Anti-emetic effects of a novel NK-1 receptor antagonist HSP-117 in ferrets

We have developed a non-peptide compound, HSP-117, antagonist of the tachykinin NK-1 receptor. Binding of 3H-substance P (SP) to the membranes of IM-9 cells was inhibited by the antagonists HSP-117 and CP-99,994, the inhibitory activity of HSP-117 being about 50-fold that of CP-99,994. The SP-induced firing responses of single neuron activity in slices of the nucleus tractus solitarius of ferrets were inhibited by 10 microM HSP-117. Intracerebroventricular injection of HSP-117 significantly inhibited retching and vomiting induced by copper sulphate and morphine and the inhibitory effect of HSP-117 on emesis was greater than that of CP-99,994. These results indicate that (1) HSP-117 is a potent anti-emetic agent, blocking NK-1 receptors in the nucleus tractus solitarius and (2) NK-1 receptors in the nucleus tractus solitarius play an important role in emesis induced by broad-spectrum emetic stimuli.

[Effects of arginine-vasopressin on neuronal interaction from the area postrema to the nucleus tractus solitarii in rat brain slices]

The effects of vasopressin (AVP) on area postrema (AP) neurons and the neuronal connection between the AP and nucleus tractus solitarii (NTS) were investigated electrophysiologically in slices preparation of the medulla oblongata of rats. In the AP, 27.9% of 129 neurons were excited by AVP and 20.5% were inhibited. The excitation was blocked by a V1 receptor antagonist. Synaptic transmission of the AP to the NTS was mainly mediated by non-NMDA receptors. Local application of AVP to the AP activated the NTS neurons. This activation was blocked by an NMDA antagonist. These results suggest that the excitation originating in the AP is conveyed to the NTS via non-NMDA receptors and modified by NMDA receptor activation secondly. These processes may be important in regulation of the arterial baroreceptor reflex.

[Epidemiology of acute coronary syndrome]

We reviewed the epidemiology of ischemic heart disease (IHD) focusing on acute myocardial infarction (AMI) in Japan. The age-adjusted mortality from IHD and the age-adjusted incidence of AMI in Japan were nearly the lowest in the world. Vital statistics of Japan showed that the age-adjusted mortality from IHD and AMI had been decreasing since the 1970's until 1993. Rates of new patients of AMI per day have been stable since the early 1980's according to "patient survey". Several population-based studies reported the unchanged age-adjusted incidence of AMI since the late 1950's. In conclusion, the mortality from IHD and the incidence of AMI are very low in Japan, and there is no epidemiological evidence showing an increase in either one.

Relationship between the structure and cytotoxic activity of asterriquinone, an antitumor metabolite of Aspergillus terreus, and its alkyl ether derivatives

Asterriquinone (ARQ) is an antitumor metabolite of Aspergillus terreus IFO 6123. In this study we synthesized several ARQ alkyl ethers and studied their cytotoxic activity against mouse leukemia P388 cells. The dissociation constant was also similar among the ARQ monoalkyl ethers. There was a good correlation between the hydrophobicity of ARQ monoalkyl ethers estimated by high performance liquid chromatography and the intracellular content accumulated for 60 min. ARQ monoalkyl ethers were cytotoxic, but ARQ dimethyl ether was not, as previously reported. The cytotoxicity of the ARQ monoalkyl ether derivatives was increased with extension of the alkyl chain length. The cytotoxicity was closely correlated with the intracellular content. The strongest ARQ derivative, ARQ monohexyl ether (ARQHex), formed more DNA-interstrand cross-links in the cells than ARQ. After treatment of P388 cells with ARQ and ARQHex for 6 h, a nucleosomal ladder pattern, as well as the appearance of degraded DNA, observed by flow cytometry, indicated that these compounds caused cellular apoptosis. Moreover, ARQ and ARQHex accumulated in the cells at the G1 phase of the cell cycle. These results indicated that ARQ monoalkyl ethers increased cytotoxicity, according to their membrane permeability based on the hydrophobicity, and they caused apoptotic cell death, as did ARQ.

[A clinical comparison of orthodox myringoplasty and a simple method with fibrin glue]

Orthodox myringoplasty was clinically compared with a simple method with fibrin glue which rapidly came into wide use after the report of Yuasa in 1989. In Okayama Saiseikai General Hospital, orthodox myringoplasty was performed in 109 ears from September 1988 to November 1995, and the simple method with fibrin glue was performed in 84 ears from May 1991 to November 1995. The results showed that 90.8% of all eardrum perforations treated by orthodox myringoplasty and 79.8% of all eardrum perforations treated by the simple fibrin glue method were successfully closed. The rate of closure with each method was low in patients with large perforations. Generally speaking the hearing prognosis with each method, hearing improvement was observed right after the operation, and the improved hearing became stable about six months later. The difference in hearing prognosis was investigated in patients with small or large perforations. In patients with large perforations, the improved hearing slightly worsened a year after treatment by orthodox myringoplasty. These results show that the simple method with fibrin glue had the advantage of good hearing prognosis over orthodox myringoplasty, while it was inferior in the rate of closure of large eardrum perforations. It was considered that a simple fibrin glue method should be devised to prevent reperforation and should be used for patients with large perforations.

Bcl-2 is located predominantly in the inner membrane and crista of mitochondria in rat liver

Bcl-2 is now recognized as a potent inhibitor of apoptotic cell death. It has been reported that Bcl-2 is located in the mitochondria, endoplasmic reticulum, and nuclear membrane in some cell lines, and it is not expressed in normal human and rat liver. An earlier study showed that Bcl-2 is an inner mitochondrial membrane protein. On the contrary, the following investigations using immunoelectron microscopy demonstrated that Bcl-2 resides predominantly in the mitochondrial outer membrane. In this study, using a cryo-sectioning immunogold labeling technique and immunoblotting, we carefully determined the subcellular localization of Bcl-2. Here we report that Bcl-2 is expressed in normal rat liver, and it is located predominantly in the inner membrane and crista rather than in the outer membrane of mitochondria.

[An experience of video-assisted thoracoscopic surgery for an intrapulmonary needle under CT-guided marking]

A 46-year-old female visited a near hospital, complaining of repeating skin eruption with spontaneous remission. A chest X-ray and CT examinations revealed a needle in the left S6, about 5 mm in length, which was suspected of causing the eruption. She was admitted to our hospital for operation. After CT-guided marking, video-assisted thoracoscopic surgery was performed. Because the needle was too small to be palpable, we decided to respect of it with the lung surrounding the marker and clamped the lung, followed by finding the needle finally. The analysis of the removed needle showed that it contained lead and tin besides iron, nickel and chromium, which are components of stainless steel. Although dermatological examination could not reveal the relation between the needle and the eruption, it has never recurred since the operation. It is thought that CT-guided marking is very useful for resection of an intrapulmonary needle and that a foreign body should be removed for the possibility of being harmful.

Combined anterior thigh flaps and vascularised fibular graft for reconstruction of massive composite oromandibular defects

Six massive, composite oromandibular defects were reconstructed using combined anterior (anterolateral and anteromedial) thigh flaps and vascularised fibular graft in bridge or chimeric fashion. Except for minor dehiscence in one case and infection in another, all flaps survived without complication. Anterior thigh flaps provide large-calibre, long vascular pedicles while derivative branches from the lateral circumflex femoral system facilitate simultaneous transplantation of multiple components. Because the pedicle of the vascularised fibular graft is of insufficient length, the lateral circumflex femoral vessels provide a remote vascular source as a flow-through vascular conduit. A combined flap using the lateral circumflex femoral system is considered to be most suitable for reconstruction of through-and-through defects of the head and neck. The authors describe the advantages of this method and the detailed anatomy of the cutaneous perforators of the anterior thigh flaps.

Central administration of a nitric oxide synthase inhibitor causes pressor responses via the sympathetic nervous system and the renin-angiotensin system in Wistar rats

The central roles of nitric oxide (NO) in regulations of the blood pressure and heart rate were examined in anesthetized rats. Intracerebroventricular (i.c.v.) injection of Nomega-nitro-L-arginine methyl ester (L-NAME) caused dose-dependent increase in the blood pressure and heart rate. The pressor response of the blood pressure to L-NAME (2 micromol, i.c.v.) was reduced by L-arginine (5 micromol, i.c.v). Pretreatment with a ganglionic blocker, pentolinium (10 mg/kg, i.v.), significantly inhibited both pressor responses induced by L-NAME (2 micromol, i.c.v). The later pressor response of the blood pressure to L-NAME was also inhibited by the angiotensin II AT-1 blocker losartan (10 mg/kg, i.v). These results suggest that the response of the blood pressure to L-NAME is mediated by both the sympathetic nervous system and the renin-angiotensin system.

Peripheral edema after esophagectomy

Patients who have undergone major surgery such as esophagectomy may develop peripheral edema in the immediate postoperative period, the cause of which is not fully understood. The purpose of this study was therefore to determine the mechanism of this phenomenon. Finger edema was measured as a marker for peripheral edema before and after esophagectomy in eight patients. Plasma interleukin-6 (IL-6) was also measured by an enzyme-linked immunosorbent assay. Finger edema markedly increased in the immediate postoperative period and remained significantly elevated until after postoperative day (POD) 3 compared to the preoperative value (P < 0.05). Plasma IL-6 also markedly increased in the immediate postoperative period and remained significantly elevated on POD 2 compared to the preoperative value (P < 0.05). The degree of finger edema highly correlated with the level of plasma IL-6 (r = 0.71, P = 0.0001). These findings indicate that peripheral edema after esophagectomy might be caused by a proinflammatory cytokine response.

Recovery from complete atrioventricular block caused by idiopathic giant cell myocarditis after corticosteroid therapy

Giant cell myocarditis (GCM) is a rapidly progressive disease that leads to ventricular tachycardia or high-grade atrioventricular (A-V) block, frequently requiring a pacemaker. A 64-year-old woman developed syncope as a result of idiopathic GCM with A-V block. She required both a temporary and a permanent pacemaker. Two-dimensional echocardiography showed severely reduced wall motion. There was no histologic or clinical evidence to suggest sarcoidosis. Despite treatment with diuretics and an angiotensin-converting enzyme inhibitor, exertional dyspnea persisted. She received prednisolone 4 months after the onset of complete A-V block in the late phase of GCM. Prednisolone improved A-V nodal conduction in spite of the fact that there was no influence from LV wall motion, and sinus rhythm has continued for more than 2 years. In this patient, prednisolone was effective in the treatment of GCM.

[Subcapsular hematoma of the liver after extracorporeal shock wave lithotripsy]

We experienced a case of a hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for a right renal stone. To our knowledge this presentation is the second case in the Japanese literature. A 63-year-old female with a right renal stone received 2,800 shots of 14.0 kilo-volts shockwave with Sonolith 3,000. Preoperative examination of the blood disclosed no abnormalities in the coagulating system except slight reduction of platelet count and slight impairment of liver function. Postoperative routine ultrasound echograms revealed a hepatic subcapsular hematoma although she had no symptom. The size of the hematoma measured 11.0 x 5.0 cm in computed tomograms (CT). She was carefully observed without any treatments because the hematoma did not increase in size. CT scans 6 months after the ESWL treatment demonstrated neither hematoma nor masses in the liver. As a complication of ESWL for urolithiasis a hepatic subcapsular hematoma is very rare. We herein presented the case and discussed the complications of ESWL briefly in the literature.

Identification and characterization of families with aggregation of lung cancer

BACKGROUND

To clarify genetic factors involved in the susceptibility to lung cancer, it is essential to identify families with lung cancer clustering and to characterize the mode of clustering. Since somatic mutations of the p53, RB and p16 genes occur frequently in lung cancer and the replication error phenotype is seen in a subset of lung cancer, it is possible that germ-line mutations of the p53, RB, p16 and mismatch repair genes influence the susceptibility to lung cancer.

METHODS

In this work, cases with familial clustering of lung cancer were selected from 1068 families with primary lung cancer cases in analogy with the criteria for hereditary non-polyposis colorectal cancer (HNPCC). Cases with Li-Fraumeni syndrome, familial retinoblastoma, familial melanoma and HNPCC were also searched among these 1068 families.

RESULTS

There were only four families (0.4%) in which more than three relatives were affected by lung cancer. Two successive generations were affected in 36 families (3.4%). Patients with lung cancer before the age of 50 were present in 165 families (15.5%). However, no family conformed to all three criteria. There was only one family with Li-Fraumeni syndrome and no family with familial retinoblastoma, familial melanoma and HNPCC.

CONCLUSION

Familial aggregation of lung cancer is rare and germ-line mutations of the p53, RB, p16 and mismatch repair genes may not contribute greatly to susceptibility to lung cancer.

[An analysis of the mechanism of postoperative hyperbilirubinemia following resection of thoracic esophageal cancer in terms of hepatic venous oxygen saturation and excessive systemic reactions]

Hepatic venous oxygen saturation (ShvO2), parameters of systemic circulation and cytokine (Interleukin 6) (IL-6)) level were measured in 21 patients with thoracic esophageal cancer in order to analyze the mechanism of occurrence of postoperative hyperbilirubinemia (PHB). ShvO2 fell during operation, especially during intrathoracic procedures, and a significant correlation was noted between the total time during which ShvO2 was below 60% and the postoperative peak serum bilirubin level (peak-Bil) (r = 0.595, p = 0.0037). Patients with PHB (group H) had worse systemic circulation and a lower oxygen supply postoperatively than patients without PHB (group N). Body weight and water balance recovered earlier in group N. Postoperatively, numbers of peripheral lymphocytes and platelets changed lower in group H, while CRP and IL-6 changed higher in group H. Furthermore, a significant correlation was noted between the IL-6 level just after operation and peak-Bil (r = 0.669, p = 0.0006). These results suggests PHB results from intraoperative liver hypoxia and poor postoperative systemic circulation. Individual severeness of reactions to the operative stress, excessive or adequate, plays a role in the occurrence of PHB as well.

Hydrogen peroxide derived from hepatocytes induces sinusoidal endothelial cell apoptosis in perfused hypoxic rat liver

BACKGROUND & AIMS

Evidence is accumulating that hypoxic liver injury involves not only necrosis but also apoptosis. Reactive oxygen species can cause apoptosis. This study examined the hypothesis that H2O2 induces apoptosis in hypoxic rat liver.

METHODS

Blood-perfused rat livers were made hypoxic by reducing the perfusion flow. H2O2 was detected by both 2',7'-dichlorofluorescein fluoroimaging and cerium electron-microscopic methods. To evaluate the apoptosis, the liver was stained with the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling (TUNEL) method. To further investigate the involvement of H2O2 in hypoxia-induced liver cell apoptosis, small pieces of liver in the cultured media were exposed to 0.5 mmol/L of reagent H2O2 and stained with the TUNEL method.

RESULTS

In the hypoxic liver, H2O2 was produced predominantly by hepatocytes, and the number of apoptotic nonparenchymal cells was significantly increased, particularly in the midzone. All the apoptotic cells were positively stained with monoclonal antibody against the hepatic sinusoidal endothelial cells (SECs). In incubated liver pieces, reagent H2O2 induced apoptosis selectively in SECs.

CONCLUSIONS

Low-flow hypoxia induces H2O2 production in hepatocytes, and this H2O2 induces apoptosis selectively in SECs in the rat liver.

Mechanism of the cytotoxicity of asterriquinone, a metabolite of Aspergillus terreus

Asterriquinone (ARQ) is an antitumor metabolite of Aspergillus terreus IFO 6123. ARQ is a quinone compound and the mechanism of its antitumor action was compared with that of its analog ARQDMe which was dimethylated at the dihydroxy benzoquinone moiety, and adriamycin (ADR). The cytotoxicity of ARQ against P388 cells was less than that of ADR, and ARQDMe showed hardly any cytotoxicity. ARQ and ADR formed DNA-interstrand cross links (ISC) in P388 cells in a concentration while the ISC index by ARQDMe was very low even at 10 microM. P388 cells treated with ARQ and ADR for 18 hours showed, dose-dependently, nucleosomal ladder formation as well as the appearance of degraded DNA. Difference between the action of ARQ and ADR were observed by flow cytometric cell cycle analysis. ARQ caused the cells to accumulate at the G1 phase of the cell cycle, while use of ADR led to arrest in the G2/M phase. ARQDMe never caused apoptotic changes or cell cycle alterations. These results indicate that ARQ intercalates in the genomic DNA, causes G1 arrest, and leads to apoptotic cell death, this suggests that the dihydroxybenzoquinone moiety of the compound is essential to elicit these actions.

Reduction of infarct volume by halothane: effect on cerebral blood flow or perifocal spreading depression-like depolarizations

Halothane is a strong inhibitor of potassium evoked spreading depression (SD) in cats. In the current study, we investigate halothane effects on induction of perifocal SD-like depolarizations, CBF, and infarct evolution in focal ischemia. Calomel and platinum electrodes measured cortical direct current potential and CBF in ectosylvian, suprasylvian, and marginal gyri. Left middle cerebral artery occlusion (MCAO) induced permanent focal ischemia for 16 hours in artificially ventilated cats (30% oxygen, 70% nitrous oxide) under halothane (0.75%, n = 8) or alpha-chloralose anesthesia (60 mg/kg intravenously, n = 7). Under alpha-chloralose, MCAO induced severe ischemia in ectosylvian and suprasylvian gyri(mean CBF < 10 mL/100 g/min), and direct current potentials turned immediately into terminal depolarization. In marginal gyri, CBF reduction was mild (more than 20 mL/100 g/min), and in six of seven animals, frequent SD-like depolarizations turned into terminal depolarization at a later stage of the experiments. Under halothane, MCAO induced severe ischemia (less than 10 mL/100 g/min) and immediate terminal depolarization only in ectosylvian gyrus. In suprasylvian gyrus, residual CBF remained significantly higher (more than 10 mL/100 g/min) than under alpha-chloralose, whereas in marginal gyri, CBF did not differ between groups. Compared with chloralose, the number of transient depolarizations was significantly reduced in marginal gyrus, and in suprasylvian gyrus transient but significantly longer depolarizations than in marginal gyrus were recorded. Except for one animal, transient depolarizations did not turn into terminal depolarization under halothane, and infarct volume reduction was particularly seen in suprasylvian gyrus. We conclude that halothane, the most commonly used anesthetic in studies of experimental brain ischemia, has protective properties, which may depend on both cerebrovascular and electrophysiologic influences.

Epithelial hyperplasia of the larynx a clinical follow-up study

In this retrospective study, the records of 40 patients with epithelial hyperplasia of the larynx, seen between 1980-1991, were reviewed to determine the incidence of malignant transformation during long term follow-up. The mean follow-up time was 58.6 months. The initial pathological diagnoses were hyperkeratosis in one case, parakeratosis in one, dyskeratosis in 12 and dysplasia in 26. During follow up, nine patients developed carcinoma in situ and/or invasive carcinoma. Of these, two patients had been diagnosed with dyskeratosis without dysplastic cells at the initial biopsy. It is therefore important to follow up patients with epithelial hyperplasia of the larynx even when no dysplastic cells are found at the time of diagnosis.

Modulation of the arterial baroreceptor reflex by the vasopressin receptor in the area postrema of the hypertensive rats

The role of arginine8-vasopressin (AVP) in regulation of the baroreceptor reflex in the area postrema was examined in anesthetized hypertensive rats. The sensitivity of the baroreceptor reflex in a one-kidney one clip (1K1C) hypertensive rats was increased in only the initial stage (2 weeks), in association with increase in blood pressure, and then returned to the normal level. This increase in the sensitivity of the baroreceptor reflex in the initial stage was reversed by microinjection of a V1 or V2 antagonist (1 microg) into the area postrema. AVP V2 receptor mRNA was expressed temporarily in the area postrema in this period. These results suggest that vasopressin receptors in the area postrema is important in regulating the sensitivity of the baroreceptor reflex.

YSK1, a novel mammalian protein kinase structurally related to Ste20 and SPS1, but is not involved in the known MAPK pathways

To clarify the upstream regulatory mechanism of mitogen-activated protein kinase (MAPK), we performed the reverse transcriptase-based polymerase chain reaction (RT-PCR) with degenerate primers synthesized based on sequences conserved among the kinase domains of yeast MAPK kinase kinases (MAPKKKs), Stell, Bck1, and Byr2. We isolated several mammalian cDNA fragments that encode kinase subdomains sharing significant sequence homology with yeast MAPKKKs. Subsequent screening of a HeLa cell cDNA library using one of these cDNA fragments as a probe resulted in the isolation of a full-length cDNA that encodes a novel protein kinase. The catalytic domain sequence of this gene product is closely related to those of budding yeast Sps1 and Ste20 protein kinases. Thus, we call this protein YSK1 (Yeast Sps1/Ste20-related Kinase 1). The transcript of YSK1 was detected in a wide range of tissues and cells. Immunoprecipitated YSK1 shows protein kinase activity. Although YSK1 is significantly similar in its kinase domain to kinases of the yeast and mammalian MAPK pathways, the overexpression of YSK1 did not lead to the activation of the ERK (extracellular signal-regulated kinase) pathway, JNK (c-Jun NH2-terminal kinase)/SAPK (stress-activated protein kinase) pathway, or p38/Mpk2 pathway. These results suggest that YSK1 may be involved in the regulation of a novel intracellular signaling pathway.

Hierarchical Structure of Lattices in Film Formation of Core-Shell Type Polymer Microspheres

By adding polystyrene homopolymer in the solid state, super-lattice structures of poly(4-vinyl pyridine) core-polystyrene shell type polymer microspheres were hierarchically changed from a disordered state to a face-centered cubic via a body-centered cubic. The transition of the lattice structures was investigated from the view point of the excluded volume of the microsphere, which was controlled by a changing of the molecular weights and blend tarios of polystyrene homopolymers.

Cytologic analysis of primary stomach adenocarcinoma metastatic to the uterine cervix

OBJECTIVE

To investigate the cytologic and pathologic features of endocervical lesions in cases of gastric adenocarcinoma metastatic to the uterine cervix.

STUDY DESIGN

From 1986 to 1994, four patients with gastric adenocarcinoma metastatic to the uterine cervix were treated at our department. The cervical cytologic samples were obtained by swabbing and were stained by the Papanicolaou method. Presence of tumor diathesis, number of atypical cells, cell arrangement, cytoplastic vacuoles, cellular and nuclear diameter, chromatin distribution and size of the nucleolus were investigated.

RESULTS

The smear backgrounds were dirty (tumor diathesis) in two cases and clean in two. No significant difference in the number of atypical cells or in cell or nuclear diameter between primary and metastatic adenocarcinoma was shown. Cell arrangement was the different cytologic finding between primary and metastatic adenocarcinoma. Sheetlike or isolated arrangement was seen frequently in metastatic cervical adenocarcinoma.

CONCLUSION

Because different cytologic features have been found in past and the present series, cytologic diagnosis of metastatic cervical adenocarcinoma should be made carefully.