Propylthiouracil-induced alveolar haemorrhage associated with antineutrophil cytoplasmic antibody

Propylthiouracil (PTU) is known to cause vasculitis as a rare complication. We report the case of a patient who developed alveolar haemorrhage and haematuria whilst treated with PTU. The serum was positive for antineutrophil cytoplasmic antibody (ANCA) with myeloperoxidase (MPO) specificity (MPO-ANCA). All symptoms resolved completely after discontinuation of PTU. Alveolar haemorrhage or pulmonary-renal syndrome associated with antineutrophil cytoplasmic antibody with myeloperoxidase specificity may be a new complication of propylthiouracil therapy.

Laminin alpha 1, alpha 2, alpha 4 and beta 1 chain mRNA expression in mouse embryonic, neonatal, and adult hearts

We examined the relative expression of laminin alpha 1, alpha 2, alpha 4 and beta 1 chain genes in the heart of embryonic, neonatal and adult BALb/c mice. The reverse transcriptase-polymerase chain reaction was employed to determine the mRNA expression of these chains because of the relatively small amount of RNA extracted from rat embryonic hearts. Glyceraldehyde 3-phosphate dehydrogenase and beta-actin were used as internal controls. Among the hearts examined, a relatively high expression of laminin alpha 1 chain was observed in the embryonic hearts, while its expression was very weak in the neonatal and negligible in the adult hearts. Conversely, expression of laminin alpha 2 chain was virtually not observed in the embryonic hearts, but this chain was expressed weakly in the neonatal and substantially in the adult hearts. Similar to laminin alpha 1, laminin alpha 4 was expressed in the embryonic hearts, while its expression was relatively weak in the neonatal and adult hearts. Laminin beta 1 was expressed in the hearts of mice at all stages examined. These results demonstrate that the laminin chain gene expression changes in the different developmental stages of the hearts of BALb/c mice.

Difference in gene expression for matrix metalloproteinase-1 between early and advanced hepatocellular carcinomas

The histological observation that well-differentiated cancer cells in early hepatocellular carcinoma (HCC) invade portal tracts and/or fibrous bands and that these fibrous tissues then disappear suggests the participation of matrix metalloproteinase-1 (MMP-1) in the degradation of fibrous tissue. To confirm this hypothesis, the authors investigated the localization of both the MMP-1 protein and its messenger RNA (mRNA) in early HCC immunohistochemically and by in situ hybridization using complementary DNA (cDNA) and synthetic antisense probe of MMP-1; they then compared the results with those in advanced HCC. MMP-1 gene transcripts and protein were observed in well-differentiated cancer cells of early HCC but not in moderately or poorly differentiated cancer cells. Thus, cancer cells producing MMP-1 in early HCC may destroy the portal tract tissue adjacent to the cancer lesion and/or the fibrous band of cirrhosis. These results seem to have demonstrated a difference in the mechanism of cancer growth and invasion between early and advanced HCCs.

Subclinical Fabry's disease occurring in the context of IgA nephropathy

A 28-year-old male patient with both IgA nephropathy and an unusual case of Fabry's disease has been followed for 10 years. Diagnosis of both these diseases was made by histological examination of renal biopsy tissues and the enzyme activities of alpha-galactosidase A. Serial biopsies revealed the hithertofore unrecognized process of glomerular glycolipid accumulation peculiar to Fabry's disease at the initial stages of the disease. Physical examinations and routine laboratory analyses failed to show significant signs of Fabry's disease throughout the 10-year period. While alpha-galactosidase A activity is markedly decreased in the plasma of this patient as in classical Fabry hemizygotes, the activity in leukocytes and culture fibroblasts showed a considerable residual activity. Fabry's disease associated with IgA nephropathy apparently is extremely rare, and the present subclinical case is unique in that the early stages of substrate accumulation are demonstrable.

Stromal and blood vessel wall invasion in well-differentiated hepatocellular carcinoma

We examined hepatocellular carcinomas (HCCs) that were smaller than 2 cm in diameter. Ninety-nine nodules from 65 patients were removed for treatment. The nodules were divided into four types (A, B, C and D) according to the following criteria: first, the appearance of the margin of nodules, distinct or indistinct; and second, cellular atypia, uniform or multiple as "nodules in nodule". In 45 indistinct margin nodules, 28 showed uniform atypia (type A) and 17 were of "nodules in nodule" (type B). As for 54 distinct margin nodules, 23 were "nodules in nodule" (type C) and 31 showed uniform atypia (type D). Cancer cell invasion was divided into three types: (1) stromal invasion into fibrotic tissue and/or portal tracts, (2) blood vessel wall invasion of portal veins or hepatic veins, and (3) tumor thrombus. The stromal and vessel wall invasion occurred almost at the same rate regardless of degree of atypia. This study shows that well-differentiated HCCs in which the cancer cells show only very slight atypia have the potential for metastasis to intrahepatic and other sites.

Relationship between calculated blood concentration of propofol and electrophysiological variables during emergence from anaesthesia: comparison of bispectral index, spectral edge frequency, median frequency and auditory evoked potential index

We studied four electrophysiological variables (bispectral index (BIS), 95% spectral edge frequency (SEF), median frequency (MF) and auditory evoked potential index (AEP index) in 10 patients during emergence from anaesthesia. We compared correlation of the signals with gradually decreasing calculated blood propofol concentrations, and evaluated the signal differences between preinduction and emergence from anaesthesia. Values of BIS, MF and SEF correlated with calculated blood concentrations of propofol during emergence from anaesthesia. The correlation was best with BIS, but was poor with MF and SEF at low calculated blood propofol concentrations. Although AEP index values did not correlate with calculated blood concentrations of propofol during emergence from anaesthesia, values after eye opening and before anaesthesia were well distinguished from those during emergence from anaesthesia. BIS correlated best with calculated blood concentrations of propofol. AEP index appeared to distinguish the awake from asleep state.

Influence of air flow on the behavior of thoron and its progeny in a traditional Japanese house

Air flow influence on the spatial distribution of thoron (220Rn) concentration in a typical Japanese traditional house was investigated at various indoor air flow levels. The effect of air flow on the behavior of both thoron and radon progeny were examined simultaneously. Measurements were carried out by using two types of passive monitors, the radon-thoron discriminative monitor and the Radtrak monitor. Thoron and radon progeny were measured by filter grab sampling with ZnS scintillation counting. Under static condition, a horizontal distribution with greatly varied thoron concentrations was found as reported by previous studies. Under turbulent conditions, thoron concentrations in the middle of the room increased and the concentration gradient of thoron gas became lower. An obvious vertical distribution of thoron was also observed. Prominent diurnal variation of radon progeny concentrations was observed whereas that of thoron progeny concentrations was not. Concentration of thoron progeny changed little at different air flow levels, although the thoron gas level at the middle of the room varied significantly. The influence of air flows on detection efficiencies of the two types of thoron monitors were also checked. The mechanism of behavioral change of thoron and its progeny in turbulent atmosphere is discussed.

Reduced expression of calponin in canine basilar artery after subarachnoid haemorrhage

Calponin, an actin- and tropomyosin-binding protein, has been characterized as an inhibitory factor in the smooth-muscle actomyosin activity. The level of calponin was determined in canine basilar arteries in a double-haemorrhage model. Thirty dogs were assigned to three groups: day 0 group, control; day 2 group, dogs sacrificed 2 days after cisternal injection of blood; and day 7 group, dogs given double cisternal injections of blood and sacrificed 7 days after the first injection. Constriction of the basilar artery was confirmed by arterial angiography. Portions of the affected arteries or the corresponding region in control animals were solubilized for sodium dodecylsulphate-polyacrylamide gel electrophoresis and Western blotting. A major band corresponding to calponin was seen at 34 kD in the basilar artery extracts using chicken gizzard polyclonal antibodies. The densitometer values of the band on Coomassie blue-stained gels were expressed as percentages of day 0 control values. The signals of day 2 and day 7 samples were 47% +/- 20% and 23% +/- 12%, respectively (mean +/- standard deviation). The proportions of calponin to actin/tropomyosin in the day 0, day 2, and day 7 groups were 13% +/- 6%, 6% +/- 2%, and 4% +/- 2%, respectively. The reduced expression of calponin may be related to sustained contraction during cerebral vasospasm.

A left atrial myxoma complicated with acute myocardial infarction

A 43-year-old female, admitted because of acute infero-posterior myocardial infarction, showed angiographic findings of 100% occlusion of left circumflex artery. Echocardiographic findings showed inferior hypokinesis, while a large left intraatrial tumor was also observed. The coronary angiography on the 17th hospital day showed complete reperfusion of the culprit lesion without stenosis. On the 21st hospital day, the removal operation of the tumor was performed. Pathological findings showed typical cardiac myxoma, and the etiology of the occlusion at the culprit vessel was presumed to be closely related to the existence of the left atrial tumor.

Endothelium-dependent relaxation and vasospasm in the single-hemorrhage canine model

We have investigated the relationship between angiographic vasospasm and the ability of spastic vessels to relax in response to agents which promote release of endothelium derived relaxing factor. Vasospasm was induced in dogs by the 'single hemorrhage' technique. Animals received a single intracisternal injection of blood, blood activated with thromboplastin or collagen, or inert material, and angiograms were obtained day 0 and day 7. Vasospasm was estimated by measuring the ratio of the diameter of the vessel before and after treatment. Rings of cerebral artery obtained from these animals were suspended in a standard organ-bath arrangement, contracted with prostaglandin F2 alpha and then treated with increasing doses of adenosine triphosphate or bradykinin, both of which cause relaxation by an endothelium-dependent process. The arteries from animals with moderate to severe vasospasm showed a response to bradykinin and adenosine-triphosphate which was reduced, absent or converted to a contraction, when compared with normal vessels. Vessels in which vasospasm was mild or absent relaxed as expected to these agents. The reduction in vessel diameter showed a highly significant correlation with the reduction in relaxation to bradykinin or adenosine-triphosphate. These results have demonstrated that impairment of endothelium-dependent vasorelaxation correlates with the existence of vasospasm.

[A case of acute occlusion of left middle cerebral artery due to an embolus treated successfully with percutaneous transluminal angioplasty]

The acute occlusion of cerebral artery by embolism causes severe cerebral infarction. In cases with poor colateral circulation, cerebral infarction develops more severely. In these cases, quick recanalization of the occluded cerebral artery is necessary to prevent severe hemorrhagic infarction and brain edema. We report a case where interventional techniques were used to bring about quick recanalization of occluded cerebral artery. We encountered a case of a sixty-year-old male who experienced complete occlusion of the left middle cerebral artery due to an embolus. It was very hard to pass a guide wire through the embolic lesion. At first, we tried mild local fibrinolysis therapy using tissue plasminogen activator, but we could not get any recanalization. However, after mild local fibrinolysis therapy, the guide wire could be passed through the occlusion point. Secondly, we tried percutaneous transluminal angioplasty (PTA) with 2.0mm diameter angioplastic balloon using up to five atomic pressures, after which we obtained partial recanalization. Finally we achieved total recanalization of the middle cerebral artery by PTA with a 2.5mm diameter angioplastic balloon. We crushed this embolus using the angioplastic balloon with up to six atomic pressures. The point of the techniques is to press the embolus against the arterial wall. After this angioplasty, there was an occlusion of the common trunk of the posterior parietal artery and the angular artery. However there was neither massive hemorrhagic infarction nor massive brain edema on follow up CT. In the treatment of acute occlusion of the cerebral artery due to embolism, we found PTA is very effective against the embolus. In the future, we need to develop a retrieving device and a balloon that will prevent the production of small emboli during the crush process involved when bringing about recanalization using PTA.

An artificial CuII complex with intriguing oxygen radical-quenching profile. X-ray structure, cytochrome c assay, and ESR study

A novel artificial peptide named HPH-Pep, comprising a pyridine and two histidine units, was synthesized. The HPH-Pep-CuII complex had unique pentacoordinated structure as shown by X-ray crystallography and exhibited superoxide-scavenging activity as indicated by ESR spectroscopy. The superoxide-quenching profile of HPH-Pep-CuII was studied in detail by cytochrome c assay and ESR spin trapping and it was found that (1) HPH-Pep-CuII did not scavenge hydrogen peroxide or hydroxyl radical and hence the scavenging activity was specific to superoxide, and (2) HPH-Pep-CuII did not generate hydrogen peroxide upon scavenging superoxide.

Analysis of the mRNA cap-binding ability of human eukaryotic initiation factor-4E by use of recombinant wild-type and mutant forms

In order to identify the amino acid residues necessary for the selective recognition of the mRNA cap structure by human eukaryotic initiation factor-4E (eIF-4E), which plays a central role in the first step of mRNA translation, we prepared recombinant wild-type and fourteen mutant forms and compared their cap-binding abilities by affinity chromatography. By the direct expression of a synthetic gene encoding human eIF-4E as the soluble form in Escherichia coli and the application on a 7-methylguanosine-5'-triphosphate-Sepharose 4B cap affinity column, pure recombinant eIF-4E was prepared; the optimum pH for the binding of the mRNA cap was 7.5. Among the amino acid residues conserved among various eIF-4E species, each of 14 functional residues was replaced with a nonpolar amino acid (alanine or leucine). All mutant eIF-4E genes, which were constructed by site-directed mutagenesis, were expressed in the same way as the wild type, and their cap-binding abilities were compared with that of the wild type. Consequently, all eight tryptophan residues. Glu103, and two histidine residues at positions 37 and 200 in human recombinant eIF-4E were suggested to be important for the recognition of the mRNA cap structure through direct interaction and/or indirect contributions. Indirect contributions included the construction of the overall protein structure, especially the cap-binding pocket.

Genetic analysis of Drosophila virilis sex pheromone: genetic mapping of the locus producing Z-(11)-pentacosene

Z-(11)-pentacosene, Drosophila virilis sex pheromone, is predominant among the female cuticular hydrocarbons and can elicit male courtship behaviours. To evaluate the genetic basis of its production, interspecific crosses between D. novamexicana and genetically marked D. virilis were made and hydrocarbon profiles of their backcross progeny were analysed. The production of Z-(11)-pentacosene was autosomally controlled and was recessive. Of the six D. virilis chromosomes only the second and the third chromosomes showed significant contributions to sex pheromone production, and acted additively. Analysis of recombinant females indicated that the locus on the second chromosome mapped to the proximity of position 2-218.

[Successful treatment of pulmonary alveolar proteinosis by massive bronchoalveolar lavage]

In two patients with pulmonary alveolar proteinosis, PaO2 was normalized by massive bronchoalveolar lavage (BAL). Patient 1: A 29-year-old man presented with exertional dyspnea and a PaO2 of 57.8 mmHg. After four BALs, the PaO2 was 106.4 mmHg. For ten years thereafter he has been doing well. Patient 2: A 58-year-old women presented with extertional dyspnea and a PaO2 of 64.4 mmHg. The PaO2 increased to 110.6 mmHg after four BALs. BAL required much skill, but it is one of the most effective methods for the treatment of pulmonary alveolar proteinosis. Because this condition is related to an interstitial process, these two patients need to be followed carefully.

Structural versatility of peptides from C alpha, alpha-disubstituted glycines: crystal-state conformational analysis of peptides from C alpha-methylhomophenylalanine, (alpha Me) Hph

The molecular and crystal structures of the C alpha-tetrasubstituted, delta-branched alpha-amino acid C alpha-methylhomophenylalanine, H-D-(alpha Me)Hph-OH, and three peptides (to the pentamer level), including the homotripeptide, have been determined by X-ray diffraction. The peptides are Z-L-(alpha Me)Hph-(L-Ala)2-OMe pBrBz-[D-(alpha Me)Hph]3-OtBu and Ac-(Aib)2-L-(alpha Me)Hph-(Aib)2-OtBu. All the (alpha Me)Hph residues prefer phi, psi torsion angles in the helical region of the conformational map. The two terminally blocked tripeptides adopt a beta-bend conformation stabilized by a 1<--4 C = O... H-N intramolecular H-bond. The terminally blocked pentapeptide is folded in a regular 3(10)-helix. In general, the relationship between (alpha Me)Hph alpha-carbon chirality and helix handedness is the same as that exhibited by protein amino acids. A comparison is also made with the conclusions extracted from published work on peptides from other types of C alpha-alkylated aromatic alpha-amino acids.

Fibrinogen, coagulation factor VII, tissue plasminogen activator, plasminogen activator inhibitor-1, and lipid as cardiovascular risk factors in chronic hemodialysis and continuous ambulatory peritoneal dialysis patients

Mortality rates associated with cardiovascular disease (CVD) are high in long-term dialysis patients. Increased levels of plasma fibrinogen (FBG), coagulation factor VII (FVII), tissue plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) as well as hyperlipidemia are regarded as important risk factors for CVD. To investigate whether there are differences in the risk of CVD between chronic hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients, serum lipid levels and plasma FBG, FVII, t-PA, and PAI-1 levels were measured in 17 patients on HD and 17 patients on CAPD. FBG was measured by the thrombin time method, FVII activity (FVIIc) by the chromogenic prothrombin time method, and t-PA and PAI-1 activity by the chromogenic substrate assay. No difference was found in body mass index (BMI) between HD and CAPD patients. Total cholesterol (TC), TC/high-density lipoprotein (HDL)-C ratio, low-density lipoprotein (LDL)-C, and triglycerides (TG) were significantly increased, and HDL-C was significantly decreased in CAPD patients compared with HD patients. FBG and FVIIc were significantly elevated in CAPD patients compared with controls or HD patients. T-PA activities were significantly higher in HD and CAPD patients than in controls. CAPD patients showed significantly higher PAI-1 activities than controls or HD patients. Significant positive correlations were found between FBG or FVIIc and TC, between FBG and LDL-C or TG, and between FVIIc and LDL-C in these patients. T-PA showed significant negative correlations with FBG, PAI-1, TC, LDL-C, and TG. There was a significant positive correlation between PAI-1 and TG and a significant negative correlation between PAI-1 and HDL-C. We conclude that CAPD patients may have a greater risk of CVD than do HD patients, and that coagulation and fibrinolytic activity are correlated with lipid disorders in these patients.

Conformational dynamics of DNA during biased sinusoidal field gel electrophoresis

DNA motion during biased sinusoidal field gel electrophoresis around the antiresonance condition was investigated by direct observation using fluorescent microscopy and Brownian dynamics simulation. Time development of the center of mass velocity, vx, and the principal value of the gyration tensor, R1, was measured at this antiresonance condition. The typical stretch-contract motion, which is observed in steady field and at high frequency field, is severely suppressed, and there are two or more dominant kinks that compete with each other. Analysis of the kink motion from the simulation results supports this picture.