivity suggest that the sensitivity of the NMDA- and GABAA-related neuronal pathways to ethanol varies among different anatomical structures.

Comparison of pleuropneumonectomy and limited surgery for lung cancer with pleural dissemination

The role of surgery in the management of lung cancer with pleural dissemination is controversial. We performed a retrospective analysis of our patients with lung cancer and pleural dissemination who were treated surgically. Between 1973 and 1993, 1,206 patients with lung cancer underwent pulmonary resection at Kanazawa University Hospital. Among them, 40 (3.3%) had pleural dissemination without pleural effusion. The 1-, 3-, and 5-year survival rates for 38 patients (except 2 patients undergoing exploratory thoracotomy alone) were 51.5%, 19.4%, and 19.4%, respectively. The 1-year survival rate in the 10 patients who underwent pleuropneumonectomy was only 20%, and 9 of these patients died within 18 months postoperatively (1 patient has survived for 25 months). In contrast, the 1-, 3-, and 5-year survival rates for the 14 patients who underwent resection of the primary tumor plus parietal pleurectomy were 85.1%, 35.5%, and 35.5%, respectively, a significantly better outcome (P < 0.01). Seven patients are still alive (the longest survival time is 65 months with the disease). The average survival time in the seven fatal cases was 18 months. In patients with lung cancer accompanied by pleural dissemination, it is quite possible that local excision plus pleurectomy will be justified.

[A clinical analysis of the patients with chest wall reconstruction]

Twenty-three patients underwent chest wall reconstruction in our department. The underlying disease was bronchial carcinoma in 14, urachus tumor in 2, breast cancer in 1, renal cancer in 1, thymic Hodgkin's lymphoma in 1, tuberculosis in 1, fibrosarcoma in 1, and pseudoaneurysm of the aortic arch caused by reconstructed material in 1. An average of 3.4 ribs were resected in 18 patients and sternectomies were performed in 5. Chest wall reconstruction was performed with Marlex mesh in 14, Marlex mesh with methyl methacrylate in 5, Marlex mesh with steel wire in 1, Marlex mesh with omentopexy in 1, Marlex mesh with A-O plate in 1, and net formation with catgut in 1. There was no operative death. Postoperative wound infection occurred in only 1 patient with Marlex mesh cleaned by irrigation and administration of antibiotics. Three patients with Marlex mesh and metyl methacrylate required removal of the prosthetic material postoperatively because of wound infection in 1, seroma in 1, and dislocation of the former reconstructed material in 1. One patient with Marlex mesh and steel wire had protrusion of the wire under the skin and the wire was removed. Eleven patients of lung cancer died at 2-17 months after surgery. In conclusion, chest wall reconstruction with Marlex mesh had excellent results, and chest wall resection and reconstruction for malignancy could be good palliation.