Bone mineral density of the radius in patients with ossification of the cervical posterior longitudinal ligament. A longitudinal study

Radial bone mineral density (BMD) in the distal one sixth and distal one third of the left radius was measured by single-photon absorptiometry (SPA) in patients with ossification of the cervical posterior longitudinal ligament (OPLL). Twenty-three OPLL patients (15 men and 8 women) with mean initial age of 60.1 years were studied longitudinally for mean follow-up period of 3.9 years. Based on roentgenologic findings, the patients were divided into two groups, those with advancing OPLL and those with non-advancing OPLL. The final value of distal 1/6th BMD in the advancing group was significantly lower than its initial value, but no change of the value of the distal 1/3rd BMD was observed in either group. The final value of distal 1/6th BMD/distal 1/3rd BMD ratio in the advancing group was significantly decreased compared with its initial value. These results suggest that, in the advancing OPLL group, trabecular bone mass decreased while cortical bone mass remained unchanged.

Effects of extracorporeal circulation on blood ketone body ratio reflecting hepatic energy metabolism during cardiac operation

To examine the effects of extracorporeal circulation using an artificial heart and lung machine on hepatic energy metabolism in patients with cardiac operation using hypothermia, the arterial blood ketone body ratio (AKBR) reflecting the hepatic mitochondrial redox state was determined in 12 patients who had undergone cardiac operation using extracorporeal circulation from March to August 1991. Changes in AKBR were compared with those before and after extracorporeal circulation. AKBR decreased significantly after the beginning of extracorporeal circulation (p < 0.001) and remained at a lower level throughout extracorporeal circulation. On termination of extracorporeal circulation, the initial level was immediately resumed. The extent of decrease in ketone body ratio at ten minutes before termination of extracorporeal circulation was correlated with short term postoperative hepatic insufficiency. The patients whose ratio decreased below 0.4 showed increased levels in glutamic-pyruvic transaminase at the end of the first and second week after operation. Changes in AKBR were significantly associated with those in blood pressure (r = 0.433; p < 0.005) and body temperature (r = 0.472; p < 0.005). It was concluded that blood pressure and body temperature influence the blood ketone body ratio during extracorporeal circulation.

[Empty sella syndrome]

An empty sella is defined as a sella which, regardless of its size, is completely or partly filled with cerebrospinal fluid (CSF). Empty sella is occasionally found as a normal anatomical variation, which is referred to as primary empty sella. On the other hand, empty sella is also seen after surgery, irradiation or medical treatment of pituitary adenoma, which is called secondary empty sella. Magnetic resonance imaging (MRI) is useful in diagnosing empty sella. Primary empty sella is usually free from clinical symptoms but sometimes associated with headache, obesity, visual disturbance, non-traumatic CSF rhinorrhea and pituitary insufficiency. These associated findings constitute the empty sella syndrome. CSF rhinorrhea, visual disturbance and severe increased intracranial pressure are the indications for surgical treatment. Non-symptomatic cases require no treatment but periodical follow up is necessary.

Novel isoforms of mouse myelin basic protein predominantly expressed in embryonic stage

Myelin basic protein (MBP), a major protein of myelin, is thought to play an important role in myelination, which occurs postnatally in mouse. Here we report that the MBP gene is expressed from the 12th embryonic day in mouse brain and that most of the predominant embryonic isoforms are not those reported previously. These isoforms have a deletion of a sequence encoded by exon 5 from the well-known isoforms. These isoforms show a unique developmental profile, i.e., they peak in the embryonic stage and decrease thereafter. In jimpy, a dysmyelinating mutant, the level of these isoforms remains high even in the older ages. These results suggest that MBPs have heretofore unknown functions unrelated to myelination before myelinogenesis begins. The possible presence of 18 isoforms of MBP mRNA, which are classified into at least three groups with different developmental profiles, is also reported here.

A pilot study of long-term weekly interferon-beta administration for chronic hepatitis B

Interferon-beta was given weekly for 24 wk, at a dose of 3 million units, intravenously, to 10 patients with chronic hepatitis B who were serologically positive for HBsAg and HBeAg. Their condition was followed for 6 months after the end of therapy. Both serum hepatitis B virus-associated DNA-polymerase activity and alanine aminotransferase level became significantly lower during therapy and during the 6 months after the end of therapy than at the beginning of therapy. In five of 10 patients, the seroconversion from HBeAg positive to anti-HBe positive had occurred by 6 months after the end of therapy, and in four of these five patients, serum alanine aminotransferase level became normal. Weekly interferon-beta administration over 6 months seems effective in inducing seroconversion and in normalizing serum alanine aminotransferase level.

[Measurements of bone mineral density of lumbar vertebrae in the lateral projection by dual-energy X-ray absorptiometry--comparison with anteroposterior spinal and radial bone mineral measurements]

Bone mineral density (BMD) of lumbar vertebral bodies in the lateral projection were evaluated using dual-energy X-ray absorptiometry (DEXA) with respect to reproducibility of spinal bone measurements in two projections in healthy men, age-related bone mass changes in healthy women, and the bone mass in osteoporotic women. The BMD of the third lumbar vertebral body in the lateral projection (L3-LAT-BMD) and of the entire third lumbar vertebra in the anteroposterior projection (L3-AP-BMD) were measured with DEXA. The BMD of the distal metaphysis and distal diaphysis of the left radius were measured by single photon absorptiometry. The coefficient of variation in six men aged from 24 to 28 years was 1.7% for L3-LAT-BMD and 1.8% for L3-AP-BMD. In 82 healthy women ranging from 26 to 69 years of age (mean 50 years), BMD decreased rapidly after 50 years of age and above at all measured sites. However L3-LAT-BMD value showed wide distribution and decreased at an earlier age. Correlations within the two BMD values in the same bones were high (r = 0.799 for the vertebra and 0.803 for the radius), while those for any two BMD parameters for different bones were relatively low, with r values varying from 0.456 to 0.560. In 22 women with involutional osteoporosis ranging from 54 to 75 years of age (mean 65), values for L3-LAT-BMD and BMD of the distal metaphysis of the radius were lower than values predicted based on BMD of healthy women.(ABSTRACT TRUNCATED AT 250 WORDS)

A randomized, controlled trial of weekly administration of lymphoblastoid interferon in patients with chronic hepatitis C

To evaluate the efficacy of a treatment of weekly interferon administration in patients with chronic hepatitis C, 36 patients were randomly assigned to two groups. In one group lymphoblastoid interferon was given at a dose of 6 million units, intramuscularly, once per week for 24 weeks, and no treatment was given to the other. Serum alanine aminotransferase levels in the treated group were significantly lower during therapy than in the control group, although there was no significant difference between these two groups before therapy. The normalization of serum alanine aminotransferase levels at the end of therapy was observed in 50% of the treated group, and in 11.1% of the control group. This difference was statistically significant (p < 0.03). Response to interferon was better in patients with chronic persistent hepatitis or with chronic active hepatitis than in patients with chronic active hepatitis with cirrhosis. Relapse after the end of therapy was observed in 83.3% of the responders. These results indicate that the weekly administration of 6 million units of lymphoblastoid interferon is effective in decreasing serum alanine aminotransferase levels in patients with type C chronic persistent hepatitis or chronic active hepatitis.

Retrovirus-mediated gene transfer targeted to malignant glioma cells in murine brain

A murine model for meningeal metastasis of malignant glioma was developed to study selective gene transfer into tumor cells and to establish a reliable means of determining the rate of tumor cell infection. A murine ecotropic retroviral vector was created in which the Escherichia coli beta-galactosidase gene served as a marker for gene expression from the integrated retrovirus. This retrovirus exhibited a high rate of infectivity in RSV-M mouse glioma cells in vitro. The recombinant retrovirus was injected directly into the cisterna magna of the mice. Staining of beta-galactosidase showed that the rate of gene integration was high in the disseminated glioma cells. These results suggest the possibility of retrovirus-mediated gene therapy for meningeal dissemination of malignant glioma.

Characterization of male meiotic germ cell-specific antigen (Meg 1) by monoclonal antibody TRA 369 in mice

We have identified a male meiotic germ cell-specific antigen (Meg 1) with monoclonal antibody (mAb) TRA 369 in mice. The Meg 1 antigen was strongly expressed in specific steps of meiotic germ cells from pachytene spermatocyte to early spermatid, and not in other germ cells or somatic cells. Immunohistochemical examination revealed that the antigen was localized to the cytoplasm and was not distributed in the nucleus or on the cell surface. This antigen was demonstrated to have a molecular weight of 93 kDa and an isoelectric point of 5.2 by Western blotting. This molecule was first detected in the testis of 13-day-old mouse when pachytene spermatocytes first appeared. Thus this is a differentiation-specific antigen in male meiotic germ cells, and mAb TRA 369 is a useful tool to study the regulation of germ cell differentiation and to define germ cell development in a molecular level.

A morphological and ultrastructural investigation of normal mouse brain tissue after intracerebral injection of tumor necrosis factor

Morphological and ultrastructural changes in normal mouse brain tissue were investigated after intracerebral stereotactic injections of tumor necrosis factor (specific activity: 2.0 x 10(6) U/mg protein) into the right frontal lobe. The mice received either a single infusion or multiple tumor necrosis factor infusions in three different dose groups (10, 100, or 500 U). Compared with sham-treated control mice that received adjusted intracerebral injections of purified albumin, the tumor necrosis factor-treated mice in all dose groups did not show any specific in vivo behavioral abnormalities during the 2 months of study following the infusions. Histological studies revealed hemorrhage attributable to the mechanics of the intracerebral infusions, a thickening of the arachnoid membranes, a reactive gliosis, and neutrophilic and/or mononuclear cell infiltration along the infusion pathway. A local neutrophilic response was prominent 1 day after tumor necrosis factor injection. An immunohistochemical analysis indicated that the mononuclear cell infiltration consisted of lymphocytes and macrophages. Except for the transient neutrophilic infiltration, these histological alterations did not differ from those seen in the sham-treated control groups, and most nonspecific reactive changes disappeared within 8 weeks after the injections. Furthermore, an ultrastructural study showed no apparent pathological changes in the cytoplasmic organelles of neuronal, glial, and endothelial cells in the tumor necrosis factor-injected mouse specimens. These results suggest that the tumor necrosis factor injections caused no specific toxicity and did not alter the parenchymal and stromal cells comprising normal mouse brain tissue.

Selective expression of DM-20, an alternatively spliced myelin proteolipid protein gene product, in developing nervous system and in nonglial cells

Mutations within the gene for myelin proteolipid protein (PLP), a major myelin structural protein, result in abnormal glial differentiation, suggesting that the PLP gene products play some other functional roles. Transcripts from the PLP gene were analyzed in the developing mouse brain by a sensitive method using polymerase chain reaction. The mRNA for DM-20, an alternatively spliced transcript from the PLP gene, was detected in the embryonic mouse brain as early as embryonic day 11, long before the appearance of oligodendrocytes, which were considered to be responsible for PLP production. PLP gene expression was analyzed in various cell lines to determine whether synthesis of the DM-20 mRNA is restricted to those of glial cell lineage. All of the nervous system cell lines examined, including nonglial cell lines, produced DM-20 mRNA but no or very little PLP mRNA. Peripheral sciatic nerve from adult Wistar rats also produced mainly DM-20 mRNA. These results indicate that DM-20 is not only a myelin structural protein, but it also plays other roles in the nervous system that seem to relate, at least in part, to glial differentiation.

Visualization of oxidative processes at the cellular level during neutrophil-mediated cytotoxicity against a human hepatoma cell line, HCC-M

Human neutrophil-mediated oxidative processes against a human hepatoma cell line, HCC-M, was visualized at the cellular level by using a silicon-intensified target camera and subsequently processing with a computer-assisted digital-imaging processor. Neutrophils were activated by a streptococcal preparation, OK-432. A hydroperoxide-sensitive tracer, dichlorofluorescein diacetate, was loaded in HCC-M and temporal and spatial changes of lipid peroxides in this cell after addition of stimulated neutrophils were analyzed. The luminol-dependent chemiluminescence activity of neutrophils was significantly enhanced and continued for at least 2 hr by stimulation with OK-432, and its activity was shown to be accumulated at the site where a neutrophil attached with HCC-M. The intensity of dichlorofluorescein fluorescence in HCC-M rapidly increased after adding stimulated neutrophils, and their reaction was significantly attenuated by superoxide dismutase. The number of non-viable cells was increased as the dichlorofluorescein fluorescence increase. It is suggested that oxidative stress may play an important role in neutrophil-mediated tumor-cell damage.

Relationship among serum levels of luteinizing hormone, estradiol, and progesterone during follicle stimulation and results of in vitro fertilization and embryo transfer (IVF-ET)

Eighty-eight IVF-ET cycles were classified into four groups according to the results of IVF-ET (Group A-conceptional cycles, 10 cycles; Group B-cycles with cleaved oocytes, 58 cycles; Group C-cycles with fertilized oocytes, 9 cycles; Group D-cycles without fertilization, 11 cycles). Serum luteinizing hormone (LH), estradiol (E2), and progesterone (P) levels during follicle stimulation were studied in these groups. Patients participated in our IVF-ET program due to irreparable tubal damage. Follicle development was stimulated with a clomiphene-human menopausal gonadotropin (hMG)-human chorionic gonadotropin (hCG) regimen. Group C showed a low E2 response to follicle stimulation. Groups B and D showed significantly higher serum P levels on day 0 (the day of hCG injection) than Group A (Group A, 0.73 +/- 0.11, vs Groups B and D, 1.43 +/- 0.15 and 2.17 +/- 0.42 ng/ml; P less than 0.01). The effects of serum P and LH levels on the fertilization and pregnancy rates were studied. The pregnancy rate was not affected by the serum LH level but was only 2.7% in cycles in which serum P was 1.2 ng/ml on day 0, which was significantly lower than that in cycles in which serum P was less than 1.2 ng/ml on day 0 (19.1%) (P less than 0.05). The fertilization rate was significantly lower in the cycles with higher levels of serum P and/or LH than in cycles in which serum P was less than 1.2 ng/ml and serum LH was normal (50.5 vs 78.8%; P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

[Osteoporosis in rheumatoid arthritis]

Rheumatoid arthritis may be associated with generalized, as well as, juxta-articular osteoporosis. To assess the skeletal distribution of bone loss, bone mass was measured in women with rheumatoid arthritis, using single photon absorptiometry and dual energy X-ray absorptiometry. Bone loss was more rapid in the distal metaphyseal region of the radius than in the diaphyseal region. Bone loss in the legs was correlated with gait disturbance and bone loss in the third lumbar vertebra was recognized only in the patients treated with corticosteroids for more than 1 year. These results indicate that rheumatoid arthritis was not universally associated with generalized osteoporosis. Patients treated with corticosteroids are likely to be at risk from generalized osteoporosis.

Radial bone mineral changes in pre- and postmenopausal healthy Japanese women: cross-sectional and longitudinal studies

Healthy premenopausal and postmenopausal Japanese women were evaluated by longitudinal and cross-sectional studies to assess changes in radial bone mineral density. A total of 300 healthy Japanese women were enrolled in the cross-sectional study, and 126 of them were chosen for the longitudinal study. In the cross-sectional study significantly lower bone mineral density was found in the women over 50 years old. In the longitudinal study, premenopausal women aged 45-54 years showed rate of change of -0.61%/year at the distal radius and 0.49%/year at the radial shaft. The perimenopausal changes were -1.95 and -0.93%/year and the postmenopausal changes were -1.88 and -1.37%/year at the distal radius and at the radial shaft, respectively, in the women aged 45-54 years. These rates of premenopausal and postmenopausal change were similar to those reported for whites in the United States. The strength of the relationship between the rate of change in radial bone mineral density and the anthropometric values, biochemical data, and menopausal status was evaluated by multiple linear regression analysis. Menopausal status had the greatest influence on the rate of change in radial bone mineral density. It is concluded that menopausal status was the most important variable related to bone loss in our longitudinal study and the rate of bone loss was greatest during the early postmenopausal period in healthy Japanese women.

Detection of brain-specific gene expression in brain cells in primary culture: a novel promoter assay based on the use of a retrovirus vector

Promoter activities of the brain-specific genes for glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP) were investigated in brain cells in primary culture with the use of a novel retrovirus vector, pIP200. With this vector, promoter activity can be expressed in terms of beta-galactosidase activity. Differentiation of the primary brain cells to mature glial cells was not affected by treatment with the pIP200 virus vector. The 256-bp 5'-flanking region of the GFAP gene directed astrocyte-specific expression of lacZ. It was silent in fibroblasts, even in multiple copies. The 1.3-kb 5'-flanking region of the MBP gene exhibited strict tissue (oligodendrocyte) specificity under the present assay method but showed some leakiness when integrated into the chromosome in multiple copies. Promoter regions conferring cell type specificity in brain were effectively identified by the present method.

A potential approach for gene therapy targeting hepatoma using a liver-specific promoter on a retroviral vector

Recent technological advances made in molecular biology and in vitro culture of human and other mammalian cells have led to broad medical and scientific acceptance of the feasibility of gene therapy for genetic diseases. Cancer might practically be one of the attractive targets for such therapy. For the treatment of cancer, it is important to manipulate the gene of interest such that it is expressed solely in cancer cells. We have developed a tissue-specific gene expression system, based on a tissue-specific promoter on a retroviral vector. A murine ecotropic retroviral vector was constructed in which the Escherichia coli beta-galactosidase gene served as a reporter; it was expressed under control of the albumin enhancer element and promoter. The tissue specificity of this vector was first assessed in vitro, and beta-galactosidase activity was detected exclusively in hepatoma cell lines. This recombinant retrovirus was injected directly into a subcutaneous tumor composed of transplantable murine MH-134 hepatoma cells, and expression of the gene was observed in vivo. Then this recombinant retrovirus was injected via the spleen or directly into the liver, resulting in the gene expression in dividing hepatocytes in partially hepatectomized mice, but not in nondividing hepatocytes in normal mice. Gene transfer specific to dividing hepatocytes and expression by means of retroviral vectors should possess high potential for selective elimination of hepatoma cells surrounded by nondividing normal hepatocytes.

Characterization of B cells in human thymus

The surface characteristics of B cells present in the human thymus were investigated. Cytofluorometrical and immunohistological studies, using anti-human IgM or anti-B cell monoclonal antibodies (mAbs; anti-Leu 12Ab, anti-Leu 16Ab, or L26), revealed that a small number of B cells are present in the human thymus. The thymic B cells were detected only in a low-density cell population, whereas in a high-density cell fraction, only T cells were found. In 15 cases, all of which the thymi were histologically normal, the percentages of B cells in the low-density fraction were 0.28% to 50% (6.8% in average), and Leu 1+ (CD5+) B cells in the low-density fraction were 0.1% to 26% (3.5% in average); approximately 50% of the thymic B cells were Leu 1+ B cells. These results indicate that B cells, especially Leu 1 (CD5)+ B cells, are also present in the human thymus, as suggested from our previous reports on mice.

Proto-oncogene expression in three human hepatoma cell lines, HCC-M, HCC-T and PLC/PRF/5

Changes of nucleotide sequences and expressions of cellular oncogenes in human hepatoma cell lines, PLC/PRF/5, HCC-M and HCC-T cells, were examined by Southern and Northern blot analyses. The probes used are DNA fragment of myc, N-, H-, K-ras, fos, fms, raf, erb-A, erb-B, and erb-B2 genes and synthetic oligonucleotides corresponding to the part of N-, H-, K-ras genes. The results are as follows. DNA amplification and rearrangement were not detected in these three human hepatoma cell lines. Point mutations at codons 12, 13, and 61 in N- and K-ras genes were not demonstrated in these cell lines. N-, H-, K-ras and myc transcripts were detected in these three cell lines. However, fos gene transcript was detected only in PLC/PRF/5 and HCC-M cells which were derived from hepatitis B related hepatocellular carcinoma and having integrated hepatitis B virus (HBV) DNA. These data showed that there are no specific proto-oncogene expression into RNA except for myc and ras genes, nor DNA rearrangement in these 3 human hepatoma cell lines with regards to at least 10 different oncogenes examined and suggest the relationship between fos gene expression and integration of HBV DNA in host cell DNA.

Treatment of chronic hepatitis C with weekly administration of interferon-alpha

To evaluate the efficacy of weekly administration of interferon (IFN)-alpha, we studied 23 anti-HCV positive patients with chronic hepatitis diagnosed by liver needle biopsy. Thirteen patients received weekly intramuscular injections of 6 MU human lymphoblastoid interferon (HLBI) for 24 weeks, and the other 10 patients were given no treatment. We examined liver-specific idiotype-bearing antibody (LSIA) in the patients' sera. This HLBI treatment was easily tolerated by all the treated patients. In the treated group serum alanine aminotransferase (ALT) level significantly decreased during HLBI treatment. Normalization of serum ALT level by the end of treatment was observed in 7/13 (54%) of the treated patients but in 0% of the non-treated patients. Anti-HCV was detectable in all the patients during the treatment. Those who had high LSIA levels did not respond to HLBI treatment. These results demonstrate that weekly administration of IFN is sufficient to suppress disease activity in patients with chronic hepatitis C and that patients with high LSIA levels are unlikely to respond to IFN therapy.

Differentiating effect of sodium butyrate on human hepatoma cell lines PLC/PRF/5, HCC-M and HCC-T

The in vitro effect of sodium butyrate (SB) on human hepatoma cell lines PLC/PRF/5, HCC-M and HCC-T was investigated. SB was added at the non-toxic but cytostatic concentration of 1 mM. In all these cell lines, SB reduced cell proliferation and changed the morphology of the cells into a fibroblast-like shape. In PLC/PRF/5, alpha-fetoprotein production and c-myc expression were inhibited. In contrast, gene expression of albumin, one of the normal liver-cell products, and that of integrated hepatitis B virus genome, was increased. In HCC-M and HCC-T, c-myc expression, which was enhanced in the naive state, was reduced. In HCC-M, fos expression was inhibited but the expression of N- and K-ras genes did not change. SB seemed to induce normal or mature properties of hepatocytes in human hepatoma cell lines.

Effects of long-term cerebral ischemia caused by bilateral carotid artery ligation on the acceleration or the development of hypertension in spontaneously hypertensive rats (SHR) or Wistar-Kyoto rats (WKY)

Bilateral carotid artery ligation (BCL) was performed with one week interval between the each operation in male spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) aged 4 months. BP rose immediately after unilateral carotid artery ligation (UCL) and BCL in both WKY and SHR due to carotid sinus reflex. Once returning to preoperative levels after both UCL and BCL, BP of SHR and WKY increased again gradually one and 4 months after BCL and thereafter, respectively. BP was significantly higher than that in the controls of each strain, and the BP increment was significantly greater in SHR than in WKY. A significant regional cerebral blood flow (rCBF) increase on the contralateral side of carotid ligation was observed in SHR in contrast to a little change in that of WKY and a reduction of rCBF after BCL was significantly greater in SHR than in WKY. Behavioral activities in SHR were also reduced after BCL. Cerebral edema with nerve cells damage was recognized in SHR. In contrast, little change was found in WKY. On the other hand, upper cervical sympathectomy attenuated convulsive seizures after BCL more markedly in SHR, which survived longer than non-denervated SHR. These results suggest that chronic mild cerebral ischemia caused by BCL with one week interval accelerates the development of severe hypertension in SHR and developed mild hypertension in WKY. Sympathetic innervation might play much more important role in collateral circulation through the vertebrobasilar system in SHR.