Inhibition of IL-6 and IL-8 induction from cultured rheumatoid synovial fibroblasts by treatment with aurothioglucose

Gold compounds have long been used in the treatment of rheumatoid arthritis (RA). However, their actions in RA have not been clarified. In this study, we examined the effect of one of the monovalent gold compounds, aurothioglucose (AuTG), on the IL-1-induced production of IL-6, IL-8 and granulocyte macrophage colony stimulating factor (GM-CSF) from rheumatoid synovial fibroblasts (RSF) isolated from three RA patients. IL-6 and IL-8 induction but not GM-CSF induction was inhibited in most of the RSF after pretreatment with AuTG. Since gene expression of these cytokines is known to be under the control of a common transcription factor, NF-kappaB, the effect of AuTG on the cellular localization of NF-kappaB (p65 subunit) and on NF-kappaB-DNA binding was examined. Although AuTG treatment did not prevent NF-kappaB nuclear translocation, AuTG blocked the DNA-binding activity of NF-kappaB when examined in vitro. Morphologically, both metal-specific cell staining using p-dimethylaminobenzylidene rhodamine and transmission electron microscopic examinations demonstrated the accumulation of metal gold in the cytoplama and some organella (mitochondria and lysosomes) of the AuTG-treated RSF. These results indicate that one of the anti-rheumatic actions of AuTG might be through its inhibitory action on NF-kappaB.

Establishment of a non-union model using muscle interposition without osteotomy in rats

Many attempts have described a standard experimental model for fracture non-union in laboratory conditions, but the majority of them produced after an experimental osteotomy, so it is different from clinical disturbed fracture healing. The purpose of this study is to establish a standard method for producing fracture non-union with only muscle interposed into the fracture site in rats. Bilateral tibial fractures were made in forty-eight male Wister rats by three point bending and we surgically interposed the distal end of the tibialis anterior muscle into the fracture site. They were sacrificed at 1, 2, 3, 6, 12, 24, 48, and 96 weeks after fracture. The rentgenograms were obtained, and the fractured tibias were harvested in each time period and investigated histologically and immunohistochemically. The rentgenogram at six weeks, in the non-union rats, showed abundant callus at each end of the fracture fragments, but no bridging callus. The histological finding with hematoxylin and eosin, at this point, shows no bridging soft callus, and small isolated regions of cartilage were observed only where the bone was not covered by the muscle. The proliferating cell nuclear antibody immunostaining which is associated with cell proliferation was abruptly lost in chondrocytes at two weeks. This early disappearance of chondrocytes without endochondral ossification may be a significant etiological factor in the development of a non-union. This non-union model is technically simple and reproducible, and dose not require periosteal stripping or surgical osteotomy to produce an artificial bone gap.

Complete response of early gastric cancer to uracil and tegafur

A 74-year-old Japanese woman with early gastric cancer was successfully treated with uracil and tegafur (UFT). She was diagnosed by endoscopy (including endoscopic biopsy and endosonography) with an early gastric cancer, type IIa + IIc, on the greater curvature of the angulus. Surgical procedures or endoscopic therapy could not be performed because the patient had severe ischemic heart disease. Therefore, chemotherapy with UFT was administered at 300 mg/day for 15 months. Follow-up endoscopy, endosonography, and biopsy showed disappearance of the gastric cancer. To our knowledge, this is the first case report of the complete response of an early gastric cancer to UFT in the English-language literature.

Regulation of Zn-alpha2-glycoprotein-mediated cell adhesion by kininogens and their derivatives

MC3T3-E1 (mouse osteoblast-like) cells adhered to a tissue culture plate coated with human Zn-alpha2-glycoprotein (Znalpha2gp). The adhesion of MC3T3-E1 cells to Znalpha2gp was inhibited by synthetic peptides such as RGDS and ELRGDV, and by antibody against vitronectin receptor. These findings suggested that the RGD region of Znalpha2gp interacts with the vitronectin receptor (alphavbeta3) on the MC3T3-E1 cell surface. Furthermore, we found that the common heavy chain of both HMW- and LMW-kininogens accelerated the Znalpha2gp-mediated MC3T3-E1 cell adhesion. Among the three domains of the common heavy chain of both kininogens, domain 3 promoted the cell adhesion by up to 200%. Among the nine synthetic peptides covering domain 3, the peptide, N334AEVYVVPWEKKIYPTVN351 accelerated in a dose-dependent manner the Znalpha2gp- and vitronectin (VN)-mediated MC3T3-E1 cell adhesion. These findings suggested that a defined region of domain 3 is responsible for the acceleration of cell adhesion.

Rotation plasty for osteosarcoma of the femur

A 20-year-old female with right femoral osteosarcoma noted severe pain and swelling of the right thigh, and was transferred to the authors' hospital after suffering a pathologic fracture of the right femur. Plain x-ray disclosed a tumor shadow extending from the pathologic fracture of the distal portion of the femur to the center of the diaphysis. MRIs showed a broad lesion and hematoma, and invasion to the femoral vascular bundle was suspected. Angiograms revealed vascularization coincidental to the tumor, and an irregular vascular wall of the femoral artery, which was shifted posteriorly. After consultation with the patient and her family, rotation plasty was performed. The sciatic nerve was isolated and preserved; major vessels were sectioned proximally and distally because of tumor tissue invasion to the femoral artery and vein. After wide excision of the tumor, the leg was rotated outward 180 degrees, and osteosynthesis was performed between the remaining femur and the tibia, followed by microsurgical anastomosis of vessels. Five years postoperatively, no local recurrence or metastasis has been observed. The patient has excellent functional recovery without pain, and no other complications.

[Role of superoxide generation and degradation system of mast cells in allergic inflammation]

Rat peritoneal mast cells are stimulated to generate superoxide anion (O2) by the addition of compound 48/80 and A23187. Recently, we demonstrated by immunohistochemical and Western blot analysis that the mast cells contained the p47phox protein, which was one of cytosolic component of the NADPH oxidase system. In the present study, it was demonstrated that the mast cells contained the p47phox mRNA, much similar to that of mouse leukocyte. The permeabilized mast cells were stimulated to generate O2- by the addition of Ca2+, phospholipase A2 (PLA2) and arachidonic acid. Our data suggest the following:(1) cytosolic PLA2 may be activated by the elevation of [Ca2+]i; (2) the conjugation of membrane component with cytosolic component may be stimulated by the released arachidonic acid. The mast cell granules contained superoxide dismutase (SOD)-like enzyme, which degradated O2-, generated in xanthine-xanthinoxidase system. SOD-like enzyme was released from the granules by the treatment with Ca2+ and trapped by the treatment with heparin. In conclusion, our studies suggest that the disorder of the degradation system of O2- may contribute to the development of allergic inflammation.

MaMi, a human endometrial stromal sarcoma cell line that constitutively produces interleukin-6, interleukin-8, and monocyte chemoattractant protein-1

BACKGROUND

Uterine endometrial stromal sarcoma is a rare neoplasm with a morphology that closely resembles that of the proliferative endometrial stroma. To understand its pathologic characteristics, we established a novel cell line, MaMi, from a primary culture of an endometrial stromal sarcoma obtained from a 65-year-old Japanese woman.

METHODS

We observed the morphology of MaMi cells and performed immunohistochemical analysis on the primary tumor and transplants in nude mice. Prolactin, insulin-like growth factor-binding protein-1, interleukin (IL)-6, IL-8, monocyte chemoattractant protein-1, intercellular adhesion molecule-1, E-selectin, vascular cell adhesion molecule-1, and fibronectin production in the culture medium of MaMi cells were also examined.

RESULTS

MaMi cells were shown to exhibit a fibroblast-like morphology in vitro, and they adopted a more elongated appearance in response to 12-O-tetradecanoyl phorbol-13-acetate (TPA). On injection into nude mice, the cells gave rise to subcutaneous tumors. Immunohistologically, both the primary tumor and MaMi cell-induced tumors stained positively with antibodies to neuron-specific enolase or vimentin. MaMi cells constitutively produced IL-6, IL-8, and monocyte chemoattractant protein-1 in vitro. Interleukin-1beta, (100 pmol/L), tumor necrosis factor-alpha (1 nmol/L), and lipopolysaccharide (1 microg/mL) each increased the release of IL-6, IL-8, and monocyte chemoattractant protein-1 by MaMi cells. TPA (10 nmol/L) also stimulated the production of IL-6 and IL-8 by these cells, but inhibited that of monocyte chemoattractant protein-1.

CONCLUSIONS

We demonstrated that MaMi cells closely resemble proliferative endometrial stromal cells not only morphologically, but also functionally. This cell line may prove valuable in understanding the role of cytokines produced by tumor cells in the pathogenesis of endometrial stromal sarcoma and may also be useful as an in vitro model of functioning endometrial stromal cells.

Effects of interferon-gamma on cytokine production by endometrial stromal cells

To clarify the role of interferon-gamma (IFN-gamma) in reproduction, we have examined its effects on cytokine production by human endometrial stromal cells (ESC). Concentrations of interleukin (IL)-6, IL-8, monocyte chemoattractant protein-1 (MCP-1), and macrophage colony-stimulating factor (M-CSF) in the culture media of normal ESC and an endometrial stromal sarcoma cell line, MaMi, were measured using an enzyme-linked immunosorbent assay. Both non-stimulated ESC and non-stimulated MaMi cells constitutively secrete IL-6, IL-8, MCP-1, and M-CSF. In a dose-dependent manner, IFN-gamma increased the concentrations of IL-6, MCP-1, and M-CSF and reduced the concentrations of IL-8 in ESC and MaMi cells. These results suggest that IFN-gamma produced by both decidual inflammatory cells and the developing embryo plays a role in the maintenance of early pregnancy by modulating the production of these cytokines by human ESC.

[Optimization of arbitrarily primed polymerase chain reaction (AP-PCR)-based DNA fingerprinting of Mycobacterium tuberculosis and its clinical application]

Since the number of outbreaks of pulmonary tuberculosis is increasing in Japan, epidemiological analysis is important to prevent the disease. Since Mycobacterium tuberculosis lacks the variety of biotypes among strains, genetical analysis is considered to be a promising measure to differentiate various of this pathogen. We applied arbitrarily primed polymerase chain reaction (AP-PCR)-based DNA fingerprinting to clinically isolated strains of M. tuberculosis. Although genetic analyses of M. tuberculosis by AP-PCR were reported by several investigators, reproducibilities of their results were not sufficient to be widely accepted as a reliable epidemiological tool. To attain high reprodicibulity, we attempted to optimize AP-PCR conditions including primers and annealing temperature, and to purity of DNA preparations. In this study, high reproducibility was attained by using the mixed primers of 1309F and 92R, and DNA preparations with an absorbance ratio (A260/A280) of higher than 1.50. Twenty two clinical isolates, including strains isolated from one incidence of nosocomial infection and from that of intrafamilial infection were analyzed by the optimized method; consequently they were grouped into 16 types. This AP-PCR method requires only one week subculture of M. tuberculosis and less than 24 hours for analysis. This AP-PCR method allowed us to obtain the highly reproducible results within a considerably short term, which would be applicable to clinical epidemiological investigation.

Magnetic resonance imaging of experimental subacute spinal cord compression

STUDY DESIGN

Subacute compression of the spinal cord was applied to rats. The animals were chronologically observed using magnetic resonance imaging for more than 8 weeks after surgery and were killed for histopathologic examination.

OBJECTIVES

To investigate the correlation of changes in signal intensity on magnetic resonance images with those observed in histopathologic study and with the degree of spinal cord compression and paralysis.

SUMMARY OF BACKGROUND DATA

No consensus has been reached concerning the correlation of magnetic resonance images to clinical symptoms of compressive myelopathy. Few reports are available in which magnetic resonance imaging findings are compared with histopathologic features in chronic or subacute experiments.

METHODS

In rats under general anesthesia, the T11 lamina was thinned and a slow increase in volume was applied. Hind limb paralysis appeared 1 week after the procedure and spontaneously subsided thereafter. The degree of spinal compression and signal intensity was observed chronologically using magnetic resonance imaging. The signal intensity on the final MR images was rated on a four-point scale and compared with histopathologic findings.

RESULTS

As spinal compression increased, the incidence of high signal intensity on long spin-echo images became higher. Low signal intensities on short spin-echo images were visible in animals in which compression and paralysis were the most severe. In these animals, cavitation and a dilated central canal were visible. High signal intensities on long spin-echo images reflected various pathologic changes.

CONCLUSIONS

Changes in signal intensity on MR images are visible after the induction of myelopathy by high-pressure compression. These signal intensities may be useful in predicting the outcome of compressive myelopathy.

Effect of exercise-induced acidosis on aldosterone secretion in men

The present study was carried out to elucidate whether an exercise-induced increase in plasma hydrogen ion concentration influences aldosterone secretion. Six healthy men (aged 22-25 years) performed two intermittent exercise tests with and without drug administration. The intensities of these exercise tests were 40% maximal oxygen uptake (VO2max) and 90% VO2max, respectively. Administration of 2-mg Dexamethasone and 50-mg Captopril caused an almost complete suppression of adrenocorticotropic hormone (ACTH) and an enhancement of the elevation in renin concentration during exercise, indicating successful inhibition of ACTH release and angiotensin II production during exercise. While the magnitude of the increase in aldosterone in the drug experiment was depressed compared with the control experiment, a significant increase in aldosterone concentration was observed at the end of the 90% VO2max exercise. Whilst the change in aldosterone concentration did not correlate with the change in plasma potassium concentration, there was a significant correlation between aldosterone and plasma hydrogen ion concentrations in the drug experiment. Since the correlation coefficient was low (r = 0.455), the biological meaning of this correlation should be further investigated. These results would suggest that an elevation of plasma hydrogen ion concentration induced by exercise per se appears to be related, at least in part, with increased aldosterone secretion, independent of the pituitary-adrenal axis, and the renin-angiotensin system.

Critical interval for rescue of axotomized neurons by transplants

To determine whether embryonic spinal cord transplants retained the ability to prevent retrograde death of Clarke's nucleus (CN) neurons if supplied after a delay, we hemisected adult rats at the T8 spinal cord segment and placed transplants of fetal tissue into the hemisection cavity immediately or up to 14 days later. Transplants provided in the first 7 days after injury prevented virtually all of the 30% loss of CN neurons at L1 ipsilateral to hemisection that occurs without a transplant. Transplants supplied at 14 days post-hemisection were ineffective. Because prevention of retrograde neuron death is one mechanism by which transplants may contribute to locomotor recovery after spinal cord injury, this window of effectiveness should be considered in the design of clinical trials.

Protective effects of polysaccharide fucoidin on myocardial ischemia-reperfusion injury in rats

We tested whether polysaccharide fucoidin, which inhibits leukocyte rolling in the mesenteric venule, has protective effects in the rat myocardial 30-min ischemia and 6-h reperfusion injury model. Intravenous infusion of fucoidin (27 microg/kg/min from 10 min before to 6 h after reperfusion) significantly attenuated myocardial infarct size 6 h after reperfusion. In this ischemia and reperfusion heart model, expression of P-selectin (determined immunohistochemically) was observed on the venular endothelial cells in the heart 30 min after reperfusion and also was sustained after 6 h. Neutrophil infiltration as estimated by myeloperoxidase activity significantly increased 2 h after reperfusion and kept increasing with time until 6 h after reperfusion. Four-hour infusion of fucoidin after reperfusion significantly reduced neutrophil infiltration, whereas the 2-h infusion of fucoidin did not. These results indicate that neutrophil infiltration and myocardial injury are attributed to expression of P-selectin after reperfusion, and that one of the inhibitory mechanisms of fucoidin seems to be blockade of P-selectin-mediated neutrophil rolling on the vessel wall.

Changes in urinary excretion of pyridinium cross-links during Spacelab-J

In SLJ-1 we proposed to study three major objectives. They were; 1. hormonal changes associated with fluid and electrolyte metabolism, 2. the effect of space flight on the circadian rhythms of endocrine and metabolic systems, 3. the changes in the indices of the bone and muscle metabolism during space flight. In this report, the changes in the bone metabolism during Spacelab-J will be presented with a special emphasis on urinary excretion of pyridinium cross-links. Timed urine samples from three Japanese payload specialists were obtained for 3 days from May 19 to 21, 1991 (one year before the launch = L-1 year). Immediately before the launch (L-3 to L-0), urine samples were obtained from a payload specialist who was on board the Space Shuttle Endeavor (PS). During the inflight period (flight from September 3 to 10 in 1992), urine samples from the PS were collected by using Urine Monitoring System (UMS). After the landing, they were obtained from the PS for three days (R+0-R+2). Various parameters related to bone metabolism such as hydroxyproline, pyridinium cross-links and calcium were determined. It was noted that excretion of hydroxyproline decreased during the preflight periods when compared with that in the control L-1 year period. The average excretory rate during control period was 846.2 +/- 198.7 milligrams/hour (mean +/- SD), while those in the preflight 474.6 +/- 171.1 milligrams/hour, suggesting the diminished collagen intake during the preflight period. Average excretion rate of pyridinium cross-links during the first 4 mission days (MD0-MD3) was similar to that of preflight and control L-1 year period. However, it was significantly increased during the last 4 mission days (MD4-MD7). It returned to the preflight level during postflight days (R+0-R+2). Increased urinary excretion of calcium during the last 4 mission days were also observed. These results suggest that increase in bone resorption could occur during relatively short stay in microgravity.

Insulin-like growth factor-binding protein-1 in human follicular fluid: a marker for oocyte maturation

In order to investigate the role of insulin-like growth factors (IGFs) in human ovulation, we evaluated the concentrations of IGF-binding proteins (IGFBPs) in human follicular fluid (FF). The concentrations of IGFBP-1 in the FFs of 15 women undergoing in vitro fertilization and embryo transfer were measured and related to those of 17beta-estradiol (E2), progesterone and androstenedione in the FFs. IGFBP-1 levels in the FFs were positively correlated with those of E2 and progesterone. No correlation was found between the IGFBP-1 and androstenedione levels in FFs. The concentrations of IGFBP-1 were significantly increased in the FFs which contained mature oocytes compared with those of immature oocytes, whereas IGFBP-3 in FFs tended to decrease as oocytes matured. It is suggested that IGFs may play important roles in human preovulatory processes, and that IGFBP-1 may be a valuable biochemical marker in the evaluation of oocytes.

[Double negative adult T-cell leukemia with hemophagocytic syndrome]

A 79-year-old woman was admitted with general fatigue, jaundice and hepatosplenomegaly. Perpheral blood examination showed 8.0 g/dl Hb, 15 x 10(3)/microliter platelet and 10,490/microliter leukocytes with 86% abnormal lymphocytes. Immunophenotypic analysis of abnormal lymphocytes demonstrated CD2(+), CD3(+/-), CD4(-), and CD8(-). Serum antibody for HTLV-1 was positive. In addition, the monoclonal integration of HTLV-1 proviral DNA into the genome of leukemic cells was demonstrated on Southern blot hybridization. Bone marrow revealed ATL cell in vasion with myelofibrosis and hemophagocytic cell proliferation. Therefore, adult T-cell leukemia with hemophagocytic syndrome was diagnosed. She was treated with methyl prednisolone pulse therapy and gammaglobulin. But she died of hepatic failure 14 days after hospitalization. On autopsy, EB virus LMP-1 was detected in ATL cells in bone marrow. ATL with hemophagocytosis is relatively rare. The association of both pathological states was discussed.

Effect of acid-base disturbances on aldosterone secretion in man

The present study was carried out to elucidate whether changes in blood pH induced by administration of alkalinizing and acidifying agents influence aldosterone secretion in man. Since aldosterone secretion is known to be regulated by various factors such as the renin-angiotensin system, adrenocorticotropic hormone (ACTH), and serum potassium concentration, these indices were simultaneously measured during manipulation. Oral administration of tris hydroxymethyl aminomethane (THAM) resulted in a moderate but not significant decrease in serum aldosterone together with an increase in blood pH, whereas plasma renin activity (PRA) remained unchanged and serum potassium was elevated. ACTH and cortisol decreased significantly. Following CaCO3 ingestion, blood pH, serum potassium concentration, and hormones did not change significantly compared with before ingestion. NH4Cl ingestion showed a significant fall of blood pH and serum cortisol, on the other hand, aldosterone increased significantly compared with CaCO3 ingestion. Following NaHCO3 ingestion, serum aldosterone decreased with an increase in blood pH compared with before ingestion, while serum cortisol and PRA did not change significantly. The overall results of experiments using THAM, CaCO3, NaHCO3, and NH4Cl led to the conclusion that under acid-base disturbances a change in aldosterone can not be induced by either renin-angiotensin or ACTH. We suggest that under acid-base disturbances blood pH may be related, at least, in part to changes in aldosterone in humans.

Quasi-steadiness approximation for the two-compartment solute kinetic model

We analytically solved the equation of the variable volume, two-compartment solute kinetic model (TCSKM). From the solution, we constructed an expression of weekly concentration profiles developing in the patient's body by routine hemodialyses. Obtained formulas can be used to calculate Kt/V, solute reduction index (SRI), the solute generation rate (G) per unit distribution volume (V), and a mass transfer coefficient (MTC) between the two compartments. To estimate these parameters, the formulas only need three-point data during a dialysis, that is, pre-, one-hour, and post-dialysis solute concentrations instead of four that would otherwise be needed. A 48 hour data point is not required. The weekly concentration profiles can be easily calculated by the formulas. As examples of clinical applications, we calculated Kt/V, G/V, and SRI of urea, Cr, and uric acid using plasma data of 121 hemodialyzed patients. Then the results were compared with the single-compartment solute kinetic model (SCSKM). The obtained mean MTC/V values, that is, 1.08 (1/hr) for urea, 0.53 (1/hr) for Cr, and 1.11 (1/hr) for uric acid, were consistent with the previous works. SCSKM overestimated the mean G/V by 7.1%, 15.9%, and 10.0%, and the mean SRI by 6.7%, 18.6%, and 10.0%, for urea, Cr, and uric acid, respectively. The solute distribution volume ratio of TCSKM to SCSKM, (V)TCSKM/(V)SCSKM, depended on the value of MTC/V and the hemodialysis duration. Using pedometers, we measured the total number of steps the patients took during a week. We found that the total number of steps in a week was significantly correlated with the Cr generation rate (r = 0.285, P < 0.03), but that it was not significantly correlated with the other generation rates (r = 0.204, P > 0.09 for urea, and r = 0.209, P > 0.08 for uric acid). These data suggest that the Cr generation rate is related to the patient's physical activity. We conclude that the formulas can estimate an adequate dialysis prescription for the hemodialyzed patient.

Reduction of hyponatremia in a schizophrenic with polydipsia-hyponatremia syndrome by surgical intervention

In a chronic schizophrenic with polydipsia-hyponatremia syndrome, we observed physiological data consecutively before and after a successful LAPIDES vesicostomy for his bladder retention. Although his polydipsia was unchanged, frequency of hyponatremia was significantly reduced after the operation. We found that bladder retention might be one of the factors relevant to the prediction of hyponatremia from diurnal weight gain.

The treatment of enchondromas in the hand by endoscopic curettage without bone grafting

Nine patients with enchondromas in the hand were treated by endoscopic curettage of the tumour without bone grafting. The procedure was performed on an out-patient basis using axillary block anaesthesia. New bone formation and remodelling of the lesions were observed in all patients. There were no postoperative fractures, infections, recurrences or other complications. Functional recovery was rapid. We conclude that endoscopic curettage without bone grafting is an effective treatment of enchondroma in the hand.

Osteoblasts express types I and II activin receptors during early intramembranous and endochondral bone formation

Increasing evidence suggests a potential role for activin in bone formation. However, the cognate receptors through which activins function with respect to skeletal tissues have not yet been identified. Identification and regulation of expression of these receptors are necessary prerequisites to understanding the role of activins in bone metabolism. We detected mRNAs for three activin receptors, type I (ActRI), type II (ActRII), and type IIB (ActRIIB), in multiple skeletal tissues in rat, including tibia and costochondral growth plate, and also in cultured osteoblasts. To gain information about the relationship between receptor expression and different skeletal cell functions, we evaluated expression of the three receptors in a semiquantitative manner during the early stages of fracture healing, a model for rapid bone formation. Relatively high levels of ActRI and ActRII expression were detected in the callus at 7, 10, and 14 days after fracture, times that correlate with the interval of rapid intramembranous bone formation and the initiation of endochondral bone formation. Expression of the ActRIIB in the fracture callus was strikingly lower than either ActRI or ActRII. Immunostaining of the fracture callus and the newborn rat femur with an anti-ActRII antibody localized the receptor to osteoblasts at regions of membranous and endochondral bone formation. No staining of osteoblasts in fracture callus or bone was seen with an anti-ActRIIB antibody. These results provide strong evidence of the identification of the principal receptors through which activins could function in the skeletal system and further shed light on activin's mechanism of action in bone formation.

Gliostatin/platelet-derived endothelial cell growth factor as a clinical marker of rheumatoid arthritis and its regulation in fibroblast-like synoviocytes

The objective was to assess the congruity of gliostatin/platelet-derived endothelial cell growth factor (GLS PD-ECGF) with other clinical markers of rheumatoid arthritis (RA) and to define its molecular mechanism of action in the complicated cytokine network during RA pathogenesis. Immunoassay systems were used to quantify GLS or cytokine levels in laboratory and clinical samples. Expression levels of GLS were determined by reverse transcription-polymerase chain reaction methods. The GLS levels in synovial fluid were correlated with interleukin-1 (IL-1) and IL-8. The serial data of serum GLS levels reflected well changes in the disease activity during the clinical course of four representative patients with RA. In cultured fibroblast-like synoviocytes, tumour necrosis factor-alpha (TNF-alpha), IL-1, IL-6 and IL-8 induced GLS expression. In conclusion, our results suggest that the serum GLS level, mostly derived from cytokine-stimulated synoviocytes, was a useful clinical marker of RA.

Identification of a dual leucine zipper kinase involved in rat fracture repair

Complete cDNA sequence was obtained for a gene found to be expressed at a high level during fracture healing in the rat. Comparison of the amino acid sequence (deduced from the cDNA sequence) with known sequences showed 99% identity with mouse Dual Leucine Zipper Kinase (mDLK) and 96% identity with human Zipper Protein Kinase (hZPK). Relative quantitation by RT-PCR indicates abundant expression of this gene in cultured chondrocytes, growth plate and brain tissue. Further, regulated expression of this gene has been observed during fracture healing in rat femur fracture model; maximum gene expression in this model appears to coincide with chondrogenesis and bone formation. Since DLK has been shown to function in the mitogen activated signaling (MAP) pathway, these results provide the first evidence for the involvement of this signaling pathway in fracture healing.

Immunohistochemical study of c-erb B-2 expression in malignant mixed müllerian tumors of the female genital tract

OBJECTIVE

To study the expression of c-erb B-2 in gynecologic malignancies, especially in malignant mixed müllerian tumors (MMTs).

METHODS

Using immunohistochemical techniques, we examined 6 cases of primary MMT, 6 cases of leiomyosarcoma (LMS), 7 cases of endometrial adenocarcinomas, and 10 cases of normal endometria.

RESULTS

The expression of c-erb B-2 was observed in the carcinomatous area of all 6 cases of MMT (100%), the sarcomatous area of 5 of 6 cases of MMT (83.3%), in 1 of the 6 cases of LMS (16.7%), in all 7 cases of adenocarcinoma (100%), and in all cases of normal epithelial cells (100%), but was not observed in any of the cases of normal stromal cells (0%).

CONCLUSION

The results suggest that the carcinomatous and sarcomatous elements of MMT are similar in their expression of c-erb B-2. MMT differed immunohistochemically from pure sarcoma cells and normal stromal cells, but resembled pure carcinoma cells and normal epithelial cells of the female genital tract.

Changes in responses of wide dynamic range neurons in the spinal dorsal horn after dorsal root or dorsal root ganglion compression

STUDY DESIGN

The electrophysiologic responses of wide dynamic range neurons in the spinal dorsal horn by compression of the dorsal root or of the dorsal root ganglion were investigated.

OBJECTIVES

This study identified differences between the compression of the dorsal root against the compression of the dorsal root ganglion by examining the responses of wide dynamic range neurons.

SUMMARY OF BACKGROUND DATA

The wide dynamic range neurons studied were known to be excited by primary afferent fibers, not only combined A delta and C-nociceptive fibers but also low threshold mechanoreceptive A beta fibers and A delta fibers of down hairs. Thus, the wide dynamic range neurons are classified as nociceptive neurons.

METHODS

Extracellular activities of 32 wide dynamic range neurons were recorded from the laminae 4-6 of the seventh lumbar cord in anesthetized cats. A microvessel clip (40 g) was applied to compress the dorsal root or the dorsal root ganglion.

RESULTS

Dorsal root compression produced only an initial burst (about 10-40 seconds). Prolonged repetitive firings were rarely maintained. In contrast, dorsal root ganglion compression resulted in a maintained repetitive firing throughout the period of compression. After release of compression of the dorsal root and the dorsal root ganglion, responses to brushing were facilitated, and the low threshold center of the receptive field expanded.

CONCLUSIONS

These findings are consistent with the previous report that the radicular pain associated with a herniated intervertebral disc initially results from compression of the dorsal root ganglion.

Hyperthermia induces apoptosis in malignant fibrous histiocytoma cells in vitro

The effect of mild hyperthermia on a cultured rat malignant fibrous histiocytoma (MFH) cell line, MFH-2NR, was investigated. MFH cells in log-phase (growing phase) were heated at 41 degrees-44 degrees C for 1 hr. Hyperthermic treatment at 41 degrees C did not substantially affect cell proliferation and treatment at 44 degrees C caused necrosis. After hypothermic treatment at 42 degrees or 43 degrees C, proliferation of MFH cells was arrested and morphological changes characteristic of apoptosis, cell shrinkage accompanying apoptotic bodies and chromatin condensation, became apparent. Hyperthermia-induced apoptosis was further confirmed by terminal deoxynucleotidyl transferase staining and a ladder pattern on agarose gel electrophoresis. Flow cytometric analysis indicated that the population in the G1 phase of the cell cycle significantly decreased with a concomitant increase in apoptotic cells, indicating that apoptosis might occur mainly in the G1 phase population.

Liddle disease caused by a missense mutation of beta subunit of the epithelial sodium channel gene

Mutations in beta or gamma subunit of the epithelial sodium channel (ENaC) have been found to cause a hereditary form of human hypertension, Liddle syndrome. Most of the mutations reported are either nonsense mutations or frame shift mutations which would truncate the cytoplasmic carboxyl terminus of the beta or gamma subunits of the channel, suggesting that these domains are important for the normal regulation of this channel. We sequenced ENaC in a family with Liddle syndrome and found a missense mutation in beta subunit which predicts substitution of Tyr by His at codon 618, 2 bp downstream from a missense mutation (P616L) that has been reported recently. Presence of this mutation correlates with the clinical manifestations (hypertension, hypokalemia, suppressed aldosterone secretion) in this kindred. Functional expression studies in the Xenopus oocytes revealed constitutive activation of the Y618H mutant indistinguishable from that observed for the deletion mutant (R564stop) identified in the original pedigree of Liddle. Our data suggest that the region between Pro616 and Tyr618 is critically important for regulation of ENaC activity.

Quasi-steadiness approximation for the single-compartment urea kinetic model (SCUKM)

Using SCUKM, we constructed recurrence formulae expressing weekly pre- and post-dialysis urea levels. Then we mathematically derived simple methods to estimate Kt/V0 and the urea generation rate (G) per unit urea distribution space post-dialysis (V0), which only required the measurement of pre- (C) and post-dialytic blood urea concentrations (C0) of a single hemodialytic session (two-point method). Underlying fundamental assumptions were: (i) patients receive weekly scheduled hemodialysis; (ii) the ultrafiltration rate, intradialytic urea generation, interdialytic water increase rate, and residual renal function are small enough to be retained only as the leading term in the formulae. In the derivation, we proved relations: C = f(Kt/V0)G/V0, and C0 = g(Kt/V0)G/V0, which state that both C and C0 are directly proportional to G/V0, and that the proportional constants are functions of Kt/V0. Errors of the formulae were also checked to make the limitation of the approximations clear. The present formulae exactly reproduced Kt/V0 and G/V0 of virtual patients strictly obeying the SCUKM in a computer simulated model. Using the blood urea nitrogen concentration data of 20 actual patients, we compared our method with the usual three-point method and obtained substantial correlations between them (r = 1.00 for Kt/V0, r = 0.98 for G/V0). Finally, we proposed convenient and easily calculable new formulae, which give sufficiently accurate Kt/V0 and G/V0.

Dynamic regulation of striatal dopaminergic grafts during locomotor activity

The present experiment was designed to estimate the neurochemical activity of dopaminergic grafts in hemiparkinsonian model rats during locomotion and to examine the functional importance of dynamic regulation of the grafted neurons in the host brain. Rats were trained to run on a straight treadmill at various speeds (300, 660, 1200, 1800 cm/min), and extracellular dopamine (DA) and its metabolites, dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), were measured by in vivo microdialysis during and after running. Grafted rats were divided into two groups depending on their running ability and data were compared with those of normal and lesioned controls. Although the tonic level of extracellular DA in grafted rats recovered to 70% of control, levels of DOPAC and HVA remained 15-20% of controls. A small number of grafted rats showed full recovery in treadmill running tasks. In these animals, the percentage increase in DOPAC and HVA showed similar time courses and magnitudes as those in normal rats. Most grafted rats showed partial recovery in locomotor ability. The percentage increase in DOPAC and HVA in these animals remained at a lower level than that in normal rats, though the tonic levels of DA, DOPAC and HVA were not lower than those of fully recovered rats. Data suggest that grafted DAergic cells in functionally well recovered rats were dynamically regulated in the host brain in an actual behavior and that well-controlled release of DA might be involved in the recovery of complex motor behavior, such as high speed locomotion.

Adenocarcinoma arising from a mature cystic teratoma of the ovary: a case report of successful treatment with cisplatin-based chemotherapy

A case of mucin-producing adenocarcinoma arising from a mature cystic teratoma of the right ovary is reported in a 67-year-old multiparous Japanese woman. The patient underwent total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and adjuvant chemotherapy containing cisplatin, Adriamycin, and cyclophosphamide with the diagnosis of ovarian cancer, probable stage Ic. Treatment was successful even though the tumor extended through the cyst wall.

Effects of recombinant human erythropoietin and exercise training on exercise capacity in hemodialysis patients

The effects of recombinant human erythropoietin (rHuEPO) and exercise training on exercise capacity were evaluated in 20 hemodialysis patients. After improvement of anemia by rHuEPO (Phase I), patients were divided into 2 groups. Group 1, 10 patients, was placed in a 3-month exercise training program. Group 2, 10 patients, served as a control group (Phase 2). A symptom-limited exercise tolerance test was performed at the start of Phase 1 and before and after Phase 2. Hemoglobin (Hb) values were kept constant throughout Phase 2. In Phase 1, maximum workloads (62.0 +/- 19.1 to 76.5 +/- 25.6 W, p < 0.001), maximum O2 uptake (VO2max) (18.7 +/- 3.5 to 2.2 +/- 5.9 ml/min/kg, p < 0.01), and VO2 at anaerobic threshold (AT) (VO2AT) (8.5 +/- 2.1 to 10.2 +/- 2.9 ml/min/kg, p < 0.01) were all improved by rHuEPO. However, in Phase 2, despite unchanged Hb values and maximum workloads, VO2max (20.7 +/- 4.6 to 17.6 +/- 2.6 ml/min/kg, p < 0.05) and VO2AT (10.6 +/- 1.4 to 9.5 +/- 1.8, ml/min/kg p < 0.05) were decreased in Group 2. However, in Group 1, maximum workloads (66.7 +/- 8.2 to 81.7 +/- 7.5 W, p < 0.01) were improved, and VO2max and VO2AT were not decreased significantly in the same period. Exercise training in rHuEPO-treated hemodialysis patients resulted in an improved aerobic exercise capacity, whereas those without exercise training did not have increased capacity. Throughout the study, O2 uptakes were lower than those of nonrenal anemic patients who had similar Hb values. Maximum lactate values also remained low. In conclusion, improvement in the exercise capacity in hemodialysis patients treated with rHuEPO was minimal. Some defects were suggested in the aerobic energy production system in skeletal muscle of dialysis patients. Anemia-improved patients should participate in incremental physical activity to maintain an improved exercise capacity.

[Clinical features of epithelial ovarian cancer in young reproductive women]

A 10-year retrospective review of epithelial carcinoma of the ovary was performed about 95 patients which were diagnosed and treated at the Oita Medical University Hospital. The patients' ages at the first diagnosis ranged from 15 to 85 years with a mean of 51.6 years. Twenty-two of 95 patients (23.2%) were below the age of 40. Most patients analysed in this study complained of lower abdominal pain, lower abdominal mass, and/or lower abdominal fullness. Sixteen of 22 patients under the age of 40 (72.7%) and 27 of 73 patients over the age of 40 (37.0%) were diagnosed as having mucinous cystadenocarcinoma. The incidence of mucinous cystadenocarcinoma below the age of 40 was significantly higher than that over the age of 40 (p < 0.005, chi 2-test). Eleven patients below the age of 40 had FIGO stage Ia grade 1 disease and 2 of these patients were pregnant. The incidence of stage Ia disease under the age of 40 was significantly higher than that over the age of 40 (p < 0.005, chi 2-test). Both pregnant patients and 5 other patients with stage Ia disease were treated with only unilateral salpingo-oophorectomy. All patient with stage Ia disease had no evidence of recurrence within 5 years. This suggests that conservative surgery may be considered as the treatment for the FIGO stage Ia grade 1 ovarian cancer.

[Characterization of intraoperative rupture of epithelial ovarian cancer at early stage]

OBJECTIVE

To investigate whether intraoperative rupture of epithelial ovarian cancer. influences the prognosis.

METHODS

Between 1984 and 1994, 46 patients with stage Ia and Ic epithelial ovarian cancer were treated at Oita Medical University Hospital. Of 46 patients, 20 had stage Ia tumors, 16 stage Ic secondary to capsular invasion-serosal disease or positive ascites or washings (stage Ic-ascites), and 10 stage Ic secondary to intraoperative rupture (Ic-rupture). Survival analysis was performed to compare the three groups of patients.

RESULTS

The ages (mean +/- SD) of patients with stage Ia, Ic-ascites and Ic-rupture at the first diagnosis were 40.1 +/- 17.0, 47.6 +/- 13.4 and 52.8 +/- 15.7, respectively. The age of the stage Ia group tended to be lower than those of the Ic-ascites and Ic-rupture groups. At operation, ovarian tumors of all patients in the Ic-rupture group were firmly adhered to surrounding organs, had markedly thin weak cyst walls and were easily ruptured during operation. Fourteen of 20 patients in the Ia group (70%), 5 of 16 patients in the Ic-ascites group (31.3%) and 3 of 10 patients in the Ic-rupture group (30%) showed signs of mucinous cystadenocarcinoma. The incidence of mucinous cystadenocarcinoma in Ia group was significantly lower than in the Ic-ascites (p < 0.025, chi 2-test) and Ic-rupture (p < 0.05, chi 2-test) groups. The Kaplan-Meier survival plot for stage Ia, Ic-ascites and Ic-rupture patients revealed a probability of 5-year survival of 100%, 87.5% and 63.5%, respectively. The probability of 5-year survival in the Ic-rupture group tended to be lower than that in other groups.

CONCLUSIONS

The results of our study suggest that intraoperative rupture of a malignant ovarian cystic tumor may worsen the prognosis of patients with the FIGO stage I epithelial ovarian cancer.

Murine tumorlytic factor, immunologically distinct from tumor necrosis factor-alpha and -beta, induced in the serum of mice treated with a T-cell mitogen of Corynebacterium kutscheri

Murine tumorlytic factor (TF), immunologically distinct from murine tumor necrosis factor (TNF)-alpha and -beta, was purified to a homogeneity from the serum of mice injected with a T-cell mitogen of Corynebacterium kutscheri. The treated mouse serum was purified by Lentil lectin-Sepharose chromatography, DEAE-cellulose chromatography, preparative isoelectric focusing, and high-pressure liquid chromatography to the specific activity of 1.5 x 10(6) U/mg protein. TF was 42 kDa in its oligomeric form and 14 kDa in its monomeric form. TF activity was not impaired with hamster monoclonal antibody (mAb) to recombinant murine TNF-alpha and -beta and, reciprocally, rabbit antibody to TF neutralized the bioactivity of neither murine TNF-alpha nor -beta. TF was not precipitated with the mAb to murine TNF-alpha and -beta in Western blot analysis. The partial amino acid sequence of TF was at most 33% homologous to the 46-63 sequence of mouse TNF-beta. Thus, these results suggest that TF might be a novel tumorlytic factor which is immunologically distinct from mouse TNF-alpha and -beta.

Immunohistochemical study of c-erb B-2 protein expression in endometriosis

Using immunohistochemical techniques, we studied the expression of c-erb B-2 in normal human endometrial tissue (n = 8), endometriosis interna (adenomyosis) (n = 8) and endometriosis externa (endometriotic cyst of the ovary) (n = 6). The glandular epithelium of normal endometrial tissue specimens in the proliferative phase stained positively. Most of the cases of endometriosis studied showed no expression of c-erb B-2 in glandular epithelium. No expression was detected in either the normal or endometriotic stromal cells. Results suggest that c-erb B-2 is not significantly involved in the pathogenesis of endometriosis.

Periodic lateralized epileptiform discharges in EEG during recovery from hyponatremia: a case report

PLEDs were observed in a case of undifferentiated schizophrenia, transiently during the course of recovery from hyponatremia, and diffuse EEG slowing remained even after the serum sodium had returned to normal range. It was considered that PLEDs had occurred transiently in relation to hemispheric ischemic disturbance induced by hyponatremia. The characteristics of PLEDs associated with hyponatremia will need to be studied further in more patients with hyponatremia.

Aberrant production of gliostatin/platelet-derived endothelial cell growth factor in rheumatoid synovium

OBJECTIVE

To purify a protein inhibitor from rheumatoid arthritis (RA) synovial fluids which suppresses the apparent incorporation of 3H-thymidine into fibroblasts and synovial cells, and to define its biochemical features that have clinical relevance to the pathogenesis of RA.

METHODS

Several standard chromatographic techniques were employed for the purification of the protein. Immunochemical methods with monoclonal antibody were used to quantify and visualize the protein in sera, synovial fluids, and tissues from RA patients.

RESULTS

The chemical properties of purified inhibitor from RA synovial fluids confirmed its identity as gliostatin/platelet-derived endothelial cell growth factor (PD-ECGF), a potent angiogenic factor. The gliostatin/PD-ECGF level in synovial fluid and serum was higher in RA patients than in osteoarthritis controls.

CONCLUSION

These findings strongly suggest that gliostatin/PD-ECGF might play an important role in the aberrant neovascularization of rheumatoid synovium.

Transfer of protection to murine typhoid conferred by L-form Salmonella typhimurium in dependence of cooperation between L form-adopted macrophages and L form-induced Lyt-2+ T cells

The effector cells responsible for protection to Salmonella typhimurium in C3H/HeJ mice, conferred by L-form S. typhimurium, were determined by cell transfer test. Nonfractionated spleen cells from 6-week immune mice but not from 24-week immune animals transferred anti-S. typhimurium immunity. Treatment with anti-macrophage antiserum and complement most effectively abolished protective capacity in 6-week immune cells, while anti-T cell monoclonal antibody plus complement reduced it to a lesser extent. However, adoptive protection was achieved only by transfer of immune macrophages along with Lyt-2+ T cells selected from 6-week immune spleen cells. These Lyt-2+ T cells were cytotoxic to Kupffer cells from C3H/HeJ mice which had been infected 48 hr previously and from the mice which had been immunized 1 week previously, but not to the cells from 6-week immune mice and from normal animals. Moreover, protective capacity in immune macrophages seemed to be correlated to the degree of colonization by the L forms, and the inability to transfer immunity of 24-week immune spleen cells may be due to the decrease in the L form-colonization. These results suggest that cooperation between the L form-colonized macrophages and L form-induced cytotoxic Lyt-2+ T cells contributes to anti-S. typhimurium immunity, and might imply the immunological difference between the 6-week immune phagocytes and the cells at an early stage of infection or immunization.

Inhibition of histamine release from RBL-2H3 cells by protein synthesis inhibitors

Effects of cycloheximide, an inhibitor of protein synthesis, on histamine release from RBL-2H3 cells were examined. RBL-2H3 cells sensitized by rat antiserum to ascaris extract were challenged by the antigen, and histamine release during a period of 30 min was measured. Pretreatment with cycloheximide (1 microgram/ml) for 1 h significantly inhibited the antigen-induced histamine release (36% inhibition). The cycloheximide-induced inhibition of histamine release was abolished when the cells were further incubated in the absence of cycloheximide for 2 h. Pretreatment with puromycin (3 and 10 micrograms/ml), an inhibitor of protein synthesis, or actinomycin D (0.1-1 microgram/ml), an inhibitor of DNA-dependent RNA synthesis, also inhibited the antigen-induced histamine release in a concentration-dependent manner. Both ionomycin- and thapsigargin-induced histamine release were also inhibited by pretreatment with cycloheximide. Measurement of intracellular Ca2+ levels using quin 2 revealed that cycloheximide inhibits the increase in Ca2+ levels induced by the antigen, ionomycin or thapsigargin. These results suggest that histamine release induced by the antigen, ionomycin and thapsigargin in RBL-2H3 cells is mediated by protein(s) which is newly synthesized and inactivated rapidly, and the newly synthesized protein(s) is involved in the increase of intracellular Ca2+ levels induced by these stimulants.

Hormonal responses to head-out water immersion diminish after exposure to head-down tilt

It has been postulated that gravitational change from 1 g to microgravity may cause cephalad fluid shift, resulting in suppression of antidiuretic hormone (ADH) secretion and diuresis (Gauer-Henry's reflex). However, results obtained in space flights did not confirm this. Since astronauts are confined at supine position for hours before launch, this posture may abolish the reflex in space flight. To investigate this possibility, effects of head-out water immersion (WI) after 2-hour head-down tilt (HDT) on hormonal and metabolic responses were examined and compared with those after 1-hour upright posture (UP). Hematocrit decreased by WI after UP, indicating hemodilution, but it did not change by WI after HDT. Plasma ADH, renin activity and aldosterone fell and atrial natriuretic peptide (ANP) rose by WI after UP, resulting in increased urine flow. On the other hand, appreciable hormonal changes were not elicited by WI after HDT, and urine flow stayed unchanged. These results indicate that fluid shift and hormonal and metabolic responses to WI are strongly attenuated by the prior exposure to HDT. Pre-launch posture of astronauts may at least partly explain why either suppression of ADH or diuresis was not observed on arrival at space.

[Sex determination with a discriminant function analysis of deciduous teeth size in plaster models]

Plaster models of the teeth of 3-year-old Japanese children (96 males, 98 females) were used to record the crown length, crown width and crown thickness of 5 maxillary and 5 mandibular deciduous teeth (30 measurement values). These measurements were used to devise a number of sex determination formulae. A sex-determination formula using all 30 values was calculated. Furthermore, a number of practical formulae were derived from only the crown width and crown thickness values because the deciduous teeth wear in 4 years and older children rapidly progress, making the crown length measurement unreliable. These formulae were calculated for the maxillary teeth alone and mandibular teeth alone. The formulae based on only the crown width or thickness were also calculated for both maxillary and the mandibular teeth. A step-wise discriminant analysis was then used to ascertain the most reliable measurements and a practical formula subsequently devised. The results obtained were as follows: 1. The mean value for each measurement was greater in males than in females. 2. Significant differences in the values recorded were seen in 28 out of the 30 measurements taken. The measurement items not exhibiting these significant differences were the crown width of the maxillary lateral incisor and the crown thickness of the mandibular second molar. 3. The accuracy rates for the sex-determination analysis and the step-wise sex determination analysis calculated using all 30 values were 78.6% and 75.7%, respectively. 4. The accuracy ranges for the modified sex-determination formulae and the associated step-wise sex determination analyses were 70.6-78.4% and 67.0-76.8%, respectively.