Guide wire-induced coronary artery spasm during percutaneous transluminal coronary angioplasty. A case report

Coronary artery spasm induced by a guide wire is a very rare complication of percutaneous transluminal coronary angioplasty (PTCA). The authors describe a patient who developed coronary vasoconstriction distal to the dilated lesion during PTCA, which was refractory to intracoronary nitroglycerin and intravenous calcium antagonist injection and balloon angioplasty but responded promptly and completely to withdrawal of the guide wire from the coronary artery, suggesting that the spasm had been induced by the guide wire.

Vasospastic angina after chemotherapy by with carboplatin and etoposide in a patient with lung cancer

We report here a case of vasospastic angina following the administration of Carboplatin (CBDCA) and Etoposide (VP-16) in a patient with small cell lung carcinoma. Although these drugs are commonly used to treat small cell lung carcinoma, there has been no previous report of vasospastic angina in a patient without a history of heart disease. Therefore, we should be aware of the possibility that vasospastic angina may develop even in a patient without any history of heart disease. While calcium antagonist and isosorbide dinitrate are generally helpful for preventing vasospastic angina, these drugs could not completely suppress vasospastic angina in this case.

Transfection of wild-type TP53 induces differentiation in human gingival carcinoma cells

We investigated the effects of transfection of wild-type TP53 on the growth properties of a human gingival carcinoma cell line, KOSC-3, in which the TP53 gene is mutated at codon 248 and overexpressed. The wild-type TP53 expression plasmid, pCDM8-p53/neo and the control plasmid, pCDM8/neo, were each stably transfected into KOSC-3 cells by using the calcium phosphate method. The number of G418-resistant colonies from wild-type TP53-transfected cells was approximately half that from plasmid controls. Exogenous wild-type TP53 transcripts were identified in four of the 20 G418-resistant clones analysed by reverse transcription PCR. Although the growth rates of the wild-type TP53+ clones did not drastically change during log phase, their saturation density was significantly reduced. The wild-type TP53+ cells were morphologically flat and enlarged when cultured in vitro, and were less able to form colonies in soft agar. In nude mice, the wild-type TP53+ clones formed subcutaneous tumours with conspicuous keratinisation and notable cell death that was not manifested in the parental and plasmid control cells. These findings indicate that the wild-type TP53 gene, even when it coexists with a mutated form, may function as a growth suppressor and differentiation inducer under restricted conditions in gingival squamous cell carcinoma.

[Accessory scrotum with lipoma: a case report]

A newborn male infant was referred to our clinic because of anomalies of external genitalia. The infant was born at term after a normal pregnancy and delivery, and was appropriate for gestational age. A tumor mass covered with scrotum-like skin on its tip was noticed in the right side of perineum between the scrotum and anus. The raphe, which ran along the midline at the penis and the normal scrotum, circumscribed the right side of this structure. Both testes had descended into the scrotum. The condition was associated with incomplete penoscrotal transposition. There was no other urological anomaly including lower urinary tract. Histological findings of the tumor indicated perineal lipoma, and the scrotum-like portion was diagnosed as an accessory scrotum. Thirty-one report cases of the accessory scrotum including our own were reviewed and discussed.

Dipyridamole enhances interleukin-1beta-stimulated nitric oxide production by cultured rat vascular smooth muscle cells

We examined whether dipyridamole affected interleukin-1beta-stimulated nitric oxide (NO) production by cultured rat vascular smooth muscle cells. Interleukin-1beta stimulated the production of nitrite and nitrate, stable metabolites of NO, in a dose- and time-dependent manner in vascular smooth muscle cells. Dipyridamole (1-100 mu M) enhanced interleukin-1beta-induced nitrite production in a dose- and time-dependent manner. The mRNA expression of inducible NO synthase was up-regulated by dipyridamole (0.3-10 mu M) treatment in a dose-dependent manner. Both 8-bromo-guanosine 3',5'-cyclic monophosphate (8-bromo-cGMP) and dibutyryl adenosine 3',5'-cyclic monophosphate (db-cAMP) enhanced the nitrite production in the presence of interleukin-1beta. Dipyridamole up-regulated the effect of both 8-bromo-cGMP and db-cAMP on the interleukin-1beta-induced nitrite production. Dipyridamole increased the intracellular cAMP content in the presence of interleukin-1beta (10 ng/ml), but did not affect the intracellular cGMP content. 8R*,9S*,11S*-(-)-9-hydroxy-9-n-hexyloxy-8-methyl-2,3,9,10- tetrahydro-8,11-epoxy-1H,8H,11H-2,7b,11a-triazadibenzo-(a,g)-cy cloocta ++-(c,d,e)-trinden-1-one (KT 5720), a selective inhibitor of cAMP-dependent protein kinase, abolished the enhancement of interleukin-1beta-induced nitrite production by dipyridamole, whereas 8R*,9S*,11S*-(-)-9-methoxy-carbamyl-8-methyl-2,3,9,10-tetrahydro-8,11-ep oxy-1H,8H,11H-2,7b,11a-trizadibenzo-(a,g)-cyclo-octa-(c,d,e)-tr inden-1-one (KT 5823), an inhibitor of cGMP-dependent protein kinase, did not attenuate the enhancement. Furthermore, Rolipram and 4-(3-butoxy-4-methoxybenzyl)-2-imidazolidinone (Ro-20-1724), cAMP-specific phosphodiesterase type IV inhibitors, augmented the interleukin-1beta-induced nitrite production. We concluded that dipyridamole enhanced the interleukin-1beta-induced NO production via an increase in intracellular cAMP content in cultured rat vascular smooth muscle cells.

Characteristics of the insulin resistance syndrome in a Japanese population. The Jichi Medical School Cohort Study

We investigated the relationships between hyperinsulinemia (a major indicator of the insulin resistance syndrome), blood pressure, dyslipidemia, and coagulation factors in 2606 community-dwelling Japanese individuals as part of the Jichi Medical School Cohort Study. An age-related decrease of the fasting insulin level was found in men but not in women. Body mass index, systolic and diastolic blood pressure, triglyceride and fasting glucose levels, and factor VII activity all increased in both sexes as the insulin level became higher, while the HDL cholesterol level decreased. In addition, total cholesterol and LDL cholesterol levels increased as the insulin level became higher and lipoprotein(a) levels decreased in the men. Fibrinogen levels were not related to the insulin level in either sex. Multiple logistic regression analysis revealed that fasting insulin levels were positively correlated with body mass index and fasting glucose and factor VII activity levels, whereas they were negatively correlated with HDL cholesterol in both sexes. In addition, fasting insulin levels were positively correlated with LDL cholesterol levels in men and with triglyceride levels in women. Our results indicate that hyperinsulinemia is associated with high factor VII activity in a general Japanese population as well as with high blood pressure and dyslipidemia. The accumulation of these cardiovascular risk factors in hyperinsulinemic subjects appears to contribute to cardiovascular events in the Japanese as well as in westerners.

Regulation of ICAM-1 expression by inflammatory cytokines in rat mesangial cells

We investigated the regulation of intercellular adhesion molecule 1 (ICAM-1) expression by the inflammatory cytokines interleukin 1 beta (IL-1), IL-6 and IL-8 in rat mesangial cells by enzyme-linked immunosorbent assay, flow cytometry and Northern blot analyses. ICAM-1 expression on mesangial cells was stimulated significantly by IL-1 beta, but not by IL-6 nor IL-8, in a dose-dependent manner. Levels of ICAM-1 mRNA were very low in unstimulated mesangial cells, while its expression was markedly induced by exposure to IL-1 beta for 3 h. IL-6 and IL-8 showed no effect on ICAM-1 mRNA accumulation. These results demonstrate that IL-1 beta, but not IL-6 nor IL-8, induces ICAM-1 mRNA and protein accumulation in rat mesangial cells.

Isolation and characterization of retinoic acid-inducible cDNA clones in F9 cells: a novel cDNA family encodes cell surface proteins sharing partial homology with MHC class I molecules

Rae-1 cDNA is one of the retinoic acid (RA) inducible cDNA clones in mouse embryonal carcinoma F9 cells. Rae-1 mRNAs were detected in mouse early embryos, but not in various tissues of adult mice. RAE-1 protein apparently consists of 253 amino acids and is likely to be a glycoprotein consisting of a leader sequence, an extracellular domain, a serine, threonine, proline-rich domain, and a transmembrane domain. Interestingly, it has a weak, but significant homology with major histocompatibility complex (MHC) class I molecules and was immunocytochemically identified as a cell surface protein. By determining partial nucleotide sequences of 17 Rae-1 cDNAs isolated from the RA-induced F9 cells, at least three different kinds of Rae-1 cDNAs were identified and were named Rae-1 alpha, Rae-1 beta, and Rae-1 gamma cDNAs, respectively. As the overall nucleotide sequence homology among these three cDNAs was about 98%, they constitute a novel gene family which is likely to be involved in early mammalian embryogenesis.

Morphology of the lateral ligament in the human temporomandibular joint

The morphology of the lateral ligament of the human temporomandibular joint is of two types: ligamentous and without distinct structure. Under the scanning electron microscope, a sheath-like structure that contained bundles of collagen was mainly found in the posterior region of the lateral ligament. Analysis of macromolecular components revealed that type III collagen was mainly present on the collagenous framework of the sheath-like structure. Type I collagen, laminin, and tenascin were found in the framework of the sheath-like structure. Supported collagenous bundles and the distribution of macromolecular components might be related to the stability of the temporomandibular joint. The sheath-like structure and other components of the lateral ligaments store energy and protect the capsule from stress and tension during movements of the jaw.

l-Menthol, oleic acid and lauricidin in absorption enhancement of free and sodium salt of diclofenac using ethanol treated silicone membrane as model for skin

The mechanism of l-menthol, oleic acid and lauricidin as enhancers on percutaneous absorption was examined using diclofenac (DH) as a hydrophobic drug and sodium diclofenac (DNa) as a hydrophilic drug in in vitro diffusion experiments with two kinds of membranes: ethanol-treated and untreated silicone membranes; these were models for the lipid and pore pathways of skin. A 20% w/w ethanol-aqueous solution decreased the flux of DH but increased the flux of DNa significantly across the treated membrane compared with those fluxes across the untreated membrane, suggesting that DH penetrated by the lipid pathway and DNa by the pore pathway. The permeability of DNa through the pore pathway decreased significantly across the treated membrane with the addition of oleic acid and lauricidin. l-Menthol increased the permeability coefficients of DH and DNa more in a treated membrane than in an untreated one, showing the same tendency as in rat skin. Thus, while oleic acid and lauricidin did not increase the permeation of DNa by the pore pathway, l-menthol appeared to enhance the permeation of the drug by both the lipid and pore pathways.

Establishment of a hepatocyte cell line producing growth-promoting factors for liver-colonizing tumor cells

A hepatocyte-derived cell line designated MLE-15A2 was established from a primary culture of mouse hepatocytes. The MLE-15A2 cells appeared to retain the basic nature of hepatocytes in that they showed morphology of an epithelial cell type and secreted albumin into the culture medium. These cells were grown on collagen-coated plates and could be easily expanded to a large-scale culture. Therefore, MLE-15A2 cells may provide a more useful model for studying liver microenvironments than primary cultures of hepatocytes. We found that conditioned media from MLE-15A2 cells, as well as from primary cultures of hepatocytes, promoted the proliferation of highly liver-colonizing colon 26 NL-17 cells better than the poorly liver-colonizing colon 26 NL-4 cells. Moreover, the conditioned media stimulated the growth of some human colon cancer cell lines. These results indicate that MLE-15A2 cells secrete growth factors that selectively stimulate certain tumor cell types. Hepatocyte-derived growth factors may regulate selective survival and colonization of tumor cells in the process of liver metastasis. The growth-promoting activity was unaffected by dialysis, was stable at 80 degrees C for 30 minutes and was bound to a heparin-Sepharose column. The major activity was eluted from the column with 0.7-0.75 M NaCl, and some minor activities eluted with lower concentrations of NaCl. These results suggest that the active components are heterogeneous heparin-binding proteins with lower affinity to heparin than platelet-derived and fibroblast growth factors.

Effect of aging from infancy to childhood on flow velocity patterns of pulmonary vein by Doppler echocardiography

This study demonstrated the age-related changes in pulmonary venous flow velocities during 36 months of life. These results suggest that age-related changes in the D and S wave reflect the maturational or developmental alterations in both LV and left atrial diastolic properties, especially during the relaxation process.

[Assessment of clinical utility of 111In-DTPA-IgG scintigraphy in the detection of inflammation/infection--a report of multicenter phase II clinical trials]

A Phase II clinical study was performed in patients with strongly suspected focal sites of inflammation/infection to investigate clinical utility of 111In-DTPA-IgG. Neither adverse effects nor abnormal laboratory changes were noted in the all cases. Out of 59 patients, the clinical utility was evaluated in 56 patients with a total of 67 suspicious sites (19 in thorax, 13 in abdomen and pelvis, 30 in musculoskeletal system, and 5 in other regions). True positive results were obtained in 100% of lesions in the thorax (13/13) and the musculoskeletal system (26/26). There were three false negative and five false positive results. Overall sensitivity and specificity was 94.0% and 70.6%, respectively. Most of the true positive scintigram with the best image quality was acquired at Day 1 or Day 2 post-injection. A dose of 80 MBq was considered to be a practical dose for imaging. Our study indicates that 111In-DTPA-IgG is a safe and promising imaging agent for the detection of inflammation/infection, and that it is reasonable to proceed with Phase III studies to further evaluate clinical utility of the agent.

Human endothelin converting enzyme gene (ECE1) mapped to chromosomal region 1p36.1

The chromosomal localization of the human endothelin converting enzyme gene (ECE1) has been identified. Southern blot analysis of human genomic DNA from human x mouse somatic cell hybrids demonstrated that ECE1 maps to chromosome 1. Fluorescence in situ hybridization of a digoxigenin-labeled human ECE1 probe to normal human metaphase chromosomes showed that the gene is located within chromosome band 1p36.1.

Whole saliva dried on filter paper or diagnosis of HIV-1 infection by detection of antibody IgG to HIV-1 with ultrasensitive enzyme immunoassay using recombinant reverse transcriptase as antigen

Whole saliva samples collected from HIV-1 seropositive subjects by simple spitting without using any devices were dried on filter paper strips, from which filter paper discs of 3-mm diameter were punched out. The eluates of the discs were subjected to the immune complex transfer enzyme immunoassay for antibody IgG to HIV-1 using recombinant reverse transcriptase of HIV-1 as antigen and a two-site enzyme immunoassay for whole IgG. The signals for antibody IgG to HIV-1 and the amounts of whole IgG obtained with one disc per assay tube were 126-290% of those obtained with 1 microliter of whole saliva samples, provided that filter paper strips were treated with nonspecific rabbit serum prior to drying whole saliva samples and that filter paper discs were tested within a few days after drying whole saliva samples. From these results, diagnosis of HIV-1 infection was indicated to be possible with whole saliva samples dried on filter papers, since the diagnosis was previously shown to be possible with 1 microliter of whole saliva samples. The test for HIV-1 infection with whole saliva samples dried on filter papers was suggested to be useful for various purposes.

Nocturnal fall of blood pressure and silent cerebrovascular damage in elderly hypertensive patients. Advanced silent cerebrovascular damage in extreme dippers

To study the relation between diurnal blood pressure variations and silent cerebrovascular damage, we performed both 24-hour ambulatory blood pressure monitoring and brain magnetic resonance imaging in 131 elderly asymptomatic hypertensive patients. Silent cerebrovascular damage was identified by the magnetic resonance imaging findings of lacunae (low intensity in T1-weighted images and high intensity in T2-weighted images) and advanced periventricular hyperintense lesions (on T2-weighted images). The frequency of silent cerebrovascular damage in the 100 patients with sustained hypertension was greater than that in the 31 patients with white coat hypertension. We further classified the former group into nondippers (nocturnal reduction of systolic pressure by < 10% of awake systolic pressure; n = 46), dippers (reduction by > or = 10% to < 20%; n = 38), and extreme dippers (reduction by > or = 20%; n = 16). The extent of silent cerebrovascular damage was least severe in the dipper group (P < .05). This J-shaped relation was not found either with the cardiac hypertrophy detected by electrocardiography or with the renal damage assessed by urinary albumin excretion. More than half of the extreme dippers were patients with isolated systolic hypertension, and this prevalence was significantly greater than that in dippers or in nondippers (21% and 30%, respectively). Extreme dippers also had greater variability of pressure (standard deviation of awake systolic pressure) than dippers. Our results indicate that in addition to nondipping, extreme dipping (marked nocturnal fall of blood pressure) should be considered a type of abnormal diurnal blood pressure variation in elderly patients with hypertension who are likely to have advanced silent cerebrovascular damage.

A replacement vector used to introduce subtle mutations into mouse genes

A replacement vector convenient for introducing subtle mutations into various mouse genes has been developed using, a model system, the mouse transthyretin-encoding gene (ttr) and mouse embryonal carcinoma F9 cells. The vector consists of part of ttr carrying a subtle mutation in its second exon, and a cassette of the neomycin-resistance (neo)- and herpes simplex virus thymidine kinase (HSV-tk)-encoding genes flanked with a 3-kb duplication of mostly the second intron of ttr. In the first step ('replacement'), part of the endogenous ttr was replaced by vector DNA via homologous recombination, and two such clones, #33 and #77, were isolated from 185 G418-resistant clones by allele-specific PCR. In the second step ('excision'), gancyclovir-resistant colonies were screened, and 7 and 84% of those isolated from clones #33 and #77, respectively, were demonstrated to carry the subtle mutation in ttr, without the cassette of selection markers. In five independently isolated random integrants of the same vector DNA, the cassette of selection markers was excised efficiently by recombination within the duplication.

KatG sequence deletion is not the major cause of isoniazid resistance in Japanese and Yemeni Mycobacterium tuberculosis isolates

One of the mechanisms of isoniazid resistance to Mycobacterium tuberculosis has been proved to be the chromosomal deletion of katG. Based on this finding, 22 isoniazid-resistant isolates of M. tuberculosis obtained in Japan and Yemen were analysed for katG by polymerase chain reaction and catalase activity. Only six (27%) of the 22 isolates were compatible with the mechanism (lack of amplification of katG and loss of catalase activity). In contrast, eight isolates (36%) were katG positive but catalase activity-negative and eight (36%) were positive for both factors, indicating that isoniazid resistance is multifactorial and the deletion of katG was not the major cause of resistance in the isolates examined in this study.

Inflammatory cytokines and rat vascular tone

1. Experiments were performed to examine the effect of inflammatory cytokines, interleukin-2 (IL-2), IL-6 and IL-8, on the contractility of rat aorta. 2. Pretreatment of the endothelium-denuded aortic ring with IL-6 for 3 h caused a significant inhibition of its contraction (58.9 +/- 7.8%, n = 9, P < 0.01) when induced by 10(-6) mol/L phenylephrine. 3. On the other hand, IL-2 and IL-8 failed to show significant effects on the contractility of the aorta. 4. This inhibitory effect of IL-6 on phenylephrine-induced contraction showed dose-dependency, and completely disappeared in the presence of 10(-5) mol/L indomethacin. 5. In cultured rat vascular smooth muscle cells (VSMC), the release of 6-keto-prostaglandin F1alpha into the extracellular medium was significantly increased by exposure to IL-6, but not by exposure to IL-2 or IL-8. 6. IL-2, IL-6 and IL-8 showed no effects on the release of nitrite, a stable metabolite of nitric oxide (NO), from VSMC. 7. These results indicate that IL-6, not IL-2 or IL-8, is a potent inhibitor of the alpha-adrenergic-stimulated contraction of vascular smooth muscle and its action is mediated by the increased synthesis of prostacyclin rather than NO.

[Relationship between static images of 13N ammonia positron emission tomography and left ventricular wall motion in patients with coronary artery disease]

Observed myocardial activities in static image of 13N ammonia positron emission tomography (PET) contains factors about not only myocardial blood flow but also wall motion, wall thickness and glutamine synthetase activity. Those factors may help to delineate myocardial viability in 13N ammonia static image. To assess the role of 13N ammonia static image in prediction of reversibility of regional wall motion abnormalities after revascularization, we studied 20 patients with coronary artery disease. Of these patients, 15 patients underwent successful coronary revascularization (8 PTCA, 7 CABG). Regional 13N concentration before revascularization was expressed as a percent of maximal myocardial concentration and compared with regional wall motion. Wall motion was assessed by visual analysis using left ventriculography. Regional myocardial 13N concentration in normal, hypokinetic, akinetic and dyskinetic segments was 85 +/- 9.3%, 75 +/- 11%*, 71 +/- 17%* and 58 +/- 7.7%*#+, respectively (*p < 0.05 vs. normal, #p < 0.05 vs. hypokinesis, +p < 0.05 vs. akinesis). The segments with functional improvement showed significantly higher concentration of 13N than those without functional recovery (80 +/- 9.7% vs. 67 +/- 8.3%, p < 0.05). By using an optimized threshold value for normalized 13N activities, the sensitivity and specificity reached to 67% and 100%, respectively, to predict functional recovery. Our data suggested that myocardial 13N concentration in static PET image is closely related to the left ventricular wall motion in the patients with coronary artery disease and that it has a possible value of prediction of myocardial viability.

High-performance liquid chromatographic determination of cholesterol and cholestanol in human serum by precolumn derivatization with 2-[2-(isocyanate)ethyl]-3-methyl-1,4-naphthoquinone combined with platinum catalyst reduction and electrochemical detection

The precolumn derivatization reagent, 2-[2-(isocyanate)ethyl]-3-methyl- 1,4-naphthoquinone (IMQ) was applied to the simultaneous determination of cholesterol and cholestanol in human serum by HPLC with electrochemical detection. The compounds extracted with hexane from human serum, to which was added 1-eicosanol as an internal standard, were reacted with IMQ in acetone and converted into the corresponding carbamic acid esters. After chromatographic separation of the derivatives, they were reduced once in a platinum catalyst reduction column connected on-line, then quantified with an electrochemical detector in the oxidation mode. The detection limits at a signal-to-noise ratio of 3 were 6.6 pg (17 fmol) and 7.4 pg (19 fmol) for cholesterol and cholestanol, respectively in a 10 microliter injection volume. This method was successfully applied to the determination of free and total cholesterol and total cholestanol in normal human serum, and the concentrations of free and total cholesterol were compared with those obtained by an enzymatic method.

Effects of inflammatory cytokines on vascular tone

OBJECTIVE

To assess the direct effects of the inflammatory cytokines interleukin-2 (IL-2), interleukin-6 (IL-6) and interleukin-8 (IL-8) on vascular smooth muscle contraction.

METHODS

Smooth muscle contractility was studied in the thoracic aorta isolated from male Sprague-Dawley rats. Syntheses of cAMP and nitric oxide (NO) were investigated in cultured rat vascular smooth muscle cells (VSMC).

RESULTS

Pretreatment of the rings with IL-6 (10 ng/ml) for 180 min caused a significant inhibition of their contraction in response to 10(-5) M phenylephrine, wile Il-2 (10 ng/ml) and IL-8 (100 ng/ml) showed no significant effect on the contraction. The inhibitory effect of IL-6 exhibited a dose-dependency (0.1 approximately 10 ng/ml). In cultured rat VSMC, synthesis of cAMP was increased time-dependently by IL-6, while IL-2 and IL-8 failed to show any significant effects. IL-2, IL-6 and IL-8 did not affect the production of nitrite, a stable metabolite of NO, by VSMC.

CONCLUSIONS

IL-6, but not IL-2 and IL-8, is a potent inhibitor of vascular contraction, which effect is mediated through the increased cAMP synthesis.