Inhibitory effects of KW-3902, a selective adenosine A1-receptor antagonist, on the adenosine-induced shortening of action potential duration in guinea pig atrial muscles

We investigated the effects of KW-3902 (8-(noradamantan-3-yl)-1,3- dipropylxanthine), a newly-synthesized selective adenosine A1-receptor antagonist, on the shortening of action potential duration (APD) in guinea pig atria exposed to adenosine. The APD shortening by adenosine was inhibited by KW-3902 at higher than 10(-8) M, but not by 10(-5) M of KF17837, an adenosine A2-receptor antagonist. These results support the notion that the APD shortening by adenosine in atria is mediated via adenosine A1-receptors. The potency of KW-3902 in antagonizing the APD-shortening were similar to those in antagonizing the negative inotropic and chronotropic action of adenosine in the isolated right atria, suggesting that these responses to adenosine are mediated via the receptors of the same type.

Prognostic value of DNA ploidy in squamous cell carcinoma of esophagus. Analyzed with improved flow cytometric measurement

BACKGROUND

The prognostic value of flow cytometric DNA analysis on paraffin-embedded tumor samples has been controversial in esophageal cancer. To clarify its true significance, the authors developed an improved method that excludes the possibility of contamination by lymphocytes in tumor sample.

METHODS

Single nuclear suspension was prepared from paraffin-embedded samples on 103 patients with squamous cell carcinoma of the esophagus. Both DNA content and nuclear size were simultaneously measured by flow cytometry on 30,000 nuclei, and contaminated lymphocyte nuclei were eliminated from the data by optimal gating. Correlation between DNA ploidy and postoperative survival was examined.

RESULTS

Analysis using a flow cytometric cell sorter showed that the frequency of tumor cells in the lymphocyte-reducing gating fraction (LGF) was significantly higher than that in the conventional nongating fraction (NGF). LGF analysis showed aneuploid peaks in 58 patients (56.3%), but NGF analysis showed aneuploid peaks in only 38 patients. LGF analysis revealed that the aneuploid tumors had higher histologic grading (P < 0.05) and worse survival rate (P < 0.01) compared with diploid tumors. However, conventional methods could not detect this difference.

CONCLUSIONS

Flow cytometric analysis gating by nuclear size may be helpful to detect aneuploid peaks, and for predicting prognosis of patients with squamous cell carcinoma of esophagus.

Embryo-dependent induction of uterine receptivity assessed by an in vitro model of implantation in mice

To investigate the molecular basis of initial interactions between the trophoblast and the uterine epithelium at implantation, we developed an in vitro model for implantation in mice using primary uterine organ cultures as the substrate. In this model, embryos attached to the endometrial explants within 60 min. We were able to observe the attachment between embryos and endometrial explants in real time. Using this model, we investigated the attachment of embryos to uterine strips cultured from pregnant mice, pseudopregnant mice, pseudopregnant mice that had received hCG injections, and pregnant mice whose utero-tubal junctions had been ligated on Day 2 of pregnancy. The serum levels of progesterone in pregnant and pseudopregnant mice were also compared. The percentages of embryos that attached to uterine strips cultured from pregnant mice on Days 1-4 were low (0.0-15.0%). However, by Days 5-7, percentages of attachment increased markedly (66.8-74.8%). These levels were significantly higher than those observed for pseudopregnant mice (0.0-18.0%) and pseudopregnant mice that had received hCG injections (0.0-15.0%). The percentages of attachment to the ligated horns of pregnant Day 5 uteri (58.3-61.5%) were significantly higher than that of pseudopregnant mice (10.0%). The percentages of attachment to the ligated horns of pregnant Day 6 and 7 uteri decreased significantly (3.2%-19.4%). On the other hand, the percentages of attachment to the unligated horns of pregnant Day 6 and 7 mouse uteri did not decrease significantly (61.1-70.0%). The serum progesterone levels of pseudopregnant mice were not significantly lower than those of pregnant mice on Days 1-5.(ABSTRACT TRUNCATED AT 250 WORDS)

[Analysis of 30 patients with hypercalcemia]

We have treated 30 patients with hypercalcemia from 1984 to 1991. Twenty four out of 30 patients were associated with primary hyperparathyroidism and the other six were associated with malignancy. Of 24 cases primary hyperparathyroidism, 15 were due to single parathyroid adenoma, five to MEN 1 and one to familial hyperparathyroidism. In the other three cases, it was difficult to identify the cause of the hyperparathyroidism. Following conclusions were obtained: 1. Hypercalcemia shows no specific and characteristic symptoms, so it is essential to keep hypercalcemia in mind in diagnosis of patients with vague or general complaints. Malignancy associated hypercalcemia shows high serum calcium level and PTH level. When considering malignancy, it is easy to diagnose that it might be the cause of hypercalcemia. 2. When serum PTH is over 2000pg/ml (high sensitivity PTH assay) in primary hyperparathyroidism, the probability of swelling of multiple parathyroid glands should be considered in evaluation of localization study and surgery. When serum PTH is high or swelling of multiple glands is found. It is essential to evaluate the possibility of MEN 1.

Growth-regulatory mechanism of two human esophageal-cancer cell lines in protein-free conditions

We investigated the growth-regulatory mechanism of 2 esophageal squamous-cancer cell lines, TE2-NS and TE3-OS cells, both of which can grow stably in protein-free conditions in vitro. Protein-free conditioned media from TE2-NS and TE3-OS cells stimulated the growth of these cells. Exogenous epidermal growth factor (EGF), transforming growth factor-alpha (TGF-alpha), insulin-like growth factor (IGF)-I and -II enhanced cell proliferation by 2.2- to 3.8-fold in protein-free conditions, as compared with an untreated control. Receptor-binding assays showed that both TE2-NS and TE3-OS cells possessed a single class of high-affinity binding sites for IGF-I and 2 classes of binding sites for TGF-alpha, as confirmed on the cell membrane by immunochemistry. These results suggest that EGF, TGF-alpha and IGFs are candidates for the autocrine growth factor in cancer cells. The addition of inhibitory monoclonal antibodies against TGF-alpha and EGFR, but not those against either EGF or IGF-IR, significantly inhibited growth of the cells. Immunocytochemical staining and ELISA of the conditioned media both confirmed the production of TGF-alpha protein, but not EGF protein, in these cell lines. The data for a protein-free culture system strongly suggested that TGF-alpha, but not EGF or IGF, is biologically important as an autocrine growth factor in the growth of these cell lines in vitro.

Identification of the IL-6-responsive element in an acute-phase-responsive human pancreatic secretory trypsin inhibitor-encoding gene

Pancreatic secretory trypsin inhibitor (PSTI) has been suggested to be an acute-phase reactant in humans and to be induced by inflammatory cytokines such as the interleukins IL-1 and IL-6. We report that PSTI is synthesized in hepatoma cells and that the gene expression is augmented by IL-6. The start points (tsp) for basal and augmented transcription are exactly the same as the tsp in normal pancreas. Analysis of the PSTI gene revealed that a 40-bp DNA fragment located between kb -3.84 and -3.80 carries the element responsible for both transcriptional activity and IL-6-induced gene expression. This 40-bp fragment contains TTGNNGNAATG, the consensus sequence for the NF-IL6-binding site, which is also known as the IL-6-responsive element that is conserved among various acute-phase genes. The basal activity was augmented by another sequence that lies between kb -4.0 and -3.9.

Prognostic value of DNA ploidy in squamous cell carcinoma of esophagus. Analyzed with improved flow cytometric measurement

BACKGROUND

The prognostic value of flow cytometric DNA analysis on paraffin-embedded tumor samples has been controversial in esophageal cancer. To clarify its true significance, the authors developed an improved method that excludes the possibility of contamination by lymphocytes in tumor sample.

METHODS

Single nuclear suspension was prepared from paraffin-embedded samples on 103 patients with squamous cell carcinoma of the esophagus. Both DNA content and nuclear size were simultaneously measured by flow cytometry on 30,000 nuclei, and contaminated lymphocyte nuclei were eliminated from the data by optimal gating. Correlation between DNA ploidy and postoperative survival was examined.

RESULTS

Analysis using a flow cytometric cell sorter showed that the frequency of tumor cells in the lymphocyte-reducing gating fraction (LGF) was significantly higher than that in the conventional nongating fraction (NGF). LGF analysis showed aneuploid peaks in 58 patients (56.3%), but NGF analysis showed aneuploid peaks in only 38 patients. LGF analysis revealed that the aneuploid tumors had higher histologic grading (P < 0.05) and worse survival rate (P < 0.01) compared with diploid tumors. However, conventional methods could not detect this difference.

CONCLUSIONS

Flow cytometric analysis gating by nuclear size may be helpful to detect aneuploid peaks, and for predicting prognosis of patients with squamous cell carcinoma of esophagus.

Non-radioisotopic quantitative RT-PCR to detect changes in mRNA levels during early mouse embryo development

We developed a non-radioisotopic quantitative RT-PCR method with high sensitivity and reproducibility. The results of this RT-PCR were in agreement with those of the Northern blot analysis. We measured the mRNA levels of beta-actin, transferrin receptor, and two cell cycle-related genes, cyclin B and cdc25, in early mouse embryos by the RT-PCR. In late two-cell stage embryos, beta-actin, transferrin receptor and cyclin B mRNA levels were 10-20% of those in MII stage oocytes. In contrast, the cdc25 mRNA levels were not different between these stages. When we cultured mouse embryos, the presence of an RNA polymerase inhibitor, alpha-amanitin, in the medium did not affect the mRNA levels at the two-cell stage, indicating that most of the detected mRNAs in two-cell embryos were maternally derived. These results suggest that the rate of mRNA degradation is different between cyclin B and cdc25 during early embryogenesis.

Cloning of a human immunoglobulin gene fragment containing both VH-D and D-JH rearrangements: implication for VH-D as an intermediate to VH-D-JH formation

In an Epstein-Barr virus-transformed human B cell line we found an unusual immunoglobulin heavy chain gene rearrangement. Restriction mapping and sequencing analysis led us to conclude that VH-D and D-JH recombination took place in a single allele. Both VH-D and D-JH complexes still had their recombination signal sequences adjacent and the DNA sandwiched by these two complexes retained a germ-line configuration, suggesting the potential for a secondary rearrangement resulting in a VH-D(-D)-JH formation. With this finding, we propose a novel pathway, in which the VH-D complex is an intermediate in the formation of a functional VH exon.

The effects of calpeptin (a calpain specific inhibitor) on agonist induced microparticle formation from the platelet plasma membrane

Platelets activated by various agonists produce formation of vesicles shed from the plasma membrane (microparticles). However, the mechanism of microparticle (MP) formation has not been clarified yet. The aim of the present study was to determine the possibility of involvement of calpain (a Ca(2+)-dependent thiol protease) in MP formation. Washed platelets preincubated with calpeptin, a cell permeable calpain specific inhibitor, or with a vehicle were activated by thrombin plus collagen or by calcium ionophore A23187. Flow cytometry was used to detect the amount of microparticle formation by using murine monoclonal antibodies against GP IIb-IIIa or GP IIb and fluorescein 5-isothiocyanate labeled goat anti-mouse IgG. MP formation stimulated either by thrombin plus collagen or by A23187 was inhibited by calpeptin in a dose dependent manner. The microparticle formation from platelets activated by A23187 reached a plateau in approximately 5 min after activation, whereas that from platelets activated by thrombin plus collagen reached a plateau at 30 min following the stimulation. These time sequences corresponded well with those of degradation of actin-binding protein (ABP), a well known substrate of calpain, of platelets activated by these two stimulations. However, the inhibition of MP formation by calpeptin was more marked in the early stage (within 10 min) than in the late stage (after 30 min) of platelet activation. At 30 min after platelet activation by either two stimulations, a significant amount of microparticle formation was observed in the presence of 30 microM calpeptin, which inhibited hydrolysis of ABP almost completely. Our data suggest the involvement of calpain in the early stage (especially within 10 min) of microparticle formation.

Effect of PSK, a protein-bound polysaccharide preparation, on liver tumors of Syrian hamsters induced by Thorotrast injection

The contrast medium Thorotrast, an agent well known to be carcinogenic, was injected into 400 congeneic Syrian hamsters. The resulting incidence of malignant hepatic tumors such as cholangiocarcinoma, hepatocellular carcinoma and hemangiosarcoma, was significantly higher in the male experimental group than in the control group, and the 50% survival period in the male group was shortened by about 100 days (P < 0.01). However administration of the antitumor drug PSK (Polysaccharide Kureha), a protein bound-polysaccharide extracted from basidiomycete fungi, prevented this carcinogenic effect. The incidence of malignant hepatic tumors in the experimental group was 22.5% compared with 2.8% in the control group (P < 0.01) and 10.5% in the PSK-treated group (P < 0.01). PSK also increased the 50% survival period by 61 days (P < 0.01).

[Flow cytometry in clinical laboratory medicine]

Flow cytometric analysis of blood cells is an important technique for the evaluation of the immunological functions of patients with various disorders, and also for the differential diagnosis of leukemias. In the lymphocyte subset analysis, special attention should be paid to the optimal gating of lymphocytes. We recommend the use of CD13 and CD33 to ascertain more accurate gating of lymphocytes and more efficient monitoring of the contamination of non-lymphoid cells, especially in patients with PNH, in addition to CD45 and CD14, which are already utilized routinely. We also feel that 2-color and 3-color analyses should be applied more frequently for the routine laboratory tests for lymphocyte subsets. With regard to the analysis of leukemia cells, the combined use of nuclear DNA content or TdT (terminal deoxynucleotidyl transferase) with other routine cellular markers is quite useful for the analysis of a small number of leukemia cells, and enables the differentiation of leukemia cells from the contaminating non-malignant cells, particularly in the analysis of the minimal residual diseases. Among the cellular markers defined by specific monoclonal antibodies, we stress the physiological significance of recently developed cell adhesion molecules, such as selectins and their carbohydrate ligands, which are closely involved in the recruitment of leukocytes in inflammatory responses, as well as in the infiltration processes of leukemia cells.

The sources and biochemical characteristics of cobalamin-binders in human amniotic fluid

The sources and biochemical characteristics of cobalamin-binders in amniotic fluid were investigated. Using gel-permeation chromatography, cobalamin-binder, extracted from amniotic fluid at term, was recovered in a single peak with the molecular size of haptocorrin. Neonatal saliva also contained only haptocorrin. However, neonatal gastric juice contained two types of cobalamin-binders: haptocorrin and intrinsic factor. Amniotic fluid in midtrimester contained three types of cobalamin-binders: haptocorrin, intrinsic factor, and transcobalamin II. The cultured amnion cells secreted mainly apo-transcobalamin II. Concentrations of both apo-haptocorrin and salivary amylase in amniotic fluid increased as gestation advanced. These results suggest that cobalamin-binder in amniotic fluid in midtrimester originates from the fetal salivary gland, fetal gastric mucosa, and amnion cells, and that the contribution by the fetal salivary gland increases at term, when almost all cobalamin-binders in amniotic fluid are haptocorrin.

Apparent genetic difference between hypothyroid patients with blocking-type thyrotropin receptor antibody and those without, as shown by restriction fragment length polymorphism analyses of HLA-DP loci

HLA types in Japanese patients with primary hypothyroidism were analyzed to see whether those with blocking-type TSH receptor antibody (TSH-R BAb M) differed genetically from those with idiopathic myxedema (IM). HLA typings of -A, -B, -C, -DR, and -DQ (73 antigens) were performed serologically, and those of -D and -DP (29 antigens) were analyzed by the restriction fragment length polymorphism method. Thirty patients were studied with TSH-R BAb M, and 28 with IM. The data were analyzed and compared with our previous results from 88 Graves' patients, 46 Hashimoto patients, and 186 control subjects. Overall, 192 patients with 4 autoimmune thyroid disorders showed a decrease in -Aw19 and an increase in -DQw4 (corrected P < 0.05) and significant associations of -Aw33, -Bw46, -Cw3, -DRw8, -DR9, and -DQw3. In TSH-R BAb M patients, increases in -B35, -Bw60, and -Dw8 and decreases in -DR4 and -DPw2 were seen, whereas IM patients showed increased -DPw2, -Bw61, and -Dw23. In comparisons between TSH-R BAb M and IM, the difference in -DPw2 was highly significant. HLA-B35 differed significantly in these 2 types of hypothyroidism. In conclusion, TSH-R BAb M patients have decreased frequency of -DPw2 and are genetically similar to Graves' disease, whereas IM patients are characterized by high frequency of -DPw2 and are genetically similar to Hashimoto's thyroiditis.

Thyroid histology of hyperthyroid Graves' disease with undetectable thyrotropin receptor antibodies

To determine the histological characteristics of hyperthyroid Graves' disease with undetectable TSH receptor antibodies (TRAb), we examined the thyroid histological findings of patients with hyperthyroidism who were referred for subtotal thyroidectomy and who lacked circulatory TRAb. Four patients had undetectable TRAb (6.4 +/- 4.2%) before treatment (group A). Their pathological and clinical findings were compared with those of four patients who had hyperthyroid Graves' disease with detectable TRAb (83.8 +/- 8.3%) before treatment (group B). The groups were matched for sex, age, duration of antithyroidal drug therapy, anti-Tg antibody, and antimicrosomal antibody levels. All patients were in a euthyroid state just before operation. Papillate hyperplastic epithelia in group A were significantly less severe than in group B. Enlarged colloids were not observed in two of the four patients in group A but were observed in all four patients in group B. Moderate or marked lymphocytic infiltrations were observed in all patients in group A but were virtually absent in group B. Based on these results, it is probable that hyperthyroid Graves' disease with undetectable TRAb titers represents an early stage or subtype of usual hyperthyroid Graves' disease in which there is marked or moderate lymphocytic infiltration.

Calyculin A inhibits the exposure of fibrinogen receptor in thrombin-stimulated platelets

Calyculin A (CLA) and okadaic acid (OA), specific and potent inhibitors of protein phosphatase 1/2A, inhibit platelet aggregation. However, their inhibitory mechanisms remain unknown. We investigated the effects of CLA on the exposure of fibrinogen receptor in thrombin-stimulated platelets, using flow cytometry with a monoclonal antibody against the fibrinogen receptor of activated glycoprotein(Gp)IIb/IIIa complex (PAC-1). CLA inhibited the exposure of fibrinogen receptor in a dose related manner when added either before or 3 min after thrombin stimulation. In contrast, CLA had no significant effect when the expression of GpIIb/IIIa complex was examined in resting platelets, using a monoclonal antibody recognizing non-activated GpIIb/IIIa complex (NNKY1-32). These results suggest that protein phosphatase 1/2A may be directly involved in the exposure of platelet fibrinogen receptor.

The impact of intensified supervisory activities on tuberculosis treatment

A Health Subcentre-based randomized controlled trial was conducted in order to determine the importance of the motivation of the tuberculosis personnel in improving the results of a treatment programme. A total of 1300 newly detected tuberculosis patients from 7 Health Centres were divided into study and control groups using the Health Subcentre areas as sampling units. In the study group, worker motivation was intensified through special regular sessions and closer supervision, while in the control group the usual procedures were followed. Treatment performance was remarkably improved in the study areas: treatment completion rate was 78.8% in the study group, compared with 65.2% in the control group. Bacteriological conversions among those having completed the treatment were 91.9% and 62.2% respectively, and overall efficacy was 75.2% and 45.8%, respectively. In addition to improved treatment, the follow-up case examinations also showed markedly increased performance. Although this study was done in facilities using conventional regimens which have been replaced with short-course regimens more recently, the study results still clearly indicate the importance of motivating personnel in the field to attain better case management.

Suppression of tumourigenicity in human colon carcinoma cells by introduction of normal chromosome 1p36 region

Development of colon carcinomas appears to be associated with inactivation of multiple tumour suppressor genes. Cytogenetic and DNA analyses of colon carcinomas have detected a high frequency of chromosome 1p deletion, which suggests the presence of a tumour suppressor gene. We therefore introduced normal human chromosome 1 into colon carcinoma COKFu cells, through microcell hybridization. Six clones of hybrid cells containing normal chromosome 1 were obtained, four of which had a small fragment of the introduced chromosome 1, including 1p36-34. The morphology of hybrid cells with chromosome 1 markedly altered to a flat shape. The cloning efficiency of all six hybrid cells in soft agar was significantly reduced, and the tumourigenicity in athymic nude mice was completely suppressed. Hybrid cells containing only the region of 1p36-34, as well as those containing intact chromosome 1, showed suppressed transformed phenotype. Furthermore, several tumourigenic revertant cells were obtained from the hybrid cells. These revertant cells had a morphology similar to that of COKFu cells, and were found to have lost the 1p36 region from the introduced chromosome 1. These results indicate that a normal chromosome 1p36 carries a tumour suppressor gene for colon carcinogenesis.

Systemic deposits of thorium in thorotrast patients with particular reference to sites of minor storage

It is well established that injected Thorotrast is deposited in the liver, spleen, bone marrow, and lymph nodes, but accumulations in organs with lower macrophage activity have previously been given little attention. In this work, neutron activation analysis has been used to investigate concentrations of thorium in autopsy samples taken at sites of major and minor deposition in 24 Thorotrast patients. In the latter category, the highest values were found in the testis [40 x 10(-6) g/g(wet)], followed by those in the adrenal gland, gallbladder, lung, and pancreas. The resulting alpha-particle dose rates (mGy/year) are tentatively estimated to be 8.5 to the testis, 5.5 to the gallbladder, and 5.3 to the lung. These results may be relevant to the residual excess mortality among Thorotrast patients after diseases of the principal organs of deposition have been excluded; they also support previous indications that thorium deposited in pulmonary tissues is responsible for an important component of the total dose to the lung. In another context, our data may bear on the connection, postulated elsewhere, between exposure to alpha-particle emitters and elevated incidence of leukemia in the children of workers engaged in the reprocessing of nuclear fuel.

Sequential observation of mitochondrial distribution in mouse oocytes and embryos

OBJECTIVE

The purpose of this study was to elucidate changes in the distribution of mitochondria through the cell cycle.

MATERIALS AND METHODS

Mouse oocytes and embryos were recovered sequentially from mice and stained with the vital fluorescent mitochondrial stain rhodamine 123. Mitochondrial staining pattern were classified into three types: aggregation (Ag), homogeneous (H), and perinuclear accumulation (PA).

RESULTS

Sequential observations revealed that mitochondria of oocytes and embryos grown in vivo translocated in the cytoplasm during the cell cycle, showing the H pattern before human chorionic gonadotropin (hCG) administration, the PA pattern 8-9 hr post-hCG, the H pattern again 10-14 hr post-hCG, and the PA pattern again 24 and 31-32 hr post-hCG following fertilization. In the two-cell stage, the Ag pattern was shown 35 hr post-hCG, the H pattern was observed 40 hr post-hCG, and the PA pattern was found 48 hr post-hCG. In the embryos cultured in vitro and showing developmental block, mitochondrial translocation was shown to be inhibited after they aggregated in the early two-cell stage (35 hr post-hCG). Moreover, the translocation of mitochondria was restored by the addition of superoxide dismutase or thioredoxin to the culture medium. Both of these enzymes have already been shown to have the ability to overcome developmental block.

CONCLUSION

The present study revealed that mitochondria translocated in the cell cycle and suggested that there is a close relationship between mitochondrial translocation and developmental arrest.

Granulocyte colony-stimulating factor down-regulates the surface expression of the human leucocyte adhesion molecule-1 on human neutrophils in vitro and in vivo

The leucocyte adhesion molecule-1 (LAM-1) is the human homologue of the murine peripheral lymph node homing receptor, MEL-14, and might play a crucial role in neutrophil localization at inflammatory sites. We have reported previously that recombinant human granulocyte colony-stimulating factor (rhG-CSF) stimulates or enhances several neutrophil functions in vivo, as well as in vitro. To further explore the possible role of G-CSF in inflammation we studied the effect of rhG-CSF on the surface expression of LAM-1 on human neutrophils, both in vitro and in vivo. The expression of LAM-1 by human neutrophils was investigated by indirect immunofluorescence using flow cytometry and monoclonal antibodies anti-Leu-8 and TQ1. A whole blood analysis was performed to minimize in vitro manipulation. Most circulating human neutrophils expressed LAM-1 on the cell surface. Brief exposure of neutrophils to rhG-CSF in vitro decreased the surface expression of LAM-1. rhG-CSF down-regulated neutrophil LAM-1 expression in a time- and dose-dependent manner. Neutrophils from healthy volunteers and from patients who were receiving rhG-CSF exhibited a decreased expression of LAM-1 after rhG-CSF administration, and the expression thereafter returned or overshot the pretreatment level after stopping rhG-CSF administration. These findings indicate that rhG-CSF down-regulates the surface expression of LAM-1 on human neutrophils in vivo, as well as in vitro, and G-CSF might participate in neutrophil-endothelial cell interaction in inflamed tissue.

[Two cases of intrahepatic biloma during hepatic arterial infusion chemotherapy proved by CT-Scan]

Hepatic arterial infusion chemotherapy using 5-FU is effective for colorectal cancer, but there are increasing reports of complications, for example, liver abscess, bile duct necrosis and sclerosing cholangitis. We encountered two cases of liver cell necrosis around the Glisson's sheath which were discovered by CT-scan. At the first operation, liver metastasis was present and a resection of the main tumor and metastatic lesion was performed. Hepatic cannulation was done in one case at the same time as the operation, and another at a different time. The metastatic lesion was well controlled and the blood serum CEA was within normal limits. It was pointed out that the mechanism of the liver cell necrosis was due to ischemia or toxicity of the anticancer drug. In two cases, the destruction of the second or third branch of bile duct was remarkable, because of the high 5-FU levels in the proximal part of the liver cells. One mechanism involved the laminar flow of the artery. Percutaneous transhepatic drainage was effective for the biloma around the Glisson's sheath.

Suppression of spontaneous development of uterine adenomyosis by a Chinese herbal medicine, keishi-bukuryo-gan, in mice

Keishi-bukuryo-gan (KBG) is a traditional Chinese herbal remedy and has been used for the treatment of gynecological disorders, such as hypermenorrhea, dysmenorrhea, and infertility. The effects of KBG on the development of uterine adenomyosis, which is characterized by an abnormal growth of glands and stroma into and beyond the smooth muscle layers of the uterus, were examined in an experimental animal model using the SHN strain of mice. Mice fed handmade chow containing relatively high doses of KBG (0.5% and 1%) showed a significantly lower incidence of adenomyosis and lower activity of thymidylate synthetase (TS) in the uteri than mice fed control handmade chow containing no KBG. The long-term exposure to KBG between 25 and 120 days of age hardly affected the estrous cycle, food intake and body weight. However, mice provided with chow containing a low dose of KBG (0.1%) showed no difference in the incidence of adenomyosis as compared with the controls. The inhibitory effects of the high doses of KBG were nullified by pituitary isografting, which has been proved to enhance the development of adenomyosis. The present mouse data support the view in humans that the oral administration of KBG is a useful tool for the treatment of uterine adenomyosis.

[Exercise therapy of atherosclerosis]

The effect of exercise on the progression of atherosclerotic diseases is reviewed. Prospective studies have reported that a low daily physical activity is associated with a lower incidence of coronary artery disease. Mild aerobic exercise improves survival in patients with coronary artery disease, lowers blood pressure in patients with mild hypertension, improves insulin resistance in diabetes mellitus, lowers weight in obesity and increases HDL-cholesterol and decrease triglyceride in patients with dyslipidemia. Mild exercise therapy may be beneficial in the management of atherosclerotic diseases.

Central interferon-alpha inhibits natural killer cytotoxicity through sympathetic innervation

The brain has been known to produce high levels of interferon-alpha (IFN-alpha) during viral infections. We investigated the central and peripheral mechanisms of the brain IFN-alpha-induced suppression of natural killer (NK) cytotoxicity in the rat. The activity of NK cells in the spleen and the peripheral blood decreased 30-120 min after intracerebroventricular (icv) injection of recombinant human IFN-alpha of > 1,000 U but not after its intraperitoneal injection. This effect was antagonized by pretreatment with icv naltrexone (NLTX). Splenic denervation was observed to completely abolish the IFN-alpha-induced suppression of NK activity, whereas bilateral adrenalectomy did not. Furthermore, this immunosuppression was blocked by an icv injection of an antagonist of corticotropin-releasing factor (CRF), alpha-helical CRF-(9-41). The icv injection of CRF resulted in reduced NK activity, which was not affected by NLTX. The results suggest that brain IFN-alpha activates the CRF system through central opioid receptors and thereby suppresses the NK cytotoxicity predominantly through splenic sympathetic innervation.