Increased pre-therapeutic serum vascular endothelial growth factor in patients with early clinical relapse of osteosarcoma

To investigate the clinical significance of circulating angiogenic factors, especially in association with early relapse of osteosarcoma, we quantified pre-therapeutic levels of vascular endothelial growth factor, basic fibroblast growth factor and placenta growth factor in the sera of 16 patients with osteosarcoma using an enzyme-linked immunosorbent assay. After a 1-year follow-up, the serum level of angiogenic factors was analysed with respect to microvessel density of the biopsy specimen and clinical disease relapse. The serum vascular endothelial growth factor levels were positively correlated with the microvessel density with statistical significance (P=0.004; Spearman rank correlation) and also significantly higher in seven patients who developed pulmonary metastasis than the remaining nine patients without detectable disease relapse (P=0.0009; The Mann-Whitney U-test). In contrast, the serum levels of basic fibroblast growth factor or placenta growth factor failed to show significant correlation with the microvessel density or relapse of the disease. Although there was no significant correlation between serum vascular endothelial growth factor levels and the tumour volume, the serum vascular endothelial growth factor levels were significantly higher in patients with a vascular endothelial growth factor-positive tumour than those with a vascular endothelial growth factor-negative tumour. These findings suggest that the pre-therapeutic serum vascular endothelial growth factor level reflects the angiogenic property of primary tumour and may have a predictive value on early disease relapse of osteosarcoma.

Immunohistological indication for arthroscopic synovectomy in rheumatoid knees: analysis of synovial samples obtained by needle arthroscopy

To determine the histological indication for arthroscopic synovectomy in rheumatoid knees, 23 patients underwent lavage and biopsy by needle arthroscopy. Eighty-one patients were treated with arthroscopic knee synovectomy after needle arthroscopy, and 51 of these patients underwent only arthroscopic synovectomy. Thirty patients who showed no improvement following arthroscopic synovectomy underwent open surgical synovectomy. Intra-articular lavage of knee joints by needle arthroscopy did not result in any clinical improvements. In the patients who underwent only arthroscopic synovectomy, two groups (only macrophages, no macrophages or B cells) showed clinical improvement (symptoms of the knee, ESR, RF). Patients in whom open surgical synovectomy was performed because of the failure of arthroscopic synovectomy showed clinical improvement. However, there was a significant loss of movement in the knee joint and more severe radiological deterioration in patients who underwent open surgical synovectomy than in those who underwent only arthroscopic synovectomy. Arthroscopic synovectomy should be used for rheumatoid patients with synovial tissue containing only macrophages or none of these two cells.

Effects of needle-arthroscopic lavage with different volumes of fluid on knee synovitis in rheumatoid arthritis

To determine the appropriate volume of physiological fluid needed to effectively reduce synovitis and to determine the indications for intra-articular lavage of knee joints with rheumatoid arthritis (RA), intraarticular lavage with different volumes of physiological fluid via needle arthroscopy were performed on 102 rheumatoid knees in 98 patients (25 males, 77 females) with an average age of 46 years at the time of operation. Intra-articular lavage of a knee joint with 5 or 10 l of physiological fluid gave better clinical results than did intra-articular lavage with 0.5-1.5 l. There was no difference between the beneficial effects of intraarticular lavage using 5 1 or 10 l of fluid. The preoperative conditions (CRP, frequency of the susceptible factors of HLA-DRB1 alleles, radiological change in the knee joint) and the intraoperative chondroscopic assessments were correlated with clinical improvement. Our study demonstrated that intra-articular lavage with 5 l of physiological fluid performed using needle arthroscopy was beneficial. The following points at least should be checked before performing intra-articular lavage: (1) CRP is not elevated to a high level (> or =5 mg/dl), (2) the patient does not have susceptible factors in both HLA-DRB1 alleles, (3) the grade of rheumatoid knee is below Larsen II in preoperative X-ray findings, and (4) the degree of cartilage damage is not more than grade 3 in arthroscopic findings.

Valgus deformity of the ankle following harvesting of a vascularized fibular graft in children

Progressive valgus ankle deformity is a problematic postoperative donor-site morbidity of a vascularized fibular graft in children. To prevent this complication, tibiofibular metaphyseal synostosis (the Langenskiöld procedure) has been recommended. The authors objectively evaluated the preventive and therapeutic effects of this procedure on five children who had received free vascularized fibular grafts. Their average age at the time of operation was 3 years (range: 1 to 9 years). The Langenskiöld procedure was performed primarily in four patients, and not in one patient. The anteroposterior (A-P) mortise angle and the empirical axis of the donor-site ankle were measured radiographically. With regard to the A-P mortise angle, four of five patients showed valgus with a mild lateral wedging of the distal tibial epiphysis. The patient who did not receive the operation showed the largest A-P mortise angle and mild osteoarthritic changes. The empirical axis exceeded normal range in all of the five patients. These observations indicated that valgus deformity of the ankle in children after harvesting a vascularized fibular graft is inevitable, even if the Langenskiöld procedure is performed. The procedure can delay the ankle valgus. The authors recommend close follow-up of the children who receive the Langenskiöld procedure after harvesting a vascularized fibular graft.

Effects of preconditioning on ischemia/reperfusion injury of hepatocytes determined by immediate early gene transcription

Ischemia reperfusion (I-R) of the liver induces various events leading to cell death (apoptosis) and subsequent cells proliferation. Recent experimental studies have described the protective effect of ischemic preconditioning (IPC) on I-R injury of the liver. However, the mechanisms involved in this protection remain unknown. The protein products of immediate early genes (IEGs) behave as crucial transcriptional regulators not only in apoptosis but also in cell proliferation. Here, we evaluated the effects of IPC on IEG transcription after I-R injury, using a rat liver I-R injury model. Injury to hepatocytes was evaluated by measuring serum levels of aspartate transaminase (AST), alanine transaminase (ALT), and lactate dehydrogenase (LDH) and that to endothelial cells by plasma concentration of hyaluronic acid (HA). The extent of necrosis was evaluated by H&E staining, while cell proliferation and apoptosis were evaluated by proliferating cell nuclear antigen (PCNA) and terminal deoxy(d)-UTP nick end labelling (TUNEL) staining, respectively. Alterations in the transcription of IEGs (c-fos and c-jun) were examined by Northern blotting. Rats subjected to 40-min liver ischemia, preceded by 10-min preconditioning, showed significantly lower AST, ALT, LDH, and HA levels at 6 h after I-R than untreated animals (P < 0.05; n at least 5 rats per group). The percentage of necrotic areas at 24 h after I-R was significantly lower in IPC-treated animals than in the controls. The numbers of apoptotic cells at 24 h after I-R and the numbers of PCNA-positive cells at 24 and 48 h after I-R were significantly lower in IPC-treated rats than in controls. Transcription levels of IEGs were low in IPC-treated rats, particularly c-jun at 1 and 1.5 h after I-R (P < 0.05). Our results indicate that IPC provides a significant protective effect on for liver cells against I-R injury and that its effect is evidenced by a significant decrease in the transcription levels of IEGs following the insult.

Chloride conductance determining membrane potential of rabbit articular chondrocytes

Membrane conductance of cultured rabbit articular chondrocytes was characterized by means of the patch-clamp technique. The resting membrane potential of the articular chondrocytes was about -42 mV. The membrane potential shifted in accordance with the prediction by the Nernst equation for Cl- when intracellular and extracellular concentrations of Cl- were changed. On the other hand, change in extracellular concentration of K+ produced no shift in the membrane potential of chondrocytes. The Cl- channel blocker 4-acetamido-4'-isothiocyanatostilbene-2'2-disulfonic acid (SITS) depolarized the membrane potential. These findings suggest that the membrane potential of the chondrocytes is determined mainly by Cl- conductance. Using the cell-attached patch-clamp method, a large unitary conductance of 217 pS was observed in the articular chondrocytes. The unitary current was reversibly blocked by SITS. Therefore, the unitary current was carried by Cl-. The Cl- channel showed voltage-dependent activation and the channels exhibited long-lasting openings. Therefore, the membrane potential of rabbit cultured articular chondrocytes was mainly determined by the activities of the large-conductance and voltage-dependent Cl- channels.

Comparison of sequences of cDNA clones obtained from oligo-capping cDNA libraries with those from unigene

We compared in detail the characteristics of the sequences of the cDNA clones obtained by the oligo-capping method (oligo-capping clones) with that of the sequences in the UniGene database. To compare the completeness of the sequences, three new variables, "fullness-proportion of clones" (the ratio of complete clones to total clones in a library), "fullness-proportion of genes" (the ratio of complete genes to total genes in a library), and "fullness-proportion of database" (the ratio of complete genes to total genes in a database sampled from a library), were defined. The fullness-proportion of clones of oligo-capping clones was 57.3%, 2.2 times larger than that of UniGene (25.9%). The fullness-proportion of genes of oligo-capping clones was 41.8%, 2.4 times larger than that of UniGene (17.8%). When gene length was restricted to > or = 1.5 kb, the fullness-proportion of genes of oligo-capping clones was four times larger than that of UniGene. The fullness-proportion of database of oligo-capping clones was approximately the same as that of UniGene. By simulating the clone redundancy, this coincidence was found to be due to the large redundancy of the UniGene database. Consequently, the cDNA sequence database of oligo-capping clones enabled high throughput selection of full-length cDNA clones.

Intracellular localization of the Ret finger protein depends on a functional nuclear export signal and protein kinase C activation

The Ret finger protein (RFP) was identified initially as an oncogene product and belongs to a family of proteins that contain a tripartite motif consisting of a RING finger, a B box, and a coiled-coil domain. RFP represses transcription by interacting with Enhancer of Polycomb and is localized to the cytoplasm or nucleus depending on the cell type. Here, we have identified the nuclear export signal (NES) located in the coiled-coil region of RFP. Mutation of this NES or treatment with leptomycin B abrogated the nuclear export of RFP in NIH3T3 cells. In addition, fusion of this NES to other nuclear proteins, such as yeast transcription factor Gal4, resulted in their release into the cytoplasm of NIH3T3 cells. Although the NES function of RFP in HepG2 cells is masked by another domain in RFP or by another protein, 12-O-tetradecanoylphorbol-13-acetate treatment or overexpression of constitutively active protein kinase Calpha (PKCalpha) abrogated masking, leading to the cytoplasmic localization of RFP. Furthermore, treatment of NIH3T3 cells with PKC inhibitors blocked the function of NES, resulting in nuclear localization of RFP. Thus, the nuclear export of RFP is regulated positively by PKC activation. However, RFP was not a direct substrate of PKC, and additional signaling pathways may be involved in the regulation of nuclear export of RFP.

Increased susceptibility to tumorigenesis of ski-deficient heterozygous mice

The c-ski proto-oncogene product (c-Ski) acts as a co-repressor and binds to other co-repressors N-CoR/SMRT and mSin3A which form a complex with histone deacetylase (HDAC). c-Ski mediates the transcriptional repression by a number of repressors, including nuclear hormone receptors and Mad. c-Ski also directly binds to, and recruits the HDAC complex to Smads, leading to inhibition of tumor growth factor-beta (TGF-beta) signaling. This is consistent with the function of ski as an oncogene. Here we show that loss of one copy of c-ski increases susceptibility to tumorigenesis in mice. When challenged with a chemical carcinogen, c-ski heterozygous mice showed an increased level of tumor formation relative to wild-type mice. In addition, c-ski-deficient mouse embryonic fibroblasts (MEFs) had increased proliferative capacity, whereas overexpression of c-Ski suppressed the proliferation. Furthermore, the introduction of activated Ki-ras into c-ski-deficient MEFs resulted in neoplastic transformation. These findings demonstrate that c-ski acts as a tumor suppressor in some types of cells. The level of cdc25A mRNA, which is down regulated by two tumor suppressor gene products, Rb and Mad, was upregulated in c-ski-deficient MEFs, whereas it decreased by overexpressing c-Ski in MEFs. This is consistent with the fact that c-Ski acts as a co-repressor of Mad and Rb. These results support the view that the decreased activities of Mad and Rb in ski-deficient cells at least partly contribute to enhanced proliferation and susceptibility to tumorigenesis. Human c-ski gene was mapped to a region close to the p73 tumor suppressor gene at the 1p36.3 locus, which is already known to contain multiple uncharacterized tumor suppressor genes.

Unrelated cord blood transplantation for an infant with chemotherapy-resistant progressive Langerhans cell histiocytosis

The authors describe a patient successfully treated with unrelated cord blood transplantation (CBT) for chemotherapy-resistant progressive Langerhans cell histiocytosis (LCH). An 8-month-old boy had LCH diagnosed based on the histologic examination of skin lesions. Despite intensive chemotherapy and immunotherapy, the disease was progressive, with organ dysfunction. He received unrelated CBT after a conditioning regimen consisting of total body irradiation, etoposide, and melphalan. He was in complete remission 12 months after the transplantation. The authors suggest that CBT could be considered in the treatment of patients with chemotherapy-resistant progressive LCH, especially if there are no available human leukocyte antigen-matched family donors.

[Troubles inherent to long-term home parenteral nutrition (HPN) and the use of technologies to improve communication between medical institutions and patients]

The continuous advance of technology has contributed to the improvement of the quality of life of patients under long-term home parenteral nutrition (HPN). But the longer the patient stays home, the higher the risk of many kinds of troubles. We designed an HPN system in June 1999, which uses E-mail for patients and to contact with each other (including the patient's family) and to prevent troubles from worsening. We describe the case of a patient which shows the efficacy and usefulness of our system, which makes use of the Internet, video mail, voice mail and electric medical records.

[Choosing effective laboratory tests for diabetes care, and the reimbursement system]

Diabetes mellitus is a prototype chronic disease. The number of patients with diabetes in Japan is estimated to be about 6.9 million. Expenditure for diabetes care is increasing rapidly and this increase imposes a major economic burden. The Japanese Government has developed health-care payment policies designed to balance the growth of health-care expenditure against other national priorities. Often these policies tend to limit the various services. The Japan Diabetes Society(JDS) published management guidelines for diabetes for general practitioners in 1999. There is increasing concern about the cost of laboratory studies, including self-monitoring blood glucose(SMBG), as well as the cost of general diabetes care. The Japanese Society of Laboratory Medicine(JSLM) has also developed standards to choose effective laboratory tests for general practitioners. Health professionals must have a clear knowledge of the reimbursement system in order to understand the economic factors that control the services available to their patients. Ideally, however, the reimbursement system should meet the financial needs of the services necessary to conform to the professional consensus of the acceptable quality of care for people with diabetes.

Gaussian process approach to spiking neurons for inhomogeneous Poisson inputs

This article presents a new theoretical framework to consider the dynamics of a stochastic spiking neuron model with general membrane response to input spike. We assume that the input spikes obey an inhomogeneous Poisson process. The stochastic process of the membrane potential then becomes a gaussian process. When a general type of the membrane response is assumed, the stochastic process becomes a Markov-gaussian process. We present a calculation method for the membrane potential density and the firing probability density. Our new formulation is the extension of the existing formulation based on diffusion approximation. Although the single Markov assumption of the diffusion approximation simplifies the stochastic process analysis, the calculation is inaccurate when the stochastic process involves a multiple Markov property. We find that the variation of the shape of the membrane response, which has often been ignored in existing stochastic process studies, significantly affects the firing probability. Our approach can consider the reset effect, which has been difficult to deal with by analysis based on the first passage time density.

Asymmetric synthesis with a chiral catalyst generated from asymmetric autocatalysis

A new and efficient one-pot system of asymmetric catalysis is presented in which a chiral catalyst (5-pyrimidyl alkanol) self-improves its ee by asymmetric autocatalysis and then acts as a highly enantioselective chiral catalyst for other asymmetric synthesis (addition of dialkylzincs to aldehydes) to provide products (sec-alcohols) with very high ee (up to 99%).[reaction: see text]

PML-RARalpha alleviates the transcriptional repression mediated by tumor suppressor Rb

A fusion between the promyelocytic leukemia (PML) protein and the retinoic acid receptor-alpha (RARalpha) results in the transforming protein of acute promyelocytic leukemia, PML-RARalpha. PML has growth-suppressive properties and is localized within distinct nuclear structures referred to as nuclear bodies. PML participates in numerous cellular functions, including transcriptional activation, apoptosis, and transcriptional repression, whereas PML-RARalpha blocks these functions. However, the role played by PML-RARalpha in leukemogenesis remains unclear. Here we report that PML is required for transcriptional repression mediated by the tumor suppressor Rb. Rb interacts with the histone decaetylase (HDAC) complex containing co-repressors and represses the transcription of the E2F target genes. Overexpression of PML enhanced Rb-mediated repression. The degree of Rb-mediated repression was weakened by injecting anti-PML antibodies and was lower in Pml-deficient mouse embryonic fibroblasts. PML-RARalpha inhibited Rb-mediated repression, and two co-repressor-interacting sites on the PML-RARalpha molecule were required for this activity. Furthermore, PML-RARalpha blocked the interaction between Rb and HDAC. Thus, aberrant binding of PML-RARalpha to co-repressor-HDAC complexes may inhibit their association with Rb, resulting in the abrogation of Rb activity. Thus, the disruption of Rb-mediated repression may be a contributory factor in leukemogenesis.

Single nucleotide polymorphism of human platelet-activating factor receptor impairs G-protein activation

Various proinflammatory and vasoactive actions of platelet-activating factor (PAF) are mediated through a specific G-protein-coupled PAF receptor (PAFR). We identified a novel DNA variant in the human PAFR gene, which substitutes an aspartic acid for an alanine residue at position 224 (A224D) in the putative third cytoplasmic loop. This mutation was observed in a Japanese population at an allele frequency of 7.8%. To delineate the functional consequences of this structural alteration, Chinese hamster ovary cells were stably transfected with constructs encoding either wild-type or A224D mutated PAFR. No significant difference was observed in the expression level of the receptor or the affinity to PAF or to an antagonist, WEB2086, between the cells transfected with wild-type and mutant PAFR. Chinese hamster ovary cells expressing A224D mutant PAFR displayed partial but significant reduction of PAF-induced intracellular signals such as calcium mobilization, inositol phosphate production, inhibition of adenylyl cyclase, and chemotaxis. These findings suggest that this variant receptor produced by a naturally occurring mutation exhibits impaired coupling to G-proteins and may be a basis for interindividual variation in PAF-related physiological responses, disease predisposition or phenotypes, and drug responsiveness.

Chronic central infusion of ghrelin increases hypothalamic neuropeptide Y and Agouti-related protein mRNA levels and body weight in rats

Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor (GHS-R), was originally purified from the rat stomach. Like the synthetic growth hormone secretagogues (GHSs), ghrelin specifically releases growth hormone (GH) after intravenous administration. Also consistent with the central actions of GHSs, ghrelin-immunoreactive cells were shown to be located in the hypothalamic arcuate nucleus as well as the stomach. Recently, we showed that a single central administration of ghrelin increased food intake and hypothalamic agouti-related protein (AGRP) gene expression in rodents, and the orexigenic effect of this peptide seems to be independent of its GH-releasing activity. However, the effect of chronic infusion of ghrelin on food consumption and body weight and their possible mechanisms have not been elucidated. In this study, we determined the effects of chronic intracerebroventricular treatment with ghrelin on metabolic factors and on neuropeptide genes that are expressed in hypothalamic neurons that have been previously shown to express the GHS-R and to regulate food consumption. Chronic central administration of rat ghrelin (1 microg/rat every 12 h for 72 h) significantly increased food intake and body weight. However, it did not affect plasma insulin, glucose, leptin, or GH concentrations. We also found that chronic central administration of ghrelin increased both neuropeptide Y (NPY) mRNA levels (151.0 +/- 10.1% of saline-treated controls; P < 0.05) and AGRP mRNA levels (160.0 +/- 22.5% of saline-treated controls; P < 0.05) in the arcuate nucleus. Thus, the primary hypothalamic targets of ghrelin are NPY/AGRP-containing neurons, and ghrelin is a newly discovered orexigenic peptide in the brain and stomach.

Reconstruction of chaotic dynamics by on-line EM algorithm

In this paper, we discuss the reconstruction of chaotic dynamics by using a normalized Gaussian network (NGnet), which is a network of local linear regression units. The NGnet is trained by an on-line EM algorithm in order to learn the vector field of the chaotic dynamics. We investigate the robustness of our approach to two kinds of noise processes: system noise and observation noise. System noise disturbs the system dynamics itself. Observation noise is added when the state variables are observed. It is shown that the trained NGnet is able to reproduce a chaotic attractor, which approximates the complexity and instability of the original chaotic attractor well, even under various noise conditions. The trained NGnet also shows good prediction performance. When only part of the dynamical variables are observed, the delay embedding method is used. The NGnet is then trained to learn the vector field in the delay coordinate space. Experiments show that the chaotic dynamics embedded in the delay coordinate space is able to be learned under the two types of noise.

Murine Schnurri-2 is required for positive selection of thymocytes

A key step in T cell development involves the positive selection of cells that recognize antigen presented by self-major histocompatibility complex. Yet, the signals that are activated by T cell receptor engagement and lead to cell survival remain unclear. We show here that mice lacking the transcription factor Schnurri-2 (Shn-2), a large metal-finger protein, had severely defective positive selection of CD4+ and CD8+ cells. Drosophila Shn acts as a cofactor of Smad homolog and is required for Decapentaplegic signaling. Vertebrates have at least three Shn orthologs (Shn-1, Shn-2 and Shn-3), which are thought to act as nuclear targets in the bone morphogenetic protein-transforming growth factor-beta-activin signaling pathways. These data raised the possibility that the Smad-Shn-2 complex is involved in the thymic selection of T cells.

[Embolization of the bilateral internal pudendal arteries for intractable priapism in a child with chronic myelogenous leukemia]

Priapism is an uncommon clinical symptom in children with chronic myelogenous leukemia (CML). Here we report a 14-year-old boy with this symptom, which had appeared 4 days prior to hospitalization. Peripheral blood examination revealed a leukocyte count of 510,000/microliter, (87% neutrophils, 3% eosinophils, 6% basophils, and 1.6% lymphocytes), a hemoglobin level of 6.5 g/dl and a platelet count of 640,000/microliter. Karyotype analysis revealed the Ph1 chromosome and myeloid hyperplasia in the bone marrow. The patient was diagnosed as having chronic myelogenous leukemia (CML) complicated by priapism. In an unsuccessful attempt to alleviate and improve the priapism, urokinase was injected and hydroxyurea was administered for the CML. Angiography confirmed the presence of venous return from the scrotum, and embolization of the bilateral internal pudendal arteries was performed to reduce the amount of inflow. Although this relieved the patient of his pain and prevented penile necrosis, the patient's future sexual potency was sacrificed. Selective embolization of the pudendal arteries can be one of the most effective ways of treating intractable priapism, if angiography confirms the presence of venous return from the penis.

An electrophysiologic study of mechanoreceptors in the sacroiliac joint and adjacent tissues

STUDY DESIGN

The somatosensory afferent units in the sacroiliac joint of an animal model were investigated using an electrophysiologic technique.

OBJECTIVES

To identify the mechanosensitive receptive fields in the sacroiliac joint, and to determine their distribution and characteristics.

SUMMARY OF BACKGROUND DATA

The sacroiliac joint is considered to be a source of lower back pain. Although there have been clinical studies on the diagnosis of sacroiliac joint pain, no satisfactory diagnostic method other than joint blocks has been reported. It still is not clear whether the sacroiliac joints actually transmit pain to the central nervous system. The sensory innervation of the sacroiliac joint has not been fully characterized neurophysiologically.

METHODS

Experiments were performed on 10 adult cats weighing 2.6 to 4 kg. The animals were anesthetized with intravenous sodium pentobarbital. An L4-L7 laminectomy was performed. The L4-L6 dorsal roots were cut at their proximal ends, split, and draped over a bipolar recording electrode. Glass probes were used to search the sacroiliac joint and adjacent tissues for mechanosensitive units. When units were identified, they were stimulated electrically to obtain conduction velocities and by Semmes-Weinstein monofilaments to determine mechanical thresholds.

RESULTS

In the sacroiliac joint and adjacent muscles, 29 discrete mechanosensitive units were identified. Of these 29 units, 26 were found in the posterior sacroiliac ligament and the remaining 3 in the adjacent muscles. Also, 16 units (55%) were identified in the proximal third of the sacroiliac joint. Conduction velocities of the units ranged from 3.1 to 22 m/second (average, 9.2 m/second), and 26 units were group III. Mechanical thresholds of the units ranged from 4.6 to 164.3 g (average, 69.7 g). Whereas 28 units (96.6%) had thresholds higher than 7 g, one unit (3.4%) had a threshold lower than 7 g.

CONCLUSIONS

Group III units with mechanical thresholds higher than 7 g may serve as nociceptors, and units with thresholds of lower than 7 g may serve as proprioceptors. The current study showed that most of the units in the sacroiliac joint were high-threshold group III units that perhaps had a nociceptive function. This result suggests that the sacroiliac joint may be a source of lower back pain in humans. This study also showed that the sacroiliac joint has little proprioceptive function.

Induction of immediate early genes after partial hepatectomy in cholestatic liver

The protein products of immediate early genes (IEGs) behave as transcriptional regulators and play an important role in the regulation of gene expression associated with liver cell proliferation and apoptosis. The aim of this study was to examine whether the transcription of IEGs was induced by obstructive jaundice during liver regeneration after 70% partial hepatectomy, and to examine their association with animal survival, cell proliferation, and apoptosis. Obstructive jaundice (OJ) was induced in rats by common bile duct ligation (CBDL), and 70% partial hepatectomy was performed 5 days after CBDL (OJ group). Changes in the induction of the IEGs, c-fos and c-jun, were compared between control and OJ groups in relation to survival before and after partial hepatectomy. Cell proliferation and apoptosis were evaluated by proliferating cell nuclear antigen (PCNA) immunohistological staining and by an in situ TdT-mediated d-UTP-digoxigerin nick-end labeling (TUNEL) method. The 2-week survival in the OJ group (2/7) was significantly less that of the sham operation (control) group (7/7). Enhanced induction of IEGs was evident in the OJ group after partial hepatectomy compared with findings in the control group. The PCNA-labeling index (LI) in the OJ group was increased after partial hepatectomy, but only minimally, compared with that in control animals. Apoptotic cells appeared in bile ducts and surrounding hepatocytes after partial hepatectomy in the OJ group, although apoptotic cells were rare in the control group. IEG transcription does occur after partial hepatectomy in jaundiced liver but it is enhanced and sustained, and leads to apoptosis rather than leading to the efficient proliferation of hepatocytes.

Kudo total elbow arthroplasty in patients with rheumatoid arthritis: a long-term follow-up study

BACKGROUND

Improvements in the design of total elbow prostheses over the last two decades have led to better and more consistent results. The type-3 Kudo total elbow prosthesis was developed in 1980. The long-term results of use of this implant have not been reported. Because it is an unlinked prosthesis, it is not known whether preservation of the anterior oblique component of the ulnar collateral ligament at the time of implantation is important.

METHODS

A type-3 Kudo total elbow arthroplasty with cement was performed in forty-seven patients (fifty elbows) with rheumatoid arthritis. Revision rates, clinical symptoms, postoperative complications, and radiographic changes were assessed eleven to sixteen years (mean, thirteen years) postoperatively.

RESULTS

The overall survival rate of the prosthesis was 90% at sixteen years. The mean Mayo elbow performance scores were all poor (mean overall score, 43 points) initially. The overall score was substantially improved at both the intermediate follow-up examination (four to six years after the operation) and the late follow-up examination (eleven to sixteen years after the operation), to 81 and 77 points, respectively. The overall rate of radiolucency about the humeral component was 45% at the intermediate follow-up examination and 100% at the long-term follow-up examination. The rate of radiolucency about the ulnar component at the intermediate and late follow-up examinations was 4.3% and 8.9%, respectively. No great differences in results were found with preservation of the anterior oblique component of the ulnar collateral ligament.

CONCLUSIONS

This long-term follow-up study showed acceptable results of the type-3 Kudo total elbow arthroplasty in patients with rheumatoid arthritis. Preservation of the ulnar collateral ligament does not seem to be necessary when performing this procedure.

Horse-related injuries in a thoroughbred stabling area in Japan

To investigate the demographic details and patterns of injuries related to horse handling, we reviewed 637 horse-related injuries in 581 stable- or stud-workers in a representative area of thoroughbred stabling in Japan. We found that (1) injuries occurred most frequently in a group of a relatively young workers, with a seasonal variation; (2) the principal mechanism of injury was kicks, which accounted for 39.2% of all injuries, including 11 serious and one lethal visceral injuries; (3) the upper half of the body was more frequently involved than the lower half; and (4) the peripheral bones (hand and foot) and the ribs accounted for more than half of 148 fractures. These findings are distinct from those in horse-riding injuries reported in the literature and emphasize the importance in developing preventive strategies specifically for workers in horse stables.

[Percutaneous hot ethanol injection therapy (PHEIT) for hepatocellular carcinoma]

Percutaneous ethanol injection therapy (PEIT) is widely performed as a local treatment for hepatocellular carcinoma (HCC). However, PEIT must be repeated because only a limited amount of ethanol can be injected in a single treatment. In addition, PEIT is only indicated for up to 3 tumors of 30 mm or less in diameter. We therefore invented a percutaneous hot ethanol injection therapy (PHEIT) to enhance the antitumor effect of PEIT. For this, we developed a liquid-heating and injection device to heat the liquid to the intended temperature and inject it from the tip of the needle safely and accurately using a puncture technique under ultrasonographic guidance. An experiment on normal rat livers demonstrated that injected ethanol at temperatures over 60 degrees C enhances the necrotizing effect on tissue. The technique was clinically applied to patients with HCC using ethanol heated to 60 degrees C or 70 degrees C. The total volume of the ethanol injection was smaller in PHEIT than in PEIT, and the frequency of injection was lower in PHEIT than in PEIT, while the necrotic area obtained by a single treatment was larger with PHEIT than with PEIT. PHEIT is a potential radical treatment for patients with multiple hepatoma with 4 more lesions or those with large hepatomas exceeding 30 mm in diameter that do not respond to PEIT.

Evaluation of bone metabolic markers in breast cancer with bone metastasis

PURPOSE

In the present study, four bone metabolic markers were examined to clarify them meaning and clinical value in the detection of bone metastasis (BM) from breast cancer.

METHODS

we examined serum carboxyterminal telopeptide of type I collagen (ICTP), tartrate resistant acid phosphatase (TRACP), total alkaline phosphatase (ALP) and urinary type I collagen cross-linked N-telopeptides (NTx) as potential markers. These bone markers were evaluated simultaneously in 156 breast cancer patients; 114 patients without metastasis (group A), 23 patients with BM (group B) and 19 patients with metastasis at sites other than bone (group C).

RESULTS

The mean values of ICTP and TRACP in group B were significantly greater than those in group A. Group B consisted of the patients with varying degrees of BM and variation in their treatments. The patients in group B were divided into BM (+) and BM (++) according to hot spots in bone scan. ICTP and TRACP were elevated in BM (++) patients compared to BM (+) patients (p<0.05). The values of ICTP and TRACP of the twelve patients without treatment in group B were significantly higher than those in group A. In the treated patients of group B, the mean values of ICTP and TRACP were lower in responders and cases of stable disease than those with progression. NTx and ALP were inferior to ICTP and TRACP for clinical evaluation of BM.

CONCLUSIONS

We confirmed that ICTP and TRACP might be useful markers for screening and monitoring BM in breast cancer.

The Ski protein family is required for MeCP2-mediated transcriptional repression

DNA methylation is essential for development in the mouse and plays an important role in inactivation of the X chromosome and genomic imprinting. MeCP2 is the founder member of a family of methyl-CpG-binding proteins. MeCP2 directly binds to the co-repressor mSin3, which interacts with class I histone deacetylase, recruiting them to methyl-CpG regions to suppress transcription. Here, we report that MeCP2 directly binds to two co-repressors, c-Ski and N-CoR, in addition to mSin3A, and that the c-Ski, which is encoded by the c-ski proto-onocogene, is required for MeCP2-mediated transcriptional repression. The two regions of c-Ski, including the C-terminal coiled-coil region, interact with the transcriptional repression domain in the center of the MeCP2 molecule. The immunostaining signals for c-Ski and MeCP2 overlap in the nuclear heterochromatin region, suggesting the co-localization of the two proteins. The degree of transcriptional repression mediated by a Gal4-MeCP2 fusion protein was abrogated by overexpression of the putative dominant negative form of c-Ski. Furthermore, injection of antibodies against c-Ski and Sno almost completely abolished the transcriptional repression mediated by the Gal4-MeCP2 fusion protein. These results suggest that the ski gene family is involved in methyl CpG-mediated transcriptional repression.

Regulation of the ghrelin gene: growth hormone-releasing hormone upregulates ghrelin mRNA in the pituitary

Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor (GHS-R), was originally purified from the rat stomach. Ghrelin specifically releases GH following intravenous administration, and its GH-releasing activity in vivo is dependent on growth hormone-releasing hormone (GHRH). We previously reported that the expression of the GHS-R gene in the pituitary is developmentally regulated and GHRH infusion increases pituitary levels of GHS-R mRNA. Ghrelin mRNA and peptide have recently been detected in rat and human pituitaries. However, the regulation of the ghrelin gene in the pituitary is unknown. In this study, pituitary levels of ghrelin mRNA were measured with the reverse transcriptase-polymerase chain reaction in male rats at embryonic day (e)18 and postnatal days 1, 10, 30, and 75. The highest concentrations of ghrelin mRNA in the pituitary were observed at e18 and then they declined with age. The infusion of GHRH (10 microg/h, 4h) in freely-moving adult male rats resulted in a 1.9-fold increase in ghrelin mRNA levels relative to control rats (P < 0.05). These data indicated that the expression of the ghrelin gene in the pituitary is developmentally regulated and the pituitary ghrelin/GHS-R signaling system could modulate the regulation of GH secretion by GHRH.

Early anchoring collagen fibers at the bone-tendon interface are conducted by woven bone formation: light microscope and scanning electron microscope observation using a canine model

To clarify the early process of recovery at the bone-tendon interface, we used light microscopy and SEM to examine the process of anchoring of collagen fibers to bone in a canine model. At two weeks, tendon, scar tissue, woven bone and lamellar bone were present at the insertion site. SEM revealed anchoring of collagen fibril bundles of the scar to the woven bone. By 4 weeks, the number of anchoring fibers had increased and a parallel arrangement of fibers was observed. SEM demonstrated deep penetration of fibers into the woven bone layer. In addition, the fibers were observed to project into and intermingle with the scar tissue. By 6 weeks, the anchoring fibers had developed fully and were distributed densely over the interface. SEM also revealed that the collagen fibril bundles in the scar tissue had connected with the collagen fibrils of the woven bone by way of the anchoring bundles. The woven bone was identifiable throughout the early stages of recovery as the interface between soft tissue and hard tissue. Throughout all experimental periods, no staining was observed at the interface of the tendon and bone by Saffranin-O. The formation of woven bone was important during early recovery of the tendon-bone interface prior to the completion of fibrocartilage-mediated insertion.

Environmental occurrence of nitrotriphenylene observed in airborne particulate matter

1- and 2-Nitrotriphenylenes were found in the airborne particulate matter extracts collected in central Tokyo between the winter of 1998 and the winter of 1999. In particular, we have identified and quantified nitrotriphenylenes in the airborne particulate matter extracts collected over four consecutive 6-h periods on 2 December 1999. The concentrations of 1- and 2-nitrotriphenylene ranged from 0.04 to 0.44 and from 0.02 to 0.47 ng/m3, respectively, and the concentrations in the airborne particulate matter extracts collected during the 18:00-24:00 h time period were the highest of the four collection periods. 1-Nitropyrene and 2-nitrofluoranthene were also identified and quantified in the four 6-h samples. Although the concentrations of 1- and 2-nitrotriphenylenes were not higher than that of 2-nitrofluoranthene except during the 18:00-24:00 h time period, the concentrations were much higher than that of 1-nitropyrene during the four collection periods. The higher concentrations of 1- and 2-nitrotriphenylenes during the 18:00-24:00 h time period are presumably responsible for the high reactivity of parent triphenylene with NO2/NO3/N2O5, and high stability of 1- and 2-nitrotriphenylenes toward O3 + O2. In addition, the observed isomer distribution of nitrotriphenylenes suggested that direct emission of nitrotriphenylenes is also a source as well as their atmospheric formation.

Phase-independent inhibition by retinoic acid of mineralization correlated with loss of tetranectin expression in a human osteoblastic cell line

We have recently reported that retinoic acid inhibits dexamethasone-induced alkaline phosphatase activity and mineralization in human osteoblastic cell line SV-HFO. In this study, we show that this inhibitory effect on alkaline phosphatase activity depends on the stage of cell differentiation; however, expression of tetranectin, which is a recently reported bone matrix protein, was completely inhibited by treatment with retinoic acid, irrespective of the stage of cell differentiation. Similarly, mineral deposit formation in SV-HFO cells was phase-independently inhibited by retinoic acid. To our knowledge, this is the first report that retinoic acid downregulates the tetranectin expression in human osteoblastic cells independent of the stage of cell differentiation, and is correlated with inhibition of mineralization.

Allelic loss of the NF1 gene in anal malignant melanoma in a patient with neurofibromatosis type 1

A 64-year-old man with neurofibromatosis type 1 (NF1) developed a primary malignant melanoma of the anus. Genetic analysis of the resected tumor confirmed loss of heterozygosity (LOH) of the NF1 gene. Anorectal malignant melanoma in NF1 is extremely rare, and genetic studies of the NF1 gene in such patients have not been reported. The allelic loss detected in the present patient supports the previously raised idea that NF1 can function as a tumor suppressor gene in the development of malignant melanoma in patients with NF1.

Overexpression of the granulocyte colony-stimulating factor gene impairs bone morphogenetic protein responsiveness in mice

Granulocyte colony-stimulating factor (G-CSF) is the major hematopoietic growth factor regulating the production and differentiation of neutrophils. We previously demonstrated that permanent overexpression of G-CSF in transgenic mice produces a dramatic enlargement of the bone cavity and reduction of bone mass. This phenotype was shown to be associated with an increase of osteoclast-mediated bone resorption. As a way of determining the role of G-CSF in bone formation in vivo, an ectopic bone was induced subcutaneously into G-CSF transgenic mice by bone morphogenetic protein (BMP)-2, a potent initiator of bone and cartilage from undifferentiated mesenchymal cells. A BMP-2/atelocollagen pellet containing recombinant human BMP-2 was implanted into a dorsal subfascial pocket. At one week after implantation, proliferation of mesenchymal cells around the implant was significantly decreased in transgenic mice compared with control mice. At three weeks, an ectopic bone containing bone marrow was formed both in transgenic and control mice. However, the ectopic bones of the transgenic mice were smaller and less consistent than those of control mice, and the calcium contents were reduced to 56.2% of those of controls. The ectopic bone in the G-CSF mice showed poor development of both lamellar and trabecular bone. Semiquantitative reverse transcription-polymerase chain reaction analysis of the ectopic bone at 3 weeks disclosed no significant differences in the mRNA levels of type I collagen, osteopontin, and osteocalcin between G-CSF mice and control mice. Immunohistochemical study in G-CSF mice showed reduced staining of osteocalcin in the bone matrix surrounding the reduced number of osteoblasts. The half-life of BMP in the implants was prolonged to 7 to 9 days in the G-CSF mice, whereas it was 5 days in the control mice. Collectively, the permanent expression of G-CSF may retard the differentiation process of osteoblasts by impairing the initial induction of mesenchymal cells, resulting in reduction of bone mass, suggesting that G-CSF regulates the bone metabolism by modulating both osteoclast and osteoblast function. Furthermore, it is suggested that G-CSF is a potent modulator of the BMP-2 signal pathway in vivo.

Loss of ErbB2 expression in pulmonary metastatic lesions in osteosarcoma

OBJECTIVES

The c-erbB2 protooncogene is located on human chromosome 17 and encodes a 185-kilodalton transmembrane glycoprotein (ErbB2). Elevated ErbB2 expression or gene amplification has been shown to be associated with a poor prognosis in many cancers. Recently, it has been demonstrated that overexpression of the ErbB2 protein in osteosarcoma is associated with the presence of pulmonary metastasis and decreased survival. To further investigate the role of ErbB2 overexpression in pulmonary metastasis of osteosarcoma, its expression in the primary and metastatic lesions of the same osteosarcoma patients was compared.

METHODS

We compared the expression levels of ErbB2 receptor protein between the biopsy samples and pulmonary metastatic lesions in each of 19 patients with osteosarcoma who had not presented with metastasis at diagnosis. All archival materials from patients were retrieved and stained with monoclonal antibody CB11 to detect ErbB2 protein.

RESULTS

The rate of overexpression was significantly lower in the pulmonary metastatic tumors than in the biopsy samples (11 versus 42%; p = 0.03). Among 8 patients who had shown increased levels of ErbB2 in the biopsy samples, 7 exhibited complete absence of ErbB2 in the pulmonary metastatic lesions. Overall loss of ErbB2 expression was noted in 14 of 19 patients as the initial tumor became metastatic.

CONCLUSIONS

It is suggested that overexpression of ErbB2 decreases within individual osteosarcomas as they become metastatic. Overexpression of ErbB2 may not play an important role in the development of pulmonary metastases of osteosarcoma. Further data are needed before ErbB2 can be used in making clinical decisions for osteosarcoma patients.

Mechanosensitive afferent units in the lumbar posterior longitudinal ligament

STUDY DESIGN

The mechanosensitive afferent units in the lumbar posterior longitudinal ligament were investigated in an animal model using an electrophysiologic technique.

OBJECTIVES

The objectives of this study were to identify the mechanosensitive receptive fields in the lumbar posterior longitudinal ligament and to investigate their distribution and characteristics.

SUMMARY OF BACKGROUND DATA

The lumbar posterior longitudinal ligament has a nerve network originating from the sinuvertebral nerve. These fibers are thin, and most of their terminals are free nerve endings. Some immunohistochemical studies have indicated that they are immunoreactive to calcitonin gene-related peptide and/or substance P, suggesting a nociceptive function. Most of these studies investigated morphologic aspects, and there have been few studies employing electrophysiologic techniques to examine mechanosensitive units.

METHODS

We used 13 adult cats. They were anesthetized and then laminectomy was performed. The L5 and L6 dorsal rootlets were draped over a recording electrode. To investigate the receptive fields in the posterior longitudinal ligament, afferent impulses were evoked by mechanical stimulation with a glass probe. When the receptive fields were located, they were stimulated electrically to obtain conduction velocity and were stimulated with a set of 17 nylon filaments to determine their mechanical thresholds.

RESULTS

Thirteen units were identified in the lumbar posterior longitudinal ligament. The majority of the units were located around the intervertebral disc level of the posterior longitudinal ligament. The mean mechanical threshold was 47.04 +/- 15.25 g. According to the conduction velocities of the units, 12 units were classified into Group III (0.5-2.5 m/sec) and one unit into Group IV (2.5-20 m/sec).

CONCLUSION

Mechanosensitive units classified into Group III or Group IV and with a high mechanical threshold (>7.0 g) were thought to act as nociceptive units. All units identified in this study satisfied these criteria. Our result suggests that afferent fibers from the lumbar posterior longitudinal ligament have a principally nociceptive function.

Length and width of the tendinous portion of the palmaris longus: a cadaver study of adult Japanese

We examined 72 forearms of 36 cadavers to measure the length and width of the tendinous portion of the palmaris longus in adult Japanese. The palmaris longus muscles were absent in both arms in 1 cadaver and in a unilateral arm in 1 cadaver. Double palmaris longus muscles were found in 1 arm in another cadaver. Most cadavers had a typical palmaris longus muscle and tendon shape. The mean length and width of the tendons were 124.6 +/- 17.0 and 4.5 +/- 0.7 mm, respectively, in male specimens and 108.3 +/- 16.4 and 4.0 +/- 0.7 mm in female specimens, respectively. The mean lengths of the forearms were 240.0 +/- 12.6 mm in male specimens and 218.8 +/- 14.6 mm in female specimens. There was a statistically significant correlation between the lengths of the palmaris longus tendon and forearm. These results indicate that one can estimate the length of palmaris longus tendons before surgical intervention.

Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee

We studied 99 patients who were undergoing total knee arthroplasty (TKA) to determine the optimum protocol for the administration of tranexamic acid (TNA) in order to reduce blood loss. It decreased by more than 40% after the administration of TNA. The haemostatic effect was greatest when TNA was given preoperatively and on deflation of the tourniquet. There was no increase in the incidence of adverse affects in the patients receiving TNA, compared with a control group.

We conclude that two injections of TNA, one given preoperatively and one on deflation of the tourniquet, significantly reduce blood loss without increasing the risk of thromboembolic complications.

Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee

We studied 99 patients who were undergoing total knee arthroplasty (TKA) to determine the optimum protocol for the administration of tranexamic acid (TNA) in order to reduce blood loss. It decreased by more than 40% after the administration of TNA. The haemostatic effect was greatest when TNA was given preoperatively and on deflation of the tourniquet. There was no increase in the incidence of adverse affects in the patients receiving TNA, compared with a control group. We conclude that two injections of TNA, one given preoperatively and one on deflation of the tourniquet, significantly reduce blood loss without increasing the risk of thromboembolic complications.

Role of PML and PML-RARalpha in Mad-mediated transcriptional repression

Fusion of the promyelocytic leukemia (PML) protein to the retinoic acid receptor-alpha (RARalpha) generates the transforming protein of acute promyelocytic leukemias. PML appears to be involved in multiple functions, including apoptosis and transcriptional activation by RAR, whereas PML-RARalpha blocks these functions of PML. However, the mechanisms of leukemogenesis by PML-RARalpha remain elusive. Here we show that PML interacts with multiple corepressors (c-Ski, N-CoR, and mSin3A) and histone deacetylase 1, and that this interaction is required for transcriptional repression mediated by the tumor suppressor Mad. PML-RARalpha has the two corepressor-interacting sites and inhibits Mad-mediated repression, suggesting that aberrant binding of PML-RARalpha to the corepressor complexes may lead to abrogation of the corepressor function. These mechanisms may contribute to events leading to leukemogenesis.

Evidence for the autocrine induction of capacitation of mammalian spermatozoa

Mammalian spermatozoa require a maturational event after ejaculation that allows them to acquire the capacity for fertilization. This process, known as capacitation, occurs spontaneously in simple defined medium implicating a potential role of autocrine induction. This study shows that the ether phospholipid 1-O-alkyl-2-acetyl-sn-glyceryl-3-phosphocholine (PAF) meets the criteria for an autocrine mediator of capacitation. Sperm released PAF after their dilution into capacitation medium and expressed a receptor for PAF on their membranes. PAF stimulated changes in the motility of sperm and enhanced fertilization in vitro. These actions were inhibited by a PAF receptor antagonist (UR-12519) and by extracellular recombinant PAF:acetylhydrolase (an enzyme that degrades PAF to a biologically inert form). Seminal plasma contained an acid-labile PAF:acetylhydrolase, whereas capacitation was inhibited by an acid-labile factor within seminal plasma, implicating this factor as a potential decapacitation factor within seminal plasma. Sperm from a PAF receptor knock-out mouse strain failed to express the receptor and displayed a significantly (p < 0.01) reduced rate of capacitation, as assessed by the spontaneous onset of the acrosome reaction in vitro. When used for in vitro fertilization, sperm from PAF receptor knock-out mice gave a significantly lower rate of fertilization (21.5%) than did wild-type sperm (66.7%). The study shows for the first time the operation of an autocrine loop that induces capacitation in sperm in vitro and shows that this loop acts in concert with other mediators of capacitation to promote efficient fertilization.

Intramolecular C−H Insertion Reactions of (η5-Cyclopentadienyl)dicarbonyliron Carbene Complexes: Scope of the Reactions and Application to the Synthesis of (±)-Sterpurene and (±)-Pentalenene

(eta(5)-Cyclopentadienyl)dicarbonyliron carbene complexes, [(eta(5)-C(5)H(5))(CO)(2)Fe=CHR](+)BF(4)(-), are generated as reactive intermediates from thioether derivatives, (eta(5)-C(5)H(5))(CO)(2)FeCH(R)SPh, by S-alkylation with trimethyloxonium tetrafluoroborate and loss of thioanisole. The carbene complexes undergo intramolecular C-H insertion into appropriately situated side chains to form cyclopentane derivatives. The reaction has been developed into a general procedure employing cycloalkanones as scaffolds bearing the iron carbene moieties and the side chains at C(2) and C(3), respectively. The products of the intramolecular insertion reactions are substituted bicyclo[n.3.0]alkanones. The scope and limitations of the reaction are described. The reaction is applied to a total synthesis of sterpurene and to a formal synthesis of pentalenene. Overall, this approach to cyclopentane annulation complements the related metal-catalyzed insertion reactions of diazocarbonyl compounds, which are also believed to occur via metal carbene complexes.

Elevation of carboxyl methylation activity on GTP-binding protein gamma-subunit in synovial tissues from rheumatoid arthritis: how does elevation of the methylation relate to the signal transduction system of rheumatoid arthritis?

We examined guanosine triphosphate (GTP)-binding proteins (G-proteins) in synovial tissues obtained from patients with rheumatoid arthritis or osteoarthritis. The results of immunoblot analysis with anti-bovine G-protein betagamma-subunit antibody in the rheumatoid synovial tissue were similar to those in the osteoarthritis synovial tissue. On the other hand, the carboxyl methylation activity on G-protein gamma-subunit in the rheumatoid synovial tissue was enhanced compared with that in the osteoarthritis synovial tissues: Km and Vm values were 2.6 microM and 10 pmol/mg x min, respectively, for the rheumatoid arthritis, and 4.8 microM and 5.6 pmol/mg x min, respectively, for the osteoarthritis. These results suggest that G-protein-linked signal transduction, in reference to carboxyl methylation of the gamma-subunit, is affected in rheumatoid tissues.

Synthesis and preliminary evaluation of a carbon-11-labeled adenosine transporter blocker [(11)C]KF21562

We prepared an (11)C-labeled adenosine transporter blocker, [1-methyl-(11)C]-3-[1-(6,7-dimethoxyquinazolin-4-yl)piperidin-4-yl]-1,6-dimethyl-2,4(1H, 3H)-quinazolinedione ([(11)C]KF21652) and examined its potential as a positron emission tomography (PET) ligand for mapping adenosine transporters in the brain and peripheral organs. The log P(7.4) value of KF21652 was 3.14, and the K(i) value was 13 nM for adenosine transporters using [(3)H]nitrobenzylthioinosine as a radioligand. In mice, the highest initial uptake was found in the liver, followed by the kidney and small intestine. The brain uptake was very low. The radioactivity level slightly increased with time in the liver and small intestine, but decreased in the other organs. Coinjection of carrier KF21652 slightly decreased the uptake of [(11)C]KF21562 only in the liver, but not in any other organs. Ex vivo autoradiography of the rat brain showed that [(11)C]KF21652 was scarcely incorporated into the brain. On the other hand, in vitro autoradiography showed the binding of [(11)C]KF21562 to adenosine transporters with high nonspecific binding. These results show that the compound is not a suitable PET ligand for mapping adenosine transporters.

The efficacy of intra-articular analgesia after total knee arthroplasty in patients with rheumatoid arthritis and in patients with osteoarthritis

The pain relief provided by intra-articular injection of morphine plus bupivacaine after total knee arthroplasty (TKA) plus partial synovectomy in patients with rheumatoid arthritis was compared with pain relief after TKA alone in patients with osteoarthritis. There were lower pain scores, a much smaller requirement for systemic analgesics, longer duration until the first requirement of systemic analgesics, and improvement in the range of motion of the knee joint in the patients who received intra-articular injection of analgesics. There was more pronounced postoperative analgesia in the patients with rheumatoid arthritis than in the patients with osteoarthritis in the study groups that received intra-articular injection of analgesics.

Structural analyses of DNA recognition by the AML1/Runx-1 Runt domain and its allosteric control by CBFbeta

The core binding factor (CBF) heterodimeric transcription factors comprised of AML/CBFA/PEBP2alpha/Runx and CBFbeta/PEBP2beta subunits are essential for differentiation of hematopoietic and bone cells, and their mutation is intimately related to the development of acute leukemias and cleidocranial dysplasia. Here, we present the crystal structures of the AML1/Runx-1/CBFalpha(Runt domain)-CBFbeta(core domain)-C/EBPbeta(bZip)-DNA, AML1/Runx-1/CBFalpha(Runt domain)-C/EBPbeta(bZip)-DNA, and AML1/Runx-1/CBFalpha(Runt domain)-DNA complexes. The hydrogen bonding network formed among CBFalpha(Runt domain) and CBFbeta, and CBFalpha(Runt domain) and DNA revealed the allosteric regulation mechanism of CBFalpha(Runt domain)-DNA binding by CBFbeta. The point mutations of CBFalpha related to the aforementioned diseases were also mapped and their effect on DNA binding is discussed.

Thyroid hormones regulate pituitary growth hormone secretagogue receptor gene expression

Thyroid hormones regulate growth hormone (GH) secretion by actions both at the hypothalamus and at the pituitary gland. At the level of the pituitary, thyroid hormones increase GH and GH-releasing hormone receptor (GHRH-R) mRNA expression. To test if thyroid hormones might also regulate the pituitary expression of mRNA for the recently identified GH secretagogue (GHS) receptor, GHS-R, primary pituitary cell cultures from adult male rats were treated with triiodothyronine (T3) and GHS-R mRNA levels were assessed by reverse transcriptase-polymerase chain reaction. T3 increased pituitary GHS-R mRNA levels in a dose- and time-dependent manner. The stimulatory action of T3 on GHS-R mRNA levels was also observed in the presence of the RNA synthesis inhibitor, actinomycin D, indicating that gene transcription is not required. Closer examination of the decay rates of GHS-R mRNA in the presence of actinomycin D revealed T3 extended the half-life of the GHS-R mRNA from 8 h (basal) to15 h, demonstrating that T3 increases GHS-R mRNA levels in vitro by increasing message stability.

Fibrous connection to bone after immediate repair of the canine infraspinatus: the most effective bony surface for tendon attachment

The purpose of this histologic study was to identify the most effective bony surface for fibrous connection to bone after immediate repair of the canine infraspinatus. Light microscopic views were used to evaluate collagen fiber development. The left infraspinatus tendon of 15 dogs was transected and repaired to 3 different bone surfaces: a tendon end adjacent to the tendon insertion (group 1, n = 5), a calcified fibrocartilage layer (group 2, n = 5), and a cancellous surface (group 3, n = 5). Tendon repair to distal tendon ends restored the 4-layered enthesis in the healing period, whereas tendon repair to the calcified fibrocartilage layer considerably delayed fiber development into bone. Fiber connection to cancellous surface developed according to the remodeling of trabecular bone. Secure fiber connection into the thickened trabecular bone developed by 16 postoperative weeks. On the basis of these results, in clinical settings, ruptured tendon ends should be attached to the remaining distal tendon end or to a cancellous surface; they should not be attached to a calcified fibrocartilage layer.