Potentiating Effect of Adenosine on Other Inhibitors of Platelet Aggregation

Adenosine was rapidly incorporated into human platelets, and the inhibitory effect of adenosine on platelet aggregation was correlated with the incorporation process. Adenosine potentiated the inhibitory action of other inhibitors, such as dipyridamole, prostaglandin E1 and Y-3642. The inhibition of aggregation was associated with the preservation of platelet adenine nucleotides and the prevention of ADP release. On the other hand, the radioactive adenine nucleotide pattern of platelets was not substantially affected by inhibitors. The relation of inhibition of aggregation with ADP release was discussed.

Bleeding Tendency with Platelet Dysfunction and Albinism

A Japanese boy, who had combined congenital defects - a hemorrhagic disorder due to abnormal platelet function and incomplete albinism, was described. His parents were first cousins. Platelet aggregation by collagen and epinephrine was markedly defective. A rapid disaggregation was observed in ADP-induced aggregation. Platelet factor 3 availability and in vitro adhesiveness were subnormal, while platelet factor 3 activity was normal. Defective ADP release was associated with impaired aggregation by collagen. Before aggregation, labeled adenine nucleotide pattern in patient’s platelets was not different from that in normal platelets. The increase of intermediates of platelet ATP breakdown, such as AMP and IMP, was less in patient’s platelets after collagen-induced aggregation. The release of labeled ATP and ADP in patient’s plasma was less than that in normal plasma.

Practical usefulness of atypical endometrial cell categories within the new classification of endometrial cytology when applied to conventional smears

OBJECTIVE

Endometrial cytology has been widely used as a screening tool in Japan. Traditionally, a three-tier reporting system, consisting of 'negative', 'suspicious' and 'positive' categories, has been used. However, a more descriptive system, the New Terminology in Endometrial Cytology (NTEMC), which is based on the Bethesda System for uterine cervical cytology, was introduced recently. The objective of this study was to validate the NTEMC criteria.

METHODS

Endometrial cytology specimens that had been categorised as 'suspicious' were collected in our hospital between 2003 and 2013, and from these, 106 specimens with corresponding histological results, were re-evaluated according to the NTEMC criteria. Diagnostic categories were assigned based on that chosen by the majority of the examining members.

RESULTS

Negative, atypical endometrial cells, of undetermined significance (ATEC-US), atypical endometrial cells for which atypical endometrial hyperplasia or worse cannot be excluded (ATEC-A), endometrial hyperplasia, atypical endometrial hyperplasia and malignancy were selected as the diagnostic categories for 9 (8.5%), 34 (32.1%), 17 (16%), 34 (32.1%), 5 (4.7%) and 7 (6.6%) specimens, respectively. Corresponding histological categories of benign, endometrial hyperplasia, atypical endometrial hyperplasia and malignancy were established in 28 (82.4%), 1 (2.9%), 2 (5.9%) and 3 (8.8%) ATEC-US specimens, respectively, and in 6 (35.3%), 3 (17.6%), 2 (11.8%) and 6 (35.3%) ATEC-A specimens, respectively. The histological category distribution differed significantly (P = 0.001), and there was a significant correlation between corresponding cytological and histological categories (P = 0.005).

CONCLUSION

The ATEC category of NTEMC system works well in a practical setting and resembles the Bethesda reporting system ASC (atypical squamous cells) category for cervical cytology.

Bovine milk contains microRNA and messenger RNA that are stable under degradative conditions

We previously reported that microRNA (miRNA) is present in human breast milk. Recently, other groups have reported that bovine milk also contains miRNA; however, these reports are few. We therefore investigated bovine milk miRNA using microarray and quantitative PCR analyses to identify the differences between colostrum and mature milk. The RNA concentration in a colostrum whey fraction was higher than that in a mature milk whey fraction. In total, 102 miRNA were detected in bovine milk by microarray analysis (100 in colostrum and 53 in mature milk; 51 were common to both). Among these miRNA, we selected several immune- and development-related miRNA, including miR-15b, miR-27b, miR-34a, miR-106b, miR-130a, miR-155, and miR-223. These miRNA were detected in bovine milk by quantitative PCR, and each of these miRNA was significantly more highly expressed in colostrum than in mature milk. We also confirmed the presence of some mRNA in bovine milk. Nevertheless, synthesized miRNA spiked in the raw milk whey were degraded, and naturally existing miRNA and mRNA in raw milk were resistant to acidic conditions and RNase treatment. The RNA molecules in milk were stable. We also detected miRNA and mRNA in infant formulas purchased from Japanese markets. It is still unknown whether milk-derived RNA molecules play biological roles in infants; however, if milk-derived RNA do show functions in infants, our data will help guide future studies.

Usefulness of an original self-completed questionnaire for screening of cancer-related mental disorder in patients with newly diagnosed early breast cancer

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Background: Cancer-related mental disorder reduces (e.g., depression and anxiety disorder) not only treatment compliance but also compromises the quality of life of the patient. However, psychiatric intervention at the cancer notification has been barely performed in Japan because Japanese people traditionally tend to have a prejudice against psychiatric consultation and about sexual activity. In order to provide more effective treatment for breast cancer patients, it is necessary to treat cancer-related mental disorder in Japan.

Methods: Based on Self-rating Depression Scale, Hamilton's Rating Scale for Depression and Beck Depression Inventory, the questionnaires were modified for Japanese patients by psychiatrists and clinical psychologists of our hospital. We asked newly diagnosed breast cancer patients an original self-completed questionnaire regarding the depression and anxiety disorder between January 2010 and March 2011. This questionnaire consists of 14 questions about depression and anxiety disorder without questions of sexual activity, which has two points each question (maximum total points were 28). We recommended the psychiatric interference by a psychiatrist and the clinical psychologist to all patients with more than 14 points in this questionnaire.

Results: We obtained data from 116 patients. No patient refused to answer the questionnaire. 23 patients had higher than 14 points in this questionnaire. Of 23 patients, 9 patients received psychiatric intervention without medication, and four patients received psychotropic medications. Based on the results, we avoided the administration of anticancer agent by intravenous infusion in three patients who had higher than 14 points in the questionnaire. Multivariate analysis revealed that unmarried status is associated with a significantly higher score (OR 16.1; p = 0.013).

Conclusions: Our data suggest that our original self-completed questionnaire is useful for the screening of the cancer-related mental disorder in order to provide appropriate therapy to newly diagnosed breast cancer patients.

Effects of Milk Casein-derived Peptides on Absolute Oxyhaemoglobin Concentrations in the Prefrontal Area and on Work Efficiency after Mental Stress Loading in Male Students

This study examined the influence of milk casein-derived peptides on cerebral activity after mental stress loading. In a crossover study, 16 male students were given a drink containing peptides (peptide group), or water (control group) before stress loading. The oxyhaemoglobin (HbO2) concentration in the prefrontal area of the brain and work efficiency were measured as indicators of cerebral activity and differences in these parameters were examined according to type A or type B personality. Type A behaviour was defined as: aggression–hostility, hard-driving—time-urgency and speed–power, whereas type B behaviour did not have these characteristics. Peptide intake resulted in a significant increase in both HbO2 concentration and work efficiency, whilst a similar increase was not seen in the control group. When divided into type A or type B personality, the changes in HbO2 concentration for the control group differed significantly in the right prefrontal area. Moreover, in type A subjects the HbO2 concentration in the right prefrontal area following intake was significantly different between the peptide and control groups.

Bovine α-Lactalbumin Stimulates Mucus Metabolism in Gastric Mucosa

Bovine alpha-lactalbumin (alpha-LA), a major milk protein, exerts strong gastroprotective activity against rat experimental gastric ulcers induced by ethanol or stress. To elucidate the mechanisms underlying this activity, the influence of alpha-LA on gastric mucus metabolism was investigated in vitro and in vivo. For the in vitro study, RGM1 cells (a rat gastric epithelial cell line) were selected for observation of the direct activity of alpha-LA on gastric mucosal cells and cultured in the presence of either alpha-LA or ovalbumin (OVA), a reference protein showing no gastroprotective activity. Amounts of synthesized and secreted mucin, a major component of mucus, were determined using [3H]glucosamine as a tracer, and prostaglandin E2 (PGE2) levels in the culture medium were determined by RIA. For the in vivo study, the thickness of the mucus gel layer, a protective barrier for gastric mucosa, was evaluated histochemically in rat gastric mucosa. alpha-Lactalbumin (3 mg/mL) significantly stimulated mucin synthesis and secretion in RGM1 cells and also increased PGE2 levels in the culture medium. In contrast, OVA showed no enhancing effects under identical conditions. Neither indomethacin, a cyclo-oxygenase inhibitor, nor AH23848, a prostaglandin EP4 receptor antagonist, affected alpha-LA-induced enhancement of mucin synthesis and secretion. In vivo, oral administration of alpha-LA (300 mg/kg x 3 times/d x 7 d) increased the thickness of the mucus gel layer in rats. These results indicate that alpha-LA fortifies the mucus gel layer by stimulating mucin production and secretion in gastric mucus-producing cells, and that this enhancing effect is independent of endogenous PGE2. Comparison of the efficacy of alpha-LA with OVA suggests that the activities observed in RGM1 cells are closely related to the gastroprotective effects in rat gastric ulcer models. In conclusion, alpha-LA stimulates mucus metabolism, and this action may be responsible for its gastroprotective activity.

[Report on the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America--cone beam artifact and helical artifact on the MDCT helical scan]

Because MDCT use narrow cone beam x-ray, to quantitatively evaluate cone beam artifact and helical artifact is very important with different x-ray beam width (detector configuration) . The both effect (helical artifact and cone beam artifact) was confirmed on the MDCT helical scan. It does not have cone beam artifact in the Isocenter or using center detector row for conventional scan, but helical artifact basically does not depend position of x-y plane. From quantitative evaluation of cone beam artifact, helical scan has fewer cone beam artifact than conventional scan on the 200 mm position of x-y plane: the cone beam artifact index is 11.76 (8 x 2.5mm conventional scan with most edge detector row) , 6.86 (8 x 2.5mm helical pitch 0.625) and 4.9 (8 x 2.5mm helical pitch 1.675). From phantom experiment, it was concluded that cone beam angle more contribute cone beam artifact than increasing slice numbers. And it was concluded that helical scan has fewer cone beam artifact than conventional scan, because helical scan use multi detector row information and special recon algorithm with cone beam correction on the GE LightSpeed MDCT scanner.

Expression of P450 aromatase protein in developing and in sex-reversed gonads of the XX/XY type of the frog Rana rugosa

Gonadal differentiation in some species of amphibians is sensitive to steroids. The phenotypic sex of XX/XY-type frogs such as Rana rugosa can be reversed from female to male by injection of testosterone into tadpoles, but little is known about the molecular mechanism of this sex reversal. To elucidate the mechanism of the sex differentiation, we examined the role of P450 aromatase (P450arom), an enzyme that converts testosterone to estrogen, during gonadal differentiation of amphibians. In this study, we first cloned a P450arom cDNA homolog of the frog R. rugosa and analyzed by RT-PCR its expression profile in developing and in female-to-male sex-reversed gonads. P450arom expression was observed in the gonad of tadpoles during ovarian differentiation and became much stronger in the developing ovary in which only immature oocytes were observed. However, its expression declined significantly in the ovary of frogs 2 months after metamorphosis, when oocytes were growing; and it was no longer seen in adult ovaries. By RT-PCR, we also examined the expression of P450arom and SF-1 (steroidogenic factor-1; the orphan nuclear receptor) in the female-to-male sex-reversed gonad. The level of P450arom mRNA was high in the ovary, but it declined rapidly after the injection of testosterone. In contrast, no change in the SF-1 (also known as Ad4BP) expression was observed. Moreover, to identify the type(s) of cells expressing P450arom protein, we performed immunostaining with an antibody against frog P450arom protein. Cells giving positive signals were observed around oocytes in the ovary of frogs 1 month after metamorphosis. They were identified as follicle cells by both light and electron microscopy. The results, taken together, indicate that P450arom protein is synthesized in follicle cells and that P450arom is very much involved in ovarian differentiation in R. rugosa.

Spectral and correlation analyses of the verapamil-induced conversion of ventricular fibrillation to tachycardia in isolated rat hearts

Ventricular tachycardia (VT) is considered to be the most common precursor of ventricular fibrillation (VF). However, the mechanisms underlying the transition from VT to VF remain unclear. Here, we investigated whether and how perfusion of the heart with verapamil, a blocker of L-type calcium channels, changed the macro-dynamics of the heart between VT and VF. The experiments were performed with Langendorff perfused isolated rat hearts, in which left ventricular pressure and left ventricular cardiomyogram were measured. Sustained VT or VF was induced by burst pacing of the left ventricular muscles. During sustained VF, verapamil perfusion resulted in the conversion of VF to VT. A cross-correlation analysis between left ventricular cardiomyogram and left ventricular pressure revealed that the correlation coefficient was small during VF, but became larger during VT. This study showed that inactivation of L-type Ca(2+) channels occurred during verapamil-induced conversion of pacing-induced sustained VF to VT, and characterized the changes in macro-dynamics of the heart associated with the transition.

Expression of Dmrt1 protein in developing and in sex-reversed gonads of amphibians

Many genes are known to be involved in gonadal differentiation in vertebrates. Dmrt1, a gene that encodes a transcription factor with a DM-domain, is considered to be one of the essential genes controlling testicular differentiation in mammals, birds, reptiles, amphibians and fish. However, it still remains unknown which testicular cells of animals other than mice and chicks express Dmrt1 protein. For an explanation of its role(s) in testicular differentiation in vertebrates, the expression of the Dmrt1 protein needs to be studied. For this purpose, we conducted an immunohistochemical study of this protein in an amphibian by using an antibody specific for Dmrt1. No positive signal was found in the indifferent gonad of tadpoles of Rana rugosa at early stages. However, in the testis of tadpoles at later stages (XV-XXV) and in frogs one month after metamorphosis, this protein was expressed in interstitial cells and Sertoli cells. In the testis of adult frogs, germ cells also expressed Dmrt1 protein. RT-PCR analysis revealed that the gene for this protein was not transcribed at any time during ovarian development, but was expressed in the female to male sex-reversed gonad. This was true when immunohistological studies were performed. In addition, Southern blot analysis showed DMRT1 to be an autosomal gene. Taken together, our findings indicate that Dmrt1 protein is expressed by interstitial cells, Seroli cells and germ cells in the testis of R. rugosa. Dmrt1 may thus be very involved in the testicular differentiation of amphibians.

Ruthenium red-induced transition from ventricular fibrillation to tachycardia in isolated rat hearts:

INTRODUCTION

Ventricular tachycardia (VT) is considered to be the most common precursor of ventricular fibrillation (VF) and sudden cardiac death. However, the mechanisms underlying the transition from VT to VF remain unclear despite more than a century of study. Here, we investigated whether perfusion of the heart with blockers of mitochondrial Ca(2+) uniporter changed the macrodynamics of the heart between VT and VF.

METHODS

The experiments were performed using Langendorff perfused isolated rat hearts in which left ventricular pressure (LVP) and left ventricular cardiomyogram (LVCMG) were measured. Sustained VT or VF was induced by burst pacing of the left ventricular muscles.

RESULTS

During pacing-induced sustained VF, perfusion of the heart with ruthenium red (RR) or Ru 360, blockers of mitochondrial Ca(2+) uniporter, resulted in the reversible conversion of VF to VT. In contrast, during pacing-induced sustained VT, perfusion of the heart with spermine, an activator of mitochondrial Ca(2+) uptake, resulted in the reversible conversion of VT to VF, and the effect was antagonized by cotreatment with RR. In addition, RR-induced conversion of VF to VT was antagonized by cotreatment with S(-)-Bay K8644 (Bay K), an activator of L-type Ca(2+) channels, suggesting that the inactivation of L-type Ca(2+) channels was responsible for the RR-induced effect on the macrodynamics of hearts. In fact, perfusion with verapamil, an antagonist of L-type Ca(2+) channels, during pacing-induced sustained VF, resulted in the conversion of VF to VT.

CONCLUSION

This study demonstrated that perfusion of isolated rat hearts with blockers of Ca(2+) uptake by mitochondria resulted in the reversible conversion of pacing-induced sustained VF to VT, suggesting that changes in mitochondrial Ca(2+) uptake were possibly involved in the transition between VT and VF.

Lactoferricin derived from milk protein lactoferrin

Lactoferricin (LFcin) was initially identified as an antimicrobial peptide derived by pepsin digestion of lactoferrin (LF), a multifunctional innate-defense protein in milk. Various synthetic analogs of LFcin have also been reported. LFcin inhibits a diverse range of microorganisms such as gram-negative bacteria, gram-positive bacteria, yeast, filamentous fungi, and parasitic protozoa, including some antibiotic-resistant pathogens. LFcin kills target organisms by membrane perturbation and acts synergistically with some antimicrobial agents. LFcin exhibits numerous biological activities in common with those of LF. Whereas LFcin suppresses the activation of innate immunity by microbial components such as lipopolysaccharide (LPS) and CpG DNA, the peptide itself activates immunity. Administration of LFcin analogs has been shown to protect the host via direct antimicrobial activity and immunostimulatory effects in several infection models of mice. Here we present a comprehensive review of investigations of LFcin and related peptides.

Increased vulnerability to ischemia/reperfusion-induced ventricular tachyarrhythmias by pre-ischemic inhibition of nitric oxide synthase in isolated rat hearts

INTRODUCTION

The relationship between vulnerability to reperfusion-induced ventricular tachyarrhythmias, such as ventricular tachycardia (VT) and fibrillation (VF), and the endogenous activity of nitric oxide synthase (NOS) has not been well documented. The objective of the present study was to clarify whether the vulnerability to reperfusion-induced VT/VF changes with preishemic, sustained inhibition of NOS.

METHODS

The experiments were performed using Langendorff-perfused isolated rat hearts, in which left ventricular pressure (LVP) and left ventricular cardiomyograms (LVCMGs) were measured.

RESULTS

A pre-ischemic, sustained inhibition of NOS resulted in an increased vulnerability to reperfusion-induced VT/VF, and the increase was markedly attenuated by co-treatment with L-arginine or by post-ischemic treatment with 2,4-diamino-6-hydroxypyrimidine (DAHP), an inhibitor of tetrahydrobiopterin (BH(4)) synthesis. We then tried to elucidate whether nitric oxide (NO) and superoxide were produced during reperfusion, and ATP-sensitive potassium channels (K(ATP)), especially mitochondrial ATP-sensitive potassium channels (mitoK(ATP)), are involved in the increased vulnerability. Post-ischemic inhibition of NOS and treatment with a NO scavenger attenuated the increased vulnerability to reperfusion-induced VT/VF, but post-ischemic treatment with a superoxide scavenger did not. In addition, post-ischemic treatment with S-nitroso-N-acetyl-DL-penicillamine (SNAP), a NO donor, or with diazoxide, a selective opener of mitoK(ATP), increased the VT/VF duration during reperfusion. The increased vulnerability to VT/VF was attenuated by the treatment with a selective mitoK(ATP) blocker.

CONCLUSION

The results suggest that a pre-ischemic, sustained inhibition of NOS increases the vulnerability to reperfusion-induced VT/VF, and the NO-mitoK(ATP) pathway is one of the possible factors contributing to the increased vulnerability to VT/VF.

Duodenal wall cysts may be derived from a ductal component of ectopic pancreatic tissue

AIMS

To clarify the mechanism of origin of duodenal wall cysts in patients with chronic pancreatitis, developing into duodenal stenosis.

METHODS AND RESULTS

Specimens from 12 pancreatoduodenectomized patients with chronic pancreatitis and 51 controls were studied histopathologically and immunohistochemically. Variously shaped cystic lesions, averaging about 15 mm in diameter, were found in the duodenum in six of the 12 patients with chronic pancreatitis, but were not observed in the controls. Each case had an average of two cysts, which were located mainly in the muscularis propria of the duodenum with or without submucosal or extraduodenal-peripancreatic extensions. The inner part of the cyst wall consisted of a moderate rim of granulation tissue, with both myofibroblasts and smooth muscle proliferation in the tissue surrounding the cyst and the submucosal layer of the duodenum, occasionally accompanied by an epithelial lining. A ductal structure in the muscularis propria of the duodenum, possibly a ductal component of ectopic pancreatic tissue, was found in five of the six cases. Some of these structures showed cystic changes. Three of the six patients had accompanying duodenal stenosis.

CONCLUSIONS

Duodenal wall cysts occur mainly in the muscularis propria of the duodenum associated with both myofibroblasts and smooth muscle proliferation, and may result in duodenal stenosis. These cysts may be derived from a ductal component of ectopic pancreatic tissue.

Omental cyst: report of a case

We report the case of an omental cyst, a rare type of abdominal cystic lesion that is difficult to diagnose preoperatively. A 43-year-old man with no clinical symptoms was admitted to our hospital for investigation of an abdominal cyst detected by ultrasonography (US). We performed diagnostic examinations including US, computed tomography, and magnetic resonance imaging. An omental cyst was diagnosed because of its position and connection to the surrounding tissues. Pathological examination of the surgical specimen revealed endothelial cells on its internal wall and colonies of lymphocytes, confirming a diagnosis of lymphangioma, which is the most common type of omental cyst.

Expression of Dax-1 during gonadal development of the frog

Dax-1, a member of the nuclear hormone receptor superfamily of transcription factors, is known to be involved in gonadal development in mammals. To date, Dax-1 has only been isolated in reptiles, birds and mammals. The expression of Dax-1 is down-regulated in the developing testis, but persists in the ovary of mice (Swain et al., Nat. Genet. 12 (1996) 404) and chicken (Smith et al., J. Mol. Endocrinol. 24 (2000) 23). Curiously, there is no sex difference in the expression patterns of Dax-1 in the American alligator (Western et al., Gene 241 (2000) 223). To understand its role(s) in gonadal development in vertebrates, molecular cloning of Dax-1 in amphibians is required. In this study, we cloned an amphibian Dax-1 homologue of the frog Rana rugosa and examined its expression profile during gonadal development. Cloned Dax-1 cDNA encoded a protein of 287 amino acids. Unlike mammalians that possess the three and one half repeat elements representing the putative DNA binding domain in the predicted sequence of Dax-1 protein, the frog had a single poorly conserved copy of the repeat unit. By RT-PCR analysis, the Dax-1 mRNA was detected in the liver and pancreas, but not in the testis and ovary of adult frogs. However, Dax-1 expression was seen first in the embryo at stage 12 and became stronger in tadpoles until stage X. The Dax-1 was transcribed in the testis stronger than in the ovary of frogs at stage XXV (just after completion of metamorphosis). In the gonad of frogs 2 months after metamorphosis (at this stage postmeiotic cells can be seen in the seminiferous tubules), the Dax-1 was expressed only in males. In addition, the Dax-1 transcription declined gradually as ovarian development proceeded, but its expression was down-regulated and then up-regulated rapidly when female-to-male sex reversal was caused by administration of testosterone into female tadpoles. Taken together, the results suggest that the Dax-1 may be closely involved in testicular development of amphibians.

Ferrocene-modified bis(spiropyridopyran)s as synthetic signaling receptors for guanine-guanine dinucleoside derivatives

A ferrocene-linked bis(spiropyridopyran) was designed and synthesized, that recognized guanine-guanine dinucleoside derivatives via complementary hydrogen bonds in CH2Cl2, resulting in the isomerization of the colorless spiropyridopyran as self-indicating receptors.

Nurse-environment misfit and nursing practice

AIM OF THE STUDY

The purpose of the following descriptive correlational study was to investigate nurses' responses to the image discrepancy between the public and nurses, and its relationships with their self-concept, job satisfaction and performance.

BACKGROUND

It has been long said that nurses live in a dual structure wherein the nurse's journey toward professionalization is constrained by nursing stereotypes in a society. This duality of the nursing universe is assumed to have created a person-environment misfit which could lead to nurses' job dissatisfaction and low job performance. Nonetheless, little study has been done in this area.

DESIGN/METHODS

The study was conducted in 1999 with ethical approval from an Australian University. A sample of 80 Australian registered nurses participated by completing the Porter Nursing Image Scale, Index of Work Satisfaction (IWS) and Six-Dimension Scale of Nursing Performance. Data were analysed using descriptive statistics and Pearson correlation.

RESULTS

The results suggested that there is a discrepancy in the images of the nursing profession between nurses and the public, which can contribute to the nurse-environment misfit. The results also supported a negative correlation of the misfit with nurses' job satisfaction and performance.

CONCLUSION

Despite the limited sample size and characteristics, this study provides evidence to encourage nurses to improve the public image of nurses, which will enhance the professionalization of nursing.

Usefulness of bronchoalveolar lavage for the diagnosis and treatment of refractory pneumonia in a patient with Kostmann syndrome, a severe congenital neutropenia

An 11-year-old girl with Kostmann syndrome developed refractory pneumonia. Culture of oral discharge, throat-swab specimens, and blood could not identity the causative organism, and systemic antimicrobial therapy failed to achieve improvement. We then performed diagnostic bronchoalveolar lavage (BAL) and culture of BAL fluid (BALF) yielded Pseudomonas aeruginosa. Therapeutic BAL using gentamicin produced a striking improvement of her pneumonia.

CONCLUSION

In immunocompromised children with pneumonia, BAL helps to identify the causative organism. If the patient is unresponsive to systemic antimicrobial therapy, BAL using antimicrobial agents is also worth trying.

Expression of FTZ-F1alpha in frog testicular cells

Fushi tarazu transcription factor-1 (FTZ-F1), a member of a nuclear hormone receptor superfamily, is a transcriptional regulator for fushi tarazu gene expression in Drosophila (Ueda et al., '90). We have cloned a homologue (rrFTZ-F1alpha) of the FTZ-F1 gene of the frog Rana rugosa. The gene, in frogs, has been shown to have high expression level in the testis (Nakajima et al., 2000). In this study, the RT-PCR analysis showed that the FTZ-F1alpha mRNA level in adult frogs did not change throughout the year, even during hibernation. However, when immunohistological studies using the anti-rrFTZ-F1alpha antibody were employed to examine which testicular cells expressed this gene, Sertoli cells were found to produce rrFTZ-F1alpha in the two seasons: the breeding season (from March through May) and the pre-hibernating season (from October through November). Interstitial cells, however, did it in only the breeding season (from April through May). Taken together, the results suggest that the rrFTZ-F1alpha expression is regulated at the post-transcriptional step, and that the rrFTZ-F1alpha may play an important role(s) in the seasonal activities of Sertoli and interstitial cells in the frog testis. J. Exp. Zool. 290:182-189, 2001.

Silent period in the mentalis muscle induced by facial nerve and cutaneous stimulation

The aim of this study was to demonstrate that silent periods of the mentalis muscle are induced after facial nerve stimulation and cutaneous stimulation in normal subjects. When the marginal mandibular branch of the facial nerve and the cutaneous nerve in areas adjacent to the lower lip were stimulated during slight voluntary contraction of the mentalis muscle, silent periods were elicited with surface electrodes on the mentalis muscle. The early phase and the late phase of the silent period were elicited by marginal mandibular branch stimulation. The early phase of the silent period was recognized following the F waves and it disappeared at 36.3 msec. The average duration of the late phase of the silent period was 59.2 msec, with an average latency of 62.5 msec. Only the late phase of the silent period after cutaneous stimulation could be elicited, with a duration and latency of 55.9 msec and 54.0 msec respectively. The authors conclude that the silent period is able to be elicited in the mentalis muscle by peripheral nerve stimulation, and is one of the late responses in facial muscles.

Expression of steroidogenic factor-1 in frog embryo and developing gonad

Steroidogenic factor-1 (SF-1), originally identified as an orphan nuclear receptor that regulates expression of genes encoding cytochrome P-450 steroid hydroxylases, is an essential transcriptional factor for adrenal and gonadal development in mammals. Since sex steroid hormones have been shown to play important roles in the sex determination of frogs, it is of interest to know how SF-1 gene expression is regulated during the sexual development of this organism. A previous study isolated the cDNA of the frog Rana rugosa SF-1 (rrSF-1) and found sexual differences in its gene expression in adult frogs; positive in testis and negative in ovary (Kawano et al., 1998). This study examined rrSF-1 gene expression in frog embryos and developing and mature gonads by immunohistochemical staining using anti-rrSF-1 protein antibody for protein localization and by in situ hybridization analysis for mRNA transcription. The results obtained in this study indicated that cells expressing SF-1 that originate in the mesoderm and endoderm probably migrate into the developing gonad via the dorsal mesentery, genital ridge, and mesorchium or mesovarium. Thus, SF-1 may play an important role in gonadal development in amphibians.

Histopathological study on mechanism and background of tumor-forming pancreatitis

Fifteen cases of tumor-forming pancreatitis, detected as tumors by diagnostic imaging or by physical examination were histologically examined. Eleven of the 15 patients were heavy drinkers. Tumorous lesions were located in the head of the pancreas in 11 cases and in the body or tail of the pancreas in four cases. Macroscopic examination revealed tumorous swelling or sclerotic appearance in the pancreatic tissue. Histologically, these lesions showed tumorous swelling with (n = 12) or without (n = 3) a background of chronic pancreatitis. In the former, the tumorous lesions consisted of extensive fibrosis, including necrosis or abscesses, stones and reparative granulation tissue, and there was a successive transition to the surrounding chronic pancreatitis pattern. The latter three tumorous lesions presented with inter- and intralobular fibrosis with lymphoid hyperplasia or lymphoplasmacytic infiltration and were adjacent to normal pancreatic tissue. Therefore, tumor-forming pancreatitis shows at least two distinct types: a reparative tumorous swelling with a background of chronic pancreatitis, which is considered to have given rise to the tumor at some stage; and a lymphoid and fibrous proliferation in normal pancreatic tissue, which is considered to represent an autoimmune-related disease process.

Primary signet-ring cell carcinoma of the urinary bladder inducing renal failure

A case of primary signet-ring cell carcinoma of the urinary bladder that was found to have induced renal failure is the second such case reported in the world. Primary signet-ring cell carcinoma of the urinary bladder is a rare histologic variant of adenocarcinoma. The patient died of distant metastasis 8 months after undergoing total cystectomy. The neoplasm had a high stage at diagnosis, so the prognosis was very poor. To improve the prognosis, earlier diagnosis and establishing a regimen of chemotherapy is necessary.

Production of galactooligosaccharides from lactose using a beta-glucosidase from Thermus sp. Z-1

A thermostable beta-glucosidase from Thermus sp. Z-1 that not only hydrolyzes beta-glucosides but also beta-galactosides was shown to efficiently produce oligosaccharides during hydrolysis of lactose. The yield of oligosaccharides was more than 40% for 0.88 M lactose solution at 70 degrees C at pH 7.0. The major product was a trisaccharide, 3'-galactosyllactose, formed by a galactosyltransfer reaction.

A prospective clinical study on inhaled nitric oxide therapy for neonates in Japan

BACKGROUND

This is the first report about a prospective clinical investigation to study the efficacy and safety of nitric oxide (NO) inhalation in infants with persistent pulmonary hypertension of the newborn (PPHN) in Japan.

METHODS

Patients in the present study had to meet the following entry criteria: (i) they had to be younger than 7 days of age; (ii) they had to have evidence of PPHN as defined by echocardiograph; (iii) they had to have severe systemic hypoxemia under mechanical ventilation at 100% oxygen supplementation; and (iv) they had to have a failure to respond to conventional therapies. Patients were excluded from this trial if they had any of the following: hypoplastic lung, structural cardiac lesions or severe multiple anomalies.

RESULTS

Nitric oxide inhalation therapy was performed in 68 infants who had severe PPHN at 18 hospitals between May 1995 and May 1997. At birth, 21 of 68 infants (31%) weighed less than 1,500 g and 39 infants weighed more than 2,500 g. The diagnoses associated with PPHN were as follows: 27 infants had meconium aspiration syndrome, 15 infants had dry lung syndrome, nine infants had congenital diaphragmatic hernia, six infants had respiratory distress syndrome, three infants had pneumonia and eight infants had other diagnoses. The mean oxygenation index (OI) before NO inhalation therapy in 68 infants was 43.2; 55 infants (81%) had good responses.

CONCLUSIONS

These results may be valuable for further randomized controlled and double-blind trials in Japan to evaluate whether NO inhalation therapy is more effective than conventional therapy in infants with severe PPHN.

FTZ-F1alpha is expressed in the developing gonad of frogs

Fushi tarazu transcription factor-1 (FTZ-F1), a member of the nuclear hormone receptor superfamily, is a regulator for fushi tarazu gene expression in Drosophila. Its expression pattern during organogenesis in vertebrates, however, is not known yet. In this study, we cloned a frog FTZ-F1 homologue (rrFTZ-F1alpha) and analyzed its expression and localization during gonadal development of the frog Rana rugosa. Cloned rrFTZ-F1alpha cDNA encoded a protein of 501 amino acids including the regions I-III and FTZ-F1 box that are evolutionally conserved in the FTZ-F1 superfamily. rrFTZ-F1alpha shared high similarity at the amino acid level with mouse LRH-1 (76%), human FTF (92%), chicken OR2.0 (92%), Xenopus laevis FF1rA (94%) and zebrafish FF1A (82%). Northern blot analysis showed that the rrFTZ-F1alpha mRNA at a size of 7.4 kb was the most prominent in the testis among various tissues of adult frogs examined. The RT-PCR analysis revealed that the expression of rrFTZ-F1alpha was weak in the gonad of tadpoles before stage XVI, but it became stronger in the testis of froglets at stage XXV and much higher in the testis of frogs 2 months after metamorphosis. In addition, in situ hybridization analysis revealed that the rrFTZ-F1alpha gene was transcribed in germ cells except for sperm in the testis, and in oocytes at stage A in the ovary of frogs 2 months after metamorphosis. Together, these results suggest that FTZ-F1alpha probably plays an important role in differentiation of germ cells in the gonad of frogs in both sexes.

Herniation through both Winslow's foramen and a lesser omental defect: report of a case

The herniation of small bowel through Winslow's foramen is a rare type of internal hernia which can cause ileus; however, a hernia traversing the lesser sac is even more unusual. To the best of our knowledge, only 25 cases of herniation through Winslow's foramen and 10 cases of lesser sac hernia have been reported in the Japanese literature. We describe herein the case of a 33-year-old man who presented to our hospital complaining of abdominal pain in whom a plain abdominal radiograph revealed small bowel gas with air-fluid levels, suggesting ileus. Following admission, an ileus tube was inserted, but the intestinal shadow did not improve and surgery was performed based on suspicion of an internal hernia. Approximately 100 cm of ileum was found to have herniated through a defect in the lesser omentum after passing through Winslow's foramen. Since the herniated bowel was viable, manual reduction without resection was performed. The patient had a satisfactory postoperative course, and was discharged on postoperative day 11. There are many unknown aspects surrounding the etiology of Winslow's foramen hernia and lesser sac hernia, and although internal hernia is a rare cause of ileus, its possibility should be kept in mind.

Clinical and analytical evaluation of the simultaneous HPLC assay of retinol and alpha-tocopherol

We describe a method for the simultaneous assay of retinol and alpha-tocopherol using normal-phase, high-performance liquid chromatography (HPLC). Our normal-phase HPLC method gave better resolution (Rs) of retinol (Rs= 1.58) and alpha-tocopherol (Rs = 1.40) when compared with the Rs values for a-tocopherol and retinol from literature. Also, the alpha-tocopherol concentrations obtained by our method agreed well with another normal-phase HPLC method that used fluorometric detection (r = 0.951, p<0.001. Sy.x=0.58 mg/L). The concentrations of retinol in our method agreed well with those determined by a reversed-phase HPLC procedure, although the correlation (r=0.646, p<.001, Sy.x=62 microg/L) was not as good as the method proposed. Our procedure gave acceptable precision: the within-run CV was 7.7% for alpha-tocopherol and 5.9% for retinol. The between-day CV was 9.0% for alpha-tocopherol and 6.8% for retinol. The mean recoveries were 97% for alpha-tocopherol and 107% for retinol. Our assays were linear for alpha-tocopherol concentrations from 0.1 to 30 mg/L and for retinol concentrations from 20 to 2,000 microg/L. In children ages 7 to 12 y, and in adolescents ages 14 to 16 y, the alpha-tocopherol and retinol concentrations in the blood were significantly lower than the concentrations in normal adults. Individuals over 70 y old also showed alpha-tocopherol and retinol values that were lower than those of normal adults between ages 30 and 40 y. In female university students, the inter-individual variation of alpha-tocopherol was reduced by dividing the alpha-tocopherol results by their total cholesterol or total lipid concentrations; however, this was not obtained for retinol. In cancer patients undergoing surgery, the ratio of retinol to retinol-binding protein (RBP) remained fairly constant, although the concentrations of both retinol and RBP decreased to about one-half the preoperative values after surgery. We conclude that our normal-phase HPLC method is a stable and reproducible method for alpha-tocopherol and retinol, and is an easy-to-use analytical tool.

Pre-existing histological type and developmental mechanism of mucinous noncystic carcinoma of pancreas

Eleven cases with mucinous noncystic carcinoma (MC) of the pancreas were studied by histology and mucin immunohistochemistry, to elucidate the mechanism, or route of development, and pre-existing histological type of MC of the pancreas. These MCs were observed in close approximation to, or surrounding, intraductal papillary-mucinous carcinomas (IPMCs), and were centrally situated among ductal adenocarcinomas (DAs). Hence, the 11 cases originated from 8 IPMCs and 3 DAs. The mechanism and routes to MC were divided into four types as follows: IPMC directly invaded the stroma (4 cases), over-production of mucin in IPMC expanded the branches of the pancreatic duct possibly resulting in rupture (3 cases), DA underwent extreme mucinous degeneration (3 cases), and a recurrent form, as MC, at the surgical stump of IPMC (one case). The outcomes of MC cases with IPMC had variable survival rates, while those from DA had short durations. MUC immunoreactivity in MC was divided into three categories; anti-MUC1-positive only (2 IPMCs, 2 DAs), mixed anti-MUC1 and anti-MUC2-positive (3 IPMCs, one DA) and anti-MUC-positive only (3 IPMCs). Pre-existing MC histological types included both IPMC and DA. These two pre-existing types of MC involved mucin overproduction and mucinous degeneration. MUC immunoreactivity in MC revealed three patterns, which may be related to variable outcomes.

F-waves and facilitated late responses of the mentalis muscle in patients with a cerebrovascular accident

F-waves in the extremities result from the backfiring of antidromically activated anterior horn cells and F-waves of the mentalis muscle can be also elicited after stimulation of the marginal mandibular branch of the facial nerve. In order to investigate the influence of the descending pathway of the excitability of the facial motonucleus, the F-wave of the mentalis muscle and the facilitated late response, which follows F-waves and which seems to be the snout reflex due to their similar latency and habituation, were studied in 11 conscious patients with a hemispheric cerebrovascular accident (CVA) presenting with hemiparesis, and in 10 unconscious patients with CVA or head injury. The duration and the persistence of the F-waves increased significantly statistically on the normal side in the CVA patients compared with those of the palsy side and the normal subjects. In comatose patients the F-waves and the facilitated late response were not elicited. The latency (46.1 +/- 13.3 msec) of the facilitated late responses in the unconscious patients tended to increase compared with the latency (36.6 +/- 4.3 msec) in the conscious patients. These findings suggest that the hyperexcitability of the facial motoneuron is ipsilateral to any hemispheric lesion; the hemispheric lesion exerts a bilateral excitatory influence on the interneuron of the facilitated late response: and that the reticular formation may influence the facial motoneuron and any interneurons concerned in the facilitated late response. F-waves and facilitated late responses should be further examined as neurophysiologically useful diagnostic methods.

Histopathologic and immunohistochemical studies on the mechanism of interlobular fibrosis of the pancreas

OBJECTIVE

To elucidate the mechanism of interlobular fibrosis of the pancreas, which is categorized as chronic alcoholic pancreatitis.

METHODS

Forty pancreatic tissue samples from patients with ampullary carcinomas, which cause various degrees of stricture of the main pancreatic duct, and 20 patients with chronic alcoholic pancreatitis were studied histopathologically and immunohistochemically.

RESULTS

Fibrosis was observed in 23 of 40 patients with ampullary carcinomas and was classified into 3 categories: mild changes (10 cases), moderate changes (9 cases), and marked changes (4 cases). In the mild change cases, mild fibrosis was diffusely distributed in the interlobular areas, with scant immunoreactivity of anti-alpha-smooth muscle actin (alpha-SMA) and an expansive lobular appearance, whereas moderate and marked change cases showed interlobular and intralobular fibrosis with marked anti-alpha-SMA immunoreactivity and lobular atrophy. By quantitative analysis, the mild change cases showed both higher MIB1-positive and lower apoptotic acinar cell ratios than those of moderate and marked changes. Anti-alpha-SMA immunoreactivity in the patients with chronic alcoholic pancreatitis was found in interlobular fibrosis. Hence, mild changes in cases of ampullary carcinomas had histologic findings similar to chronic alcoholic pancreatitis, except for excessive fibrosis cases with patchy distribution.

CONCLUSION

Incomplete obstruction of the main pancreatic duct caused the beginning of interlobular fibrosis, which is categorized as chronic alcoholic pancreatitis.

Long latency response of the mentalis muscle following transcranial magnetic stimulation with a circular coil in normal subjects

Short latency response (SLR), middle latency response and long latency response (LLR) are elicited in facial muscles by transcranial magnetic stimulation. Although it has been said that the LLRs are elicited by the trigeminal nerve stimulation, a trigeminofacial reflex is recorded easily in normal subjects by the electrical stimulation in orbicularis oculi muscles as a blind reflex, but a trigeminal-facial reflex recorded in orbicularis oris, namely a snout reflex, is more difficult to record in normal subjects. The aim of this study is to demonstrate the LLR of lower facial muscles (mentalis muscle) by the transcranial magnetic stimulation, using a circular coil. The transcranial magnetic stimulations were performed over parieto-occipital scalp with frequencies of random and 0.3 Hz in 11 normal subjects and the responses in the mentalis muscle were recorded. The LLR of the mentalis muscle was recorded in all 11 subjects following SLRs. The latency, duration and LLR/SLR ratio were 37.4 msec, 20.3 msec and 9.1%, respectively. The waveform of the LLR varied trial to trial showing habituation with a stimulation of 0.3 Hz. At this time the LLR of the masseter muscle was not recorded following this transmagnetic stimulation. It was suggested that the LLR of the mentalis muscle is recorded by the transcranial magnetic stimulation of the trigeminal nerve with a circular coil. The ease and reliability of their recording make it possible to apply this LLR clinically as well as a blink reflex.

Two isoforms of FTZ-F1 messenger RNA: molecular cloning and their expression in the frog testis

FTZ-F1, a member of the orphan nuclear receptors, is a transcriptional factor regulating the expression of the fushi tarazu gene in Drosophila (Lavorgna et al., 1991. Science 252, 848-851). Previously, we cloned a frog homologue of FTZ-F1 (rrFTZ-F1alpha; GenBank Accession No. AB035498). In this study, we isolated the rrFTZ-F1beta cDNA encoding a protein of 469 amino acids. Then, expressions of two types (alpha and beta) of rrFTZ-F1 mRNAs were examined during development of embryos and gonads in the frog Rana rugosa. They were expressed in the embryo at stage 12. Expressions of both the alpha and beta mRNAs became stronger in the testis of frogs at stage XXV and were most prominent in that of frogs 2months after metamorphosis. In the former testis, spermatogonia were the only germ cells in the seminiferous tubules, whilst postmeiotic cells were observed in the latter testis. Expression of the typealpha mRNA was more prominent. In addition, we cloned the regions with either exon I or II of the rrFTZ-F1 gene. Genomic structure analysis revealed that rrFTZ-F1beta is a partial exon I-truncated variant of rrFTZ-F1alpha. The results suggest that rrFTZ-F1alpha and -beta are expressed from the same gene by alternative splicing and that they may play an important role(s) in differentiation of premeiotic germ cells in the testis of the frog R. rugosa.

Novel brain function: biosynthesis and actions of neurosteroids in neurons

Peripheral steroid hormones act on brain tissues through intracellular receptor-mediated mechanisms to regulate several important brain neuronal functions. Therefore, the brain is considered to be a target site of steroid hormones. However, it is now established that the brain itself also synthesizes steroids de novo from cholesterol. The pioneering discovery of Baulieu and his colleagues, using mammals, and our studies with non-mammals have opened the door of a new research field. Such steroids synthesized in the brain are called neurosteroids. Because certain structures in vertebrate brains have the capacity to produce neurosteroids, identification of neurosteroidogenic cells in the brain is essential to understand the physiological role of neurosteroids in brain functions. Glial cells are generally accepted to be the major site for neurosteroid formation, but the concept of neurosteroidogenesis in brain neurons has up to now been uncertain. We recently demonstrated neuronal neurosteroidogenesis in the brain and indicated that the Purkinje cell, a typical cerebellar neuron, actively synthesizes several neurosteroids de novo from cholesterol in both mammals and non-mammals. Pregnenolone sulfate, one of neurosteroids synthesized in the Purkinje neuron, may contribute to some important events in the cerebellum by modulating neurotransmission. Progesterone, produced as a neurosteroid in this neuron only during neonatal life, may be involved in the promotion of neuronal and glial growth and neuronal synaptic contact in the cerebellum. More recently, biosynthesis and actions of neurosteroids in pyramidal neurons of the hippocampus were also demonstrated. These serve an excellent model for the study of physiological roles of neurosteroids in the brain, because both cerebellar Purkinje neurons and hippocampal neurons play an important role in memory and learning. This paper summarizes the advances made in our understanding of neurosteroids, produced in neurons, and their actions.