Association of low back pain and sleep quality with presenteeism

BACKGROUND

Low back pain (LBP) and poor subjective sleep quality (SSQ) are major risk factors for presenteeism. However, no studies have investigated whether combined LBP and poor SSQ are associated with presenteeism.

AIMS

We aimed to examine whether a combination of LBP and poor SSQ is associated with presenteeism.

METHODS

This cross-sectional study included 936 workers (median age, 38 years; men, 89%), with evaluated presenteeism using the work limitations questionnaire. We divided them into 'no presenteeism' and 'presenteeism' categories. The presence of LBP was defined as a numerical rating scale (NRS) score of ≥1 in current pain intensity. SSQ was assessed using a single question regarding whether the participants typically got enough sleep. We categorized the participants into four groups: (i) LBP + poor SSQ, (ii) non-LBP + poor SSQ, (iii) LBP + good SSQ and (iv) non-LBP + good SSQ. Logistic regression analysis was used to investigate the association between presenteeism and the presence of LBP and poor SSQ, adjusting for age, sex, work type, education, marital status, smoking status, body mass index and weekly working hours.

RESULTS

The data from 533 participants were used for analysis (median age, 38 years; men, 90%, response rate, 66%). Combined LBP and poor SSQ were significantly associated with presenteeism (non-LBP + poor SSQ: adjusted odds ratio = 0.56, 95% CI 0.32-0.96; LBP + good SSQ: 0.33, 0.20-0.56; non-LBP + good SSQ: 0.29, 0.18-0.48).

CONCLUSIONS

Evaluating both LBP and SSQ may be beneficial in considering presenteeism.

Effects of pre-surgical nasoalveolar moulding on maxillary arch and nasal form in unilateral cleft lip and palate before lip surgery

OBJECTIVES

To investigate the effects of pre-surgical nasoalveolar moulding (PNAM) on the maxillary arch and nasal form in patients with unilateral cleft lip and palate (UCLP).

SETTING AND SAMPLE POPULATION

This is a retrospective case series study. The subjects were infants with complete UCLP who were treated with PNAM (n = 18) at Kagoshima University Medical and Dental Hospital (Japan) between 2006 and 2013.

MATERIAL AND METHODS

Maxillary dental casts and facial photographs were taken at the time of the first visit and immediately prior to lip surgery to evaluate the maxillary arch and nasal form changes. The dental casts were scanned with a laser scanner, and changes in the 3-Dimensional coordinates of anatomical landmarks and alveolar cleft width were analysed. Moreover, we investigated the correlation between the changes in the maxillary alveolar arch and nasal form.

RESULTS

Regarding the maxillary alveolar arch form, the anterior points of the major segment had moved significantly to the cleft side just prior to the time of lip repair, and the alveolar cleft width was significantly decreased. For nasal form, the inclination and displacement of the columella were significantly improved. The improvement of columella inclination was moderately correlated with the posterior movement of the anterior points of the major segment.

CONCLUSIONS

These findings indicate that PNAM for infants with UCLP enhanced symmetry in the maxillary alveolar arch and nasolabial form. In addition, the posterior movement of the anterior points of the maxillary alveolar arch was correlated with the improvement of columella deformation.

Toxicity of 50-nm polystyrene particles co-administered to mice with acetaminophen, 5-aminosalicylic acid or tetracycline

We investigated whether nano-sized polystyrene particles affect drug-induced toxicity. The particles, which are widely used industrially, had diameters of 50 (NPP50), 200 (NPP200) or 1000 (NPP1000) nm. The toxic chemicals tested were acetaminophen (APAP), 5-aminosalicylic acid (5-ASA), tetracycline (TC), and sodium valproate (VPA). All treatments in the absence of the nanoparticles were non-lethal and did not result in severe toxicity. However, when mice were injected with APAP, 5-ASA or TC together with polystyrene particles, synergistic, enhanced toxicity was observed in mice injected with NPP50. These synergic effects were not observed in mice co-injected with NPP200 or NPP1000. On the other hand, co-administration of VPA and NPP50, NPP200 or NPP1000 did not elevate toxicity. The results show that NPP50 differs in hepatotoxicity depending on the drug co-administered. These findings suggest that further evaluation of the interactions between polystyrene nanoparticles and drugs is a critical prerequisite to the pharmaceutical application of nanotechnology.

Influence of 50-nm polystyrene particles in inducing cytotoxicity in mice co-injected with carbon tetrachloride, cisplatin, or paraquat

The toxicity of nanomaterials has yet to be fully investigated. In particular, the interactions between nanomaterials and therapeutic drugs require further study. We investigated whether nano-sized polystyrene particles affect drug-induced toxicity. The particles, which are widely used industrially, had diameters of 50 (NPP50), 200 (NPP200) or 1000 (NPP1000) nm. The toxic chemicals tested were carbon tetrachloride, cisplatin (a popular anti-tumor agent), and a widely used herbicide, paraquat. Mice were treated intraperitoneally with either carbon tetrachloride (0.01 ml/kg), cisplatin (100 micromol/kg) or paraquat (50 mg/kg), with or without intravenous administration of polystyrene particles. All treatments in the absence of the nanoparticles were non-lethal and did not result in severe toxicity. However, when mice were injected with paraquat or cisplatin together with polystyrene particles, synergistic, enhanced toxicity was observed in mice injected with NPP50. These synergic effects were not observed in mice co-injected with NPP200 or NPP1000. These findings suggest that further evaluation of the interactions between polystyrene nano-particles and drugs is a critical prerequisite to the pharmaceutical application of nanotechnology.

[Recurrent pulmonary embolism with prolonged right heart failure and hypoxia after cerebral bleeding; report of a case]

A 56-year-old woman with right hemiplegia for recent cerebral bleeding suddenly complained of dyspnea and chest pain with hypoxia during rehabilitation. Eight days after this first attack, she suffered prolonged right heart failure and hypoxia due to recurrent pulmonary embolism. Arterial blood gas analysis of room air showed 34.5 mmHg of PaO2 and 29.2 mmHg of PaCO2. Echocardiography showed enlargement of the right atrium and ventricle with pulmonary hypertension. Enhanced chest computed tomography revealed pulmonary emboli from the main pulmonary artery to the periphery. Despite intensive treatment, heart failure and hypoxia did not improve. We conducted pulmonary embolectomy under cardiopulmonary bypass requiring percutaneous cardiopulmonary bypass support for 2 days due to right heart failure. She is currently doing well in the 9 months following surgery.

Biological effects of hormone replacement therapy in relation to serum estradiol levels

OBJECTIVE

Tissues in various parts of the body have different sensitivities to estradiol. However, it is very difficult to measure the serum estradiol levels precisely in women receiving oral conjugated equine estrogen, which is a mixture of estrogens. In the present study, we precisely measured the serum levels of estradiol in postmenopausal women undergoing hormone replacement therapy (HRT), and we clarified the relationships between serum estradiol levels and the effects of HRT on the Kupperman index, bone mineral density (BMD), serum gonadotropin, lipid metabolism and unscheduled bleeding as the clinical endpoints.

METHODS

Sixty-eight postmenopausal or bilaterally ovariectomized women, aged 30-64 years, who had been suffering from vasomotor symptoms such as hot flush or atrophy of the vagina were randomly assigned to two groups: one group of 34 patients who received oral administration of 0.625 mg conjugated equine estrogen (CEE, Premarin, Wyeth) and 2.5 mg medroxyprogesterone acetate (MPA, Provera, Upjohn) every other day, and another group of 34 patients who received oral administration of 0.625 mg CEE and 2.5 mg MPA every day. All subjects were re-classified into three groups according to the serum estradiol level after 12 months of treatment: (1) low estradiol group (<15 pg/ml, n = 25); (2) middle estradiol group (> or =15 and <25 pg/ml, n = 27), and (3) high estradiol group (> or =25 pg/ml, n = 16). We examined the relationships between serum estradiol level and the effects of estradiol on the Kupperman index, BMD, serum gonadotropin levels, lipid profile and unscheduled bleeding in these three groups.

RESULTS

RESULTS obtained by using our newly developed high-performance liquid chromatography (HPLC)-radioimmunoassay (RIA) system clearly showed that the effects on each tissue in postmenopausal women receiving oral CEE and MPA is closely related to estradiol level. The effects of HRT on BMD, serum gonadotropin levels and lipid profile were shown to be clearly dependent on the serum estradiol levels, while the effect of HRT on the Kupperman index was independent of the serum estradiol level. Furthermore, it was also found that a very low concentration of estradiol (<15 pg/ml) was sufficient to suppress the serum LH and FSH levels and to relieve vasomotor symptoms, and that the minimum concentration of estradiol required to increase BMD was 15 pg/ml. On the other hand, the level of estradiol required to reduce total cholesterol, low density lipoprotein-cholesterol (LDL-C) and apolipoprotein B (Apo B) was found to be more than 25 pg/ml, while the level required to increase high density lipoprotein-cholesterol (HDL-C) and apolipoprotein A1 (Apo A1) was at least 15 pg/ml. The incidence of unscheduled bleeding was also lower in the low estradiol group than in the other estradiol level groups.

CONCLUSION

These results suggest that the different clinical endpoints have different response thresholds and thus reflect tissue sensitivity to estradiol levels achieved by HRT.

Efficacy of every-other-day administration of conjugated equine estrogen and medroxyprogesterone acetate on gonadotropin-releasing hormone agonists treatment in women with endometriosis

We performed a randomized controlled study to determine the efficacy of add-backed therapy by every-other-day administration of 0.625 mg conjugated equine estrogen (CEE) and 2.5 mg medroxyprogesterone acetate (MPA) on GnRH agonists (GnRH-a) treatment in Japanese women with symptomatic endometriosis. At the end of treatment, serum estrone and estradiol levels in the add-back group (n = 11) were significantly higher than those in the control group (n = 10). The assessment of Beecham classification by bimanual examination, serum CA-125 levels, and the frequency of genital bleeding revealed no significant differences between the two groups. The add-back group showed reduced Kupperman indices relative to those of the control group, and could prevent the loss of bone density. These findings led to a conclusion that GnRH-a therapy added back by every-other-day administration of 0.625 mg CEE and 2.5 mg MPA was a safe and effective treatment for Japanese women with endometriosis.

Antiapoptotic activity is dispensable for insulin-like growth factor I receptor-mediated clonogenic radioresistance after gamma-irradiation

PURPOSE

The purpose of this study was to evaluate the relationship between apoptotic activity and clonogenic radiosensitivity in vitro using an insulin-like growth factor I receptor (IGF-IR) signaling model, which is known to exert tumorigenic and antiapoptotic effects.

EXPERIMENTAL DESIGN

We used mouse embryo fibroblast cell lines expressing either human IGF-IR [R+(Wt) and R+] or the marker gene alone [R-(puro)]; these cell lines were derived from R- cells, which are deficient in IGF-IR. After gamma-irradiation, apoptotic activity was determined by the presence of DNA fragmentation and caspase-3-, -8-, and -9-like activities. Clonogenic radiosensitivity was determined by a colony-forming assay.

RESULTS

R+(Wt) and R+ cells expressed similar levels of IGF-IR, transducing phosphorylation signals to major downstream substrates on insulin-like growth factor I stimulation. R+ cells were resistant to the induction of apoptosis after gamma-irradiation; however, both R+(Wt) and R-(puro) cells demonstrated significant DNA fragmentation and increase in caspase-3-, -8-, and -9-like activities. Both R+(Wt) and R+ cells were radioresistant (to a similar extent) compared with R-(puro) cells as measured by a colony-forming assay. Clonogenic radioresistance was not influenced by the inhibition of Akt/protein kinase B through treatment with wortmannin at low concentrations specifically inhibiting phosphatidylinositol 3'-kinase.

CONCLUSIONS

Our findings indicate that apoptotic activity does not necessarily predict clonogenic survival after exposure to ionizing radiation. This study provides clinical implications in the evaluation of apoptotic activities observed during the course of radiotherapy to predict accurate tumor response or local control.

Isolation and identification of antheridiogens in the ferns, Lygodium microphyllum and Lygodium reticulatum

Antheridiogens in culture media of 6-week-old prothallia of two species of Schizaeaceous ferns, Lygodium microphyllum and Lygodium reticulatum, were analyzed by gas chromatography-mass spectrometry. In both species, the gibberellin A73 methyl ester (GA73-Me) was identified as the most abundant antheridiogen, and the methyl esters of GA9 and of several monohydroxy-GA73 derivatives were also detected. Since both species produced antheridiogens at a high level, they were classified into high-antheridiogen-producing ferns. The response to GA73-Me of gametophytes of both species is also discussed.

Arylhydrocarbon receptor (AhR) is involved in negative regulation of adipose differentiation in 3T3-L1 cells

The arylhydrocarbon receptor (AhR) is the receptor for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds. Although a physiological ligand for the AhR has yet to be identified, and the precise physiological roles of the AhR are unknown, it may play important roles not only in the regulation of xenobiotic metabolism but also in the maintenance of homeostatic functions. We have previously reported that the level of AhR protein decreased with ongoing adipose differentiation in 3T3-L1 cells. Studies using a TCDD-resistant clone of 3T3-L1 cells suggested that the AhR may be involved in the negative regulation of adipose differentiation. To confirm this hypothesis, 3T3-L1 fibroblast cells were stably transfected with a vector expressing high levels of full-length sense AhR mRNA, antisense AhR mRNA or a control vector. Comparison of the differentiation potency of these clones with that of control cells showed that overexpression of the AhR suppressed morphological differentiation, as well as induction of adipocyte-related genes, whereas decreased expression of the AhR induced much greater morphological differentiation and expression of adipocyte-related genes. Activation of PPARγ2 with ligands such as troglitazone, ciglitazone and indomethacin restored the ability of the AhR-overexpressing cells to differentiate. The cells overexpressing the AhR exhibited the higher p42/p44 MAP kinase activity compared with the control cells. Treatment with PD98059 or U0126 also abrogated the inhibitory action of the AhR on adipogenesis. We also present data showing that activation of the AhR slowed clonal expansion. During clonal expansion, the AhR inhibited the pRB phosphorylation and the downregulation of p107 expression. Taken together, these results strongly suggest that AhR is a negative regulator of adipose differentiation in 3T3 L1 cells.

[Intravenous leiomyomatosis with cardiac extension in an elderly woman: report of a case]

Intravenous leiomyomatosis is a histologically benign smooth-muscle tumor arising from either a uterine myoma or the wall of a uterine vessel with extension into veins. We describe a 71-year-old woman with a prior history of subtotal hysterectomy for uterine myoma years earlier who presented with palpitation. Echocardiographic examination revealed an intracardiac mass protruding into the right ventricle during diastole. The caval tumor could be traced to the right renal vein by magnetic resonance image. She was operated on for intracardiac and intracaval leiomyomatosis. The intracaval tumor proved to be not totally resectable. Presence of smooth muscle was confirmed by smooth muscle actin and desmin positive cells in the tumor. Tumor cells also proved to possess estrogen receptors. The patient has been closely followed-up with antiestrogen therapy.

Determination of pyrimethamine in animal tissue and egg by liquid chromatography with fluorescence detection

A sensitive and selective liquid chromatographic (LC) assay was developed to determine the concentration of pyrimethamine in animal tissue and egg by fluorescent derivative. Animal samples were extracted with acetonitrile, centrifuged, and purified by hexane. Fluorescent derivatization was performed by reacting pyrimethamine with chloroacetaldehyde and subjected to LC with fluorescence detection (excitation wavelength 300 nm, emission wavelength 420 nm). The limit of detection was 10 ng/g (10 ppb) and the standard calibration curve was linear in the range of 1-100 ppb (0.01-1 ng/10 microL). Recoveries from samples fortified at levels of 0.1 and 1 ppm (microg/g) were 61.0-77.4 and 65.5-81.2%, respectively. The method was applied to the monitoring of marketed samples. Pyrimethamine was not determined in any of the 70 samples: 20 swine muscle; 20 chicken muscle; 10 chicken liver; and 20 egg.

Effects of leptin on secretion of LH and FSH from primary cultured female rat pituitary cells

BACKGROUND

Leptin, which is the product of the obese gene, is believed to play important roles in pubertal development and reproductive function in females. In a study using adult male rats, it was found that leptin stimulated secretion of gonadotropin from the pituitary in a dose-related manner. However, there has been no such study in female rats.

OBJECTIVE

To investigate the effects of leptin on the production of LH and FSH from the pituitary in female rats, using primary cultured pituitary cells.

METHODS

In this study, we determined body weight, serum leptin concentration and serum estradiol (E(2)) concentration in female Wistar rats at 3, 5, 6, 7, 9 and 11 weeks of age, and cultured pituitary cells from 6-week-old female Wistar rats with leptin (0--10(-7) mol/l) and GnRH (0 or 10(-8) mol/l). Then basal and GnRH-stimulated extra- and intracellular LH and FSH were assayed by RIA.

RESULTS

Serum leptin concentration increased with increases in body weight and E(2) concentration. The pubertal serum leptin concentration was about 10(-10) mol/l. At a lower or moderate concentration, leptin produced dose-related increases in both basal and GnRH-stimulated extra- and intracellular LH and FSH in pituitary cells. At a concentration of 10 mol/l, leptin significantly (P<0.05) stimulated both basal and GnRH-stimulated extra- and intracellular LH and FSH. However, at greater concentrations, these effects diminished.

CONCLUSIONS

These results indicated that leptin induced pituitary cells to produce and secrete both LH and FSH, with or without GnRH. The concentration of leptin that induced the greatest production of gonadotropins by pituitary cells was 10(-10) mol/l, which was the same as the physiological pubertal concentration. Leptin may be involved in the onset of puberty. It is also conceivable that leptin may be a cause of ovulatory failure, not only in weight loss but also in weight gain.

Tc-99m DTPA renography in patients with collagen disease

PURPOSE

This study evaluated the use of Tc-99m DTPA renography in patients with collagen disease.

MATERIALS AND METHODS

Tc-99m DTPA renal scintigraphy was performed in 28 patients with clinically diagnosed collagen disease. Twenty-two other patients who underwent renal scintigraphy and were subsequently shown to have no kidney abnormalities served as the control group.

RESULTS

One quarter of the patients with collagen disease had abnormal findings of renography, despite the absence of abnormal laboratory data. Renograms were 100% sensitive for the detection of renal disease in patients with collagen disease, and their specificity was 53% when serum blood urea nitrogen, serum creatinine concentration, and proteinuria were the only measures of renal impairment considered. The glomerular filtration rate was not significantly different between the groups, but the bilateral time to peak was significantly greater in the patients with collagen disease. Hydronephrosis was present in 7% of patients with collagen disease.

CONCLUSION

Renography is useful for detecting early changes of renal involvement when the clinical state of collagen disease is evaluated.

B cell subsets in postmenopausal women and the effect of hormone replacement therapy

OBJECTIVES

In elderly subjects the capacity for antibody production is depressed. This immunosenescence state of humoral immunity is associated with the occurrence of autoimmune disorders involving CD5+ B (B-1) cells. Since estrogen is capable of stimulating the production of autoantibodies, this sex steroid hormone may be a contributing cause of the higher incidence of autoimmune diseases in women. In the present study, B cell subsets in women during the postmenopausal period was determined. The effect of hormone replacement therapy (HRT) on B cell subsets was examined to establish whether the administration of gonadal hormones influence humoral immunity in postmenopausal women.

METHODS

Forty six untreated pre- and postmenopausal women and 39 women on HRT were studied. The proportion of B-1 (CD5+) and conventional CD5- B (B-2) lymphocytes was determined by two-color flow cytometry. Serum autoantibodies to a nuclear antigen and to interleukin (IL)-1alpha were measured by immunofluorescence and by radioimmunoassay, respectively. Thirteen women were examined prospectively before and during HRT.

RESULTS

In late postmenopausal women (> or = 30 years postmenopausal period), the proportion of B-2 cells was significantly reduced (p<0.01) compared to those of premenopausal and perimenopausal women. HRT induced a significant (p<0.01) increase in the percentage of B-2 cells, while that of B-1 cells remained unchanged. HRT did not affect autoantibody production.

CONCLUSION

HRT may retard the progress of immunosenescence by increasing the production of B-2 cells. Moreover, HRT appears not to increase the risk of autoimmune diseases developing in postmenopausal women.

Evidence that Toki-shakuyaku-san and its ingredients enhance the secretion of a cytokine-induced neutrophil chemoattractant (CINC/gro) in the ovulatory process

We investigated the effects of Toki-shakuyaku-san and its crude ingredients in relation to the secretion of a cytokine-induced neutrophil chemoattractant, CINC/gro, interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF alpha) in the ovulatory process. Toki-shakuyaku-san significantly (p < 0.01) stimulated the secretion of 17 beta-estradiol but did not stimulate the secretion of progesterone in cultured whole ovarian dispersates. Toki-shakuyaku-san enhanced the secretion of CINC/gro in a dose-dependent manner and the production of CINC/gro at concentrations of 10 and 100 micrograms/ml of Toki-shakuyaku-san increased significantly (p < 0.01). Toki-shakuyaku-san also enhanced secretions of both IL-1 beta and TNF alpha, which are known to stimulate the secretion of CINC/gro in the ovulatory process. The production of TNF alpha increased significantly (p < 0.05) with 10 and 100 micrograms/ml of Toki-shakuyaku-san. Atractylodis Lanceae Rhizoma, Cnidii Rhizoma, Angelicae Radix, Paeoniae Radix and Alismatis Rhizoma, which are crude ingredients of Toki-shakuyaku-san, significantly (p < 0.01) enhanced the secretion of CINC/gro at concentrations of 100 micrograms/ml. The results of this study show that Toki-shakuyaku-san can stimulate the secretion of 17 beta-estradiol and stimulate the ovulatory process by stimulating the production of CINC/gro, IL-1 beta and TNF alpha in vitro. As a treatment for ovulatory disorders, Toki-shakuyaku-san may have stimulatory effects on both steroidogenesis and the ovulatory process.

[A case of acute urticaria from hydroxyzine hydrochloride used for preanesthetic medication]

We report a case of acute urticaria probably caused by hydroxyzine hydrochloride. A 66-year-old male was scheduled for cardiac cystectomy by thoracic endoscopy. The patient was premedicated with atropine and hydroxyzine intramuscularly 30 min before arrival in the operating room. Abrupt general exanthema was observed when intravenous infusion was started. Although his general condition was stable, the operation was postponed. Three days later, the skin test was performed using several drugs. Only hydroxyzine hydrochloride gave positive result. It is assumed that hydroxyzine hydrochloride may have caused his urticaria.

Serum leptin profiles in the normal menstrual cycles and gonadotropin treatment cycles

Circulating levels of leptin, estradiol (E(2)) and progesterone (P(4)) throughout normal menstrual cycles (n = 13), and controlled, stimulated cycles (n = 33) were examined using sensitive specific radioimmunoassays in order to investigate the relationships between sex hormones (E(2), P(4)). Serum leptin levels during the normal menstrual cycle remained constant. However, in the ovulation induction cycle, E(2) levels and circulating leptin levels increased in parallel with the process of stimulation. In addition, leptin/body mass index ratios for all samples were significantly correlated with log(10)E(2). We conclude that particularly high levels of E(2) may have an effect on the secretion of leptin from adipose tissue.

2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) induces binding of a 50 kDa protein on the 3' untranslated region of urokinase-type plasminogen activator mRNA

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), a highly toxic compound that has recently attracted much attention as an environmental contaminant, elicits a variety of toxic responses. Most, if not all, of the toxic effects of TCDD are thought to result from alteration of gene expression. TCDD acts through both transcriptional and posttranscriptional mechanisms to alter gene expression of many genes. Transforming growth factor (TGF)-alpha and urokinase-type plasminogen activator (uPA) are examples of the genes up-regulated posttranscriptionally by TCDD by mRNA stabilization. While effects of TCDD on transcription have been extensively studied, the molecular mechanisms underlying the TCDD-induced changes in mRNA stability are poorly understood. In this study, we investigated the trans-acting factors involved in TCDD-dependent mRNA stabilization. UV-crosslinking study showed that a liver cytoplasmic protein of 50 kDa (p50) selectively recognized the 3' UTR of the uPA mRNA in a TCDD-dependent manner. We also showed that the activation of p50 by TCDD is mediated through a protein phosphorylation cascade but not via de novo protein synthesis. This is the first study to show the presence of the TCDD-dependent RNA binding activity which may be involved in TCDD-dependent stabilization of mRNA.

Effect of hormone replacement therapy on post-menopausal changes of lymphocytes and T cell subsets

Immunosenescence is associated with the occurrence of lethal diseases, such as infection and malignancy. Since endocrinosenescence occurs simultaneously with immunosenescence, we determined whether or not lymphocytes and T cell subsets were altered in post-menopausal women. The ability of hormone replacement therapy (HRT) to reverse or modify the aberrations of the cell populations observed in elderly women was also examined. Thirty-nine untreated post-menopausal women and 39 women on HRT were studied. The proportions of lymphocytes and T cell subsets (helper, cytotoxic and immature T cells, and naive and memory/activated T cells) were determined by two color flow cytometry. Thirteen women were examined before and during HRT. At late post-menopause (> or = 30 years post-menopausal period), the proportion of peripheral blood lymphocytes showed a tendency to decline (p=0.06) compared with that at early (< or = 10 years) post-menopause. Significant (p<0.05) decrease in naive T cells and an increase in memory/activated T cells occurred at late post-menopause compared to those at early post-menopause. The percentage of lymphocytes in women on HRT was significantly (p<0.05) higher than that in untreated women at late post-menopausal stage. Furthermore, in a prospective study, HRT induced a significant (p<0.02) increase in the percentage of lymphocytes but showed no effect on the aberrations of naive and memory/activated T cells. HRT prevents the decline in the lymphocytes observed in post-menopausal women. However, HRT appears not to influence the observed alteration in T cell subsets.

Properties of tofus and soy milks prepared from soybeans having different subunits of glycinin

The contribution of soybean protein to the physical properties of tofu, a product manufactured by curdling soy milk with coagulants such as calcium or magnesium chloride, was studied by comparing the properties of soy milk prepared from soybeans with different subunits (I, IIa, and IIb) of glycinin with amino acid residues deleted. The breaking stress value of the tofu curds prepared from soybeans having group I was higher than those without group I. The soy milks having group I contained more protein particles and showed more sensitivity to calcium and magnesium ions than those without group I. The amounts of glycinin and protein particles were higher in the soy milks having group I than those in the soy milks without group I. To elucidate the influence of each group on the breaking stress, the glycinin content was adjusted to an identical level in soy milks having each group. Among the tofu curds from three groups, their order of hardness according to their breaking stress was IIa, IIb, and I. The order of particle content among these soy milks was also IIa, IIb, and I. Therefore, the results suggested that the breaking stress value of the tofu curd is dependent upon the number of protein particles in the soy milk and that the number of the particles is determined by the proportion and structure of glycinin in the soybean.

In vitro tests of 1,3-dithia-2-thioxo-cyclopent-4-ene to evaluate the mechanisms of its hepatoprotective action

Some in vitro tests were performed using 1,3-dithia-2-thioxo-cyclopent-4-ene (DT827A) to evaluate its mode of action on hepatoprotection. Experiments with leucine, uridine and thymidine uptakes using L-132 cells showed no increase in leucine uptake, but did show a tendency toward increases in both uridine and thymidine uptakes, which suggested a stimulating effect on RNA and DNA synthesis in vitro. DT827A did not influence GSH levels in the HepG2 cultured cell system, and did not show inhibition of cytochrome P450 2El in microsomes obtained from mouse liver. There may be no possibility for DT827A to protect a liver injury through its influence on liver GSH levels and inhibiting metabolic activation of CCl4 in this in vitro system. However, the inhibitory effect of DT827A on lipid peroxidation was observed in vitro, the same as the observation in vivo. Furthermore, when DT827A was incubated with Alamar Blue in the presence of a mixture of mouse liver S9 and mitochondrial fractions for 20 hr, DT827A showed more reducibility than it did in a case of non-incubation, and it was suggested that DT827A would be metabolized in the S9-mitochondrial fraction in vitro to show an increase of Alamar Blue reducibility. The protective effect of DT827A on a liver injury is due neither to its influence on liver GSH levels nor inhibition of the metabolic activation of CCl4, but a possible mechanism of action for the DT827 series of compounds to indicate an antioxidative effect would be brought about by the role of the compounds as a radical scavenger as well as its reductive effect.

Pain-relieving posterior rod fixation with segmental sublaminar wiring for Pancoast tumor invading the vertebrae

We describe the case of a 44-year-old male patient with Pancoast lung cancer invading the vertebrae. Because irradiation did not relieve his symptoms, we conducted tumor resection with posterior rod fixation with segmental sublaminar wiring of the vertebrae. This enabled the patient to walk and to discontinue morphine immediately after surgery. Although the tumor recurred within the region of the fixation 4 months after surgery, the patient complained of no pain until his death. Although Pancoast lung cancer with extensive vertebral invasion cannot be cured surgically, posterior rod fixation with segmental sublaminar wiring with tumor resection can improve a patient's quality of life by providing immediate, long-term pain relief.

Orexins, orexigenic hypothalamic neuropeptides, suppress the pulsatile secretion of luteinizing hormone in ovariectomized female rats

It is well known that feeding disorders are deeply related to reproductive dysfunction, and some feeding regulatory factors may modulate the reproductive function. We examined the effect of orexins, the newly discovered orexigenic hypothalamic neuropeptides, on the pulsatile secretion of LH to clarify their influence on the reproductive function. We administered orexins or saline into the third ventricle of bilaterally ovariectomized (OVX) rats, and measured the serum LH concentration by RIA in blood samples drawn every 6 min for 2 hours to analyze the pulsatile secretion. In the orexin-treated groups, the mean LH concentration and the pulse frequency were significantly reduced (p < 0.01), but the pulse amplitude did not differ significantly. These data indicate that orexins suppress the pulsatile secretion of LH by influencing GnRH neurons at the hypothalamic level.

Mutagenicity tests of 4-phenyl-1,3-dithia-2-thioxo-cyclopent-4-ene

The mutagenicity of 4-phenyl-1,3-dithia-2-thioxo-cyclopent-4-ene (DT827B) was examined in reverse mutation tests using Salmonella typhimurium and Escherichia coli, in the chromosomal aberration test with Chinese hamster ovary (CHO) cells, and in the micronucleus test using mice bone-marrow. In reverse mutation assay on DT827B according to Ames' method, DT827B was not mutagenic to S. typhimurium or E. coli when tested in dimethylsulfoxide to the limit of its solubility where precipitation occurred. In chromosomal aberration assay using CHO cells, DT827B was not clastogenic to induce structural chromosomal aberration but capable of inducing polyploidy. In micronucleus test, DT827B did not show micronucleus-inducing potential at the maximum dose. In conclusion of the three mutagenicity studies, DT827B was considered to cause no mutagenicity under the conditions used in the present experiments except the increase in polyploidy, which probably is due to a toxic effect of the compound.

Depletion of arylhydrocarbon receptor during adipose differentiation in 3T3-L1 cells

Arylhydrocarbon receptor (AhR) is the receptor for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds. Although a physiological ligand for AhR has yet to be identified, several lines of evidence suggest that AhR may play an important role not only in the regulation of xenobiotic metabolism but also in the maintenance of homeostatic functions. When TCDD is administrated in vivo, this compound is primarily deposited in adipose tissue. Therefore, it is critical to know the states of AhR in adipose cells for assessing the expression of toxicities of TCDD and related compounds in vivo. In this report, we examined the levels of AhR protein and its associated protein (Arnt) during the adipose differentiation in 3T3-L1 cells. The level of AhR protein was found to decrease with ongoing adipose differentiation in 3T3-L1 cells. The binding activity to the xenobiotic response element and the cellular response to TCDD were also lowered as a result of adipose differentiation. These results indicate that the depletion of AhR is a novel event associated with adipose differentiation in 3T3-L1 cells and that the magnitude of the depletion of AhR is sufficient for 3T3-L1 cells to lose the functional response to xenobiotics. We also found a population of 3T3-L1 cells which have an adipose differentiation capability in the presence of high doses of TCDD. These cells lack nuclear AhR but not cytoplasmic AhR, suggesting a possible negative role of liganded nuclear AhR in adipose differentiation. The level of the Arnt protein also decreased as a result of the differentiation. However, the pattern of the depletion of the Arnt protein was distinct from that of the AhR protein. The data presented in this study will provide opportunities to carry out studies to better understand the roles of AhR in adipose cells which are the primary targets of TCDD.

Effect of 4-phenyl-1,3-dithia-2-thioxo-cyclopent-4-ene on liver injury induced by repeated exposure to galactosamine plus carbon tetrachloride in rats

The protective effects of 1,3-dithia-2-thioxo-cyclopent-4-ene (DT827A),4-phenyl-1,3-dithia-2-thioxo-cyclopent- 4-ene (DT827B) and 4-(4-fluorophenyl)-1,3-dithia-2-thioxo-cyclopent-4-ene (DT827C) on liver injury induced by D-galactosamine plus carbon tetrachloride (D-GalN + CCl4) and that of DT827B on liver injury induced by thioacetamide were studied using male rats. Out of the three DT827 series of compounds, DT827B was more effective on liver injury induced by the combination exposure to D-GalN + CCl4 for 4 weeks, and accordingly the following two experiments were carried out using DT827B only. Twelve-week administration of DT827B at dose levels of 5, 10 and 20 mg/kg/day revealed a therapeutic effect against liver injury induced by D-GalN + CCl4 dose-dependently, and another twelve-week administration of DT827B at the same three dose levels also revealed a therapeutic effect against liver injury induced by thioacetamide dose-dependently. A hepatoprotective potential of DT827B was suggested under the conditions of these studies.

Effect of 1,3-dithia-2-thioxo-cyclopent-4-ene and its derivatives on liver injury induced by carbon tetrachloride and orotic acid in rats

The protective effect of 1,3-dithia-2-thioxo-cyclopent-4-ene (DT827A) and its two derivatives of 4-phenyl-1,3-dithia-2-thioxo-cyclopent-4-ene (DT827B) and 4-(4-fluorophenyl)-1,3-dithia-2-thioxo-cyclopent-4-ene (DT827C) on liver injury induced by carbon tetrachloride (CCl4) and orotic acid was studied using male rats. The approximate lethal doses were about 100 mg/kg for DT827A-treated animals and more than 800 mg/kg for the other two compounds-treated groups. Single oral administration of the three test compounds at the dose levels of 2 and 10 mg/kg 1 hour before CCl4 exposure revealed a protective effect on the findings of centrolobular necrosis, balloon cells and macrophage infiltration in histopathological findings in livers in the order of DT827B-treated rats > DT827A-treated rats > DT827C-treated rats. Repeated oral administration of the compounds at the dose levels of 2 and 10 mg/kg/day for 10 consecutive days revealed a protective effect against liver injury on the findings of centrolobular necrosis, balloon cells and macrophage infiltration in the order of DT827B-treated rats > DT827A-treated rats [symbol: see text] DT827C-treated rats. Simultaneous administration of the compounds at the dose level of 10 mg/kg/day together with a high sucrose diet containing orotic acid for 12 days revealed an inhibitory effect on fatty liver formation in the order of DT827B-treated rats > DT827C-treated rats > DT827A-treated rats. A hepatoprotective potential of the DT827 series compounds was suggested under the conditions of these studies, and DT827B was considered to be the most effective.

Isolation and chemical-structural determination of a novel aromatic amine mutagen in water from the Nishitakase River in Kyoto

Water samples from the Nishitakase River in Kyoto, Japan, especially taken at sites below sewage plants, show significantly high mutagenicity in the Ames test. In the present study, mutagens in the river water were adsorbed to 24 g of blue rayon, extracted, and separated by HPLC on ODS columns. Five mutagenic compounds (I-V) were isolated, and they accounted for 21%, 17%, 11%, 12%, and 6%, respectively, of the total mutagenicity of the blue rayon-adsorbed materials. With compound I obtained from adsorbate to 24 g of blue rayon as a marker, a large quantity (1.1 mg) of mutagenic compound I was isolated by Sephadex LH-20 column chromatography and HPLC on ODS columns from material adsorbed to 27 kg of blue cotton. X-ray crystal analysis was carried out with the debrominated derivative of compound I. Based on this X-ray crystallography data and the UV, mass, and 1H-NMR spectra of both the derivative and compound I, the structure of compound I was determined to be 2-[2-(acetylamino)-4-[bis(2-methoxyethyl)amino]-5-methoxyphenyl]-5-amino - 7-bromo-4-chloro-2H-benzotriazole (PBTA-1). PBTA-1 is a newly identified potent mutagen, inducing 1,200,000 revertants of Salmonella typhimurium YG1024 per microgram in the presence of S9 mix.

Cultured retinal pericytes stimulate in vitro angiogenesis of endothelial cells through secretion of a fibroblast growth factor-like molecule

Interaction between cultured endothelial cells (EC) and pericytes (PC) was studied in vitro to clarify the mechanism of diabetic proliferative retinopathy. Conditioned medium (CM) from retinal PC strongly increased the proliferation and moderately stimulated migration of retinal EC. Moreover, CM from PC caused stimulation of angiogenesis of retinal EC and umbilical cord vein EC in vitro at the same extent as basic fibroblast growth factor (bFGF). PC also stimulated angiogenesis by EC in mixed cultures. The angiogenic, proliferative and migration activities in CM from PC were inhibited by an antibody to bFGF. These data suggest that PC play an important role in angiogenesis through secretion of an FGF-like molecule.

Stimulation of interleukin-1beta-converting enzyme activity during growth inhibition by CPT-11 in the human myeloid leukemia cell line K562

Camptothecin (CPT) was first extracted from Camptotheca acuminata and has a strong antitumor effect. Its water-soluble derivative, CPT-11, has higher therapeutic efficacy and less toxicity than CPT. Recently, CPT-treated cells have been shown to undergo apoptosis. However, the mechanism of induction of apoptosis by CPT has not been characterized in detail in any type of cells. On the other hand, interleukin-1beta-converting enzyme (ICE) is a mammalian homologue of CED3, a protein required for apoptosis in the nematode Caenorhabditis elegans. To determine how CPT-11 brings about cell death by apoptosis, we investigated the effects of CPT-11 on the expression of ICE activity in K562 cells, which represent human myeloid leukemia cells. The proliferation of K562 cells was shown to be inhibited by the presence of CPT-11 in the culture medium. We also found that the levels of mRNA for ICE in the cells were increased in the presence of CPT-11. Furthermore, we demonstrated that when CPT-11 was added to the culture medium, apoptosis of K562 cells was clearly detected in situ. These features suggested that CPT-11 enhances the apoptotic cell death in K562 cells and that a part of induction of apoptosis by CPT-11 may be correlated with the stimulation of the ICE activity.

Mechanism of angiogenic effects of saponin from ginseng Radix rubra in human umbilical vein endothelial cells

1. The effects of saponin from Ginseng Radix rubra on angiogenesis (tube formation) and its key steps (protease secretion, proliferation and migration) in human umbilical vein endothelial cells (HUVEC) were examined to elucidate the mechanism of the tissue repairing effects of Ginseng Radix rubra. The effect on a wound healing model was also studied. 2. Tube formation was measured by an in vitro system. The activity and immunoreactivity of tissue-type plasminogen activator (tPA) as a protease for angiogenesis and the immunoreactivity of its inhibitor, plasminogen activator inhibitor-1 (PAI-1), were measured in conditioned medium of HUVEC stimulated for 24 h with saponin. Cell proliferation was measured by counting the cell numbers at 2-7 days after seeding. Migration was measured by Boyden's chamber method. The effect on wound healing was studied in the skin of diabetic rats. 3. Saponin at 10-100 micrograms ml-1 significantly stimulated tube formation by HUVEC in a dose-dependent manner. Saponin in a similar concentration-range increased the secretion of tPA from HUVEC as estimated by immunoreactivity and enzyme activity. On the other hand, PAI-1 immunoreactivity was slightly increased at 10 micrograms ml-1 of saponin, but then was significantly decreased at 50 and 100 micrograms ml-1. Cell proliferation was only slightly enhanced by 1-100 micrograms ml-1 of saponin, but migration was significantly enhanced by 10-100 micrograms ml-1 in a dose-dependent manner. Moreover, saponin stimulated wound healing with enhanced angiogenesis in vivo. 4. These results indicate that saponin stimulates tube formation mainly by modifying the balance of protease/protease inhibitor secretion from HUVEC and enhancing the migration of HUVEC, and that it is effective in vivo.

[Mitral valve reconstruction: for ruptured chordae to the posteromedial commissural scallop]

The advantages of mitral valve repair for pure mitral incompetence are established. It is necessary for us to describe suture points more detailed. This article presents our standardized maneuver for mitral regurgitation due to ruptured chordae to the posteromedial commissural scallop. The first step in the repair is placement of a temporary suture in the annulus at attachment of posterior commissural chordae and one of posterior cleft chordae. After measuring the annular diameter and estimating coaptation, this suture is removed. Secondary, rupture of chordae tendinease and adjacent margin of posteromedial commissural scallop are resected. Then, one end of a thread is passed through the margin at end of this untethered segment of leaflet, and another end is passed through the margin of leaflet at opposite end of this segment. Finally, a mattress suture using 3-0 Prolene with pledget is placed as a temporary suture. Between April 1993 and December 1994, four patients underwent reconstruction of mitral regurgitation with ruptured chordae to the posteromedial commissural scallop. Left ventriculogram 4 weeks postoperatively showed no regurgitant jet in all patients.

[Reconstruction of pulmonary trunk in pulmonary atresia and tetralogy of Fallot utilizing autologous tissue]

Establishment of right ventricular-pulmonary arterial continuity with autologous tissue, avoiding the use of prosthetic conduit, is presented. From February 1992 through March 1993, 22 patients with pulmonary atresia and tetralogy of Fallot underwent reparative operation at The Heart institute of Japan. In 20 patients out of the 22 patients, the right ventricular-pulmonary arterial continuity was successfully established with either direct anastomosis or insertion of tailored autologous pericardial tube. The morphology of the right ventricular-pulmonary arterial discontinuity comprised of valvular and infundibular atresia in seven, truncal atresia in nine, and failed extracardiac conduit in four. In patients with relatively short distance between right ventricle and pulmonary artery, the pulmonary artery was retracted and anastomosed directly to the cranial margin of the ventriculotomy incision to serve as a smooth floor made of autologous tissue. In patients with long distance, tailored autologous pericardial tube was interposed between right ventricle and pulmonary artery instead of using prosthetic conduit. Both techniques were completed by mono- or bicuspid anterior patch made of equine pericardial conduit. There were no early and late deaths. Postoperative catheterization data showed satisfactory reduction of right ventricular pressure with the right-to-left ventricular systolic pressure ratio ranging from 0.42 to 0.69 (average 0.52) in direct anastomosis group and 0.43 to 0.48 (average 0.45) in autologous pericardial tube group, and the pressure gradient across right ventricular outflow tract ranged from 1 to 15 (average 8) mmHg and 1 to 15 (average 5.8), respectively. The distributing frequency of late complication, mainly conduit obstruction, of prosthetic materials prompted us to use autologous tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

In vitro effect of chromium and other trace metals on mouse hepatotoxicity induced by carbon tetrachloride exposure

Using primary cultured mouse hepatocytes, in vitro study was performed to discuss the effect of Cr(III) and several other trace metals, Cr(VI), Mn(II), Zn(II), Co(II), Cu(II), Ni(II), and Ga(III) on acute liver damage induced by CCl4 exposure. 1) The LDH activity 60 min after CCl4 exposure increased dose-dependently with CCl4 concentrations in all of the trace metal pretreatment groups, except for the Cr(VI) pretreatment group, which showed a significant protective effect even after 30 min of CCl4 exposure. 2) LDH leakage was not observed 10 min after CCl4 exposure at 3 or 5 mM, while lipid peroxidation was increased dose-dependently with CCl4 concentrations in all groups except the Cr(VI) pretreatment group, in which the production of peroxidated lipid was significantly inhibited. 3) Similarly to the pretreatment with Cr(VI), LDH leakage 30 min after exposure to 5 mM CCl4 was inhibited by pretreatment with such antioxidants as N,N'-diphenyl-p-phenylenediamine or DL-alpha-tocopherol. 4) The Cr(VI) uptake was about 50% of the added amount, whereas the Cr(III) uptake was only 5% of the added amount. 5) 90% or more of the intracellular chromium was reduced to Cr(III) 10 min after Cr(VI) treatment. The results suggested that the in vitro protective effect of pretreatment with Cr(VI) was due to a rapid reduction of Cr(VI) to Cr(III), and the radical scavenger-like effect of the produced Cr(III) was the same effect as in vivo Cr(III); it therefore suggests that Cr(III) contributes to protective effect on CCl4-induced hepatotoxicity.

DNA-strand breaks induced by dimethylarsinic acid, a metabolite of inorganic arsenics, are strongly enhanced by superoxide anion radicals

We previously reported that dimethylarsinic acid (DMAA), a major metabolite of inorganic arsenics, induced DNA single-strand breaks (ssb) both in vivo and in cultured alveolar type II (L-132) cells in vitro, possibly via the production of dimethylarsenic peroxyl radicals. Here, the interaction of superoxide anion radicals (O2-) in the induction of ssb in L-132 cells was investigated using paraquat, an O2(-)-producing agent. A significant enhancement of ssb formation was observed in the DMAA-exposed cells when coexposed to paraquat. This enhancement occurred even when post-exposed to DMAA after washing, suggesting that the DMAA exposure caused some modification of DNA such as DNA-adducts, which was recognized by active oxygens to form ssb. An experiment with UV-irradiation, which was likely to induce ssb at the modified region, supported the possibility of DNA modification by DMAA exposure. An ESR study indicated that O2- produced by paraquat in DMAA-exposed cells was more consumed than in non-exposed cells, assumingly through the reaction with the dimethylarsenic-modified region of DNA. The species of active oxygens were estimated by using diethyldithiocarbamate, aminotriazole, diethylmaleate, hydrogen peroxide (H2O2), gamma-irradiation and ethanol. O2- but neither H2O2 nor hydroxyl radicals was very likely to contribute to the ssb-enhancing action of paraquat.

Diabetic control and progression of retinopathy in elderly patients: five-year follow-up study

OBJECTIVE

To assess whether control of diabetes mellitus is as important in the elderly as in young and middle-aged diabetic patients in terms of progression of retinopathy.

DESIGN

A 5-year longitudinal cohort study.

SETTING

Outpatient diabetic clinic.

PATIENTS

One hundred fourteen non-insulin-dependent diabetic patients (30 males, 84 females) > or = 60 years of age.

MEASUREMENTS

Retinopathy was checked at the beginning and end of the follow-up period. During the 5-year follow-up period, demographic variables, body mass index, HbA1c, blood pressure, and plasma lipids were monitored. Retinopathy was classified as follows: grade 0, no lesion; grade 1, non-proliferative retinopathy; grade 2, pre-proliferative retinopathy; grade 3, proliferative retinopathy. Progression of retinopathy during the 5-year follow-up was defined as an increase in its grade.

RESULTS

At the start of the study, 13% of the patients already had retinopathy, all of grade 1. The 5-year follow-up study showed that progression of retinopathy was 23.6% in all cases, 22.2% in those with grade 0 initially, and 33.3% in those with grade 1 initially. The progression rates of retinopathy as a function of the mean HbA1c during the follow-up were as follows: lower than 7%, 2%; 7-8%, 20%; 8-9%, 40%; more than 9%, 61%. Multiple logistic regression analysis showed that, of the parameters examined, only HbA1c was a significant risk factor for progression of retinopathy.

CONCLUSIONS

Control of diabetes mellitus is the most important factor associated with prevention of progression of retinopathy in elderly patients.

Migratory and proliferative effect of platelet-derived growth factor in rabbit retinal endothelial cells: evidence of an autocrine pathway of platelet-derived growth factor

Angiogenesis is a crucial event in the progression of diabetic retinopathy. Migration and proliferation of endothelial cells (EC) are important steps in angiogenesis and are caused by angiogenic factors such as basic fibroblast growth factor (bFGF). In this work, capillary EC were isolated from rabbit retinal tissues and rabbit retinal EC (RREC) were found to secrete a migration factor for RREC in conditioned medium (CM). The activity was inhibited by an anti-platelet-derived growth factor (PDGF) antibody, but not by an anti-bFGF antibody. We also found that RREC showed a migratory response to PDGF. The response was induced by PDGF-BB and PDGF-AB dose dependently, but not by PDGF-AA, indicating that it was mediated by PDGF-beta receptor-dependent pathways, and that the PDGF-like factor was PDGF-BB or -AB. In addition, PDGF-BB induced the proliferation of RREC as well as bFGF. These data indicate that RREC have an autocrine pathway of PDGF by the secretion of and the response to PDGF. PDGF may play significant parts in angiogenesis in the progression of diabetic retinopathy.

Simultaneous demonstration of infecting fungi and DNA-synthesizing epithelial cells in the skin

An excellent staining method to demonstrate in vivo dermatophytes and DNA-synthesizing cells in the skin is described. Deparaffinized sections of guinea pig skin, infected with dermatophytes and given bromodeoxyuridine (BrdU) by intraperitoneal injection, were used. Periodic acid-Schiff (PAS) stain in combination with an immunohistochemical stain using anti-BrdU monoclonal antibody allowed simultaneous visualization of fungi and DNA-synthesizing epithelial cells in the skin. Many epithelial cells near the infecting fungi in follicles and interfollicular skin were labelled with BrdU. Only a few BrdU-positive cells were observed in the skin of uninfected animals.

Angiogenic effects of advanced glycation end products of the Maillard reaction on cultured human umbilical cord vein endothelial cells

The effects of advanced glycation end products (AGE) of the Maillard reaction on proliferation, migration and angiogenesis of cultured human umbilical vein endothelial cells (HUVEC) were studied. In an in vitro angiogenesis system, tube formation of HUVEC was dose-dependently stimulated by AGE at 0.5-50 micrograms/ml. Migration of HUVEC was also stimulated by AGE in a similar concentration range, and checkerboard analysis revealed that AGE were chemotactic but not chemokinetic. Proliferation of HUVEC was not affected by AGE. These data provide evidence that AGE are angiogenic.

[A surgical case report of severe valvular aortic stenosis with atrial septal defect in a 78-year-old female]

We have experienced open heart surgery of severe valvular aortic stenosis associated with atrial septal defect in a 78-year-old female patient. This is the oldest case in Japanese literature. Because balloon valvuloplasty can not produce improvement in hemodynamic and clinical status, open heart surgery was performed as the final decision. The operative procedure consisted of aortic valve replacement with a 19 mm St. Jude Medical valve and direct closure of atrial septal defect. Postoperative course was excellent. The patient is doing well at the two years and three months of follow-up period.

Gene damage induced in human alveolar type II (L-132) cells by exposure to dimethylarsinic acid

To analyze the mechanisms of arsenic-induced gene damage, found previously in lungs of mice and rats orally administered dimethylarsinic acid (DMAA), a major metabolite of inorganic arsenics, we employed an in vitro system using human alveolar type II (L-132) cells. The exposure to 10 mM DMAA for 10 hr caused significant single-strand breaks in DNA of the cells. At an earlier period of the exposure, the replicative DNA synthesis was markedly suppressed, and the chain length of the nascent DNA was shorter than that of the control, suggesting that the template DNA received some modification other than strand breaks. The modification, being repairable, was sensitive to ultraviolet irradiation to cause strand breaks. These results suggest the possibility of DNA-adduct formation at the early period of DMAA exposure in L-132 cells.

Crosslink formation between DNA and nuclear proteins by in vivo and in vitro exposure of cells to dimethylarsinic acid

DNA damage induced by arsenics, particularly by dimethylarsinic acid (DMAA), a main metabolite of inorganic arsenics in mammals, was investigated. DNA-protein crosslinks, similarly to DNA single-strand breaks, were induced in mouse and human culture cells by the treatment with DMAA. The crosslinks were sensitive to treatment with guanidine and hydroxylamine, suggesting that the DNA linkage sites in proteins were serine and threonine residues of H1 histone and of nonhistone proteins and that the linkage occurred through a phospho-nitrogen bond. The type of crosslinks was different from that induced by X-ray radiation. Of the radicals produced in the further metabolic processing of DMAA, the dimethylarsenic peroxyl radical rather than the superoxide anion radical is likely responsible for the formation of crosslinks, similar to the case of DNA single-strand breaks.

[A case of medically treated type A acute aortic dissection: trial of antifibrinolytic therapy while monitoring the thrombotic and fibrinolytic parameters]

A 56-year-old male was admitted with severe chest and abdominal pain. Enhanced CT revealed type-A acute aortic dissection. Enhancement of false lumen was complete in the aortic arch, but it was incomplete in the ascending and descending aorta. This finding suggested a thrombosing tendency of the false lumen. Marked elevation of Thrombin-Antithrombin III complex (TAT) and Plasmin-alpha 2 Plasmin inhibitor complex (PIC) indicated the activation of both coagulation and fibrinolysis in the false lumen. Aprotinin and Tranexamic acid were used in order to suppress the fibrinolysis. Both TAT and PIC were completely normalized at the 20th hospital day. Enhanced CT on the 40th hospital day showed that the false lumen had disappeared, and the adventitia had thickened. Care should be taken to notice activated coagulation and fibrinolysis in the false lumen. This report appears to be the first statement about the effectiveness of antifibrinolytic therapy to facilitate thrombosing and healing of the false lumen in the treatment of acute aortic dissection.

[A successful surgical case of thoracoabdominal aortic aneurysm ruptured into the right pleural cavity]

A 55-year-old man was transferred to our cardiovascular center because of right hemothorax and hemorrhagic shock. Emergency CT scan revealed a thoracoabdominal aortic aneurysm (Crawford's type I-A) ruptured into the right thorax. The aneurysm was exposed by Stoney's spiral opening approach. A 24 mm Cooley Dacron graft was implanted in end-to-end fashion between the descending thoracic aorta and the abdominal aorta just above the celiac artery. The use of aortic artery cannula, femoral artery cannula and flexible polyvinyl tube provided safe and simple means as a temporary bypass during this graft replacement. Postoperative course was uneventful.

Investigation of germinative cells in generating and renewed anagen hair apparatus in mice using anti-bromodeoxyuridine monoclonal antibody

To elucidate the cell kinetics in generating and renewed anagen hair apparatus in mice, S-phase cells in dorsal skin of new-born and 14 to 25-day-old mice were labeled with bromodeoxyuridine (BrdU) and stained immunohistochemically using anti-BrdU monoclonal antibody. In primary hair germ, lower and outer cells were positively stained. In hair peg, the positive cells were divided into upper and lower portions. In bulbous hair peg, the lower positive cells gathered at the suprapapillary area, whereas the upper positive cells were located in the outer part of the hair apparatus. The latter positive cells were further divided in the middle and upper parts of the epithelial cord. The upper cells were going to form a sebaceous gland. From the suprapapillary group of germinative cells, hair cortex through the innermost cell layer of the outer root sheath were considered to be produced. The positive cells of the outer middle group may be important for elongation of hair apparatus and produce outer root sheath cells. At the end of anagen phase, first the suprapapillary cells became negative and then the outer root sheath cells became negative. BrdU-positive cells reappeared at the bottom of telogen hair apparatus and formed a secondary hair germ. Then, a similar cell kinetics was repeated in the renewed anagen hair apparatus. The germinative cells were separated into a few groups during the generation and cyclic changes of hair apparatus. Each cell group formed the individual part of the hair apparatus in a coordinate fashion, resulting in dynamic changes of the hair apparatus.

Chromium (III) decreases carbon tetrachloride-originated trichloromethyl radical in mice

Effects of the administration of trivalent chromium (Cr(III)) to mice and the activation of carbon tetrachloride (CCl4) to form trichloromethyl radicals (.CCl3) in the liver were studied. The lipid peroxidation in liver microsomes induced in vitro by CCl4 in the presence of NADPH was decreased by the preadministration of Cr(III) to mice. The activity of NADPH-cytochrome C reductase, which presumably catalyzes the formation of .CCl3 from CCl4 in liver microsomes, was depressed by Cr(III) administration and kept at a level lower than that of the control group for at least 2 hr after CCl4 dosing. Furthermore, the frequency of appearances of ESR signals of .CCl3 in the liver homogenate of mice 1 min after CCl4 administration was markedly decreased by Cr(III) preadministration, similarly to DL-alpha-tocopherol. These results suggest that Cr(III) preadministered to mice decreases the formation of .CCl3 from CCl4, an activating process of CCl4, in the liver, presumably by scavenging the radical.

Histopathogenesis of inflammatory linear verrucose epidermal naevus: histochemistry, immunohistochemistry and ultrastructure

Skin lesions of three patients with inflammatory linear verrucose epidermal naevus (ILVEN) were examined. Histologically, orthokeratosis and parakeratosis were alternately seen in the acanthotic epidermis. By N-(7-dimethylamino-4-methyl-3-coumarinyl)maleimide staining, the horny cells in the parakeratotic epidermis showed a cytoplasmic SH pattern and a weak membranous SS pattern. The orthokeratotic epidermis revealed an increased involucrin expression, whereas the parakeratotic epidermis showed almost no involucrin expression. Ultrastructurally, in the parakeratotic epidermis, the living keratinocytes had prominent Golgi apparatuses and vesicles in the cytoplasm. In the intercellular spaces in the upper spinous layer through to the lower horny layer, an electron dense, homogeneous substance was deposited. The cytoplasm of the horny cells was filled with keratin filaments and contained remnants of nucleus and cytoplasmic membrane structures, and some lipid droplets. The marginal band formation was incomplete. Most of these ultrastructural abnormalities were not found in the orthokeratotic epidermis. There are both similarities and differences in histopathogenesis of the parakeratotic epidermis between ILVEN and psoriasis. A unique finding was the lack of involucrin expression in the ILVEN parakeratotic epidermis.