Species differences in the reflex effects of lingual afferent nerve stimulation on lip blood flow and arterial pressure

We evoked changes in lower lip blood flow and systemic arterial blood pressure by electrically stimulating the central cut end of the lingual nerve in artificially ventilated, urethane-anesthetized, cervically vago-sympathectomized cats, rats, rabbits, and guinea pig. The systemic arterial blood pressure changes were species-dependent: increases in rat, consistent decreases in rabbit and guinea pig, and variable among individuals in cat. In cat and rabbit, lip blood flow increases, which occurred only ipsilaterally to the stimulated nerve and showed no statistically significant correlation with the systemic arterial blood pressure changes. In rat, the ipsilateral lip blood flow increase was markedly greater than the contralateral one, and although there was a significant correlation between each of them and the systemic arterial blood pressure changes, the ipsilateral increase presumably included an active vasodilatation. In guinea pig, lip blood flow decreased on both sides in proportion to the systemic arterial blood pressure reductions. Thus, species variability exists in the sympathetic-mediated systemic arterial blood pressure changes and parasympathetic-mediated lip blood flow responses themselves, and in the relationship between them.

[Castleman's disease of left interloblar lymph node; report of a case]

A 21-year-old man developed an abnormal shadow of left hilum of the lung, discovered in an annual X-ray examination. The tumor grew 3 times in size as large as it had been 1 year before. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a homogenous mass lesion at the left interloblar portion of the left lung. CT revealed that the left pulmonary artery was markedly compressed by the tumor of left hilum. Surgical operation was performed under usual thoracotomy. The ligation of the branches of the left bronchial artery before tumor resection was very helpful to control bleeding from the tumor. We showed that a tumor of Castleman's disease may be resected without lobectomy of the lung or further procedures.

Tubular morphogenesis by genotoxic therapeutic agents that induce NF-kappaB activation in human vascular endothelial cells

Angiogenic stimuli induce tubular morphogenesis and angiogenesis in vascular endothelial cells, but these cells are highly vulnerable to cytokines, oxidative stress, and genotoxic anticancer agents. A transcription factor, NF-kappaB, is involved in the protection against apoptosis and in angiogenesis in response to stimuli that could induce cell death. NF-kappaB was specifically activated by the genotoxic anticancer therapeutic agents etoposide and doxorubicin, but not by bleomycin, mitomycin C and cisplatin, in human vascular endothelial cells in three independent assay systems: nuclear translocation of NF-kappaB, binding of NF-kappaB to its consensus sequence, and NF-kappaB -dependent transcription. Exposure to etoposide and doxorubicin induced tubular morphogenesis by vascular endothelial cells in type I collagen gel at rates comparable to tumor necrosis factor-alpha. Co-administration of NF-kappaB antisense oligonucleotides inhibited the angiogenesis by doxorubicin and etoposide. In contrast, bleomycin, mitomycin C, and cisplatin did not induce angiogenesis. An angiogenic factor, interleukin 8, was dramatically induced in vascular endothelial cells treated with doxorubicin, but not in cells treated with cisplatin. Co-administration of anti-interleukin 8 antibody almost completely blocked the doxorubicin-induced angiogenesis in vitro, suggesting a paracrine/autocrine control through drug-induced angiogenic factor(s). The presence or absence of NF-kappaB activation may have an essential role in tubular morphogenesis by vascular endothelial cells during chemotherapeutic treatment, possibly through interleukin 8.

Small vessel vasculitis limited to pleuropulmonary manifestations, possibly induced by endotoxin

AIMS

We investigated a rare case of small vessel vasculitis (SVV) limited to pleuropulmonary manifestations, possibly induced by endotoxin, to determine the activation of immuno-mediated cells and endothelia in the pleuropulmonary circulation.

METHODS AND RESULTS

A 44-year-old man with a high fever was X-rayed, revealing bilateral pleural effusion and atelectasis in the chest. His laboratory data were within normal limits except for a high white blood cell count and a high C-reactive protein level. Autoantibodies including anti-neutrophil cytoplasmic antibody were negative. Endotoxin was detected in his sera, but repeated cultures of sputa, urine, blood and the pleural effusion were negative for bacteria. Video-assisted thoracic surgery was performed and lung and parietal pleura specimens were obtained. Histology showed arterioles or small arteries infiltrated by monocytes or neutrophils with fibrinoid necrosis and acute or chronic venulitis. A diagnosis of SVV in the lung and pleura was made. Immunohistochemistry revealed that interleukin (IL)-1beta was expressed in monocytes and vascular cell adhesion molecule (VCAM)-1 on endothelial cells in the vasculitic lesions in the lung.

CONCLUSIONS

Endotoxin possibly induced the inflammation in this apparently unique case of pleuropulmonary small vessel vasculitis. Immunohistochemistry revealed the expression of IL-1beta and VCAM-1 which may have caused activation of monocytes and endothelial cells within the vasculitic lesions.

Transcranial magnetic stimulation over the cerebellum evokes late potential in the soleus muscle

Transcranial magnetic stimulation (TMS) with a double cone coil placed over the left lateral side of the basal occiput was able to elicit late electromyographic (EMG) responses at the bilateral soleus muscles (SOL) averaged over 30 stimulation events, with a mean latency of approximately 100 ms. These EMG responses were detected using a low frequency bandpass filter with 0.05 Hz magnetic stimulation on ten healthy subjects in standing posture. As magnetic stimulation over the left basal occiput with a double cone coil can stimulate cerebellar structure, this late response seems to be conducted from the cerebellar structure to the SOL via an as yet unknown descending pathway. Here, we report new late EMG responses in relation to cerebellum or cerebellum related structures.

Centrally mediated reflex vasodilation in the gingiva induced by painful tooth-pulp stimulation in sympathectomized human subjects

This study was designed to determine whether painful electrical stimulation of the tooth pulp induces centrally mediated reflex vasomotor changes in human gingiva and whether the sympathetic nervous system is involved in the vasomotor responses. Dynamic changes in maxillary gingival blood flow (GBF) following painful electrical stimulation of the mandibular lateral incisor were investigated, by means of laser-Doppler flowmetry, in both healthy volunteers and patients undergoing sympathetic blockade for hyperhidrosis. Increases in GBF were observed in both healthy volunteers and patients on the ipsilateral side without an increase in systemic blood pressure, but the evoked GBF increase disappeared when pain sensation was abolished by local anesthetization with 2% xylocaine solution. The vasodilator responses did not differ in amplitude between before and after the sympathectomy. These results suggest that painful tooth stimulation evokes centrally mediated reflex vasodilation, presumably via parasympathetic efferent fibers, in the human gingiva and that sympathetic vasomotor mechanisms are not involved in these responses.

[Successful transection of racemose hemangioma of bronchial artery; report of a case]

A 52-year-old female was admitted to the hospital because of increasing hemoptysis for twenty years. Chest computed tomography (CT) on admission showed bronchoectasia with dilated bronchial arteries in the left lower lung field. Bronchial arteriogram showed racemose hemangioma of bronchial arteries draining to left lower pulmonary arteries. Transresection of bronchial artery and partial lung resection was performed. The cut surface of the resected specimen showed bronchoectasia with dilated bronchial arteries (8 mm in diameter). She is well 15 months following the treatment with no evidence of hemoptysis.

N-acetylgalactosaminyl transferase-3 is a potential new marker for non-small cell lung cancers

N-acetylgalactosaminyl transferase-3 (GalNAc-T3) is an enzyme involved in the initial glycosylation of mucin-type O-linked proteins. In the present study, we used immunohistochemistry to examine GalNAc-T3 expression in 215 surgically resected non-small cell lung cancers. We analysed the biological and clinical importance of GalNAc-T3 expression, especially with regard to its potential as a prognostic factor. We found that normal bronchial epithelial cells, bronchial gland cells, and alveolar pneumocytes showed cytoplasmic immunostaining for GalNAc-T3. Low expression of GalNAc-T3, observed in 93 of 215 tumours (43.4%), was found more frequently in tumours from smokers than those from nonsmokers (P=0.001), in squamous cell carcinomas than nonsquamous cell carcinomas (P<0.0001), and in moderately and poorly differentiated tumours than well differentiated tumours (P=0.0002). Multivariate logistic regression analysis showed that an association of low GalNAc-T3 expression with squamous cell carcinomas was the only one significant relationship of GalNAc-T3 expression with various factors (P<0.0001). Moreover, tumours losing GalNAc-T3 expression had a significantly higher Ki-67 labelling index than tumours retaining GalNAc-T3 expression (P=0.0003). Patients with low GalNAc-T3 expression survived a significantly shorter time than patients with high GalNAc-T3 expression in 103 pStage I non-small cell lung cancers (5-year survival rates, 58% and 78%, respectively; P=0.02 by log-rank test) as well as in 61 pStage I nonsquamous cell carcinomas (5-year survival rates, 63% and 85%, respectively; P=0.03). Low GalNAc-T3 expression was an unfavourable prognostic factor in pStage I non-small cell lung cancers (hazards ratio, 2.04; P=0.03), and in pStage I nonsquamous cell carcinomas (hazards ratio, 2.70; P=0.03). These results suggest that GalNAc-T3 is a new marker of non-small cell lung cancers with specificity for histology and prognosis.

Activation of the alternative complement pathway by Agaricus blazei Murill

Components of Agaricus blazei Murill have been demonstrated to have a wide range of immunopotentiating activities. The present study was designed to evaluate the effect of A. blazei Murill upon activation of the complement system in human serum in vitro. Additional studies were performed to determine the cytotoxic effect of complement-opsonized particles of A. blazei Murill against human tumor cells in culture. A fine particle of A. blazei Murill (ABP), prepared by mechanical disruption, was used throughout the experiments. ABP activated the human complement system via the alternative pathway in human serum. Activation of the alternative pathway was both time- and dose-dependent. When the particles from fruiting bodies of A. blazei Murill (ABP-F) were reacted with human serum, the formation of complement-opsonized ABP, iC3b-ABP-F complexes, and binding of the complexes to human peripheral blood monocytes, were demonstrated in vitro by immunofluorescence. Further, the resident human peripheral nucleated cells incubated in the presence of iC3b-ABP-F complexes inhibited the proliferation of human tumor cell line TPC-1 in vitro.

Sp1 is a key regulator of the PDGF beta-receptor transcription

The mouse PDGF beta-receptor promoter is tightly controlled by NF-Y that binds to a CCAAT box located upstream of the initiation site [1, 2]. In this report, we show that Sp1 plays an essential role in the PDGF beta-receptor transcription. Within the upstream GC rich area there are two Sp1 binding sites located in close proximity to the CCAAT box. Deletion of the GC rich region resulted in a 50% decrease of the transcriptional activity of the promoter, and a complete loss of its responsiveness to over-expression of Sp1. There was an additive effect between NF-Y and Sp I in reporter activity when they were co-transfected together with the promoter-reporter construct. Furthermore, transfection of NF-Y failed to enhance transcriptional activity when the Sp1 binding sites were deleted from the promoter, suggesting an important role for Sp1 in this NF-Y controlled transcription. We have recently reported that c-Myc represses PDGF beta-receptor transcription through its interference with the transactivation activity of NF-Y [3]. In the case of p21(wafl/cip1) transcription, c-Myc was shown to repress its transcription by sequestering Sp1 [4]. However, we could not find any effect of Sp1 in the c-Myc-mediated repression on the PFDGF beta-receptor promoter, since the deletion of SpI binding sites could not attenuate the repression by c-Myc on the promoter activity.

Dependence of pulpal blood-flow responses on baseline blood-flow in the cat

It has been shown earlier that electrical stimulation of the distal cut end of the inferior alveolar nerve (IAN) in the cat evokes three different patterns of pulpal blood-flow (PBF) response in the ipsilateral mandibular canine tooth (a decrease, a biphasic response, or an increase). The response to a given stimulus sometimes changed to another pattern even in one and the same experimental animal during the course of the experiment. It is known that the evoked decrease is due to activation of the sympathetics and that the increase is due to antidromic activation of sensory fibres; but, it is unknown why the response varies so much. It is hypothesised that the baseline blood-flow (BBF) modulates vasomotor responses in the dental pulp. To test this hypothesis, the effects of BBF on PBF responses elicited by the IAN stimulation mentioned above were investigated. Dynamic changes in PBF in cat mandibular canine teeth were elicited by electrical stimulation of the distal cut end of the IAN, at various BBF, with blood-flow monitored by laser Doppler flowmetry. The amplitude of the PBF vasodilator response increased as BBF was adjusted downwards (by cooling the tooth). In contrast, the amplitude of the PBF vasoconstrictor response increased as the BBF rose. Vasodilator responses could be transformed into vasoconstrictor responses, and vice versa, by alterations in the BBF. No systemic blood-pressure changes were elicited throughout the experiment. These results indicate that a consideration of baseline vascular tone is important, whenever the size of PBF responses to various stimuli is discussed or calculated.

[Activities of thymidylate synthase and dihydropyrimidine dehydrogenase in patients with colorectal cancer]

Between 1998 and 2001, 82 colorectal cancers were resected in our hospital. The activities of TS and DPD were evaluated. TS activities in tumor tissues were significantly higher than in normal tissue, but the DPD activities had no significant difference between them. TS and DPD showed a correlation between normal and tumor tissues in stage III or IV patients. The TS value of patients with recurrence tended to be higher than that of patients with no recurrence. Especially in stage I or II patients with recurrence, who were administered 5-FU before recurrence, the TS value was significantly higher than in non-treated patients. In stage III or IV patients, it was considered that DPD prevention was important for 5-FU to effectively prevent TS. The TS value might be a new prospective risk factor for recurrence. Moreover, TS and DPD would be the index of biological malignancy.

Effects of a beta-adrenergic blocking agent timolol on intra ocular pressure responses induced by stimulation of cervical sympathetic nerve in the cat

We clarified whether the intraocular pressure (IOP) response elicited by stimulation of the cervical sympathetic nerve (CSN) is influenced by changes in the baseline of IOP level and by beta-adrenergic blockade. The CSN was stimulated electrically for 30 seconds (10 V, 0.1-100 Hz, 2 milliseconds pulse duration) in urethane (100 mg/kg i.v.)-chloralose (50 mg/kg i.v.)-anesthetized, paralyzed cats. The IOP was monitored manometrically, and a controlled saline infusion was delivered into the anterior chamber to gradually increase IOP. CSN stimulation was delivered at the various baseline IOP levels so obtained. When required, a beta-adrenergic blocker timolol (2%) was delivered into the conjunctival cul-de-sac. The normal IOP in our cats was 25+/-3 mmHg. This value decreased transiently on CSN stimulation. The amplitude of this IOP response depended on stimulus frequency and the pre-stimulus baseline IOP level. Topical administration of timolol increased the IOP response to CSN stimulation at a given baseline level. These results suggest that beta-adrenergic blockade increases the alpha-adrenergic mediated-IOP reduction elicited by CSN stimulation at given baseline IOP level.

A formula based on body length for determining the size of an uncuffed endotracheal tube for pediatric cardiac anesthesia

Three hundred and thirty-four pediatric patients less than 4 years old who underwent surgery for congenital heart disease were retrospectively studied to devise a practical formula for predicting the appropriate size for an uncuffed endotracheal tube for pediatric cardiac anesthesia. Furthermore, this formula was compared with that for non-cardiac anesthesia obtained from 409 patients without congenital heart disease. A simple regression equation between tube size and body length resulted in the simple predictive formula: "tube size = 0.04 x body length + 1.6" for pediatric cardiac anesthesia. This formula had the same slope and an approximately 0.3 mm larger intercept on the Y-axis compared with that for pediatric non-cardiac anesthesia. Therefore, a one-size larger endotracheal tube is more suitable for use in pediatric cardiac anesthesia than in pediatric non-cardiac anesthesia for the same body length.

Efficacy of postinfection treatment with anti-Shiga toxin (Stx) 2 humanized monoclonal antibody TMA-15 in mice lethally challenged with Stx-producing Escherichia coli

Infection with Shiga toxin (Stx)-producing Escherichia coli (STEC) causes hemorrhagic colitis and hemolytic uremic syndrome. TMA-15 is a humanized monoclonal antibody against Stx2, a major pathogenic factor. In a mouse infection model that used B2F1, a virulent STEC strain, the efficacy of TMA-15 was assessed when it was administered after bacterial and toxin exposure. In this model, a time-course analysis of the serum Stx2 level showed that the toxin was detectable from 24 h after infection. In an evaluation of the time-dependent efficacy, treatment with TMA-15 up to 24 h after infection ameliorated the lethal challenge, although treatment at 48 h showed no efficacy. To determine the effective dose, escalating doses were administered at 24 h after infection. The number of mice that survived after doses of 0, 0.25, 0.5, 1.0, and 2.0 mg/kg were 0/20, 11/20, 17/20, 20/20, and 20/20, respectively. These findings suggest that TMA-15 shows potential for prevention of severe complications associated with STEC infection.

Elevated expression of vacuolar proton pump genes and cellular PH in cisplatin resistance

V-ATPases are proton-translocating enzymes, which are found not only in numerous intracellular organelles but also in the plasma membranes of many eukaryotic cells. Using differential display, we have identified one of the proton pump subunit genes, ATP6C, as a cisplatin-inducible gene. Northern blot analysis demonstrated that expression of other members of the subunit is inducible by cisplatin treatment. Proton pump gene expression is also upregulated in 3 independent cisplatin-resistant cell lines but not in vincristine- or etoposide-resistant cell lines. Cellular pH was significantly higher in cisplatin-resistant cells than in sensitive parental cells. In vitro DNA-binding activity of cisplatin was markedly increased in acidic conditions, suggesting that the cytotoxicity of cisplatin is modulated by cellular pH. Furthermore, the proton pump inhibitor bafilomycin can synergistically potentiate the cytotoxicity of cisplatin but not of etoposide or camptothecin. These results indicate that cellular pH is one of the critical parameters for effective cancer chemotherapy with cisplatin.

[A case of mediastinal esophago-bronchogenic cyst associated with high serum level of CA 19-9]

We report a case of mediastinal esophago-bronchogenic cyst in a patient with a high serum level of CA 19-9. A 49-year-old man presented with a complaint of dysphagia. Chest X-ray, CT, and MRI showed posterior mediastinal cystic shadow which was diagnosed preoperatively. The serum level of CA 19-9 was 158 U/ml. We underwent extirpation of the cyst through video-assisted thoracoscopic surgery (VATS) and confirmed to be a bronchogenic cyst histologically. The serum level of CA 19-9 returned to normal after the operation.

Right internal jugular vein venography in infants and children

We obtained venograms of the right internal jugular vein (RIJV) in 105 infants and children with congenital heart disease during cardiac catheterization. No major anomalies were found in the course of the RIJV. The diameter of the RIJV tended to increase with the patient's age, weight, and height. However, some disproportionately small vessels were seen in 8% of the patients. The depth from the skin to the RIJV varied from 2.5 to 20 mm and did not significantly correlate with age, weight, or height. Confirmation of the diameter or the depth of the RIJV by venography may facilitate clinical decisions and may be useful for performing percutaneous cannulation.

IMPLICATIONS

We obtained venograms of the right internal jugular vein in children with congenital heart disease. Generally, the diameter increased with the patient's body size, but disproportionately small vessels were seen in 8% of the patients. Preoperative internal jugular venography may facilitate identifying those patients.

Facial palsy associated with mumps parotitis

Peripheral facial nerve paralysis is relatively common in the pediatric age group. However, facial palsy rarely has been documented in patients with mumps parotitis. This case report describes the findings of a 3-year-old Japanese boy who developed facial palsy immediately after mumps parotitis. This work calls attention to a possible association between mumps parotitis and facial palsy.

Spontaneous labor increases nitric oxide synthesis during the early neonatal period

BACKGROUND

This paper aimed to assess the influence of spontaneous labor upon endogenous nitric oxide (NO) and endothelin 1 (ET-1) during transition to extrauterine life.

METHODS

The serum levels of NO metabolites (the sum of nitrites and nitrates (NOx)) and the plasma level of ET-1 were determined in 53 healthy full-term infants (spontaneous labor group; n=40, cesarean delivery group; n=13). In both groups, blood samples were obtained from a cord vein at birth and from a peripheral vein at 5 days of age.

RESULTS

The differences in serum NOx concentrations between the spontaneous labor group and the elective cesarean group were not significant at birth. By the age of 5 days, serum NOx concentrations had risen significantly in the spontaneous labor group to become significantly higher in the elective cesarean group.

CONCLUSION

It is speculated that spontaneous labor might enhance endogenous NO synthesis at 5 days of age.

Epidermal growth factor receptor overexpression and genetic aberrations in metastatic squamous-cell carcinoma of the skin

BACKGROUND

Cutaneous squamous-cell carcinoma (SCC) sometimes causes lymph node metastasis and results in poor prognosis. However, little is known about cytogenetic alterations underlying tumor progression or metastasis. The aim of the present study was to investigate the genetic aberrations and expression of epidermal growth factor receptor (EGFR) in metastatic SCC of the skin.

METHODS

We undertook comparative genomic hybridization (CGH) analysis of 4 specimens which were obtained from a case of cutaneous SCC, including the primary lesion and 3 lymph nodes of the metastatic lesion.

RESULTS

Only one amplified locus (7p12-13) was detected in any metastatic lymph node, in which the EGFR gene is located. Therefore, we applied immunohistochemistry for EGFR to 5 cases of metastatic SCC including the case analyzed using CGH and 4 other cases (5 primary and 5 metastatic lesions). EGFR was expressed in 4 of 5 cases (both primary and metastatic lesions, including the case analyzed using CGH), and the staining patterns of primary and metastatic lesions were different. The primary tumors were focally weakly positive for immunostaining (+), whereas the 4 metastases were diffusely and strongly positive (+++).

CONCLUSIONS

Our findings suggest that the clone with EGFR expression might selectively metastasize in some cutaneous SCCs. The existence of an EGFR-negative case reveals that EGFR expression is not always required for skin carcinogenesis, but expression of EGFR might confer metastatic potential of cutaneous SCCs.

Current efficacy of postexposure prophylaxis against measles with immunoglobulin

We assessed results after postexposure prophylaxis against measles with immunoglobulin administered intramuscularly. Children were given 0.33 mL/kg of immunoglobulin from commercially available lots containing various titers of measles antibody within 5 days after exposure. In children receiving immunoglobulin with a titer of < or =16 IU/mL, 57% had clinically evident measles. Immunoglobulin preparations with higher measles antibody titers are required.

Mechanism for the transcriptional repression by c-Myc on PDGF (β)-receptor

c-Myc plays a key role in the cell cycle dependent control of the PDGF (β)-receptor mRNA. The mouse platelet-derived growth factor (PDGF) (β)-receptor promoter contains a CCAAT motif, and NF-Y plays an essential role in its transcription. Coexpression of c-Myc represses PDGF (β)-receptor luciferase reporter activity, and the CCAAT motif in the promoter is indispensable for this repression. Here we show that c-Myc binds NF-Y subunits, YB and YC, by immunoprecipitation from cotransfected COS-1 cells. The in vitro-translated c-Myc also binds the glutathione S-transferase (GST)-NF-YB fusion protein and GST-NF-YC, but not GST-NF-YA. The most C-terminal region of HAP domains of NF-YB and NF-YC, and the Myc homology boxes, but not the C-terminal bHLHZip domain, are indispensable for the coimmunoprecipitation, and also for the repression of PDGF (β)-receptor. c-Myc binds NF-Y complex without affecting the efficiency of NF-Y binding to DNA. However, the expression of Myc represses the transcriptional activation of NF-YC when fused to the GAL4 DNA binding domain. Furthermore, this repression was seen only when Myc homology boxes are present, and NF-YC contains the c-Myc binding region.