Smooth muscle cell-specific SOCS3 deficiency promote pericardial fibrosis and diastolic dysfunction in aging mice

Background

Suppressor of cytokine signaling-3 (SOCS3) is a cytokine-inducible negative regulator of signal transducer and activator of transcription-3 (STAT3) signaling pathway. We have previously shown that cardiac-specific SOCS3 deficiency spontaneously develop cardiac dysfunction with advanced age. However, the role of SOCS3 in smooth muscle cells in cardiovascular pathophysiology remains elusive. In this study, we determined whether STAT3 and SOCS3 in smooth muscle cells would play a role in cardiovascular pathophysiology.

Methods and results

To target inactivation of the SOCS3 gene to smooth muscle cells, SOCS3-flox mice were bred with transgenic mice expressing Cre recombinase under control of the mouse SM22-α promoter (sm-SOCS3-KO mice). Left ventricular weight to body weight ratio was significantly increased in sm-SOCS3-KO mice compared with wild-type mice at 12 months of age (p<0.05). Echocardiographic analyses of smSOCS3-KO mice showed significantly increased left ventricular diastolic dysfunction compared with wild-type from 12 months of age (p<0.05). Sirius-red staining revealed that thickness of pericardium and cardiac interstitial fibrosis in sm-SOCS3-KO mice were markedly greater compared with wild-type mice at 12 months of age (p<0.05). Western blot analyses showed that phosphorylated STAT3 was significantly increased in sm-SOCS3-KO hearts compared with wild-type mice at 12 months of age (p<0.05), whereas no significant differences were observed at 2 months of age. To investigate the mechanism that gave rise to promoted cardiac fibrosis and diastolic dysfunction during aging in sm-SOCS3-KO, we conducted a real-time PCR array analysis for fibrosis. The expression of pro-fibrotic CTGF (connective tissue growth factor), PDGFb (platelet growth factor-b), and TGF (transforming growth factor) family genes including TGFb1, TGFb2, and TGFb3, were significantly higher in sm-SOCS3-KO hearts than those in wild-type at 6 months of age.

Conclusion

Thus, smooth muscle cell-specific SOCS3 deletion induces increased pericardial fibrosis, cardiac interstitial fibrosis, and increased diastolic dysfunction in aging mice, possibly through the augmentation of pro-fibrotic growth factors.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant JSPS KAKENHI

P1627Increased pericardial fibrosis and cardiac dysfunction in smooth muscle cell-specific SOCS3 deficient mice

Background

Suppressor of cytokine signaling-3 (SOCS3) is an intrinsic negative-feedback regulator of signal transducer and activator of transcription-3 (STAT3) signaling pathway. We have previously shown that myocardial SOCS3 plays an important role in cardiac hypertrophy and survival; however, the role of SOCS3 in smooth muscle cells in cardiovascular pathophysiology remains elusive. In this study, we determined whether STAT3 and SOCS3 in smooth muscle cells would play a role in cardiovascular pathophysiology.

Methods and results

To target inactivation of the SOCS3 gene to smooth muscle cells, SOCS3-flox mice were bred with transgenic mice expressing Cre recombinase under control of the mouse SM22-α promoter (sm-SOCS3-KO mice). Left ventricular weight to body weight ratio was significantly increased in sm-SOCS3-KO mice compared with wild-type mice at 52 weeks of age (p<0.05). Echocardiographic analyses of sm-SOCS3-KOmice showed significantly decreased cardiac function compared with wild-typefrom 52 weeks of age (p<0.05). Interestingly, Sirius-red staining revealed that thickness of pericardium in sm-SOCS3-KOmice was markedly greater compared with wild-typemice at 52 weeks of age (p<0.05). Cardiac interstitial fibrosis in sm-SOCS3-KOmice was also greater compared with wild-typemice (p<0.05). Western blot analyses showed that phosphorylated STAT3 was significantly increased in sm-SOCS3-KOhearts compared with wild-typemice at 52 weeks of age (p<0.05), whereas no significant differences were observed at 7 weeks of age. Immunostaining revealed that phosphorylated STAT3 positive cells were in thickened pericardial area in sm-SOCS3-KOhearts. Some infiltrated inflammatory cells were also found in thickened pericardial area in sm-SOCS3-KOmice hearts.

Conclusion

These results suggest that STAT3 and its negative-feedback regulator SOCS3 in smooth muscle cells play an important role in the pathogenesis of pericardial fibrosis and cardiac dysfunction.

P1575Cardiovascular toxicity following modern multiple myeloma therapy in Japanese cohort

Background

Multiple myeloma (MM) is a plasma cell dyscrasia accounting for approximately 13% of hematologic malignancies. Patients with MM have an increased risk of cardiovascular adverse events (CAEs) due to disease burden and/or anti-myeloma treatment-related risk factors. However, little is known about the incidence of cardiovascular toxicity of patients with MM.

Methods

We analyzed 42 consecutive patients (Male/Female 22/20, age 67±10 years old) who received anti-MM therapies between October 2016 and September 2018 from our University Cardio-REnal Oncology (CREO) registry. We examined the incidence of CAEs through January 2019 including congestive heart failure and cardiomyopathy (CHF/CM), ischemic cardiac event, newly symptomatic arrhythmias included atrial fibrillation or flutter requiring treatment, and venous thromboembolism (VTE).

Results

Within the 408-day median follow-up period (range 15–844 days), CAEs occurred in 23.8% (n=10); CHF/CM in 11.9%, newly diagnosed atrial fibrillation in 4.8%, VTE in 4.8%, vasospastic angina in 2.4%, and death in 28.6%. There were no significant differences between CAEs group and non-CAEs group in terms of sex, body mass index (BMI), incidence of hypertension, ischemic heart disease, prior history of heart failure, cardiovascular medications, left ventricular ejection fraction, serum high-sensitivity troponin-I, estimated glomerular filtration rate, blood urea nitrogen and N-terminal pro-brain natriuretic peptide levels at the time of enrollment. The use of various types of proteasome inhibitors and immunomodulatory drugs were not associated with the increased risk of CAEs. By multivariate analysis, a history of prior anti-myeloma therapies was identified as an independent risk factor for CAEs.

Conclusion

CAEs were significantly associated with the recurrent MM in Japanese MM patients.

P3121Cancer therapeutics-related heart failure from a cohort study using big data of electronic health record in Japan

Background

The prognosis of cancer patients has been improved partly because of the progress in cancer therapy, which increases the cancer survivors in the society. It may raise a concern regarding the development of heart failure (HF), because the anticancer agents have some serious side effects on cardiovascular system, especially in the aging society including Japan. However, the epidemiological data for the risk of HF in the cancer survivors is limited due to the lack of comprehensive dataset in the aging society. In this regard, the electronic health record (EHR), a big data, from the National Health Insurance in Japan provides a unique opportunity to obtain the suitable dataset.

Purpose

The purpose of this study was to clarify the prevalence and the risk factors of HF in cancer survivors, focusing on the impact of their age, using EHR in Japan.

Methods

We examined the EHR of 17.8 million patients, covering 14% of the total Japanese population. The EHR includes the diagnoses as coded with International Classification of Diseases, 10th revision (ICD-10), and the information for therapeutics. We extracted 159,380 patients who received anticancer agents between April 2008 to January 2017. HF patients were identified accordingto ICD-10 codes and the record for the use of therapeutic drugs for HF at least once after the HF diagnosis following the treatment with anticancer agents. We excluded the patients if they had other conditions indistinguishable from HF or if they had past history of HF before receiving anticancer agents.

Results

The mean follow-up period was 1.75 years and mean age (standard deviation) was 68.9 (11.6) years. The population over 75 years old were 37%, while males were 59.5%. There were prostate cancer (28.1%), lung cancer (13.4%), and colon cancer (12.6%)in males, and breast cancer (42.8%), colon cancer (11.5%), and lung cancer (8.6%)in females. Among them, 5,529 patients were diagnosed with HF, corresponding to the prevalence of 3.8%. The mean time form the initiation of chemotherapy to the HF onset was 1.03 year. In the Cox's proportional hazard model after the adjustments for comorbidity, HF was more prevalent in males with hazard ratio (HR) 1.07 and 95% C.I. 1.01–1.13 (p<0.05) and in those with obesity (HR 1.18, 95% C.I. 1.09–1.26, p<0.01).We divided the subjects into three age groups (younger; <65 years, intermediate; 65–74 years, older; ≥75 years). HF was more prevalent in older group than younger group (HR 1.72, 95% C.I. 1.60–1.85, p<0.01). Among the anticancer agents, doxorubicin showed HR 2.09 (95% C.I. 1.89–2.3, p<0.01), and trastuzumab showed HR 1.47 (95% C.I 1.25–1.73, p<0.01).

Conclusion

We showed that the average prevalence of HF after anticancer agentwas 3.8%. The independent risk factors for HF were older age, male, obesity, and the use of doxorubicin or trastuzumab. This study also demonstrated the usefulness of EHR in Japan, to investigate the cardiovascular risk associated with the anticancer agents.

P5374Genetic deletion of IL-22 increased cardiac rupture after myocardial infarction in mice

Background

Interleukin-22 (IL-22) is a member of the IL-10 cytokine family, which mainly targets epithelial cells and does not target immune cells. Recently, it has been reported that IL-22 play roles in tissue repair in the skin and the liver; however, role of IL-22 in the process of tissue repair after myocardial infarction (MI) is unknown. Here, we investigated the role of IL-22 in tissue repair process after MI.

Methods and results

First, we examined the expression of IL-22 and its receptor IL-22RA1 in the wild type (WT) mice by real-time PCR. The expression of IL-22 and IL-22RA1 in the hearts were significantly increased 3 days after MI (p<0.05). To clarify the role of IL-22 in the heart after MI, we produced MI model in the WT mice and IL-22 knockout (KO) mice. We found that the IL-22 KO mice had significantly higher mortality than the WT mice after MI (p<0.05). Approximately 80% of the IL-22 KO mice died with cardiac rupture after MI. The infarct size which was estimated by evans blue dye and triphenyltetrazolium chloride staining at 3 days after MI was comparable between the IL-22 KO mice and the WT mice. Next, we performed real time PCR and PCR array analysis for tissue fibrosis and repair genes. We found that alpha-smooth muscle actin (aSMA), NF-kB, TNF-a and MMP13 (also known as collagenase-3) were significantly increased in the infarct area of IL-22 KO mice compared to WT mice. Immunostaining showed that the myofibroblast marker aSMA positive cells in the border area after MI were markedly higher in the IL-22 KO mice compared with the WT mice (p<0.05). Approximately 70% of cardiac rupture after MI in the IL-22 KO mice were occurred in the infarct area adjacent to the border area. Furthermore, we found aSMA positive cells and MMP13 positive cells around the ruptured site of the heart.

Conclusion

Thus, IL-22 KO mice exhibit high mortality and increased cardiac rupture after MI. And expression of aSMA and MMP13 were highly expressed in the ruptured site after MI in the IL-22 KO mice. These results suggest that IL-22 may play an important role in the tissue repair process after MI.

GDF-15, a mitochondrial disease biomarker, is associated with the severity of multiple sclerosis

GDF-15, a member of the transforming growth factor beta superfamily, regulates inflammatory and apoptotic pathways in various diseases, such as heart failure, kidney dysfunction, and cancer. We aimed to clarify potentially confounding variables affecting GDF-15 and demonstrate its utility as a mitochondrial biomarker using serum samples from 15 patients with mitochondrial diseases (MD), 15 patients with limbic encephalitis (LE), 10 patients with multiple sclerosis/neuromyelitis optica spectrum disorders (MS/NMOSD), and 19 patients with amyotrophic lateral sclerosis (ALS). GDF-15 and FGF-21 were significantly elevated in MD. GDF-15 and FGF-21 showed a good correlation in MD but not in LE, MS, and ALS. GDF-15 was potentially influenced by age in LE, MS/NMOSD, and ALS but not in MD. FGF-21 was not correlated with age in MS/NMOSD, ALS, LE, and MD. GDF-15 was not correlated with clinical features in LE or BMI or body weight in ALS. GDF-15 positively correlated with the Expanded Disability Status Scale (EDSS) in MS/NMOSD, while EDSS showed no correlation with age. In conclusion, the results revealed that GDF-15 may be influenced by EDSS in MS/NMOPSD and by age in LE, MS/NMOSD, and ALS but not in MD. Mitochondrial damage in MS/NMOSD is a potentially confounding variable affecting GDF-15.

Chronic myelitis associated with zoster sine herpete: A case report

RATIONALE

Neurological complications of varicella-zoster virus (VZV) infection include cerebral infarction, meningoencephalitis, segmental sensory disturbance, facial nerve palsy, and myelitis. Chronic myelitis is rarely reported. Diagnosis of VZV infection can be confirmed by elevated anti-VZV immunoglobulin G (IgG) antibody or detection of VZV DNA in the cerebrospinal fluid (CSF), the former reported to be superior. The detection rate of VZV DNA is generally thought to decrease with time after the onset of the condition. The utility of VZV DNA polymerase chain reaction (PCR) is thus thought to be limited to the acute phase of the disease. The presence of skin lesions also helps to render a diagnosis; however, cases of zoster sine herpete (ZSH), the occurrence of segmental symptoms without skin lesions, renders the diagnosis of VZV infection more difficult. Antiviral drugs, such as acyclovir, are the treatment of choice to resolve VZV infections.

PATIENT CONCERNS

A 65-year-old Japanese man felt heaviness and a throbbing pain on the ulnar side of the right forearm. He was previously diagnosed with cervical spondylosis, and received nonsteroidal anti-inflammatory drugs with little improvement. Contrast cervical magnetic resonance imaging showed a swelling and an increased signal intensity of the spinal cord, and an enhancing lesion, all of which were suggestive of myelitis.

DIAGNOSIS

We found no evidence for diagnoses of sarcoidosis, Behçet disease, multiple sclerosis, or neuromyelitis optica spectrum disorder. The CSF analysis revealed an elevation of the total protein concentration and that the patient was positive for VZV DNA, while anti-VZV IgG was not elevated. The patient was therefore diagnosed with ZSH myelitis.

INTERVENTIONS

We administered acyclovir and valaciclovir as the first therapy. At the time of recurrence, we used high-dose acyclovir, vidarabine, and high-dose methylprednisolone pulse therapy.

OUTCOMES

The patient's dysesthetic pain in the right upper limb improved following the first antiviral therapy. Two months later, he suffered a recurrence, but the second therapy significantly relieved his symptoms.

LESSONS

VZV infection should be regarded as an important differential diagnosis of chronic myelitis. VZV DNA PCR should be performed even in the chronic phase of the condition to introduce the possibility of antiviral therapy as a treatment option.

The Successful Application of Plasmapheresis in the Treatment of a Patient with Opsoclonus and Autoantibodies to Glutamate Receptor δ2

Glutamate receptor δ2 (GluRδ2) is expressed in the neuronal postsynaptic densities at the junctions between the Purkinje cells and the parallel fibers. Recent reports have described patients with opsoclonus who possess anti-GluRδ2 antibodies. We report the case of a 53-year-old man with opsoclonus whose cerebrospinal fluid was positive for anti-GluRδ2 antibodies. Electronystagmography revealed abnormal sinusoidal eye movements, which were definitively identified as opsoclonus. The frequency and amplitude of saccadic oscillations diminished after plasmapheresis (PE). The patient's opsoclonus was altered after PE, suggesting that anti-GluRδ2 antibodies may act on the saccade generator in the brainstem via the cerebellum and that they may be involved in the onset of opsoclonus.

Chronic Graft-versus-host Disease Presenting with Multiple Punctate Intracranial Lesions on Contrast-enhanced Magnetic Resonance Imaging

Central nervous system graft-versus-host disease can present quite a diagnostic challenge. We herein present a case of histologically-confirmed chronic graft versus host disease (GVHD) involving the central nervous system that occurred at 19 months after peripheral blood stem cell transplantation. Cranial magnetic resonance imaging showed areas of confluent hyperintensity in the deep/subcortical white matter with multiple punctate and curvilinear gadolinium enhancements, suggesting the disruption of the blood-brain barrier. A brain biopsy revealed perivascular CD3-positive T cell infiltration around the small vessels. We propose that the detection of punctate-enhanced lesions by magnetic resonance imaging may be a useful finding that facilitates the early diagnosis of chronic GVHD involving the central nervous system.

Vestibular Impairment in Frontotemporal Dementia Syndrome

Background

No studies to date have attempted to evaluate frontotemporal lobar degeneration from the perspective of the vestibular system.

Objective

The present study examined vestibular function in patients with frontotemporal dementia (FTD) clinical syndrome and evaluated whether vestibular disorders are involved in the clinical symptoms due to FTD.

Methods

Fourteen patients with FTD syndrome, as well as healthy elderly controls without dementia, were included in the present study. All subjects underwent vestibular function tests using electronystagmography, such as caloric tests and visual suppression (VS) tests, in which the induced caloric nystagmus was suppressed by visual stimuli. The association between clinical symptoms and vestibular function in the FTD syndrome group was further examined.

Results

In the FTD syndrome group, caloric nystagmus was not necessarily suppressed during VS tests. Furthermore, VS was observed to be significantly impaired in FTD syndrome patients with gait disturbance as compared to those without such disturbance.

Conclusion

The present study revealed that impairment of VS in patients with FTD results in an inability to regulate vestibular function by means of visual perception, regardless of multiple presumed neuropathological backgrounds. This could also be associated with gait disturbance in patients with FTD syndrome.

Utility of weekly docetaxel combined with preoperative radiotherapy for locally advanced esophageal cancer from pathological analysis

Esophageal squamous cell cancer (ESCC) is a high-grade carcinoma that is treated with multidisciplinary approaches, including chemoradiotherapy (CRT) followed by surgery. Despite some success with these therapies, overall survival remains poor. In order to investigate a newer CRT regimen, we designed a comparative study to evaluate preoperative CRT using docetaxel (DOC) or 5-Fluorouracil and cisplatin (FU+CDDP [FP] therapy) for treatment of resectable ESCC. In a retrospective review of patients with resectable, locally advanced ESCC, 95 patients received preoperative CRT between 2001 and 2007. CRT was administered using either FP (n = 40) or DOC (n = 55). Pathological response and clinical outcomes were compared between the two groups. Hazard ratios and time-to-event analyses were used to assess outcomes; the ratios were controlled by multivariate logistic regression analysis of potential prognostic factors, and survival was presented with Kaplan-Meier curves. In the FP group, a significant curative effect was observed on the basis of pathological examination of postoperative lesions. However, the DOC group presented a significantly better prognosis on the basis of cumulative survival rates. Logistic regression analysis revealed that the presence of five or more lymph node metastases was an independent predictor of reduced survival. Patients with lymph node metastasis exhibited a better prognosis in the DOC group than those in the FP group. Preoperative CRT for locally advanced esophageal cancer using DOC results in similar or better long-term outcomes compared with FP-based CRT. Therefore, CRT using DOC is a promising therapy option for esophageal cancer.

Serum high-molecular weight adiponectin is related to early postprandial glycemic increases and gastric emptying in patients with type 2 diabetes mellitus

BACKGROUND

Postprandial hyperglycemia and hyperlipidemia are frequently associated with type 2 diabetes mellitus. The aim of the present study is to investigate the clinical determinants of postprandial glycemia and lipemia, especially serum high-molecular weight adiponectin.

METHODS

Twenty-seven diabetic patients treated with diet alone and 13 healthy volunteers took liquid test meal containing 53 g carbohydrate and 47 g lipid, dosed with nonradioactive isotope (13)C-acetate. Venous blood and breath samples were obtained for 180 min after the meal. Gastric emptying was evaluated by peak excretion time of (13)CO(2) in the breath samples. Delayed gastric emptying was defined as peak excretion time > 2.5 h (mean + 2 SD in the healthy volunteers).

RESULTS

Diabetic patients showed delayed insulin secretion, postprandial hyperglycemia and hyperlipidemia compared with control. Postprandial glycemic increases significantly correlated with enhanced gastric emptying. Serum high-molecular weight adiponectin correlated with postprandial glycemic increases at 30 and 60 min after meal (r = 0.42, p < 0.05; r = 0.37, p < 0.05, respectively). Serum high-molecular weight adiponectin also correlated with gastric emptying (versus peak excretion time r = - 0.58, p < 0.05). In addition, diabetic patients with delayed gastric emptying showed the suppressed postprandial glycemia with lower serum high-molecular weight adiponectin than those with normal gastric emptying. On the other hand, postprandial increases in serum triglyceride were not related to serum high-molecular weight adiponectin or gastric emptying, but significantly related to liver function test (serum transaminases) and body mass index.

CONCLUSIONS

Early postprandial glycemic increases were related to elevated serum high-molecular weight adiponectin, which might be associated with enhanced gastric emptying.

Altered Postural Regulation of Foot Skin Oxygenation and Blood Flow in Patients with Type 2 Diabetes Mellitus

AIMS

Although skin oxygenation is an important factor in the development and healing of foot ulcers, its regulation was not fully understood. We studied changes in foot skin oxygenation and blood flow during postural changes in patients with type 2 diabetes mellitus.

METHODS

Skin oxygenation was measured using transcutaneous oxygen pressure (TcPO(2)) and skin blood flow by laser Doppler flowmetry in 40 patients with type 2 diabetes mellitus without evidence of peripheral arterial disease and 13 healthy control subjects.

RESULTS

TcPO(2) in the supine position was significantly lower in patients with type 2 diabetes mellitus compared with control, although skin blood flow was not different. In the sitting position, TcPO(2) significantly increased in control and diabetic patients. The postural change-related increase in TcPO(2) was significantly enhanced in diabetic patients. On the other hand, skin blood blow significantly decreased in the sitting position from the supine position in control subjects but remained stable in diabetic patients. Orthostatic drop in systolic blood pressure correlated negatively with TcPO(2) in the supine position while correlated positively with %change in TcPO(2) and blood flow by postural changes.

CONCLUSIONS

The present study demonstrated the dissociated regulation of skin oxygenation and blood flow in response to leg dependency. Impaired postural vasoconstriction was associated with altered regulation of skin oxygenation probably due to sympathetic vascular dysfunction in diabetic patients.

Gray matter features of schizotypal disorder patients exhibiting the schizophrenia-related code types of the Minnesota Multiphasic Personality Inventory

OBJECTIVE

Previous studies have suggested that several code types of the Minnesota Multiphasic Personality Inventory (MMPI) are useful markers for identifying schizophrenia. We hypothesized that schizotypal disorder (STD) patients with such schizophrenia-related code types have the morphological brain abnormalities associated with schizophrenia.

METHOD

Voxel-based morphometric analysis with statistical parametric mapping (SPM) 99 software was used to investigate the differences in brain morphology between 14 STD patients with the schizophrenia-related code types of the MMPI and 28 normal individuals.

RESULTS

The STD patients showed significantly decreased gray matter volume in the insular regions bilaterally and in the left entorhinal cortex, compared with the controls.

CONCLUSION

Our findings suggest that STD patients with the schizophrenia-related code types have volume reductions in these regions as an endophenotype that overlaps with schizophrenia.

Statistical parametric mapping in brain single photon computed emission tomography after carbon monoxide intoxication

The purpose of this retrospective study was to assess regional cerebral blood flow in patients after carbon monoxide intoxication by using brain single photon emission computed tomography and statistical parametric mapping. Eight patients with delayed neuropsychiatric sequelae and ten patients with no neuropsychiatric symptoms after carbon monoxide intoxication were studied with brain single photon emission tomography imaging with 99mTc-hexamethyl-propyleneamine oxime. Forty-four control subjects were also studied. We used the adjusted regional cerebral blood flow images in relative flow distribution (normalization of global cerebral blood flow for each subject to 50 ml x 100 g(-1) x min(-1) with proportional scaling) to compare these groups with statistical parametric mapping. Using this technique, significantly decreased regional cerebral blood flow was noted extensively in the bilateral frontal lobes as well as the bilateral insula and a part of the right temporal lobe in the patients with delayed neuropsychiatric sequelae as compared with normal volunteers (P< 0.005). In the patients with no neuropsychiatric symptoms, significantly decreased regional blood flow in the bilateral frontal lobes particularly on the left side was detected. There was a significantly decreased regional cerebral blood flow in the right frontal lobe and insula in the patients with delayed neuropsychiatric sequelae as compared to those with no neuropsychiatric sequelae. It is concluded that statistical parametric mapping is a useful technique for highlighting differences in regional cerebral blood flow in patients following carbon monoxide intoxication as compared with normal volunteers. The selectively reduced blood flow noted in this investigation supports the contention that the decrease following carbon monoxide intoxication may be prolonged and further worsen in the frontal lobe. In addition, the present study may help to clarify the characteristics of the pathophysiological alteration underlying delayed neuropsychiatric sequelae.

Magnetic resonance imaging study of the cavum septi pellucidi in patients with schizophrenia

OBJECTIVE

High-resolution magnetic resonance imaging was used to evaluate the prevalence of the cavum septi pellucidi (CSP) in 79 normal subjects and 86 patients with schizophrenia.

METHOD

The CSP was assessed by counting the number of consecutive coronal 1-mm slices containing the CSP. A CSP equal to or greater than 6 mm in length was defined as large.

RESULTS

The CSP was found in 74.4% of the patients and 74.7% of the normal subjects, a nonsignificant difference. No difference between groups was found in the prevalence of a large CSP.

CONCLUSIONS

The findings support the idea that a small CSP is a normal anatomical variant. More cases of a large CSP are needed to elucidate the implications of this abnormality in schizophrenia.

Enhancement of cognitive performance in schizophrenia by addition of tandospirone to neuroleptic treatment

OBJECTIVE

The goal of this study was to evaluate the effects of the addition of tandospirone, a serotonin-1A (5-HT(1A)) agonist, to ongoing treatment with typical antipsychotic drugs, on two cognitive domains that are relevant to functional outcome in patients with schizophrenia.

METHOD

Twenty-six patients with schizophrenia who were receiving stable doses of typical antipsychotics were randomly assigned to adjunctive treatment with 30 mg/day of tandospirone or placebo for 6 weeks. Executive function and verbal memory as well as psychopathology were assessed at baseline and after 6 weeks.

RESULTS

Both cognitive measures improved significantly in the patients who received tandospirone; subjects who did not receive tandospirone showed no change. There was no significant change in psychopathology ratings in either group.

CONCLUSIONS

The results suggest the usefulness of 5-HT(1A) agonists for enhancing some types of cognitive performance and possibly social and work function in patients with schizophrenia.

The effect of tandospirone, a serotonin(1A) agonist, on memory function in schizophrenia

BACKGROUND

The purpose of this study was to test the hypothesis that the addition of tandospirone, a 5-HT(1A) partial agonist, to ongoing treatment with typical antipsychotic drugs, would improve memory function in patients with schizophrenia.

METHODS

Eleven outpatients (male/female = 7/4) with schizophrenia who had been on stable doses of haloperidol and biperiden were given tandospirone, 30 mg/day, for 4 weeks. The Wechsler Memory Scale-Revised (WMS-R) was administered at baseline and 4 weeks after the addition of tandospirone. The Brief Psychiatric Rating Scale (BPRS; Total, Positive, and Negative subscale scores) and the Simpson-Angus Scale for Extrapyramidal Symptoms (SAS) were also completed on the two occasions. To exclude the possibility of a practice effect on the WMS-R test, 11 age-matched patients with schizophrenia (M/F = 7/4) were tested at baseline and after a 4-week interval.

RESULTS

Repeated measures analysis of variance revealed a significant time by group (patients with or without tandospirone) effect for the Verbal-, but not the Visual Memory composite scores of the WMS-R test; no significant change was observed in patients without tandospirone, whereas improvement in the Verbal Memory score was noted in patients receiving tandospirone. Moreover, there was improvement in the Inclusion score, an index of memory organization as measured by the Logical Memory subtest of WMS-R, only in patients with tandospirone. Scores on the BPRS and SAS were improved during treatment with tandospirone, but the effects did not reach statistical significance.

CONCLUSIONS

The results suggest that adjunctive treatment with 5-HT(1A) agonists may improve some types of memory function in schizophrenia.

Origin and evolution of the colonial volvocales (Chlorophyceae) as inferred from multiple, chloroplast gene sequences

A combined data set of DNA sequences (6021 bp) from five protein-coding genes of the chloroplast genome (rbcL, atpB, psaA, psaB, and psbC genes) were analyzed for 42 strains representing 30 species of the colonial Volvocales (Volvox and its relatives) and 5 related species of green algae to deduce robust phylogenetic relationships within the colonial green flagellates. The 4-celled family Tetrabaenaceae was robustly resolved as the most basal group within the colonial Volvocales. The sequence data also suggested that all five volvocacean genera with 32 or more cells in a vegetative colony (all four of the anisogamous/oogamous genera, Eudorina, Platydorina, Pleodorina, and Volvox, plus the isogamous genus Yamagishiella) constituted a large monophyletic group, in which 2 Pleodorina species were positioned distally to 3 species of Volvox. Therefore, most of the evolution of the colonial Volvocales appears to constitute a gradual progression in colonial complexity and in types of sexual reproduction, as in the traditional volvocine lineage hypothesis, although reverse evolution must be considered for the origin of certain species of Pleodorina. Data presented here also provide robust support for a monophyletic family Goniaceae consisting of two genera: Gonium and Astrephomene.

Neural correlates of memory organization deficits in schizophrenia. A single photon emission computed tomography study with 99mTc-ethyl-cysteinate dimer during a verbal learning task

Regional cerebral blood flow (rCBF) during a verbal learning task was measured using 99mTc-ethyl-cysteinate dimer and single photon emission computed tomography in 10 patients with schizophrenia and nine normal controls. Verbal repetition was used as a control task. The schizophrenic patients showed failure to spontaneously utilize implicit category information to learn the word lists. In the normal controls, rCBF in the left inferior frontal and left anterior cingulate regions was significantly increased during the verbal learning task, compared with the verbal repetition task. In contrast, there was no significant frontal lobe activation by the verbal learning in the schizophrenic patients. The patients had lower rCBF during the verbal learning task than the controls in the bilateral inferior frontal, left anterior cingulate, right superior frontal, and bilateral middle frontal regions. Activation in the left inferior frontal region was significantly positively correlated with categorical clustering in the task in the controls, but no such correlation was found in the patients. These results indicate that memory organization deficits in schizophrenia may be related to dysfunction in the prefrontal areas, especially in the left inferior frontal region.

Saccadic eye movements and regional cerebral blood flow in schizophrenic patients

This study examined saccadic eye movements, using simple stationary targets, in schizophrenic patients. The targets were eight black points or eight arabic-numbered points placed in randomized order on the circumference of a circle. Self-paced eye movements during clockwise tracking of these points, by 23 patients and 23 controls, were recorded using an infrared eye-mark recorder. Then the relationship between the saccades and clinical symptoms was investigated. Finally, the relationship between the performance of the saccades and resting regional cerebral blood flow (rCBF) was examined using single photon emission computed tomography with 99mTc-hexamethyl propyleneamine oxime (HMPAO). The results indicate that patients track with significantly fewer correct scores and more deviant scores than controls, in agreement with our previous study. There were two groups of patients: an ordinary group who obtained a full-target-hitting score at a 200-ms setting and a fast group who obtained the full score at 100 ms but not at 200 ms. Some patients displayed significantly more hypermetria than controls. Significant correlations were found between hallucination and delusion symptoms and correct score. With respect to relative rCBF, fast-group patients showed significantly decreased rCBF in the left limbic and inferior parietal areas as compared with ordinary group patients. These findings suggest that some schizophrenic patients view the stationary targets too fast and this may be related to dysfunction in the limbic-parietal association area in the left hemisphere.

Residual pesticides and their toxicity to freshwater shrimp in the littoral and pelagic zones of Lake Kasumigaura, Japan

Pesticide residues in water and their toxicity to the freshwater shrimp (Paratya compressa improvisa) were studied in a river mouth in Takahamairi Bay, Lake Kasumigaura, from April to July in 1987. Concentrations of fenthion, diazinon and fenobucarb in water of the littoral zone were lower than that in the pelagic zone. The maximum concentration of fenthion, diazinon, iprobenfos and simetryn in water were 1.9, 0.8, 6.5, and 1.1 micrograms 1(-1), respectively. The 4-day mortality of the freshwater shrimp increased in lake water at Takahamairi Bay, reaching 50% at maximum in May. The mortality was probably due to residual insectside fenthion.

Subunit association of gamma-glutamyltranspeptidase of Escherichia coli K-12

gamma-Glutamyltranspeptidase [EC 2.3.2.2] of Escherichia coli K-12 consists of one large subunit and one small subunit, which can be separated from each other by high-performance liquid chromatography. Using ion spray mass spectrometry, the masses of the large and the small subunit were determined to be 39,207 and 20,015, respectively. The large subunit exhibited no gamma-glutamyltranspeptidase activity and the small subunit had little enzymatic activity, but a mixture of the two subunits showed partial recovery of the enzymatic activity. The results of native-polyacrylamide gel electrophoresis suggested that they could partially recombine, and that the recombined dimer exhibited enzymatic activity. The gene of gamma-glutamyltranspeptidase encoded a signal peptide, and the large and small subunits in a single open reading frame in that order. Two kinds of plasmid were constructed encoding the signal peptide and either the large or the small subunit. A gamma-glutamyltranspeptidase-less mutant of E. coli K-12 was transformed with each plasmid or with both of them. The strain harboring the plasmid encoding each subunit produced a small amount of the corresponding subunit protein in the periplasmic space but exhibited no enzymatic activity. The strain transformed with both plasmids together exhibited the enzymatic activity, but its specific activity was approximately 3% of that of a strain harboring a plasmid encoding the intact structural gene. These results indicate that a portion of the separated large and small subunits can be reconstituted in vitro and exhibit the enzymatic activity, and that the expressed large and small subunits independently are able to associate in vivo and be folded into an active structure, though the specific activity of the associated subunits was much lower than that of native enzyme. This suggests that the synthesis of gamma-glutamyltranspeptidase in a single precursor polypeptide and subsequent processing are more effective to construct the intact structure of gamma-glutamyltranspeptidase than the association of the separated large and small subunits.

[Thyroid scintigraphy in patients with thyroid tumors using 99mTc-hexakis 2-methoxy isobutyl isonitrile]

Early and delayed thyroid scintigraphy with 99mTc-hexakis 2-methoxy isobutyl isonitrile (99mTc-MIBI) was performed in 18 patients with thyroid tumor, including 8 with papillary carcinoma, 1 each with follicular carcinoma, anaplastic carcinoma, and malignant lymphoma, and 7 with thyroid adenoma. Scintigrams obtained were compared with those taken with other radionuclides. In all 11 patients with malignant tumors, increased 99mTc-MIBI uptake was noted in the tumors on early images, although anaplastic carcinoma and malignant lymphoma had mild uptake. On delayed images, 99mTc-MIBI washout was noted in 45.4% (5/11). In one patient with extensive cervical lymph node metastasis, 99mTc-MIBI concentration was evident in the metastatic foci. In the 4 where, the thyroid adenoma consisted mainly of cystic degeneration, a focal defect was noted, but two of the three patients whose thyroid adenoma consisted mainly of a solid component had an intense tracer uptake in the tumors on early and delayed images. In conclusion, there were increased 99mTc-MIBI accumulations in all of the 14 solid thyroid tumors. The quality of 99mTc-MIBI scintigraphic images of thyroid tumors was equal or slightly superior to that taken with 201Tl scintigraphy. 99mTc-MIBI thyroid scintigraphy may be useful in detecting a solid thyroid tumor and its metastasis, although it cannot be used to differentiate between benign and malignant tumors.

Crystallization and preliminary X-ray analysis of gamma-glutamyltranspeptidase from Escherichia coli K-12

gamma-Glutamyltranspeptidase (EC 2.3.2.2) from Escherichia coli K-12 has been purified and crystallized by means of vapor diffusion in hanging drops. Two kinds of crystals on cell dimensions were found for X-ray diffraction analysis, one from ammonium sulfate and the other from polyethylene glycol 6000 as precipitants. The crystals of the orthorhombic form grown in the presence of 15% polyethylene glycol and 20 mM sodium acetate buffer were chosen for further analysis. The crystals belonged to space group P2(1)2(1)2(1), with cell dimensions of a = 128.1, b = 129.9 and c = 79.2 A, and two molecules constitute an asymmetric unit. These crystals diffracted to 2.0 A resolution and were suitable for X-ray crystallographic studies.

Escherichia coli γ-glutamyltranspeptidase mutants deficient in processing to subunits

Arginyl residues 513 and 571 of Escherichia coli K-12 gamma-glutamyl-transpeptidase (EC 2.3.2.2) were substituted with alanyl and glycyl residues, respectively, by oligonucleotide-directed in vitro mutagenesis. Both mutants were devoid of the enzymatic activity. On Western blot analysis, we found that both mutants accumulated a gamma-glutamyltranspeptidase precursor which was not processed into large and small subunits in the periplasmic space of Escherichia coli.

[Multivariate analysis on the relationship between subjective symptoms and risk factors for the development of symptoms including working conditions, life habits and physical status in forestry workers using chain saw]

To determine the risk factors of the subjective symptoms experienced by chain saw workers, we surveyed 206 forestry workers using this device in their work. The strength of the relationship between their symptoms and such potential risk factors as occupational, behavioral, and physical factors was evaluated by a multiple logistic regression model. It was found that many years of chain saw operation, and numerous hours of chain saw operation per day, increased the risk of white finger, numbness of hands and arms, chillness of hands and arms and difficulty in joint movement, indicating that these symptoms were closely related to vibration exposure. Many years of forestry work before chain saw work also increased the risk of joint pain, suggesting that bone and joint disorders are related to heavy manual work not using a chain saw. A second job involving manual labor increased the risk of weakness in the arms, stiffness of the shoulders, and lumbago. Infrequent bathing was associated with increased risk of pain in hands and arms and lumbago. Older workers had a higher prevalence of stomach discomfort. No risk factor was found to significantly increase the risk of easy fatigability, forgetfulness and sleep disorder. It was found that not only exposure to vibration but also other factors contributed to the prevalence of pain in hands and arms, joint pain, weakness in arms, stiffness of shoulder, and lumbago. Second job and infrequent bathing appeared to be related to the occurrence of certain subjective symptoms. These contributory factors should be taken into account when evaluating subjective symptoms encountered in field studies of forestry workers.

[Effects of whole-body vibration exposure on DOPAC and VIP-like immunoreactivity in the rat brain]

In order to clarify the involvement of cerebral 3,4-dihydroxyphenylacetic acid (DOPAC) and vasoactive intestinal polypeptide (VIP) in whole-body vibration stress, DOPAC and VIP-like immunoreactivity (VIP-LI) in various discrete brain regions of rats exposed to whole-body vibration (4G, 20 Hz, 90 min) were assayed. The results showed that the whole-body vibration increased the DOPAC level in the frontal cortex and nucleus accumbens, but did not induce a concurrent change of VIP-LI in these regions. VIP-LI was significantly increased in the amygdala, and decreased in the hippocampus, accompanied by no significant change of DOPAC. These results show that whole-body vibration affects cerebral VIP neuron systems in addition to its nonspecific action, i.e. the activation of mesofrontal and mesoaccumbens dopamine neuron systems. It is assumed that the amygdalofugal VIP neuronal system is involved in the regulation of hypothalamic and pituitary hormone secretions, and that VIP in the hippocampus plays a part in modulating the blood circulation in the cortex in whole-body vibration stress.

[Experimental studies on the development of acute gastric lesions induced by vibration stress in rats and its pathogenetic mechanisms]

To clarify the pathogenetic mechanisms in acute gastric lesions induced by vibration (VIB), the effects of VIB (3.0 G, 10 Hz, 90 min) on changes in gastric mucosal blood flow (GMBF), plasma corticosterone (COR) and catecholamines (CA) as well as ulcer formation were compared with those of forced water immersion stress (FWI). While the VIB increased the GMBF during the exposure, the FWI decreased it during and after the stress. No difference in the severity of ulcer formation between the VIB groups was seen. Although both VIB and FWI increased the COR and CA, the degree of increased in the COR by the VIB tended to be less than that by the FWI. The truncal vagotomy inhibited the reduction of the GMBF and ulcer formation by the FWI, but promoted the reduction of the GMBF by the VIB. These results suggest that ulceration induced by VIB is caused primarily by its direct, mechanical and specific actions and not through the central nerve system.

[Multivariate analysis on subjective symptoms in forestry workers using chain saw]

This study was conducted to evaluate the relationship between the prevalence of subjective symptoms in workers using vibrating tools and the duration of chain saw operation and to examine whether the symptoms were relevant to factors other than the usage of vibrating tools. The statistical model of multivariate analysis was adapted to analyze individual data on the subjective symptoms of 317 chain saw operators. The obtained results were as follows: 1. In analysis of covariance, age-adjusted operating year in workers with peripheral circulatory, peripheral neurological and musculoskeletal disturbances was significantly longer than that without such disturbances. For these disturbances, partial regression coefficients of operating year were significantly high in multiple regression analysis. These results show that these disturbances and age-adjusted operating year are mutually closely related. 2. Multiple regression analysis showed that the partial regression coefficients of both operating year and age were low for nine symptoms, i.e. dulling sense of touch, joint pain, headache, dizziness and/or tinnitus, profuse sweating, discomfort of stomach, palpitation and/or dyspnea, hearing disturbance and lumbago. These results suggest that such symptoms were not related to either age or chain saw operation. 3. The results of principal component analysis were visualized in three-dimensional space in order to evaluate the relationships among the symptoms. The analysis showed that peripheral circulatory and neurological disturbances appeared independently and that general symptoms such as easy fatigability, headache, forgetfulness, vertigo and/or tinnitus, easy irritability, sleep disorder, profuse sweating, discomfort of stomach, palpitation and/or dyspnea, shoulder stiffness, hearing disturbance and lumbago consisted of four independent groups. Each group has no relationship with duration of chain saw operation. This suggests other harmful factors of the groups play a role in the prevalence of the symptoms.

[Peripheral circulatory responses to sustained handgrip in workers using vibrating tools]

In order to study the effects of static force such as a handgrip in detail, the peripheral circulatory function and the autonomic nervous function of workers who used chain-saws were examined in a handgrip test at 30% of maximum voluntary contraction (30% MVC). Workers using chain-saws were divided into three groups: group A without any symptoms, group B with numbness and/or pain but without Raynaud's phenomenon and group C with Raynaud's phenomenon. The results obtained were as follows: 1. The finger blood flow (FBF) of all groups significantly decreased during the handgrip and significantly increased after the end of the handgrip as compared with the initial value. There was a tendency for the FBF decrease of group C to be less than that of group A. 2. The mean value of both maximum FBF decrease and maximum FBF increase during handgrip tests fell in alphabetical order (A, B, C). The maximum FBF increase of group C was significantly less than that of group A. 3. The finger skin temperature (FST) of each group significantly fell during the handgrip but there was no significant difference among the three groups. FST returned to the level of the initial value one minute after the end of the handgrip, and significantly rose two minutes and three minutes after the end of the handgrip as compared with the initial value. 4. Both the systolic blood pressure and the diastolic blood pressure of all groups significantly rose during the handgrip but there was no significant difference among the three groups. Concerning the maximum rise of diastolic blood pressure, which is an indicator of autonomic nervous function, there was no significant difference among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Tactile perception in hands occupationally exposed to vibration

The sensory changes that occur in hands occupationally exposed to vibration have been assessed clinically by conventional neurologic tests and, independently, by improved techniques for the determination of tactile spatial resolution (gap detection) and vibrotactile perception thresholds at frequencies from 2 to 400 Hz. Data from 10 forest workers who were exposed to chain saw vibration and seven laboratory workers of similar age, all of whom were screened to exclude confounding factors, revealed, for the first time, three patterns of response, two of which are associated with a vibration-induced neuropathy. The first appears to be characterized by normal or better than normal thresholds in SAI, FAI, and FAII mechanoreceptor types, while a second, extreme response involves elevated thresholds in all three receptor systems (and abnormal two-point discrimination). The third pattern appears to be characterized by elevated thresholds in SAI and/or FAII receptor types.

Usefulness of blood parameters, especially viscosity, for the diagnosis and elucidation of pathogenic mechanisms of the hand-arm vibration syndrome

In the present study it was found that, in vibrating-tool operators with Raynaud's phenomenon, whole blood viscosity was significantly higher than in operators without Raynaud's phenomenon at shear rates from 230 to 11.5 s-1. In addition rats were experimentally exposed to local vibration (60 Hz, 5 g) on their hind limbs for 4 h/d for 30 or 90 d. In the case of 30-d exposure, the small arteries in the exposed site did not change. However, after exposure for 90 d, disruption of the internal elastic lamina was observed in the small arteries. The disruption was followed by focal cell proliferation with regenerative formation of collagen and elastic fibers. The fibro-cellular thickening of the intima was further augmented, and, in addition, a complete stenosis of the small lumen of the small artery was observed. Medial thickness did not show significant differences between the control and exposed groups for either exposure duration. The whole blood viscosity was significantly increased by the 90-d but not by the 30-d exposure. These results suggest that there are some relationships between the increase in whole blood viscosity and the intimal thickening of some small arteries in the exposed site.

An epidemiological study on total and specific IgE levels in Japanese schoolchildren

Total serum IgE, and specific serum IgE against mites, Ascaris and Japanese cedar pollen were surveyed in 251 schoolchildren by a radioimmunoassay method. These children, aged from 10 to 13 years and living in a rural Japanese town, were selected according to one-third random population sample. A high concentration of total serum IgE (700 u/ml or more) was found in thirty-one children (12 X 3%). The sex ratio of these children, boys to girls, was 2 X 1:1. The cross-sectional and 6-year follow-up study of total IgE levels showed that they decreased with advancing age. Total IgE levels were significantly related to each of three specific IgE species investigated in this study. The levels of these three specific IgE's were also significantly related to each other. Schoolchildren with high specific IgE levels against mites have had significantly more asthmatic histories compared to children with low specific IgE levels. Such a relationship was not observed for total IgE levels and another two specific IgE species.