Acquisition of a gastric or duodenal phenotype on heterotropic transplantation of esophagus and bladder tissues in F344 rats

Cell differentiation is very important but not well understood. In the present study the ability of various tissues to newly-differentiate when transplanted into the fundus or the duodenum in rats was tested. Pieces of esophagus, bladder, diaphragm and trachea from 8-week-old male F344 rats were transplanted into the gastric fundus or duodenum of females and examined after 3 or 6 months. While the diaphragm was not recognizable as a muscle layer in either the stomach or the duodenum, the esophagus and trachea persisted, the latter with the presence of cartilage. Esophagus grafts transplanted into the glandular stomach and duodenum, newly-differentiated into gastric and duodenal mucosa, respectively. Goblet cells with alcian-blue positive mucin appeared in bladder tissue implanted into the duodenum. Six months after the operation, their numbers had increased and cytoplasm alkaline phosphatase (ALP) positivity was noted. Gastrointestinal and also bladder stem cells may thus have multipotential ability for differentiation and may be able to newly-differentiate when transplanted into different environments in the gastrointestinal tract.

Expression of hypothalamic corticotropin-releasing hormone-like immunoreactivity in isolated ACTH deficiency: a report of an autopsied case

A 77-yr-old man died of metastising adenocarcinoma of the lung. He had been treated with hydrocortisone for isolated ACTH deficiency for 9 yr. At autopsy, the pituitary and the adrenal glands were atrophic. Lymphocyte infiltration was not observed in the pituitary, the adrenal and the thyroid glands. Immunohistochemistry revealed selective loss of ACTH-like immunoreactivity in the pituitary gland whereas CRH-immunoreactive cells were found in the paraventricular nucleus of the hypothalamus. This is the first report demonstrating immunohistochemical examinations of the pituitary and the hypothalamus in isolated ACTH deficiency.

Beta-cyclodextrin-linked chitosan beads: preparation and application to removal of bisphenol A from water

Water-insoluble and highly porous chitosan beads having an ability to form inclusion complexes have been synthesized by treatment of a solution of chitosan in aqueous acetic acid with aqueous NaOH followed by crosslinking and reductive alkylation with 2-O-formylmethyl-beta-cyclodextrin. Preliminary experiments for its application to removal of endocrine disrupting chemicals were carried out using a column of the resulting beads and bisphenol A as the model substrate.

Roles and mechanisms of action of pituitary adenylate cyclase-activating polypeptide (PACAP) in growth hormone and prolactin secretion

It appears that PACAP has a direct action on somatotrophs to release GH. The intracellular signal transduction mechanisms for PACAP might be similar to but partly distinct from those for GRH. PACAP might play a role in GH secretion induced by serotoninergic mechanisms but not in ultradian rhythm of GH secretion in the rat. PACAP can stimulate PRL release from the pituitary in rats possibly through indirect paracrine effect. In addition, PACAP might participate in regulation of PRL secretion via hypothalamic VIP.

Serum antibodies to human pituitary membrane antigens in patients with autoimmune lymphocytic hypophysitis and infundibuloneurohypophysitis

OBJECTIVE

Serum antipituitary antibodies were investigated by the immunoblotting method using human anterior pituitary membrane preparation as the antigen.

PATIENTS

Thirteen patients with autoimmune lymphocytic hypophysitis, two patients with infundibuloneurohypophysitis, four patients with isolated ACTH deficiency, 21 patients with diabetes mellitus (type 1 and type 2) and 38 healthy subjects were studied.

METHODS

Human pituitary membrane antigens were electrophoresed by sodium dodecylsulphate-polyacrimide gel electrophoresis (SDS-PAGE). The antigens were transferred to polyvinylidene difluoride membrane and reacted with the sera followed by incubation with biotinylated anti-human IgG goat serum.

RESULTS

Serum antibodies to 68, 49, 43 kD human pituitary membrane antigens were detected in five of 13, one of 12 patients with infundibuloneurohypophysitis and none of four patients with isolated ACTH deficiency. These antibodies were not detectable when human thyroid, liver or rat pituitary preparations were used as the antigen.

CONCLUSION

These findings suggest that serum antibodies to 68, 49, 43 kD human anterior pituitary antigen are specific but not so frequently detected in autoimmune lymphocytic hypophysitis.

Antioxidative and 5-lipoxygenase inhibiting activities of novel bis(4-hydroxy-2,3,5-trimethylphenoxy)alkyl derivatives

Novel bis(4-hydroxy-2,3,5-trimethylphenoxy)alkyl derivatives were synthesized and evaluations were made of their inhibiting action on Fe3+-ADP induced lipid peroxidation in rat liver microsome and reducing action on alpha,alpha-diphenyl-beta-picrilhydrazyl (DPPH), a stable radical, in addition to their inhibiting action on 5-lipoxygenase (5-LO), an enzyme that synthesizes leukotrienes. We performed a structure-activity correlation study on these derivatives. A strong Fe3+-ADP induced lipid peroxidation preventing activity was observed for the derivatives with an odd number of methylene groups including 1,3-bis(4-hydroxy-2,3,5-trimethylphenoxy)propane (3b) and 3a. No change in the DPPH reducing activity was found with change in the number of methylene groups. 5-LO inhibiting activity among the derivatives was the highest for 1,6-bis(4-hydroxy-2,3,5-trimethylphenoxy)hexane (3e). MM2 calculations were performed to find a stable steric structure for the derivatives, and 1,5-bis(4-hydroxy-2,3,5-trimethylphenoxy)pentane (3d) showed a strong activity in both antioxidative action and 5-LO inhibiting action.

Reverse correlation between urine nitric oxide metabolites and insulin resistance in patients with type 2 diabetes mellitus

We studied the possible relationship between nitric oxide (NO) production and insulin resistance in patients with type 2 diabetes mellitus. Urine NO metabolites (NOx) were measured as an index for NO production by HPLC combined with a Cd column, Griess reaction and a spectrophotometer in 403 healthy control subjects and 102 hospitalized patients with type 2 diabetes. Glucose infusion rate (GIR) was measured as a reverse index for insulin resistance by euglycemic glucose clamp study using an artificial pancreas in 20 of 102 diabetic patients. Urine NOx was lower in the patients with type 2 diabetes than in healthy control subjects (mean+/-SE: 3.18 +/-0.02 versus 3.25 +/-0.01 log[-micromol/gCr], p<0.01). Urine NOx was correlated with body mass index (BMI) in 102 diabetic patients (r= -0.372, p<0.001), but not related to either age, sex, fasting plasma glucose, HbA1c or blood pressure. Urine NOx was correlated with GIR independent of BMI in 20 diabetic patients (r=0.774, P<0.0001). These findings suggest that NO production is closely related with insulin resistance in patients with type 2 diabetes.

Inflammatory action of 8-methoxypsoralen-spermine photoproduct (8-MOP-Spm-P(GFC)) and effects of various drugs on rat paw edema induced by 8-MOP-Spm-P(GFC)

The photoproducts produced by irradiating 8-methoxypsoralen (8-MOP) in the presence of spermine (Spm) were fractionated using gel filtration chromatography (GFC) on a Sephadex G-25 column. As a result, two bands which were characterized by the effects on hyaluronidase activity were obtained. The first band strongly activated the hyaluronidase, but a second band did not exhibit any effect on the enzyme activity. The first and second bands contained photoproducts with molecular weights (MW)>2700 and MW<728, respectively, determined by the GFC method. The photoproducts, 8-MOP-Spm-P(GFC) obtained from the first band, but not the photoproducts with lower MW from the second band, showed enzyme activating action. 8-MOP-Spm-P(GFC) induced paw edema, which was stronger in the first phase than the second one in rats, differing from that induced by carrageenin. This photoproduct was a substance with lower cell toxicity because it did not cause hemolysis on red blood cells or the release of lactic dehydrogenase from mast cells in rats. The effects of various drugs on 8-MOP-Spm-P(GFC)-induced edema were investigated. As a result, edema formation was inhibited by drugs with an anti-histaminic action, such as alimemazine, dl-chlorpheniramine, promethazine, ketotifen and azelastine, and with anti-serotonin action such as cyproheptadine. On the other hand, tranilast did not show significant inhibition and indomethacin showed a tendency to increase its formation. These results suggested that 8-MOP-Spm-P(GFC) is a new inflammatory substance and is very useful as an agent to develop new anti-inflammatory drugs without cyclooxygenase inhibitory action.

Renal expression of insulin-like growth factor-l in acute renal failure: a preliminary report

Renal expression of insulin-like growth factor-I (IGF-I) was examined in the specimens obtained at renal biopsy from five patients with acute renal failure (ARF) at the recovering phase. IGF-I peptide and mRNA were demonstrated in the cytoplasm of the epithelial cells of focal proximal tubules in four patients in whom renal function had been ameliorating. The stainings of IGF-I peptide and mRNA were intense in patients with favorable prognosis. Either IGF-I immunoreactivity or mRNA was not detected in the renal tissues in five cases with chronic renal insufficiency and four patients with renal carcinoma. Our preliminary findings suggest that IGF-I is locally produced in the kidney during the recovery period of ARF and might play roles in the repair processes, and extend the experimental observations in animal models into human pathophysiology.

Analysis of urinary nitric oxide metabolites in healthy subjects

Nitric oxide (NO) has divergent actions under physiological and pathological conditions. NO is rapidly decomposed to nitrite (NO2-) and nitrate (NO3-). Since these metabolites are stable, they are good indices of NO production under various conditions. In the present study, we measured NO2- and NO3- concentrations in the urine collected from 62 hospital controls and 504 healthy subjects by means of a new HPLC system combined with Griess reaction. NOx was the sum of NO2- and NO3-. There was no considerable inter-day variation in urinary NO metabolite levels, and there was close correlation between NO2-, NO3- and NOx values in spot urine obtained in the early morning and those in 24-h stored urine in hospital controls. Urinary NO metabolite levels, which were corrected by creatinine (Cr) excretion and expressed on a logarithmic scale, showed normal distribution and were independent of sex and age in healthy subjects. The normal ranges of urinary NO2-, NO3- and NOx levels were estimated as 17-72 micromol/g Cr, 1,023-2,818 pmol/g Cr, and 1,071-2,951 micromol/g Cr, respectively. We also found that urinary NO metabolite levels were lower than normal range in patients with various diseases.

[Usefulness of low dose 5'-DFUR (5'-deoxy-5-fluorouridine) for advanced or recurrent breast cancer]

The usefulness of low dose (600 mg/day) 5'-DFUR for advanced or recurrent breast cancer was evaluated. Eight patients out of 38 showed a partial response (response rate 21.1%), 22 patients had no change, and 8 patients had progressive disease. The response rate was 31.0% in soft tissue and 9.1% in bone, both of which were slight. In both one-shot (200 mg) and continuous (1-4 months) administration of 5'-DFUR (600 mg/day), the concentration of 5'-DFUR of 5-FU in sera reached a plateau from 30 minutes to 2 hours after administration of 5'-DFUR, and disappeared after 3 hours. There were no significant differences in the concentration of 5'-DFUR of 5-FU in sera between one-shot and continuous administration. It is concluded that there was no accumulation of the drug after continuous administration of 5'-DFUR, and that low dose 5'-DFUR is a useful therapy for advanced or recurrent breast cancer.

Synthesis of trimethylhydroquinone derivatives as anti-allergic agents with anti-oxidative actions

A novel series of trimethylhydroquinone derivatives was synthesized and evaluated for their anti-lipid peroxidation activity in rat liver microsomes, inhibition of rat basophilic leukemia-1 (RBL-1) cell 5-lipoxygenase and 48 h homologous passive cutaneous anaphylaxis (PCA) activity in rats. 4-[4-[4-(Diphenylmethyl)-1-piperazinyl]-butoxy]-2,3,6-trimethyl phenol (9c) exhibited the ability to inhibit Fe(3+)-ADP induced NADPH dependent lipid peroxidation (IC50 = 5.3 x 10(-7) M), 5-lipoxygenase ((IC50 = 3.5 x 10(-7) M) and PCA reaction (57% inhibition at 100 mg/kg p.o.).

A case of autoimmune hypophysitis associated with asymptomatic primary biliary cirrhosis

We report a 61-year old male patient with panhypopituitarism complicated with asymptomatic primary biliary cirrhosis (PBC). T1-weighted magnetic resonance imaging demonstrated high intensity of the anterior pituitary gland. There was no mass lesion or enlargement of the pituitary gland or the stalk. Immunoblot analysis of the patient's sera with rat pituitary antigens revealed a band with a molecular size of 22 kD. Anti-M2 mitochondrial antibody has been consistently positive for five years. Liver biopsy revealed portal hepatitis with periportal infiltration of the inflammatory cells. This is the first case report of autoimmune hypophysitis complicated with asymptomatic PBC.

Evaluation of propolis (II): effects of Brazilian and Chinese propolis on histamine release from rat peritoneal mast cells induced by compound 48/80 and concanavalin A

To establish a biological method for evaluating propolis and to reveal their anti-allergic action, the effects of the ethanol and water extracts (EA-ET and WA-WT, respectively) from Brazilian, Chinese and Japanese propolis on the histamine release induced by compound 48/80 and concanavalin A (Con A) were investigated. The relation between the inhibitory activities of these extracts on the histamine release and their E(1 cm)1% values were also examined. As a result, the following was found: 1) 0.003-0.01% ethanol and 0.03-0.1% water extracts inhibited the histamine release induced by compound 48/80 and Con A, and the inhibitory potencies of the former extracts were more than 10 times stronger than those of the latter extracts, making it clear that both the ethanol and water extracts possess an anti-allergic action; 2) most of the ethanol and water extracts responded to the histamine release induced by both the histamine releasers in a concentration-dependent manner; 3) the inhibitory activities of 0.003% EM from Hebei Province, EP from Sichuan Province, EQ from Zhejiang Province and ER from Anhui Province in China were weaker than those of 0.01% corresponding extracts, whereas 0.001% ED-EH from Brazilian propolis, EM, EN from Henan Province in China and EP-ER promoted the Con A-induced histamine release of more than 10%, suggesting that such extracts must be carefully given to humans; 4) the inhibitory potencies of only 0.03-0.1% water extracts from Chinese propolis on the Con A-induced histamine release related excellently with their E(1 cm)1% values; 5) from the results of the relation between the inhibitory potencies of the propolis extracts and their E(1 cm)1% values, it was suggested that an unknown compound, being a poorly water-soluble compound which is a non-flavonoid, with an anti-allergic action is contained in propolis; 6) to precisely evaluate the anti-allergic action of the propolis, the biological method, which measures the inhibitory activities of the propolis extracts on histamine release, was markedly superior to the physicochemical method.

Early Breast Cancer Following Treatment of Myelodysplastic Syndrome: Report of a Case

A 45-year-old woman was admitted to our hospital complaining of a mass in herleft breast. She had previously been diagnosed with myelodysplastic syndrome(MDS), a type of refractory anemia, based on bone marrow findings and chromosome analysis. She received a preoperative transfusion of fresh packed platelets and a recombinant human granulocyte colony-stimulating factor(rhG-CSF)injection. Left partial mastectomy and axillary lymph nodes dissection were performed to treat early breast cancer. Postoperatively, prophylactic radiotherapy of the residual breast and administration of medroxyprogesterone acetate(MPA)were performed because the tumor tissue was positive for progesterone receptors. She has remained clinically stable, with no evidence of recurrence, for more than three years to date. We report a rare case of breast cancer with MDS, treated with breast-conserving therapy. The strategy of pre- or postoperative platelet transfusion, rhG-CSFinjections, and hormonal therapy (MPA) appears to be suitable treatment for progesterone receptor(PgR)-positive breast cancer patients with MDS.

Histopathological improvement of acromegalic cardiomyopathy by intermittent subcutaneous infusion of octreotide

We studied functional and histopathological changes in acromegalic cardiomyopathy following intermittent subcutaneous infusion of octreotide. A 68-year-old female patient with acromegaly associated with congestive heart failure due to dilated cardiomyopathy was initially treated with cardioactive medication for three months, but it was not effective in correcting echocardiographic abnormalities. Further treatment with intermittent subcutaneous infusion of octreotide (20 microg/2 h) for 12 months not only reduced circulating GH and insulin-like growth factor-I (IGF-I) levels but also considerably improved histopathological changes in the myocardial specimen biopsied. These findings provide the first evidence of the favorable effect of octreotide on histopathological changes in acromegalic cardiomyopathy.

Effects of rat galanin and galanin message associated peptide (GMAP) on rat growth hormone secretion and stimulating effect of gamma-aminobutyric acid on galanin release from rat hypothalamus

Immunoreactive galanin and galanin message associated peptide (GMAP) were detectable in rat hypothalamus in the concentration of 563 +/- 23 and 14.3 +/- 3.1 fmol/hypothalamus, respectively. gamma-Aminobutyric acid (GABA) elicited a dose-related increase in galanin release from rat hypothalamic fragments, which was inhibited by picrotoxin, a GABA antagonist. Growth hormone (GH) secretion from rat anterior pituitary cells were stimulated by rat galanin, but not by GMAP. These findings suggest that hypothalamic galanin, but not GMAP, may play roles in GH secretion induced by GABAergic mechanisms in the rat.

Stereo fluoroscopy-assisted distal interlocking of intramedullary nails

A simulation study of distal interlocking of an intramedullary nail was performed using newly devised, portable stereo fluoroscopy. Two intramedullary nails in which ten holes were drilled perpendicular to the long axis and at various angles to the diameter were inserted into a femoral and a tibial bone model. Ten drill bits were drilled freehand into the holes in the nail with the aid of the stereo fluoroscope. All twenty drill bits were seated in the holes in the first attempt. This instrument provides a three-dimensional view in real time, which enables the surgeon to appreciate the three-dimensional relationship between the drill bit and the hole in the nail in the bone model. Distal interlocking of the intramedullary nail is facilitated with the aid of this stereo fluoroscope.

Evaluation of propolis. I. Evaluation of Brazilian and Chinese propolis by enzymatic and physico-chemical methods

To establish a method of evaluating propolis, the effects of the ethanol and water extracts from various collecting of propolis from different countries and plant sources on hyaluronidase activity were investigated along with their absorption spectra and specific absorbance (E(1%)1 cm value). The relations between the hyaluronidase inhibitory activities of these extracts and their E(1%)1 cm values were also examined, and the following was found: 1) the enzyme inhibitory activities of the ethanol extracts were more potent than those of the water extracts; 2) the enzyme inhibitory activities of the ethanol extracts from Araucaria angustifolia (BERT.) O. KTZE were low compared with those of other ethanol extracts; 3) the enzyme inhibitory activities of all the ethanol extracts correlated excellently with their E(1%)1 cm values, but in the water extracts, they decreased with increase in E(1%)1 cm values; 4) the water extracts of Chinese propolis from Hebei, Jiangsu, Sichuan and Zhejiang Provinces inhibited weakly compared with that from Brazilian and other Chinese propolis; 5) the shapes of absorption bands of the propolis extracts and the E(1%)1 cm values were approximately dependent on the place or the plant source from which propolis was collected. These experimental results indicated that, for the exact evaluation of propolis, the enzymatic method, measuring the hyaluronidase inhibitory activity, was superior to the physicochemical method.

Involvement of pituitary adenylate cyclase-activating polypeptide in growth hormone secretion induced by serotoninergic mechanisms in the rat

Pituitary adenylate cyclase-activating polypeptide-38 (PACAP-38) stimulated GH secretion in superfused rat anterior pituitary cell in vitro and in conscious male rats in vivo. PACAP-38-induced GH secretion was inhibited by PACAP-(6-38), an N-terminal-deleted analog, at 100-fold concentrations of PACAP-38 both in vitro and in vivo. In contrast, a GH-releasing hormone antagonist did not affect the action of PACAP-38 to stimulate GH release in vitro. Plasma GH increase induced by i.v. injection of 5-hydroxy-L-tryptophan (1 mg/100 g BW), a precursor of serotonin, was blunted by PACAP-(6-38) (1 nmol/100 g BW, i.v.), whereas spontaneous pulsatile GH secretion in conscious male rats, which is governed by hypothalamic GH-releasing hormone and somatostatin, was not affected by repeated i.v. injection of PACAP-(6-36). These findings suggest that PACAP-(6-38) is a potent antagonist of PACAP-38 to stimulate GH secretion both in vivo and in vitro. Taken together with the facts that PACAP-38 is highly concentrated in the hypothalamus and that is released into the hypophysial portal blood, our present findings suggest that PACAP-38 might play a stimulatory role on GH secretion induced by serotoninergic mechanisms in the rat.

Pharmaceutical properties of freeze-dried formulations of egg albumin, several drugs and olive oil

The freeze-dried ternary formulations of meclizine (MZ, an anti-motion sickness drug), prednisolone (PRED, an anti-inflammatory drug) and norfloxacin (NFLX, an anti-microbial drug) which are poorly water-soluble and are low bioavailability drugs, were prepared using egg albumin and olive oil. The powder X-ray diffractions, the dissolution rate and the bioavailabilities in vivo of these formulations were studied in comparison with each drug alone. By forming ternary formulations of these drugs, the dissolution rates of the drugs from the formulations were significantly improved compared with each drug alone. The results of their powder X-ray diffraction measurements showed that these drugs in the ternary formulations presented in an amorphous form, indicating increased dissolution rates. On the other hand, the plasma concentrations of these drugs increased significantly after oral administration in formulations to rats, except for the NFLX formulation, and the areas under the concentration-time curves (AUC) of the ternary formulations of MZ, PRED and NFLX were 2.1, 1.6 and 1.3 times those of the drugs alone, respectively. From these results, it was proven that formulations consisting of egg albumin, olive oil and poorly water-soluble drugs were useful preparations for improving the drug's disadvantageous pharmaceutical properties.

Spinal cord injures in children observed over many years

The known salient features of spinal cord injuries in children are that 1) plane X-rays may not show dislocations or fractures, 2) many of these injuries are complete transections, 3) many injuries are located at the level of upper thoracic spine, and 4) the duration of spinal shock is short. Complications such as pressure sores occur just as easily in children as in adults and the injuries tend to be just as intractable. Complications characteristic in children with spinal cord injuries are spinal deformity and hip dislocation. In this paper, we describe a case involving a C7 spinal cord injury caused by a fall when the patient was 3 years old. We have observed the physical complications for 15 years following that injury. We also report on other observed cases of spinal cord injury.

[Effectiveness of combination hormonal therapies in advanced or recurrent breast cancer--a randomized trial of tamoxifen (TAM), medroxyprogesterone acetate (MPA), their simultaneous combination, and an alternating sequential combination of TAM plus MPA]

The effects of tamoxifen (TAM), medroxyprogesterone acetate (MPA), their simultaneous combination or an alternating sequential combination of TAM plus MPA (TAM-MPA), was evaluated in 52 patients with advanced or recurrent breast cancer in a randomized controlled trial. The response rates of TAM, MPA, TAM & MPA, and TAM-MPA were 13.3%, 36.4%, 7.1% and 25.0%, respectively. All four therapies showed a higher response rate in the patients with soft tissues or with no previous therapy. However, there were no significant differences between the patient's characteristics and response rate among these four therapies. The differences in the frequency of adverse effects among these therapies were not significant, and there were no severe adverse effects with any therapy. In the cross-over trial of TAM and MPA, although 15.4% of patients who failed to show a response to TAM showed an objective response to MPA, no response to TAM was seen in the patients who had failed to show a response to MPA. In conclusion, TAM & MPA was not more effective than TAM or MPA, and TAM-MPA was not more effective than MPA. Adverse effects were not increased with TAM & MPA or TAM-MPA. MPA was useful as a second-line therapy after TAM.

Pulmonary nodules in patients with a history of radical nephrectomy for renal cell carcinoma

BACKGROUND

Nine patients with a history of radical nephrectomy for renal cell carcinoma underwent surgical removal of newly detected pulmonary nodules at the Hiroshima University Hospital. Six patients had metastatic lung tumors two patients had bronchogenic primary carcinomas and one had a granulomatous infection.

METHODS

To determine if any characteristics can distinguish a new primary carcinoma from metastatic renal cell carcinoma, we reviewed the nine patients described above. The patients with pulmonary metastases and those with new primary lung cancers did not differ in age, sex, history of smoking, clinical stage and pathological findings of the renal primary site, on the location and size of the pulmonary nodules.

RESULTS

Only the interval between the nephrectomy and the appearance of the new pulmonary lesion may be a predictive factor. This interval was 48 and 51 months for the patients with new primary lung cancers but varied from 0 to 39 months for the patients with metastatic renal cell carcinoma. A solitary nodule had an equal chance of being metastatic or primary.

CONCLUSIONS

These results indicate that a solitary nodule that is detected at a longer interval after radical nephrectomy may be a new primary lung cancer. Once new pulmonary nodules are identified in a patient with a history of radical nephrectomy for renal cell carcinoma, surgical excision is required for a final diagnosis before initiating therapy for metastases.

Possible involvement of vasoactive intestinal polypeptide in the central stimulating action of pituitary adenylate cyclase-activating polypeptide on prolactin secretion in the rat

Effect of pituitary adenylate cyclase-activating polypeptide (PACAP) on prolactin (PRL) secretion was studied in Wistar strain male rats in vivo. Intravenous injection of PACAP-38 and PACAP-27 resulted in a dose-related increase in plasma PRL levels both in conscious rats and in urethane-anesthetized rats. In anesthetized animals, i.c.v. injection of PACAP-38 and PACAP-27 also elicited a dose-related increase in plasma PRL. The PRL secretion induced by i.c.v. injection of PACAP-38 was attenuated by pretreatment with rabbit antiserum to vasoactive intestinal polypeptide (VIP). These findings suggest that PACAPs stimulate PRL secretion in the rat by acting not only directly on the pituitary but also indirectly through the central nervous system, at least partly, via hypothalamic VIP.

Pituitary adenylate cyclase activating polypeptide (PACAP) stimulates growth hormone release from GH3 cells through type II PACAP receptor

Effect of pituitary adenylate cyclase activating polypeptide (PACAP) on growth hormone (GH) release from GH3 cells was studied in a dynamic superfusion system. PACAP-38 and PACAP-27 stimulated GH release from superfused GH3 cells. The stimulatory effect of PACAP-38 was comparable to those of vasoactive intestinal polypeptide (VIP) and PACAP-27 at a concentration of 1 nM, but the duration of action was more prolonged in PACAP-38 than in the other two peptides. PACAP(6-38), a selective antagonist of PACAP, as well as a VIP antagonist blunted the GH release induced by PACAP-38 and VIP. An antagonist of GH-releasing factor (GRF) at a concentration of 1 microM, however, did not affect the GH release induced by PACAP-38. These findings suggest that PACAP and VIP stimulate GH release from GH3 cells through type II PACAP receptor but not through the GRF receptors.

[A case of breast cancer with multiple organ metastases in which single low dose administration of 5'-DFUR proved effective]

A 58-year-old woman with multiple organ metastases from breast cancer who had undergone radical mastectomy three years ago, was treated with oral 5'-DFUR 600 mg/day. Complete remission (CR) of lymph node metastasis has been maintained for twenty-two weeks, with partial response (PR) against skin, liver and pleural metastases from 94 weeks of treatment. The patient, who continues to be treated, is well and enjoying a favorable quality of life. 5'-DFUR is considered to be an effective first choice for treating a patient with advanced or recurrent breast cancer.

Intracavitary drainage procedure for giant bullae in compromised patients

Two cases of giant bullae were treated by intracavitary suction and drainage procedure under local anesthesia because of the poor pulmonary function. After staged bullectomy, the patients returned to normal life. The first case was admitted to our intensive care unit (ICU). Tube drainage was performed in the giant bulla of the left lung immediately after admission. One month after recovery from right heart failure and mediastinal shift to the right side, bullectomy was performed using linear stapler. The patient was discharged 20 days later. The second case was admitted with severe dyspnea and bilateral giant bullae were noticed. We performed tube drainage for larger bulla of the left lung under local anesthesia. Two months later, bullectomy was performed on the right side, because the bulla on the left side became smaller and the general condition of the patient improved. The patient was discharged three months later on foot and has since been asymptomatic. Giant bulla is a well-established clinical entity which includes abnormal dilatation of various parts of the tracheo-bronchial tree and other discrete sacs originating from the interstitial portion of the lung. Giant bullae are frequently associated with marked dyspnea and emphysematous symptoms. However, these symptoms depend upon various factors: size, location, valvular mechanism, condition of the contiguous lung parenchyma and the changes that may take place in the intrathoracic pressure.

Study of portal arterialization with auxiliary liver in rats

The effect of portal arterialization was examined in 20 heterotopic auxiliary rat livers. Portal blood was supplied from recipient iliac artery (0.58 mm in diameter) connected to the donor portal vein using the cuff technique. Portal hypertension caused by arterial blood pressure resulted in the immediate operative death by bleeding in four of the rats (20%) from the spontaneous rupture of the graft capsule. Severe graft congestion was noticed at autopsy 3-14 days after transplantation in 13 rats. Massive portal and sinusoidal congestion and focal hemorrhagic necrosis were confirmed by pathological examination. The results of our study demonstrate that the portal arterialization used in the auxiliary rat liver transplantation would not be applicable unless the optimal hemodynamic condition is warranted.

Radiosensitivity of skin fibroblasts from atomic bomb survivors with and without breast cancer

Fibroblasts were established in vitro from skin biopsies obtained from 55 women and 1 man with or without breast cancer and with or without exposure to radiation from the atomic bomb explosion in Hiroshima. The radiosensitivity of these cells was evaluated by clonogenic assays after exposure to X-rays or to fission neutrons from a 252Cf source. Data were fitted to a multitarget model, S/S0 = A [1 - (1 - ekD)N], for both X-ray and neutron dose-survival curves. A single hit model, S/S0 = AekD, fits the neutron dose-survival responses as well. There were no differences in the means or variances of radiosensitivity between exposed and nonexposed groups or between patients with or without breast cancer. Hence, although the sample is not large, it provides no support for the hypothesis that atomic bomb radiation preferentially induces breast cancer in women whose cells in vitro are sensitive to cell killing by radiation.

Absence of correlations between radiosensitivities of human T-lymphocytes in G0 and skin fibroblasts in log phase

Dose-survival curves were obtained for matched samples of peripheral T-lymphocytes and skin fibroblasts from a total of 22 patients who underwent various surgical procedures using loss of colony-forming ability as the end point. The results showed that the mean D10 (dose required to kill 90% of cells) +/- SD was 3.58 +/- 0.21 Gy for T-lymphocytes irradiated in G0 and 3.19 +/- 0.37 Gy for skin fibroblasts irradiated in log phase. The coefficients of variation were found to be 6 and 11%, respectively. Contrary to the expectation, regression analysis of D10 values for the two types of cells revealed no significant correlations. The absence of correlation most probably derives from the fact that the apparent interindividual variability of dose-survival curves is caused primarily by random experimental fluctuations at least in the case of lymphocytes. Possible reasons for the greater variability observed in the fibroblast assay are discussed.

[Elevated soluble interleukin-2 receptor and interleukin-2 receptor positive cells in carcinomatous pleural effusions]

Soluble interleukin-2 receptor (IL-2R) level and IL-2R positive (IL-2R+) cells were studied in twenty patients with carcinomatous pleural effusions. The mean value of soluble IL-2R level in carcinomatous pleural effusions was 2930 +/- 1722 U/ml and that in sera was 965 +/- 610 U/ml. Soluble IL-2R level in carcinomatous pleural effusions was found to be significantly higher (p less than 0.001) than that in sera of patients with carcinomatous pleural effusions and that in transudates. Serum soluble IL-2R level in patients with carcinomatous pleural effusions was found, to be significantly higher (p less than 0.001) than that in normal controls (264 +/- 70 U/ml). We also studied IL-2R+ cells in pleural fluids and peripheral blood of patients with carcinomatous pleural effusions. The mean percentage of IL-2R+ cells in carcinomatous pleural fluid lymphocytes was 22.8 +/- 17.8%, as compared with 3.0 +/- 2.2% in peripheral blood lymphocytes of normal controls (p less than 0.001). No significant differences were observed among the cell types of lung cancer examined (adenocarcinoma, squamous, small cell and large cell carcinoma) and no correlation among levels of soluble IL-2R and IL-2R+ cell in either pleural fluid or blood. Our results suggest that in patients with carcinomatous pleural effusions, T cell-mediated active immune mechanisms (IL-2/IL-2R system) against cancer cells are more active in pleural fluid than in peripheral blood.

[Intrapleural administration of recombinant interleukin-2 in a patient with pleural effusion due to non-Hodgkin's lymphoma]

A 79-year-old female was admitted with dyspnea. Chest roentgenogram showed massive left-side pleural effusion. Chest CT scan and abdominal CT scan revealed marked swelling of mediastinal and para-aortic lymph nodes. Diagnosis of non-Hodgkin's lymphoma was made by pleural fluid cytology. Recombinant interleukin-2 (1000 units/day) was administered into the pleural cavity for 14 days continuously. Clinically, pleural effusions and malignant cells in the effusions disappeared. Immunologically, levels of IL-2 receptor positive cells, soluble IL-2 receptors and CD4 positive cells in the pleural effusion increased 7 days after recombinant IL-2 administration with subsequent decrease after completion of treatment. On the other hand, levels of IL-2 receptor positive cells, soluble IL-2 receptors and CD4 positive cells in the peripheral blood increased with no subsequent decrease after completion of treatment.

[Soluble interleukin-2 receptor levels in patients with pulmonary tuberculosis]

Utilizing an enzyme-linked immunosorbent assay, we detected markedly elevated serum levels of soluble interleukin-2 (IL-2) receptors in patients with untreated pulmonary tuberculosis. In these patients, we also found that serum levels of soluble IL-2 receptors were closely correlated with serum adenosine deaminase levels (r = 0.869, p less than 0.001). Therefore, serum soluble IL-2 receptors appear to reflect the existence of active cell-mediated immunity in pulmonary tuberculosis and may prove to be a useful immunological marker for pulmonary tuberculosis.

Breast cancer in a man treated effectively with a large dose of tamoxifen citrate

Breast cancer in males is comparatively rare. A 41-year-old man visited our hospital with a complaint of left breast tumor. Initial examination showed remarkably diffuse metastatic lesions in the lung field and small metastatic lesions in the surrounding skin. Modified radical mastectomy, including the surrounding metastatic skin lesions, and incisional biopsy of the lung were performed. Estrogen receptor was positive in both the primary breast cancer and metastatic cancer lesions in the lung. Postoperative medication of tamoxifen citrate, an estrogen receptor blocking agent, in a dose of 30 mg/day, was given together with fluorouracil, BCG, cyclophosphamide, and methotrexate. No evident change could be seen in the lung field six months after the operation. The metastatic lesions in the lung disappeared two years after the operation when the dose of tamoxifen citrate was increased to 60 mg/day. At this writing, thirty months after the operation, the patient is in good health.

[Liposarcoma of the mediastinum--a case report]

A case of mediastinal liposarcoma in a 45-year-old man is reported. The patient was admitted to the hospital complaining of rhinorrhea. A large mass was found in the right thorax by chest X-ray. At thoracotomy, a tumor measuring 11.5 X 9 X 8.5 cm located in the anterior mediastinum with an extension to the pleural cavity formed in right middle and lower lobes was found and removed from the adjacent visceral pleura. The tumor had a fibrous capsule and was multinodular in external appearance. The cut surface was yellowish and gelatinous. The histological diagnosis of myxoid liposarcoma was made according to the subclassification of liposarcoma proposed by Enzinger et al.

[Interaction of proteases and their inhibitors in the pathogenesis of pancreatitis]

It was confirmed that esterolytic activity was significantly elevated in plasma of patients with acute pancreatitis, which correlated better with the stage of the disease than serum amylase level. Using the several column chromatography procedures, pancreatic kallikrein, trypsin and pancreatic elastase were separated and purified from alpha 2-macroglobulin (alpha 2-M) fractions of patients plasma with acute pancreatitis. From this this result, it was confirmed that kallikrein was liberated into the blood stream from the pancreas during attacks of acute pancreatitis and the liberated kallikrein combined with alpha 2-M. Furthermore, the coexistence of trypsin is required for the complex formation of alpha 2-M and pancreatic kallikrein. It was speculated that alpha 2-M might be decomposed by the excessive amount of elastase, and consequently, might release all of its combining enzymes into the blood stream. In the present study, the activation mechanism of fibrinolytic enzyme system in plasma by human pancreatic elastase was investigated. Elastase not only converted the co-existing plasminogen to low molecular weight plasminogen which could be easily activated by the activators, but also inhibited alpha 2-M and alpha 2-plasmin inhibitor, and consequently, induced the activation of the fibrinolytic enzyme system in plasma. Furthermore, it was also confirmed that elastase could activate plasma kallikreinogen to kallikrein.

A parathyroid cyst effectively treated with a sclerosing agent

Sclerosing solution was injected into a parathyroid cyst through a needle used for aspiration biopsy cytology. One year has passed without a recurrence and a cure is expected.

Diagnosis of breast lesions by aspiration biopsy cytology

From November 1981 to the end of August 1984, 456 patients with breast lesions underwent aspiration biopsy cytology (A.B.C.). This study includes 109 for whom the diagnosis was histologically confirmed at surgical biopsy. Seventy-five lesions were histologically proven to be malignant and 34 were benign. The accuracy of diagnoses with A.B.C. was; true positive 86.7 per cent (65/75) of the time, true negative 82.6 per cent (28/34) of the time, false negative 5.3 per cent (4/75) of the time and false positive 5.7 per cent (2/34) of the time. Unsatisfactory or inadequate aspirated tissue made A.B.C. diagnosis difficult in 5.5 per cent (6/109) of the cases. Three out of 7 with malignant tumors, who were wrongly diagnosed as benign by A.B.C., had tumors with a diameter of 1.0 cm or less. Two benign cases which were falsely diagnosed as malignant also had small tumors about 1.0 cm in diameter. Although A.B.C. is more reliable than other conventional supplementary diagnostic techniques (mammography, ultrasonography, etc.), it is important to carefully follow clinically questionable cases which appear negative, using A.B.C..