Antibody-like proteins that capture and neutralize SARS-CoV-2

To combat severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and any unknown emerging pathogens in the future, the development of a rapid and effective method to generate high-affinity antibodies or antibody-like proteins is of critical importance. We here report high-speed in vitro selection of multiple high-affinity antibody-like proteins against various targets including the SARS-CoV-2 spike protein. The sequences of monobodies against the SARS-CoV-2 spike protein were successfully procured within only 4 days. Furthermore, the obtained monobody efficiently captured SARS-CoV-2 particles from the nasal swab samples of patients and exhibited a high neutralizing activity against SARS-CoV-2 infection (half-maximal inhibitory concentration, 0.5 nanomolar). High-speed in vitro selection of antibody-like proteins is a promising method for rapid development of a detection method for, and of a neutralizing protein against, a virus responsible for an ongoing, and possibly a future, pandemic.

P4677Balloon pulmonary angioplasty improves pulmonary arterial compliance in patients with inoperable chronic thromboembolic pulmonary hypertension

Background

Right ventricular (RV) pressure overload is directly related to the increase in mortality in pulmonary hypertension. Pulmonary arterial compliance (CPA; stroke volume/pulmonary pulse pressure) was reported to be an independent determinant of RV systolic afterload in patients with pulmonary arterial hypertension (PAH). Recently, balloon pulmonary angioplasty (BPA) has been reported to reduce mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (RPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). However, the effects of BPA on CPA remain unclear.

Purpose

The aim of this study was to investigate the impact of BPA on CPA in patients with inoperable CTEPH.

Methods

We retrospectively analyzed 78 patients (388 BPA sessions) with inoperable CTEPH who underwent BPA in our hospital from September 2012 to June 2018. Total number of BPA sessions was 5.0±1.8 (range 1–10). The pressure values were obtained from right heart catheterization at baseline (n=78), just after the final BPA (n=78) and follow-up (n=19) periods. The intervals from baseline to the final BPA and the final BPA to follow-up were 593±498 days and 397±276 days, respectively.

Results

Mean age was 60.5±12.6 years old, and 64 (82%) were female. All patients were symptomatic (WHO functional class II/III/IV 16/55/7). Patients who had pulmonary vasodilators decreased from 70 (90%) at baseline to 23 (28%) at the final BPA and 2 (15%) at follow-up. BPA reduced mPAP and RPA significantly from baseline to the final BPA and follow-up periods. BPA also improved CPA with significant reduction of pulse pressure despite no significant changes in stroke volume between baseline and follow-up (Table). CPA between the final BPA and follow-up was equivalent (p=0.95).

Conclusions

BPA improved CPA just after the final BPA in inoperable CTEPH patients. In addition, CPA was preserved during the follow-up after the final BPA sessions. These data suggest that BPA consistently unloads RV systolic afterload in those patients.

Linker-free incorporation of carbohydrates into in vitro displayed macrocyclic peptides

We report a strategy for efficient post-translational modification of a library of ribosomally-translated peptides by activation and elimination of cysteine to dehydroalanine then conjugate addition of a range of exogenous thiols, with an emphasis on carbohydrates.

We report a strategy for efficient post-translational modification of a library of ribosomally-translated peptides by activation and elimination of cysteine to dehydroalanine then conjugate addition of a range of exogenous thiols, with an emphasis on carbohydrates. These reactions are selective for cysteine, and do not interfere with amplification of the nucleic acid component of an mRNA-displayed peptide. Furthermore, these reactions are shown to be compatible with two different macrocyclisation chemistries, and when applied to a peptide containing an N-terminal cysteine give a ketone that can be functionalised in an orthogonal manner. This new strategy can overcome a limitation of ribosomal translation, providing a means to incorporate untranslatable groups such as carbohydrates in amino acid side chains, and will allow for the ribosomal generation of glycopeptides, requiring only the introduction of a free thiol in the molecule to be incorporated. In combination with in vitro selection techniques, this strategy is envisaged to allow the discovery of biologically-active glycopeptides with a near-natural, but hydrolytically stable, thioglycosidic bond.

Pure laparoscopic hepatectomy for hepatocellular carcinoma patients with severe liver cirrhosis

Hepatocellular carcinoma often arises in cirrhotic livers. Patients with severe liver cirrhosis who undergo hepatectomy often develop postoperative liver failure, even if the hepatectomy is limited. Here, we report six patients with severe liver cirrhosis (Child-Pugh B/C and indocyanine green retention rate at 15 min ≥ 40%) who underwent pure laparoscopic hepatectomy. Their perioperative course was favorable and comparable to that of other hepatocellular carcinoma patients with mild-moderate liver cirrhosis. In patients with severe liver cirrhosis, pure laparoscopic hepatectomy minimizes the disturbance in collateral blood and lymphatic flow caused by laparotomy and liver mobilization, as well as the mesenchymal injury caused by compression of the liver. It limits complications such as massive ascites, which can lead to severe postoperative liver failure. Good candidates for the procedure include patients with severe liver cirrhosis who have tumors on the liver surface and in whom adaptation to ablation therapy is difficult and/or who experience local recurrence after repeat treatments.

Budgets of major ionic species and nutrients on a dam reservoir in forested watershed

To evaluate the role of a dam reservoir in the runoff of pollutant loadings from a forested watershed, the input-output budgets in the Ikuno dam reservoir had been investigated for eight years since 1996. The T-N, T-P, TOC and major ionic species in the bulk precipitation, stream water, and outflow were measured. The residence time calculated by using the data of the inflow and outflow was 0.3 year. The average precipitation was 1,772 mm during the investigation period (1996-2004). The direct deposition to water surface was less than one percentage to total loadings of nutrients and major ionic species. The ratios of output to input of TOC, TN, and TP were 1.04 to 1.42, and those of major ionic species were from 0.83 to 0.99 except for NO3(-), which was 1.12. However, the ratios of output to input of major ionic species except for NO3(-) at the Ikuno dam reservoir will be larger, and those of NO3(-), TOC, TN, and TP will be smaller, if we also include rain events. These results suggested that the dam reservoir played a role as a sink for pollutants in forested watershed, and that the pollutant loadings to downstream may decrease.

Cimetidine increases survival of colorectal cancer patients with high levels of sialyl Lewis-X and sialyl Lewis-A epitope expression on tumour cells

Cimetidine has been shown to have beneficial effects in colorectal cancer patients. In this study, a total of 64 colorectal cancer patients who received curative operation were examined for the effects of cimetidine treatment on survival and recurrence. The cimetidine group was given 800 mg day(-1) of cimetidine orally together with 200 mg day(-1) of 5-fluorouracil, while the control group received 5-fluorouracil alone. The treatment was initiated 2 weeks after the operation and terminated after 1 year. Robust beneficial effects of cimetidine were noted: the 10-year survival rate of the cimetidine group was 84.6% whereas that of control group was 49.8% (P<0.0001). According to our previous observations that cimetidine blocked the expression of E-selectin on vascular endothelium and inhibited the adhesion of cancer cells to the endothelium, we have further stratified the patients according to the expression levels of sialyl Lewis antigens X (sL(x)) and A (sL(a)). We found that cimetidine treatment was particularly effective in patients whose tumour had higher sL(x) and sL(a) antigen levels. For example, the 10-year cumulative survival rate of the cimetidine group with higher CSLEX staining, recognizing sL(x), of tumours was 95.5%, whereas that of control group was 35.1% (P=0.0001). In contrast, in the group of patients with no or low levels CSLEX staining, cimetidine did not show significant beneficial effect (the 10-year survival rate of the cimetidine group was 70.0% and that of control group was 85.7% (P=n.s.)). These results clearly indicate that cimetidine treatment dramatically improved survival in colorectal cancer patients with tumour cells expressing high levels of sL(x) and sL(a).

Application of an automatic sampling and measurement system to a mountainous stream investigation during rain events

An automatic sampling and measurement system was developed to take water samples efficiently during rain events. The system consisted of an automatic sampler, a rain gauge and a data logger as well as sensors for pH, electrical conductivity (EC), and both water and air temperature. The system was tested in a stream in a forested watershed (5.8 km2) located in the middle of Hyogo prefecture, Japan. The sampling program has been improved gradually. For several rain events of 30 to 157 mm, most water samples were in agreement with the hydrograph from the beginning of each rainfall until the rain had stopped and the water level had begun to fall. The fluctuations in water quality in the samples taken by the automatic sampler during those rain events showed patterns similar to those of water samples taken by hand. There were also no problems with the water level or the EC sensor during the investigation periods, but the pH values were lower than those in the laboratory. The results showed that the system is suitable for taking water samples from mountainous streams during rain events.

Dilazep, a nucleoside transporter inhibitor, modulates cell cycle progression and DNA synthesis in rat mesangial cells in vitro

The direct effects of the nucleoside transporter inhibitor dilazep on the cell cycle of mesangial cells have not before been investigated. The purpose of this study was to elucidate whether dilazep can inhibit the proliferation of mesangial cells and how it interferes with the cell cycle of these cells. DNA histograms were used and BrdUrd uptake rate was measured by flow cytometry. There was no significant difference in the cell numbers among the untreated group and the 10(-5) M, 10(-6) M or 10(-7) M dilazep-treated groups at 24 h of incubation. However, at 48 and 72 h, the cell numbers in the dilazep-treated groups were significantly lower compared with that of the untreated group (P < 0.005). The DNA histograms of cultured rat mesangial cells at 12, 24, and 48 h of incubation with 10(-5) M dilazep showed that the ratio of the S phase population in the dilazep-treated group decreased by 2.2% at 12 h, by 9.6% at 24 h, and by 18.9% at 48 h compared with the untreated group. The ratio of the G0/G1 phase population in the dilazep-treated group significantly increased: 6.8% at 12h (P < 0.05), 13.9% at 24 h (P < 0.001), and 76.5% at 48 h (P < 0.001) compared with the untreated group. A flow cytometric measurement of bivariate DNA/BrdUrd distribution demonstrated that the DNA synthesis rate in the S phase decreased after 6 h (P < 0.005) and 12 h (P < 0.05) of incubation compared with the untreated group. These results suggest that dilazep inhibits the proliferation of cultured rat mesangial cells by suppressing the G1/S transition by prolonging G2/M and through decreasing the DNA synthesis rate.

Heterogeneous expression of nonmuscle myosin heavy chain-B in mesangial cells of patients with Gitelman's syndrome

AIMS

It has been suggested that angiotensin II (Ang II) promotes hypertrophy and hyperplasia of mesangial cells. Nonmuscle myosin heavy chain-B (NMHC-B) and alpha-smooth muscle (SM) actin are considered to be molecular markers for phenotypic change ofproliferative mesangial cells. One of the clinical characteristics in Gitelman's syndrome (GS) is the elevation of plasma Ang II. However, little is known about the relation between Ang II and phenotypic change of mesangial cells in patients with GS. In this report, we examined the expression of NMHC-B and alpha-SM actin in mesangial cells of two GS patients.

MATERIALS AND METHODS

Plasma renin activity, and the concentrations of Ang II, 6-keto-prostaglandin F1alpha (6-keto-PGF1alpha), urinary kallikrein, and 6-keto-PGF1alpha were measured. Immunohistochemical staining of NMHC-B and alpha-SM actin in mesangial cells of GS patients was also performed.

RESULTS

Both cases of GS showed normal glomerular function, few histological abnormalities, and higher than normal plasma concentrations of renin and Ang II. Furthermore, one case showed a high urinary concentration of kallikrein and the expression of both NMHC-B and alpha-SM actin in mesangial cells. The other case showed a high urinary concentration of 6-keto-PGF1alpha but not kallikrein and without the expression of NMHC-B and alpha-SM actin.

CONCLUSION

Not only plasma kinin-kallikrein and prostaglandins, but the renal expression of NMHC-B and alpha-SM actin may be variable in different patients with GS.

Characterization of T cell receptor beta chains of accumulating T cells in chronic ongoing myocarditis demonstrated by heterotopic cardiac transplantation in mice

Autoimmne mechanisms have been implicated in the pathogenesis of chronic ongoing mycarditis. An earlier study of murine chronic ongoing myocarditis reported that infiltrating T cells and macrophages were prominent in the normal donor heart, in a heterotopic cardiac transplantation model. It was demonstrated that myocarditis was transferred to a normal heart transplanted into a mouse with chronic myocarditis. The present study investigated an autoimmune link to the pathogenesis of chronic ongoing myocarditis by analyzing the T cell clonalities in the model. To characterize the accumulating T cells in the donor heart, the T cell receptor beta genes (TCRBG) were amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) from mRNA in the donor hearts and accumulating TCRBG clonotypes were contrasted with those from recipient hearts. Inbred 3-week-old A/J mice were inoculated intraperitoneally with Coxsackievirus B3 (Nancy strain), 2 x 10(4) PFU, and housed for more than 60 days. Normal A/J mouse hearts were transplanted into the same strain of mice without myocarditis, as well as into the mice with chronic ongoing myocarditis. Both recipient and donor hearts were evaluated histologically 2 weeks after the transplantation. TCRBG were amplified by RT-PCR from mRNA of recipient and donor hearts and spleens. The specific accumulating TCRBG clonotypes were identified by their single strand conformation polymorphism. Multiple clonotypic accumulations occurred in the donor heart after cardiac transplantation. Distinct oligoclonal accumulation of TCR Vbeta1, 10, and 13 T cells was found in both recipient and donor hearts in 3 of 4 mice. Moreover, these clonotypes were not observed in spleen cells of the recipient mice. T specific cells expanding clonotypes of TCRBG are responsible for transferring myocarditis to the donor heart. An autoimmune response may, therefore, play a key role in the progression of chronic ongoing myocarditis.

Runoff characteristics of nutrients in the forest streams in Hyogo Prefecture, Japan

Nutrients and other pollutant runoffs from streams in artificial forest areas in central Hyogo Prefecture in southwest Japan have been investigated to estimate pollutant loads since 1995. The orthophosphate and ammonium nitrogen contents were usually low and constant during the investigation. When the flowrates of the streams were normal, the concentrations of suspended solids, COD(Mn), TOC and total phosphorus were very low, and did not change much. However, when stream flows were increased by rainstorms or other precipitation, higher concentrations of these parameters occurred. Otherwise, the average concentrations of nitrate nitrogen and total nitrogen were 0.26 mg/l and 0.31 mg/l, respectively, and they were often increased by precipitation events. They changed at the same time because the ratio of nitrate nitrogen per total nitrogen was high, about 80%. The fluctuation of concentrations of total phosphorus was similar to SS concentrations, which suggested that phosphorus was discharged in the types of suspended solids from forest areas. The specific loads of the nutrients and some other pollutants did not differ among the three watersheds investigated. However, the difference among them between fine days and rainy days was fairly large. It was presumed that pollutant runoff from forest areas is strongly dependent on precipitation events.

Runoff characteristics of major ionic species during rain events in forested watershed

The runoff characteristics of major ionic species from a stream in a forested watershed were investigated during two rain events. The values of EC and the concentrations of alkalinity, anions and cations, except for NO3-, decreased according to the increase of discharge, and showed a sharp lower peak. On the other hand, the concentrations of NO3- and K+ indicated an opposite change. The amount of output of anions and cations was also larger than those of the input, especially in a storm event. During a storm event, the NO3- concentrations in soil water 20 cm deep taken by a tension lysimeter were not detected, even though the surface soil of 0-5 cm deep included 20 to 50 mg/kg of NO3-. The direct contribution for NO concentrations by suspended solids in water was estimated through three percentages of the stream water output. Surface runoff was also not observed. These results suggest that the prompt subsurface runoff of the direct runoff from surface layer of soil may be predominant during rainfall in the forested area, and the increase of NO3- concentrations in the stream may be caused through the process.

Mixed connective tissue disease with multiple organ damage: successful treatment with plasmapheresis

A 24-year-old-woman with mixed connective tissue disease (MCTD) developed multiple organ failure, disseminated intravascular coagulation (DIC), metabolic acidosis, and respiratory and renal failure resulting from visceral vasospasm, so-called visceral Raynaud's phenomenon. After plasmapheresis, the condition of multiple organ failure was markedly improved. The successful treatment with plasmapheresis was dependent upon the removal of immune complexes in serum and improvement of visceral circulation. Thus plasma exchange is recommended as a possible a treatment for multiple organ damage in MCTD.

Infection Behavior of Venturia nashicola, the Cause of Scab on Asian Pears

ABSTRACT The infection of Japanese pear by Venturia nashicola, the cause of scab on Asian pears (Japanese pear, Pyrus pylifolia var. culta; Chinese pear, P. ussuriensis), was examined using light and electron microscopy to determine the mechanism of resistance in pears. Early stages of infection were similar on the susceptible cv. Kosui, the resistant cv. Kinchaku, and the nonhost European pear (P. communis) cv. Flemish Beauty. V. nashicola penetrated only the cuticle layer on pear leaves and formed subcuticular hyphae on all three cultivars. Hyphae were localized in the pectin layer of pear leaves and never penetrated into the cytoplasm of epidermal cells. This restriction of fungal growth suggested that pectinases released by infection hyphae or subcuticular hyphae may be important in infection. Subcuticular hyphae were modified ultrastructurally in the pectin layer of resistant pear cultivars accompanied by fungal cell death. In contrast, fungal cells appeared intact in susceptible pear cultivars, suggesting the existence of resistance mechanisms.

Eosinophil counts and plasma fibrinogen in patients with vasospastic angina pectoris

Epidemiologic studies have suggested a relation between white blood cell (WBC) counts and the incidence of coronary heart disease. However, the relation between vasospastic angina pectoris (VAP) and WBC counts remains to be elucidated. To clarify the relation between differential and WBC counts in VAP, we compared the hematologic values, blood chemical values, plasma fibrinogen levels, C-reactive protein levels, and coronary risk factors in patients with spontaneous attacks of VAP (n = 39) with those in patients with stable effort angina pectoris (EAP, n = 35) and in control subjects (n = 19). Patients with VAP were further divided into mild VAP (n = 22) and severe VAP groups (n = 17). There were no differences in the coronary risk factors, body temperature, total WBC counts, and C-reactive protein levels among the control, EAP, mild VAP, and severe VAP groups, except that the high-density lipoprotein cholesterol in the EAP group was significantly lower than that in the control group (p <0.01). In contrast, the eosinophil counts were significantly higher in the severe VAP group than in the other 3 groups (p <0.01). Plasma fibrinogen levels were also significantly higher in the severe VAP group than in the other 3 groups (p <0.05). The follow-up study for differential and WBC counts in patients with VAP (n = 23) demonstrated that, after medical therapy, the eosinophil counts were significantly decreased to the some level as those in the control group (p <0.0001). Thus, the eosinophil counts and plasma fibrinogen levels could predict the severity of VAP. Furthermore, a follow-up study in patients with VAP suggests that coronary vasospasm could result in an increase in eosinophil counts.

Repetitive coxsackievirus infection induces cardiac dilatation in post-myocarditic mice

The relation between mycarditis and dilated cardiomyopathy (DCM) is controversial. To clarify the pathogenic mechanism of these diseases, the present study examined the effect of repetitive inoculation with coxsackievirus B3 (CVB3) in post-myocarditic mice. Inbred 3-week-old A/J mice were inoculated intraperitoneally with CVB3 (Nancy strain; 2x10(4) plaque-forming units) and reinfected in the same manner with CVB3 at 40 weeks (3W+/40W+). All mice were killed at 42 weeks old. The weight of the hearts of the 3W+/40W+ group were significantly increased compared with those of the 3W-/40W+ group, and both the heart weight/body weight and lung weight/body weight ratios of the 3W+/40W+ group were also significantly increased over those of the 3W-/40W- group, although the levels of serum neutralizing antibody titers were significantly increased in the 3W+/40W+ group over the level of the other groups. No increase in inflammatory cell infiltration or fibrosis progression was observed in the 3W+/40W+ group relative to the 3W+/40W- group, but the second inoculation resulted in a significant left ventricular dilatation and in left and right ventricular free wall thinning (3.31+/-0.20 mm vs 2.61+/-0.19 mm, p<0.05; 0.54+/-0.09 mm vs 0.72+/-0.16 mm, p<0.05, respectively). The sarcomere length was also significantly increased in the 3W+/40W+ group compared with that of the other groups, as determined by electron microscopy. Degenerative or necrotic areas in the infected hearts were not stained with anti-mouse IgG antibody, but were stained, only in 3W+/40W+ mice, with anti-mouse IgM antibody. The concentrations of TNF-alpha in the hearts of the 3W+/40W+ group were increased significantly over those of the 3W+/40W- group. Repetitive CVB3 infection produced cardiac dilatation without inflammatory cell infiltration in post- myocarditic mice. Autoimmunity mediated by the circulation of certain antibodies (eg, antibodies against the CVB3 genome or a CVB3-related protein) may be part of the pathogenic mechanism for this phenomenon. Thus, repetitive virus infection might contribute to the pathogenesis of cardiac dilatation.

Angiotensin II type 1 receptor antagonist downregulates nonmuscle myosin heavy chains in spontaneously hypertensive rat aorta

The aim of this study was to clarify the differences between the angiotensin II type 1 (AT1) receptor antagonist and the angiotensin-converting enzyme (ACE) inhibitor on smooth muscle and nonmuscle myosin heavy chain isoforms in aortic smooth muscle cells of Wistar-Kyoto rats and spontaneously hypertensive rats. All 4 myosin heavy chain isoforms are heterogeneously expressed in the smooth muscle cells of the aortic tunica media in 20-week-old rats, and the contractile-type myosin heavy chains are highly expressed in smooth muscle cells of the aortic tunica media compared with the synthetic-type myosin heavy chains. Both the AT1 receptor antagonist and the ACE inhibitor had the same effects on hemodynamics, smooth muscle cell hypertrophy and proliferation, fibrosis, and vascular remodeling in spontaneously hypertensive rats. However, the AT1 receptor antagonist had a more potent effect on the downregulation of the synthetic-type myosin heavy chains than the ACE inhibitor in spontaneously hypertensive rat aortic tunica media. In contrast, these effects of the AT1 receptor antagonist and the ACE inhibitor on hemodynamics, morphology, fibrosis, and expression of myosin heavy chain isoforms in smooth muscle cells of the aortic tunica media were not observed in Wistar-Kyoto rats. Thus, within 6 weeks, the AT1 receptor antagonist might modulate the cellular composition of myosin heavy chain isoforms in smooth muscle cells more efficiently than the ACE inhibitor, without morphological changes in the spontaneously hypertensive rat aorta.

Fas expression and apoptosis correlate with cardiac dysfunction in patients with dilated cardiomyopathy

Fas is a transmembranous glycoprotein that mediates apoptosis. To elucidate the roles of Fas and of myocyte apoptosis in patients with dilated cardiomyopathy (DCM), the expression of Fas and the fragmentation of DNA were compared in endomyocardial biopsy specimens obtained from patients with DCM. Endomyocardial biopsy was performed on 19 subjects (16 with DCM and 3 control subjects) who also underwent cardiac catheterization and echocardiography. Fas and bcl-2 expression were assayed immunohistochemically, and in situ TdT staining was performed to estimate the number of apoptotic cells. Samples from the DCM patients stained more intensely with anti-Fas antibody than those from control patients (p<0.05). The percentage of in situ TdT-positive cells was significantly higher in the DCM group than in the control group (p<0.05). A correlation between Fas expression and in situ TdT staining was observed in 67% of myocytes in the DCM group. Moreover, the percentage of in situ TdT staining was significantly higher in subjects with severely impaired left ventricular systolic function than in those whose systolic function was mild to moderately impaired, or who had normal systolic function (p<0.05). The samples showed little expression of bcl-2. These results suggest that Fas expression and apoptosis may be involved in the progression of cardiac dysfunction in DCM.

Chronic glucocorticoid administration as well as repeated stress affects the subsequent acute immobilization stress-induced expression of immediate early genes but not that of NGFI-A

We reported that repeated immobilization for six days attenuates the subsequent acute immobilization stress-induced expression of the immediate early genes c-fos, fos B, jun B and nerve growth factor-induced gene-B (NGFI-B), but not of NGFI-A, in the rat paraventricular hypothalamic nucleus. In this study, we confirmed these findings by means of a time-course study, and further investigated whether the elevated plasma basal glucocorticoid level induced by repeated stress underlies the attenuated response of immediate early genes and the preserved reactivity of NGFI-A. Rats implanted with 100, 200 or 400 mg corticosterone or placebo pellets (control), were immobilized for 1 h and decapitated seven days later. In control rats acute immobilization induced c-fos, fos B, jun B, NGFI-A and NGFI-B messenger RNA in the paraventricular hypothalamic nucleus, whereas all of them except NGFI-A, were significantly reduced in rats given 200 and 400 mg corticosterone implants. The similarity of the results from the two procedures suggests that glucocorticoid is involved in regulating immediate early genes in the paraventricular hypothalamic nucleus under repeated stress and that the NGFI-A gene is not regulated by this mechanism. However, the plasma basal corticosterone level in repeatedly stressed rats was lower than that of rats implanted with 100 mg corticosterone, suggesting that a repetitive stress-induced corticosterone surge also contributes to this mechanism.

A tactile sensor for laparoscopic cholecystectomy

During laparoscopic surgery, surgeons observe the three-dimensional abdominal cavity on a two-dimensional TV monitor, which is a limitation. Another limitation is that surgeons are unable to estimate the softness of organs or tissues during laparoscopic surgery as they are only allowed to use instruments which touch objects and direct palpation is not permitted during the procedure. The tactile sensor which we used displays the object softness immediately as a digital score, which can then be superimposed on a TV monitor as a graph. With the tactile sensor, we were able to ascertain the presence of a gallstone in the gallbladder or cholecystic duct during laparoscopic cholecystectomy and also able to discriminate between a stone and an air bubble during intraoperative cholangiography. We were convinced that the tactile sensor would be useful in laparoscopic surgery, which does not permit surgeons to palpate objects with human fingers.

In vivo aortic wall characteristics at the early stage of atherosclerosis in rabbits

To assess whether vascular responsiveness to alpha-receptor agonist is altered at the early stage of atherosclerosis, in vivo aortic pressure-diameter relationship of the aorta over a wide range of pressures was analyzed before and after the acute administration of alpha-receptor agonist (phenylephrine) in nine hypercholesterolemic fat-fed (7-wk-old) rabbits and eight normal diet-fed (7-wk-old) rabbits. In hypercholesterolemic fat-fed rabbits, there was no major structural change in the aortic wall except fatty streak, despite a marked increase in the level of plasma cholesterol, indicating the early stage of atherosclerosis of the aorta. By using a modified three-element Maxwell model, diastolic stress-strain relationship was computed after applying several assumptions to the actual aortic pressure-diameter relationship. After the intravenous administration of phenylephrine at a rate of 5 micrograms.kg-1.min-1, the stress (ordinate)-strain (abscissa) relationship curves were shifted to the left, indicating the activation of aortic smooth muscle by phenylephrine. The difference between the stress before and after phenylephrine showed a single peak at a certain strain. The peak difference in the stress was smaller in hypercholesterolemic fat-fed rabbits than in normal diet-fed rabbits, indicating the reduction of vascular responsiveness at the early stage of atherosclerosis of the aorta.

The effects of phacoemulsification cataract surgery via local anesthesia on preoperative and postoperative blood pressure levels

PURPOSE

The authors prospectively evaluated the preoperative and postoperative blood pressure (BP) levels of 2270 patients with cataracts.

METHODS

All surgeries were performed by the same surgeon using the same method of phacoemulsification and aspiration (PEA) with posterior chamber intraocular lens implantation with the patients under local anesthesia.

RESULTS

The daily systolic BP was 140.7 +/- 22.9 mmHg; the preoperative and postoperative systolic BPs were 149.5 +/- 23.9 and 145.6 +/- 23.8, respectively. The tendency for the preoperative BPs to increase and the postoperative BPs to decrease also was evident in the diastolic and the mean BPs. However, when the authors categorized the cases into normal, intermediate, and hypertension groups, the preoperative BP increased less and the postoperative BP decreased more when the daily BP was higher.

CONCLUSION

Overall, the daily, preoperative, and postoperative BPs were relatively stable with the patients under local anesthesia. However, the BP change was characteristic of each group when the patients were categorized as normal, intermediate, and hypertensive. Surgeons should be aware of the greater-than-anticipated BP change during cataract surgery.

Autoimmune response in chronic ongoing myocarditis demonstrated by heterotopic cardiac transplantation in mice

BACKGROUND

Autoimmune mechanisms have been implicated in the pathogenesis of chronic ongoing myocarditis. To investigate this relation, we used an A/J mouse model inoculated with coxsackievirus B3 and determined whether myocarditis would be transferred to normal hearts that were heterotopically transplanted.

METHODS AND RESULTS

Inbred 3-week-old A/J mice were inoculated intraperitoneally with coxsackievirus B3 (Nancy strain; 2 x 10(4) plaque-forming units) and housed for > 60 days. The presence of the viral genome in the myocardium was determined by the polymerase chain reaction with primers specific for the 5' end of the coxsackievirus B3 genome performed at 40, 50, or 60 days after inoculation. Normal A/J mouse hearts were transplanted into the same strain of mice without myocarditis (group A) and into mice with chronic ongoing myocarditis (group B). The hearts were evaluated histologically 2 weeks after transplantation. Conventional histological examination of infiltrated T cells and macrophages was performed, and the expression of intercellular adhesion molecule-1, major histocompatibility complex (MHC) class I antigen, and MHC class II antigen was evaluated by immunoenzymatic staining. The concentrations of interleukin-1 alpha (IL-1 alpha) and tumor necrosis factor (TNF-alpha) in the grafts were measured with an ELISA. The viral RNA genomes were not detected in the mice with chronic ongoing myocarditis, but their transplanted hearts did show myocarditis. In the hearts with induced myocarditis, infiltrated mononuclear cells consisted of CD4+ T cells, CD8+ T cells (CD4+ cell number > CD8+ cell number), and macrophages. Intercellular adhesion molecule-1, MHC class I antigen, and MHC class II antigen were expressed in the vascular endothelial cells and myocardial cells in and around the infiltrated lesions. The concentrations of IL-1 alpha and TNF-alpha in group B were significantly higher than those in group A (group A versus group B: IL-1 alpha, 125 +/- 35 versus 180 +/- 34 pg/mL; TNF-alpha, 45 +/- 15 versus 96 +/- 40 pg/mL; P < .05).

CONCLUSIONS

Results suggest that an autoimmune response may play a key role in the progression of chronic ongoing myocarditis.

A case of acute eosinophilic pneumonia. Evidence for hypersensitivity-like pulmonary reaction

We examined an 86-year-old man with acute respiratory failure. A chest roentgenogram showed diffuse reticular shadows. Transbronchial biopsy revealed thickening of the alveolar septa accompanied by moderate eosinophil infiltration. After admission to the hospital, the patient's symptoms immediately improved without any medication. Clinical course and pathologic findings suggested acute eosinophilic pneumonia caused by a hypersensitivity reaction.

Echographical assessment of the early stage of experimental atherosclerosis of the descending aorta in rabbits

To assess the early stage of atherosclerosis of the thoracic descending aorta, we evaluated morphological atheromatous lesions (atherosis) and the stiffness parameter of the artery (beta; sclerosis) in 24 male rabbits using echography. Male Japanese white rabbits weighing 2.5-3.0 kg were fed a diet containing 1% cholesterol for 7 (n = 8) or 14 weeks (n = 8). Rabbits fed a normal diet were used as controls (n = 8). Atheromatous lesions were evaluated with intravascular ultrasound (IVUS: Aloka, 20 MHz, 6F). We also calculated beta using M-mode echography (7.5 or 10 MHz) and direct aortic pressure measurement. Thickening of the intima-media complex was clearly observed with IVUS in the 14-week group but was not detected in the others. Histologically, only a thin layer of foamy cells on the intima (thickness < 20 microns) was observed in the 7-week group. The value of beta was significantly increased in both the 7-week (4.7 +/- 2.2) and 14-week groups (4.5 +/- 0.8) compared with controls (1.7 +/- 0.9, both p < 0.01). These results suggest that the development of atherosis might be preceded by vascular sclerosis during the early stage of atherosclerosis when the serum cholesterol level is high: at a time when the thin layer of foamy cells could not be detected by conventional IVUS.

Immobilization stress induces c-fos and c-jun immediate early genes expression in the heart

Emotional stress is considered to be one of the etiological factors in ischemic heart disease (IHD) and sudden cardiac death (SCD), mechanisms of which are poorly understood. Immediate early genes (IEGs), such as c-fos and c-jun are used as tools for detection of cellular activation. Male Wistar rats were exposed to acute immobilization (IMO). IMO stress for 30 min induced c-fos and c-jun mRNAs expression in the myocardium and the smooth muscle layer of the coronary arteries. IMO stress for 2 h also induced Fos and Jun like-immunoreactivities in the same regions. Distribution of IEG mRNAs and their protein products in the myocardium was not uniform but rather localized. These data provided histological evidence for an early cellular event in the stress response whose consequences could result in activation of tissues in the myocardium and coronary arterial smooth muscle cells which play a role in the pathophysiological changes in IHD and SCD.

Comparative effects of type 1 angiotensin II-receptor blockade with angiotensin-converting-enzyme inhibitor on left ventricular distensibility and collagen metabolism in spontaneously hypertensive rats

We compared the cardiac effects of the selective angiotensin II type 1 (AT1)-receptor blockade, FK-739, with an angiotensin-converting-enzyme (ACE) inhibitor, enalapril, on left ventricular (LV) distensibility and collagen metabolism in spontaneously hypertensive rats (SHRs). We treated 14-week-old SHRs with FK-739 (30 mg/kg/day) or enalapril (10 mg/kg/day) for 6 weeks. Both FK-739 and enalapril induced a significant decrease in blood pressure (p < 0.001) and regression of LV hypertrophy (p < 0.001) compared with vehicle, with no differences between the treated groups. Furthermore, FK-739 caused a greater decrease in LV collagen content than did enalapril (FK-739-treated group, 3.06 +/- 0.11 mg/g; enalapril-treated group, 3.47 +/- 0.05 mg/g; p = 0.015) with no change in collagen phenotypes. Hearts taken from rats treated with FK-739 also showed greater LV distensibility than those taken from enalapril-treated rats (FK-739-treated group vs. enalapril-treated group at > or = 15 mm Hg, p < 0.001). These results suggest that, compared with ACE inhibition, AT1-receptor blockade may have additional effects on LV distensibility and collagen metabolism in the regression of LV hypertrophy induced by pressure overload.

Differential regulation of IEGs in the rat PVH in single and repeated stress models

Various kinds of stressors induce immediate early genes (IEGs) in discrete brain regions. We recently reported the reduced response of Fos expression in the hypothalamic paraventricular nucleus (PVH) when rats are repeatedly exposed to immobilization (IMO) stress. In this study, using in situ hybridization histochemistry, we further extended the research to other IEGs, and the results showed that prior exposure to IMO for 6 days suppressed the induction of fosB, junB and NGFI-B, but NGFI-A, mRNAs in response to a challenge IMO on day 7, suggesting that repeated stress has different effects on the transcription of NGFI-A and the other IEGs, in the PVH.

Differential expression of fos family and jun family mRNAs in the rat hypothalamo-pituitary-adrenal axis after immobilization stress

We aimed to clarify the regulatory mechanism of the hypothalamo-pituitary-adrenal axis that plays key roles in initiating stress responses, as well as the roles of immediate early genes in this process. We investigated the stress-induced activation of fos and jun family proto-oncogenes by means of in situ hybridization histochemistry. Immobilization stress induced c-fos and jun B mRNAs in the parvocellular region of the hypothalamic paraventricular nucleus, the anterior and intermediate lobes of pituitary, and in the adrenal gland after 7 min of immobilization, although no c-fos or jun B mRNAs were detected in these and other organs in control rats. The levels of these mRNAs peaked after 30-60 min of immobilization, then declined. A low level of fos B mRNA appeared at 15-30 min and peaked after 60-90 min. On the contrary, c-jun and jun D mRNAs were constitutively expressed in the paraventricular nucleus and adrenal cortex. These findings indicate that the members of the fos and jun family proto-oncogenes play different roles in the transcriptional regulation of genes involved in the hypothalamo-pituitary-adrenal axis, and that monitoring immediate early genes is a useful method for following stress-induced cellular responses in the neuro-endocrine system.

The expression of neuropeptides and their mRNAs in the trigeminal mesencephalic nucleus following masseteric nerve transection

By in situ hybridization and immunohistochemistry, we examined the expression of neuropeptides such as neuropeptide Y (NPY), galanin (Gal), substance P (SP), vasoactive intestinal polypeptide (VIP) and their mRNAs in the rat mesencephalic trigeminal nucleus (Mes5) following masseteric nerve transection. On the side contralateral to the nerve transection, none of the peptides examined were labeled in Mes5 cell bodies. However, on the side ipsilateral to the lesion, NPY, Gal and preprotachykinin (PPT) mRNAs appeared in Mes5 cell bodies. Double labeling for mRNAs by in situ hybridization and retrograde tracer fluoro-gold (FG) revealed that almost all (96-97%) the FG-labeled neurons which were cut expressed NPY and Gal mRNAs, whereas less neurons (87%) expressed PPT mRNA. NPY and Gal-like immunoreactivities were detected in Mes5 cell bodies ipsilateral to the axotomy. The results suggested that these neuropeptides play roles in adaptive processes after peripheral nerve injury in Mes5 neurons as they are thought to do so in dorsal root ganglion neurons.

Repeated stress reduces the subsequent stress-induced expression of Fos in rat brain

Repeated stress is known to potentiate the CNS response to subsequent stress. Various stressful stimuli can induce Fos expression in discrete regions of the brain, such as the lateral septum, the hypothalamic paraventricular nucleus and the locus coeruleus. We investigated by immunohistochemistry the effect of the stress of repeated immobilization on Fos expression in those regions of the brain in adult male rats. Six daily immobilizations suppressed the expression of Fos in all regions when immobilization was subsequently applied, suggesting that Fos does not play a major role in potentiating the stress response under repeated stressed conditions.

[Evaluation of radionuclide studies in the 8 patients with Takayasu's arteritis]

We evaluated various radionuclide studies performed in the 8 patients with Takayasu's arteritis over the past six years. Radionuclide angiography was performed in 5 patients to investigate the lesions of the branches of the aortic arch, and it demonstrated abnormalities of the affected arteries in 4 patients. Pulmonary perfusion scan demonstrated single or multiple reduced perfusion sites in all the 5 patients examined, while chest radiographies of these patients did not show any abnormalities in the reduced perfusion sites except one case. Renal scintigraphy revealed reduced renal blood flow in 3 patients. In one of those patients, MRI, CT and DSA studies could not detect any stenotic change in the renal artery. Exercise thallium scan revealed myocardial ischemic changes in 2 patients. One of them had angina pectoris, but another patient did not have any complaints. Of the 6 patients who were examined more than one kind of radionuclide studies, five patients showed abnormalities in more than one study. Ambiguous symptoms at the initial stage and rareness of Takayasu's arteritis may delay diagnosis. Radionuclide studies, which can be performed easily and noninvasively to investigate various organs and to depict multiple vascular involvement, seem to be a useful diagnostic tool of this disease.

A case of perianal Paget's disease associated with a sigmoid colon carcinoma

A case of perianal invasive Paget's disease associated with a sigmoid colon carcinoma is presented. The chief complaint was perianal irritation for a year. Histologic examination yielded a correct diagnosis and abdominosacral resection with wide excision of the cutaneous component was performed. Histology of the resected specimen revealed the Paget's disease to be invasive of the dermis, the sigmoid colon carcinoma to be in Dukes' A stage and the two lesions to be different. The patient has been disease-free for more than 5 years after the operation.

In vitro studies of determinants of smooth muscle mechanics

Smooth muscle contraction is dependent upon phosphorylation of the 20,000 Da light chain subunits of myosin. Whereas the kinetics of the hydrolysis of MgATP by smooth muscle myosin suggest a simple phosphorylation-dependent "on-off" mechanism, the contractile response in smooth muscle tissue is complex. Experiments to unravel this complexity have been performed in vitro using a combination of motility assays and kinetic techniques. Some insight into this complexity is obtained, but the mechanism and the regulation of smooth muscle contraction is still not completely known.

[Neo-adjuvant chemotherapy with tegafur suppository for rectal cancer--evaluation of the antitumor effects, tissue levels of 5-FU and inhibition of thymidylate synthase. Tochigi Colorectal Cancer Study Group]

We evaluated antitumor effect histologically and assayed the tissue levels of 5-fluorouracil (5-FU) and thymidylate synthase (TS) activity using surgical specimens obtained from the patients with rectal cancer, who were given tegafur suppositories prior to surgery. The antitumor effect was evaluated histologically according to classification of the general rules for the gastric cancer study (Japanese Research Society for Gastric Cancer). In 39 patients, 16 tumor specimens revealed no effect (grade-0), 22 tumors grade-1 effect, and one was not evaluable because of the severe inflammatory changes. In 23 of these patients, resected specimens were available for the assay. 5-FU levels in cancer tissues were significantly higher than those in normal tissues, and TS inhibition rates (TSIR) were almost identical, averaging around 20%, in both cancer and normal tissues. Comparing the 5-FU levels and TS activity according to the histological effects (i.e.: 'grade-0' vs 'grade-1'), the 5-FU levels in the tumors achieved grade-1 were significantly higher than in the tumors showed 'grade 0' (p less than 0.01), and TSIR in the former were relatively greater than in the latter (p = 0.053). It is suggested that both tissue levels of 5-FU and TSIR may be useful parameters to predict the anti-tumor effect against rectal cancer after administration of 5-FU and its derivatives.

Intra-abdominal desmoid tumors in familial polyposis coli: a case report of tumor regression by prednisolone therapy

A case of intra-abdominal desmoid tumors in familial polyposis coli (FPC), which regressed and disappeared by prednisolone treatment, is reported. A 37-year-old Japanese man with abdominal lumps was admitted to our hospital. He had had proctocolectomy two years before because of FPC with rectal cancer. At laparotomy, tumors were present in the abdominal wall, mesentery, and retroperitoneum. Only a small part of the tumors was resected and diagnosed microscopically to be desmoid tumors. With prednisolone administration (20 to 5 mg/day) subjective symptoms were ameliorated and desmoid tumors slowly regressed. Bilateral hydronephrosis continued and resulted in "retroperitoneal fibrosis." To our knowledge, this case is the first well-documented case of retroperitoneal fibrosis in a patient with FPC. The characteristics of the desmoid tumor in familial polyposis coli or in Gardner's syndrome and the methods for its management are discussed.