Hepatocellular uptake index obtained with gadoxetate disodium-enhanced magnetic resonance imaging in the assessment future liver remnant function after major hepatectomy for biliary malignancy

Background

Functional assessment of the future liver remnant (FLR) after major hepatectomy is essential but often difficult in patients with biliary malignancy, owing to obstructive jaundice and portal vein embolization. This study evaluated whether a novel index using gadoxetate disodium-enhanced MRI (EOB-MRI) could predict posthepatectomy liver failure (PHLF) after major hepatectomy for biliary malignancy.

Methods

The remnant hepatocellular uptake index (rHUI) was calculated in patients undergoing EOB-MRI before major hepatectomy for biliary malignancy. Receiver operating characteristic (ROC) curve analyses were used to evaluate the accuracy of rHUI for predicting PHLF grade B or C, according to International Study Group of Liver Surgery criteria. Multivariable logistic regression analyses comprised stepwise selection of parameters, including rHUI and other conventional indices.

Results

This study included 67 patients. The rHUI accurately predicted PHLF (area under the curve (AUC) 0.896). A cut-off value for rHUI of less than 0.410 predicted all patients who developed grade B or C PHLF. In multivariable analysis, only rHUI was an independent risk factor for grade B or C PHLF (odds ratio 2.0 × 10³, 95 per cent c.i. 19.6 to 3.8 × 10⁷; P < 0.001). In patients who underwent preoperative portal vein embolization, rHUI accurately predicted PHLF (AUC 0.885), whereas other conventional indices, such as the plasma disappearance rate of indocyanine green of the FLR and FLR volume, did not.

Conclusion

The rHUI is potentially a useful predictor of PHLF after major hepatectomy for biliary malignancy.

Effects of Time-Varying Magnetic Fields on Transient increase in Intracellular Ca²⁺Concentration of Cultured Cells

We tested the effects of some kinds of time-varying magnetic fields (0-1.2T) on neurotransmitter-induced transient increases in intracellular Ca²⁺concentration ([Ca²⁺]) of cultured chromaffin and HeLa cells. After these cells were exposed for 2 hours to these magnetic fields, transient increases in [Ca²⁺]i by addition of acetylcholine or histamine were measured. In control cells, after addition of these neurotransmitters [Ca²⁺]i was increased immediately and then decreased with time in both cells. But, addition of these drugs to the magnetic fields exposed cells increased [Ca²⁺]i to a level similar to that for control cells. These results suggest that the transient increases in [Ca²⁺]i were not significantly influenced by the magnetic fields used in this experiment.

Intracellular cytokine analysis of CD4-positive T cells predictive of sustained response to interferon therapy for patients with chronic hepatitis C

We investigated whether the measurement of serum interleukin 18 (IL-18) and intracellular cytokine analysis of peripheral blood CD4-positive T cells (ICA-CD4+ Tc) of chronic hepatitis C (CH-C) patients before and two weeks after interferon (IFN) administration are useful for predicting sustained response to IFN. Twenty-nine CH-C patients received IFN every day for two weeks and three times a week for 22 weeks. Patients were divided into two groups: responders, in whom serum HCV-RNA was undetectable at the end of the follow-up (week 48), and nonresponders, in whom any other patterns were seen. Before and two weeks after IFN administration, serum IL-18 and ICA-CD4+ Tc as described by Jung et al were measured. Serum IL-18 and the relative prevalence of IFN-gamma+ and IL-4+, IFN-gamma+ and IL-4 (Th-1), and IFN-gamma- and IL-4+ cells in the responders were significantly increased, but only the relative prevalence of Th-1 cells in the nonresponders was increased two weeks after IFN therapy. In conclusion, ICA-CD4+ Tc and the measurement of serum IL-18 might be useful for predicting IFN therapy by comparing the results between before and two weeks after IFN.

Primary retroperitoneal pure yolk-sac tumor in an adult male

Pure extragonadal tumors are rare in adult males. A 24-year-old male with an extremely high level of serum alpha-fetoprotein (32.795 ng/ml) was diagnosed by abdominal computed tomography as having a retroperitoneal tumor. A case of primary retroperitoneal pure yolk-sac tumor in an adult male is described.

Heterochronous development of intrahepatic cholangiocellular carcinoma following hepatocellular carcinoma in a hepatitis B virus carrier

A 68-year-old Japanese woman was admitted to our hospital in September 1995, because of a mass detected by ultrasonography during a follow-up examination for chronic hepatitis B. Hepatocellular carcinoma (HCC) in the right liver lobe was diagnosed based on imaging studies and elevated alpha-fetoprotein (AFP). Percutaneous ethanol injection therapy (PEIT) was performed. PEIT was repeated in November 1998, because the tumor had enlarged and serum AFP was re-elevated. Follow-up ultrasonography (US) demonstrated low echoic mass in the left liver lobe in August 1999; serum AFP was normal, but serum carbohydrate antigen 19-9 (CA19-9) was elevated to 420 U/ml. In October 1999, radiofrequency interstitial tissue ablation (RITA) was performed after tumor biopsy. Pathological findings revealed adenocarcinoma and pathological diagnosis was made as intrahepatic cholangiocellular carcinoma (ICC). Three weeks later, her serum CA19-9 was remarkably decreased (180 U/ml). The patient has been well for 5 months. Her latest AFP and CA19-9 in the serum were 2 ng/ml and 89 U/ml, respectively. The incidence of double cancer in the liver is rare. This is also the first case report to discuss ICC treated with RITA.

p300 forms a stable, template-committed complex with chromatin: role for the bromodomain

The nature of the interaction of coactivator proteins with transcriptionally active promoters in chromatin is a fundamental question in transcriptional regulation by RNA polymerase II. In this study, we used a biochemical approach to examine the functional association of the coactivator p300 with chromatin templates. Using in vitro transcription template competition assays, we observed that p300 forms a stable, template-committed complex with chromatin during the transcription process. The template commitment is dependent on the time of incubation of p300 with the chromatin template and occurs independently of the presence of a transcriptional activator protein. In studies examining interactions between p300 and chromatin, we found that p300 binds directly to chromatin and that the binding requires the p300 bromodomain, a conserved 110-amino-acid sequence found in many chromatin-associated proteins. Furthermore, we observed that the isolated p300 bromodomain binds directly to histones, preferentially to histone H3. However, the isolated p300 bromodomain does not bind to nucleosomal histones under the same assay conditions, suggesting that free histones and nucleosomal histones are not equivalent as binding substrates. Collectively, our results suggest that the stable association of p300 with chromatin is mediated, at least in part, by the bromodomain and is critically important for p300 function. Furthermore, our results suggest a model for p300 function that involves distinct activator-dependent targeting and activator-independent chromatin binding activities.

Hepatic abscess as a complication of the sump syndrome

We report a case of hepatic abscess associated with the sump syndrome. The patient was a 66-year-old woman who had undergone cholecystectomy and side-to-side choledochoduodenostomy for a common bile duct (CBD) stone in 1983, and who presented with fever and right lower chest pain. A hepatic abscess was diagnosed; after it was drained, percutaneous transhepatic biliary drainage was performed. Bacteriological studies revealed the presence of Bacteroides fragilis and Streptococcus intermedius in the pus in the hepatic abscess cavity, and Klebsiella pneumoniae and Pseudomonas aeruginosa in the bile. The hepatic abscess and cholangitis rapidly resolved in response to two drainage procedures. At surgery, simple closure of the anastomosis was performed, because free drainage was observed from the distal CBD into the duodenum, despite the existence of a periampullary diverticulum.

p300-mediated acetylation facilitates the transfer of histone H2A-H2B dimers from nucleosomes to a histone chaperone

We have used a purified recombinant chromatin assembly system, including ACF (Acf-1 + ISWI) and NAP-1, to examine the role of histone acetylation in ATP-dependent chromatin remodeling. The binding of a transcriptional activator (Gal4-VP16) to chromatin assembled using this recombinant assembly system dramatically enhances the acetylation of nucleosomal core histones by the histone acetyltransferase p300. This effect requires both the presence of Gal4-binding sites in the template and the VP16-activation domain. Order-of-addition experiments indicate that prior activator-meditated, ATP-dependent chromatin remodeling by ACF is required for the acetylation of nucleosomal histones by p300. Thus, chromatin remodeling, which requires a transcriptional activator, ACF and ATP, is an early step in the transcriptional process that regulates subsequent core histone acetylation. Glycerol gradient sedimentation and immunoprecipitation assays demonstrate that the acetylation of histones by p300 facilitates the transfer of H2A-H2B from nucleosomes to NAP-1. The results from these biochemical experiments suggest that (1) transcriptional activators (e.g., Gal4-VP16) and chromatin remodeling complexes (e.g., ACF) induce chromatin remodeling in the absence of histone acetylation; (2) transcriptional activators recruit histone acetyltransferases (e.g., p300) to promoters after chromatin remodeling has occurred; and (3) histone acetylation is important for a step subsequent to chromatin remodeling and results in the transfer of histone H2A-H2B dimers from nucleosomes to a histone chaperone such as NAP-1. Our results indicate a precise role for histone acetylation, namely to alter the structure of nucleosomes (e.g., facilitate the loss of H2A-H2B dimers) that have been remodeled previously by the action of ATP-dependent chromatin remodeling complexes. Thus, transcription from chromatin templates is ordered and sequential, with precise timing and roles for ATP-dependent chromatin remodeling, subsequent histone acetylation, and alterations in nucleosome structure.

Amino acid sequences of hemoglobin from guinea fowl (Numida meleagri) and California quail (Lophortyx californica) with phylogenetic analysis of major groups of Galliformes

We determined the complete amino acid sequences of the hemoglobin of two species, guinea fowl and California quail, in Galliformes from intact globin chain and chemical cleavage fragments in order to analyze the molecular evolution of hemoglobin for the classification of Galliformes. Galliformes have two types of hemoglobin components, HbA and HbD, which consist of identical beta chain and different alpha chains. The sequences are similar to globin chains of Galliformes reported previously. These sequences were compared with those of other Galliformes (Phasianidae, Meleagrididae) using duck and goshawk as out-groups. The phylogenetic tree of major groups of Galliformes based on hemoglobin was similar to the tree model produced based on the amino acid sequence of lysozyme c.

Effects on Rb(+)(K+) uptake of HeLa cells in a high K(+) medium of exposure to a switched 1.7 Tesla magnetic field

Effects of a switched, time-varying 1.7 T magnetic field on Rb(+)(K+) uptake by HeLa S3 cells incubated in an isosmotic high K(+) medium were examined. The magnetic flux density was varied intermittently from 0.07-1.7 T at an interval of 3 s. K(+) uptake was activated by replacement of normal medium by high K(+) medium. A membrane-permeable Ca(2+) chelating agent (BAPTA-AM) and Ca(2+)-dependent K(+) channel inhibitors (quinine, charibdotoxin, and iberiotoxin) were found to reduce the Rb(+)(K+) uptake by about 30-40%. Uptake of K(+) that is sensitive to these drugs is possibly mediated by Ca(2+)-dependent K(+) channels. The intermittent magnetic field partly suppress ed the drug-sensitive K(+) uptake by about 30-40% (P < 0.05). To test the mechanism of inhibition by the magnetic fields, intracellular Ca(2+) concentration ([Ca(2+)]c) was measured using Fura 2-AM. When cells were placed in the high K(&plus;) medium, [Ca(2+)]c increased to about 1.4 times the original level, but exposure to the magnetic fields completely suppressed the increase (P < 0.01). Addition of a Ca(2+) ionophore (ionomycin) to the high K(+) medium increased [Ca(2+)]c to the level of control cells, regardless of exposure to the magnetic field. But the inhibition of K(+) uptake by the magnetic fields was not restored by addition of ionomycin. Based on our previous results on magnetic field-induced changes in properties of the cell membrane, these results indicate that exposure to the magnetic fields partly suppresses K(+) influx, which may be mediated by Ca(2+)-dependent K(+) channels. The suppress ion of K(+) fluxes could relate to a change in electric properties of cell surface and an inhibition of Ca(2+) influx mediated by Ca(2+) channels of either the cell plasma membrane or the inner vesicular membrane of intracellular Ca(2+) stores.

Stimulatory effect of enkephalins on calcium efflux from bovine adrenal chromaffin cells in culture

The effects of leucine- and methionine-enkephalin, opiate peptides, on Ca2+ efflux from cultured bovine adrenal chromaffin cells were examined. These enkephalins stimulated the efflux of 45Ca2+ from cells in a concentration-dependent manner (10(-8) M-10(-6) M). Leucine-enkephalin did not increase the intracellular free Ca2+ level, 45Ca2+ uptake, catecholamine secretion, cAMP level or cGMP level. The peptide-stimulated 45Ca2+ efflux was not inhibited by incubation in Ca2+-free medium, but was inhibited by incubation in Na+-free medium. These results indicate that enkephalins stimulate extracellular Na+-dependent 45Ca2+ efflux from cultured bovine adrenal chromaffin cells, probably by stimulating membrane Na+/Ca2+ exchange.

Effects of a time-varying strong magnetic field on transient increase in cytosolic free Ca2+ induced by bradykinin in cultured bovine adrenal chromaffin cells

We tested the effects of exposure to a time-varying magnetic field changing between 0.07 and 1.7 T at an interval of 3 s on transient increase in intracellular Ca2+ stimulated by bradykinin in bovine adrenal chromaffin cells. Addition of bradykinin induced the increase in intracellular Ca2+ within a few minutes. The exposure to the magnetic field perfectly suppressed the increase in intracellular Ca2+ in Ca2+-free medium. The inhibition occurred for 15 min when the maximum magnetic flux density was more than 1.4 T. These results suggest that the exposure inhibits Ca2+ release from intracellular Ca2+ stores.

Effects of electromagnetic fields on membrane ion transport of cultured cells

We have studied the mechanisms of ion transport mediated by Na+/K(+)-pump and Na+,K+,Cl(-)-cotransport pathway of HeLa cells using Rb+ as an analog for K+, and proposed models of binding of ions for the transport pathways. Also, we clarified the relation between ion and water movements in the cells. Based on these findings, we have studied the effects of homogeneous and time-varying magnetic fields on the ion transport activity. The research presented here covers (i) brief explanations of our kinetic studies on the ion transport pathways for promoting understanding of the effects of magnetic fields on the pathways, (ii) our and other reports of the effects of magnetic fields on ion transport systems.

Cyclin D1 overexpression and prognosis in colorectal adenocarcinoma

Recently, it has been reported that cyclin D1 plays a major role in oncogenesis in various cancers; however, there have been few studies on the association of cyclin D1 overexpression and prognosis of patients with malignant tumors. We evaluated the prognostic significance of cyclin D1 overexpression in colorectal adenocarcinoma. One hundred twenty-three specimens resected from patients with colorectal adenocarcinomas were investigated by staining with a monoclonal antibody against cyclin D1. As a result, both overall survival and disease-free survival were significantly poorer in the patients with tumors strongly positive for cyclin D1 than in those with cyclin-D1-negative or weakly positive tumors. The 5-year survival rate of the patients with tumors strongly positive for cyclin D1 was 53.3%, while the 5-year survival rates of patients with cyclin-D1-negative and weakly positive tumors were 96.2 and 78.8%, respectively. Moreover, multivariate analysis indicated that cyclin D1 overexpression is an independent predictor of disease recurrence in our patients. In conclusion, cyclin D1 overexpression may be useful as a predictor of disease recurrence in colorectal adenocarcinoma.

Left acute scrotum associated with appendicitis

A 10-year-old boy, who had a mild inguinal hernia in his left scrotum, was referred to our clinic because of redness of the scrotal skin and tenderness of the left scrotal contents. Scrotal echography showed a hypoechoic lesion around the normal testis and epididymis. Because torsion of either the testis or testicular appendage was suspected, the scrotum was opened and 1.5 mL of purulent fluid was observed in the tunica vaginalis with inflammatory tissue around the testis and epididymis. On the first postoperative day, a low grade fever and abdominal tenderness persisted, however, the abdomen was flat and soft. There was no marked tenderness over McBurney's point, but there was moderate tenderness over Lanz's point on deep palpation. Abdominal sonography and magnetic resonance imaging revealed abscess formation between the bladder and the sacrum. With a diagnosis of perforation of the appendix, a laparotomy was performed. The inguinal hernia sac could not be observed on inspection, and it was not possible to palpate the left side because of severe adhesion due to infection. Also, the neck of the right inguinal sac could not be seen. The appendix specimen was gangrenous. On the second postsurgical day, all symptoms and signs disappeared. We present this rare condition and discuss the difficulty in establishing a diagnosis.

[Malignancy of colorectal cancer analyzed by expression of cyclin D1]

We evaluated the clinical significance of cyclin D1 expression in colorectal adenocarcinoma. One hundred twenty-three specimens resected from patients with colorectal cancers were investigated by staining with a monoclonal antibody against cyclin D1. The possible correlations among cyclin D1 expression, clinicopathologic factors and prognosis were studied. There was no significant association between cyclin D1 expression and various clinicopathological factors. However, disease-free survival was significantly worse in the patients with cyclin D1 strongly positive tumors than in those with cyclin D1 negative tumors. Cyclin D1 overexpression may be useful as a predictor of disease recurrence in patients with colorectal adenocarcinoma.

Overexpression of cyclin D1 and p53 associated with disease recurrence in colorectal adenocarcinoma

Multiple genetic changes occur during the evolution of normal cells into cancer cells. It has been reported that both cyclin D1 and p53 genes play major roles in oncogenesis and/or cell cycle control in various cancers. In this study, we examined the overexpression of cyclin D1 and p53 by the immunohistochemical method and investigated the correlation between expression of these antigen and prognosis in patients with colorectal adenocarcinoma. Disease-free survival was significantly lower in the patients with cyclin D1-strongly positive tumors than in those with cyclin D1-negative tumors. Similarly, disease-free survival of the patients with p53-strongly positive tumors was significantly lower than that of those with p53-negative tumors. Moreover, multivariate analysis indicated that both cyclin D1 and p53 overexpression are independent prognostic factors in patients with colorectal adenocarcinoma. In conclusion, both cyclin D1 and p53 overexpression may be useful predictors of disease recurrence in patients with colorectal adenocarcinoma.

Isolation and sequencing of two alpha-globin genes alpha(A) and alpha(D) in pigeon and evidence for embryo-specific expression of the alpha(D)-globin gene

By screening a pigeon genomic DNA library, we isolated a recombinant phage clone containing the alpha(A)-globin gene. The DNA sequence of the approximately 6kbp-long insert fragment of the phage clone was determined. The sequence suggested the existence of pigeon alpha(D)-globin gene located 3.1 kbp upstream from the alpha(A)-globin gene. The expression of the alpha(D)-globin in late embryo was also shown by the N-terminal amino-acid sequence of the intact globin chain. These results show that two adult alpha-globin genes, alpha(A) and alpha(D), exist in the pigeon genome, and the alpha(D)-globin is expressed at the late embryo stage. The stage-specific expression suggests the existence of regulatory elements and factors interacting to inhibit transcription at the adult stage.

Vascular endothelial growth factor expression correlates with hematogenous metastasis and prognosis in colorectal carcinoma

We investigated the expression of vascular endothelial growth factor (VEGF) in 175 colorectal carcinomas by immunohistochemistry. VEGF expression was correlated with advanced TNM stage (III, IV), advanced T stage (T3, T4), vessel involvement, lymph node metastasis, and liver metastasis. With regard to the prognosis, both overall and relapse-free survival was significantly poorer, and furthermore, the hematogenous recurrences were significantly more commonly found in the patients with VEGF-positive tumors. VEGF expresion in colorectal carcinomas may have a substantial value in predicting those patients at high risk for hematogenous recurrence after surgery.

Amino acid sequences of hemoglobin beta chains of five species of pinnipeds: Neophoca cinerea, Otaria byronia, Eumetopias jubatus, Pusa hispida, and Pagophilus groenlandica

Pinnipeds (Otariidae, Odobenidae, and Phocidae) in the order Carnivora have one or two types (Hb I and Hb II) of hemoglobin components. These hemoglobins consist of identical beta chains and different alpha chains. We determined the complete amino acid sequences of the hemoglobin beta chain of three species of Otariidae (Australian sea lion, South American sea lion, and northern sea lion) and two species of Phocidae (ringed seal and harp seal) from intact beta chain and chemical cleavage fragments. The sequences are similar to beta chains of the already known sequences of pinnipeds. These sequences were compared with those of other carnivores (Mustelidae, Ursidae, Canidae, and Felidae) and adult human hemoglobin beta chain. Using Artiodactyla (pig) as an outgroup, we find that the tree constructed by means of phylogenetic analysis shows that Odobenidae is closest to Otariidae, and that Otariidae and Odobenidae are closer to Mustelidae than to Phocidae.

Properties of Ca(2+)-dependent K+ channels of human gingival fibroblasts

Cells in the oral cavity are normally exposed to different temperatures. Ion transport systems are influenced by temperature in other tissues: In particular, changes in intracellular K+ ion can affect cell growth and synthesis of macromolecules. The purpose of this investigation was to identify K+ channels in human gingival fibroblast cells and analyze the effect of temperature on their K+ conduction properties. Ca(2+)-dependent K+ channels with a large conductance (125 pS in symmetrical K(+)-rich solutions) were identified in human gingival fibroblasts and studied by the patch-clamp technique. The open probability of the channels varied with membrane potential between +40 and -100 mV. When the bath temperature was decreased from 40 to 4 degrees C, channel conductance was reduced, but the mean open time of the channels was increased. The activation energies for the conductance and the reciprocal of the mean open time were estimated to be 9.1 and 22.9 kJ/mol, respectively. These values are lower than those reported for these and other types of channels in cells from other tissues. The open probability of the channels was nearly constant in the temperature range studied. These results suggest that the properties of Ca(2+)-dependent K+ channels of gingival fibroblasts remain relatively unchanged when the cells are exposed to a wide range of temperatures.

Amino acid sequence of alpha- and beta-polypeptide chains of turkey (Meleagris gallopavo) hemoglobin

Two hemoglobin components are recognized in erythrocytes of the adult turkey (Meleagris gallopavo). We determined the amino acid sequences of turkey alpha A-, alpha D- and beta-globin from intact globin chains and chemical cleavage fragments. The sequences are highly similar to the hemoglobin of the Phasianidae, chicken, Japanese quail and pheasant. Turkey and pheasant beta-globin are identical. The amino acid sequence of turkey alpha A-globin differs by only one residue from chicken alpha A-globin. Phylogeny trees from alpha A-, alpha D- and beta-globin were constructed by the neighbor-joining method. Although the trees generated from alpha A- and beta-globin were similar, that from turkey alpha D-globin differed.

Blood flow velocity in the common carotid artery in humans during graded exercise on a treadmill

Cerebral blood volume flow and flow velocity have been reported to increase during dynamic exercise, but whether the two increase in parallel and whether both increases occur as functions of exercise intensity remain unsettled. In this study, blood flow velocity in the common carotid artery was measured using the Doppler ultrasound method in eight healthy male students during graded treadmill exercise. The exercise consisted of stepwise progressive increases and decreases in exercise intensity. The peak intensity corresponded to approximately 85% of maximal oxygen consumption. During this exercise, the heart rate (fc), mean blood pressure (BP) in the brachial artery and mean blood flow velocity (vcc) in the common carotid artery increased as functions of exercise intensity. At the peak exercise intensity, fc, BP and vcc increased by 134.5%, 20.5% and 51.8% over the control levels before exercise (P < 0.01), respectively. The resistance index (RI) and pulsatility index (PI) were determined from the velocity profile and were expected to reflect the distal cerebral blood flow resistance. The RI and PI increased during the graded exercise, but tended to decrease at the highest levels of exercise intensity. As vcc increased with increases in exercise intensity it would be expected that cerebral blood flow would also increase at these higher intensities. It is also suggested that blood flow velocity in the cerebral artery does not proportionately reflect the cerebral blood flow during dynamic exercise, since the cerebral blood flow resistance changes.

Changes in carotid blood flow and electrocardiogram in humans during and after walking on a treadmill

Blood flow velocity in the common carotid artery and the electrocardiogram were measured simultaneously by telemetry in seven male subjects during 20-min walking on a treadmill at an exercise intensity corresponding to a mean oxygen uptake of 26.0 (SD 2.9) ml.kg-1.min-1. The mean cardiac cycle was shortened from 0.814 (SD 0.103) s to 0.452 (SD 0.054) s during this exercise. Of this shortening, 73% was due to shortening of the diastolic period and 27% to shortening of the systolic period. In the relatively small shortening of the mean systolic period [from 0.377 (SD 0.043) s to 0.268 (SD 0.029) s], the isovolumetric contraction time was shortened by 56%. During exercise, the heart rate (fc) increased by 79.4% [from 74.3 (SD 9.3) beats.min-1 to 133.3 (SD 14.8) beats.min-1], and the peak blood velocity (S1) in the common carotid artery increased by 56.1% [from 0.82 (SD 0.10) m.s-1 to 1.28 (SD 0.11) m.s-1]. After exercise, the S1 decreased rapidly to the resting level. The fc decreased more slowly, still being higher than the initial resting level 5 min after exercise. The diastolic velocity wave and the end-diastolic foot decreased during exercise. The blood flow rate in the carotid artery increased transiently by 13.5% at the beginning of exercise [from 5.62 (SD 0.63) ml.s-1 to 6.38 (SD 0.85) ml.s-1] and by 26.5% at the end of the exercise period [from 5.62 (SD 0.63) ml.s-1 to 7.11 (SD 1.34) ml.s-1].(ABSTRACT TRUNCATED AT 250 WORDS)

Arrest of cell cycle progression of HeLa cells in the early G1 phase in K(+)-depleted conditions and its recovery upon addition of insulin and LDL

Cell cycle progression of synchronized HeLa cells was studied by measuring labeling of the nuclei with [3H]thymidine. The progression was arrested in a chemically defined medium in which K+ was replaced by Rb+ (Rb-CDM) but was restored upon addition of insulin and/or low density lipoprotein (LDL). Cells started DNA synthesis 12 hr after addition of insulin and/or LDL, regardless of the time of arrest, suggesting their arrest early in the G1 phase. After incubation of cells in Rb-CDM containing insulin or LDL singly for 3, 6, or 9 hr, replacement of the medium by that without an addition resulted in marked delay in entry of cells into the S phase, but in its replacement by medium containing both agents, the delay was insignificant. Synthesis of bulk protein, estimated as increase in the cell volume, was not strongly inhibited. From these results we conclude that cell cycle progression of HeLa cells in K(+)-depleted CDM is arrested early in the G1 phase and that the arrest is due to lack of some protein(s) required for entry into the S phase that is synthesized in the early G1 phase.

Kinetic study on the effects of intracellular K+ and Na+ on Na+, K+, Cl- cotransport of HeLa cells by Rb+ influx determination

The effects of intracellular K+ and Na+ (K+c, Na+c) on the Na+, K+, Cl- cotransport pathway of HeLa cells were studied by measuring ouabain-insensitive, furosemide-sensitive Rb+ influx (JRb) at various intracellular concentrations of K+ and Na+ ([K+]c, [Na+]c). When [K+]c was increased and [Na+]c was decreased, keeping the sums of their concentrations almost constant, JRb as a function of the extracellular Rb+ or Na+ concentration ([Rb+]e, [Na+]e) was stimulated. However, the apparent K0.5 for Rb+e or Na+e remained unchanged and the ratio of the apparent K0.5 for K+c and the apparent Ki for Na+c was larger than 1. When JRb was increased by hypertonicity by addition of 200 mM mannitol, the apparent maximum JRb increased without change in the apparent K0.5 for Rb+e. These results show that K+c stimulates and Na+c inhibits JRb, without change in the affinities of the pathway for Rb+e and Na+e. The affinity for K+c is slightly lower than that for Na+c. Hypertonicity enhances JRb without any change in the affinity for Rb+e. We derived a kinetic equation for JRb with respect to K+c and Na+c and proposed a general and a special model of the pathway. The special model suggests that, in HeLa cells, JRb takes place when Rb+e binds to the external K+ binding site of the pathway after the binding of K+c to the internal regulatory site.

Different patterns of cell volume regulation in hyposmotic media between attached and suspended HeLa cells

Both attached and suspended HeLa cells swelled in a medium of a hypotonic osmolality of 235 mosmol/kg H2O. When the osmolality was further decreased to 166 mosmol/kg H2O, attached cells instantly swelled and then rapidly lost water and K+, followed by slow gains of them. Suspended cells instantly swelled and then K+ loss and regulatory volume decrease (RVD) occurred. Neither 0.1 mM ouabain nor 10 mM TEA changed the water loss of attached cells, whereas ouabain inhibited RVD of suspended cells. Quinine (1 mM) inhibited water losses from both cells and comparison of the losses implies stronger activation of K+ channel in attached cells than in suspended cells. Omission of medium Ca2+ or addition of 10 mM BaCl2 inhibited RVD in part. These results suggest that hyposmotic stress induces net water loss from attached cells, associated with K+ release through the Ca(2+)-dependent K+ channel. Suspended cells osmotically swell, followed by RVD with K+ and Na+ releases through the K+ channel and Na(+)-pump, respectively. The different patterns of volume changes may relate to the difference of activity or time of activation of the K+ channel between both cells.

Mechanism of cell swelling of HeLa cells in an isosmotic Na(+)-free, high-K+ medium: study on the K+ transport pathways

The K+ content and the free Ca2+ concentration ([Ca2+]c) in HeLa cells began to increase after a latent period following medium change to an isosmotic Na(+)-free, high-K+ medium in the presence of 10-100 microM ouabain. These increases were accompanied by cell swelling, and stimulated by the addition of 1 microM ionomycin, whereas treatment with 1 mM quinine significantly inhibited the net K+ uptake. [Ca2+]c was slightly decreased, but the K+ uptake was unaffected in the Ca(2+)-free, high-K+ medium. However, when [Ca2+]c was extremely reduced by preloading 5 microM BAPTA-AM, the K+ uptake decreased to a level attained in the presence of quinine. Addition of DIDS and substitution with NO3- or SCN- for medium Cl- inhibited the K+ uptake to similar extents, and their effects were less strong than that of quinine. Substitution of medium Cl- with an impermeable anion gluconate completely inhibited the K+ uptake. Therefore, we conclude that cell swelling in the high-K+ medium is associated with K+ uptake mediated in greater part by quinine-sensitive and in smaller part by -insensitive pathway. The former pathway depends on cellular Ca2+ and its major component is Cl(-)-dependent, whereas the latter is independent of the Ca2+ and unselective for anions.

Promotion of cell growth and macromolecular synthesis in HeLa cells by insulin and low density lipoprotein: analyses at an early stage after change to K(+)-depleted medium

Stimulations of cell growth and macromolecular synthesis of HeLa cells by insulin and low density lipoprotein (LDL) were studied in relation to the effect of intracellular K+. After replacement of the culture medium by a chemically defined medium (K-CDM), addition of insulin plus LDL stimulated their growth. Protein synthesis was fast for the first 18 hrs. and then slowed to a constant rate with or without these agents. DNA synthesis began to increase from 15 hrs., attaining a maximum at 18 hrs. After change from K-CDM to CDM containing RbCl (Rb-CDM), Rb+ replaced about 80% of the intracellular K+ in 2 hrs. Cell growth in Rb-CDM was very slow but was markedly enhanced by insulin plus LDL. No initially rapid protein synthesis was observed. DNA synthesis decreased with time, but addition of insulin plus LDL resulted in transient increase. Thus, the initial rapid protein synthesis in K-CDM may be a prerequisite for inducing DNA synthesis that stimulates subsequent cell growth. In Rb-CDM, insulin plus LDL stimulated cell growth by increasing DNA synthesis without changing the synthesis of bulk protein, implying that they induced synthesis of growth-related proteins.

Effects of time-varying electromagnetic fields on K+ (Rb+) fluxes and surface charge of HeLa cells

The magnetic flux density was varied intermittently from 0.35 to 1.77T and from 0.07 to 1.54 or 1.77T by manual and automatic switchings, respectively, of the power source of an electromagnet. The durations of the "switching-on time" and "-off time" were varied but kept equal. An electric eddy current induced in the culture medium by changes in the magnetic flux density was simulated. When the durations were shorter than 10s, ouabain-sensitive Rb+ influx (active K+ influx) into cultured HeLa cells was significantly inhibited, but the ouabain-insensitive Rb+ influx (passive K+ influx) was not influenced significantly. Inhibition of active Rb+ influx increased with time during exposure for 2 h. Conversely, K+ efflux from the cells was significantly stimulated by the exposure. Microfluorometric examinations of cells loaded with the fluorescent pH indicator 4-heptadecyl-7-hydroxycoumarin (6 microM) and the membrane potential indicator diS-C3-(5) (1 microM) suggested increase in the negative charge on the cell surface during exposure. The observed changes in the K+ (Rb+) fluxes would be related to change in the electric properties of the cell surface caused by exposure to intermittent electromagnetic fields.

Regulatory changes in the K+, Cl- and water contents of HeLa cells incubated in an isosmotic high K(+)-medium

HeLa cells had their normal medium replaced by an isosmotic medium containing 80 mM K+, 70 mM Na+ and 100 microM ouabain. The cellular contents of K+ first increased and then decreased to the original values, that is, the cells showed a regulatory decrease (RVD) in size. The initial increase was not inhibited by various agents except by substitution of medium Cl- with gluconate. In contrast, the regulatory decrease was inhibited strongly by addition of either 1 mM quinine, 10 microM BAPTA-AM without medium Ca2+, or 0.5 mM DIDS, and partly by either 1 mM EGTA without medium Ca2+, 10 microM trifluoperazine, or substitution of medium Cl- with NO3-. Addition of DIDS to the NO3(-)-substituted medium further suppressed the K+ loss but the effect was incomplete. Intracellular Ca2+ showed a transient increase after the medium replacement. These results suggest that the initial increase in cell K+ is a phenomenon related to osmotic water movement toward Donnan equilibrium, whereas the regulatory K+ decrease is caused by K+ efflux through Ca(2+)-dependent K+ channels. The K+ decrease induced a decrease in cellular water, i.e., RVD. The K+ efflux may be more selectively associated with Cl- efflux through DIDS-sensitive channels than the efflux of other anions.

Effect of fat emulsion in patients with liver disorders

The effect of fat emulsion in preoperative patients (n = 17) with liver disorders was studied by liver-function tests, intraoperative liver biopsy specimens, intravenous fat tolerance tests, and serum fatty acid analyses. There was no difference between liver-function tests before and after the administration of fat emulsion. Before the administration of fat emulsion, the levels of serum lipids were relatively low, and serum fatty acid patterns were abnormal. However, after the administration of fat emulsion, serum lipid levels increased, and serum fatty acid patterns became nearly normal. There was a significant correlation between the total fat intake and serum linoleic acid change before and after the administration of fat emulsion. From this equation, the total fat intake required for a normal range of serum linoleic acid was calculated to be 7 g/kg fat. These results suggest that the administration of fat emulsion improves serum fatty acid patterns without a deterioration of liver function in preoperative patients with liver disorders, but total intake of 10% fat emulsion greater than 70 ml/kg might induce higher serum fatty acids than in healthy control subjects and cause overload in these patients.

Stimulating effects of insulin and low-density lipoprotein on cell growth and macromolecular syntheses of HeLa cells cultured in K(+)-depleted medium

The influence of the intracellular K+ concentration on the effects of growth factors (insulin, EGF, hydrocortisone, and transferrin) and LDL on growth of HeLa cells was investigated. Upon replacement of K+ in a chemically defined medium (K(+)-CDM) by Rb+ (Rb(+)-CDM), about 80% of the intracellular K+ was replaced by Rb+ within 24 h, but showed no further change in the next 24 h, irrespective of addition of dialyzed calf serum (5%) or growth factors to the medium. In Rb(+)-CDM, cell growth and DNA synthesis were greatly suppressed, although cell viability was not significantly altered for 72 h. The suppression of cell growth was partially restored by addition of serum, insulin (5 micrograms/ml), or LDL (2.5 mg/ml) to Rb(+)-CDM. A combination of serum and insulin or insulin and LDL stimulated cell growth to approximately the level in K(+)-CDM without any addition, but a combination of serum and LDL did not have more effect than that of serum alone. Unexpectedly, other factors were ineffective in stimulating growth in Rb(+)-CDM. In Rb(+)-CDM, the effect of insulin was lost in 24-48 h, whereas that of LDL persisted for at least 96 h. Insulin and LDL also enhanced growth in K(+)-CDM. After cessation of cell growth in Rb(+)-CDM for 24 h, addition of insulin and/or LDL markedly restored cell growth and DNA synthesis. Therefore, insulin and LDL may stimulate certain mechanisms required for cell growth that can operate in K(+)-deficient conditions.

[An early cancer of the descending colon, histologically showing a poorly differentiated adenocarcinoma]

Reported is the case of a 71 year-old male with a poorly differentiated adenocarcinoma of the colon that had invaded the submucosal layer. A barium enema had revealed a polyp, 1.5 cm in diameter, in the descending colon, and an endoscopic polypectomy was performed. The resected specimen mainly consisted of an adenoma and a partial, poorly differentiated adenocarcinoma that had massively infiltrated into the submucosal layer. A left hemicolectomy was carried out, and no carcinoma was identified in the resected colon and/or the regional lymph nodes.

Kinetic mechanism of ATP action in Na(+)-K(+)-Cl- cotransport of HeLa cells determined by Rb+ influx studies

The kinetics of Na(+)-K(+)-Cl- cotransport were studied by measuring ouabain-insensitive furosemide-sensitive Rb+ influx (JRb) into HeLa cells while varying the cellular ATP and the extracellular Rb+ and Na+ concentrations. Results reveal that ATP stimulates JRb by increasing the affinity of the cotransporter for Rb+ (K+), and the apparent Michaelis constant (Km) for ATP was 0.95 +/- 0.03 mmol/l cell water. Two ATP molecules may relate to the uptake of one Rb+ by the cotransport pathway, as examined by the nonlinear least-squares method for goodness-of-fit and a Hill plot, JRb was strengthened by an increase in the inward chemical gradient associated with cell swelling on preincubation in a low-Na+ high-K+ medium, accompanying an increase in the affinity of the transporter for ATP. JRb was apparently activated by extracellular Na+, and the activation was enhanced by an increase in the cellular ATP concentration. Lactate production stimulated by 2 microM carbonylcyanide m-chlorophenyl hydrazone (CCCP) was reduced by 10 microM ouabain but not altered by further addition of 0.1 mM furosemide. Increases in cellular adenosine 3',5'-cyclic monophosphate (cAMP) caused by treatment with 0.1 mM isoproterenol plus 0.5 mM 3-isobutyl-1-methylxanthine or with 0.1 mM dibutyryl cAMP did not influence JRb. From this and previous studies, we propose a general and a specific model of Na(+)-K(+)-Cl- cotransport, which elucidate the order of binding of extracellular ions and reaction of cellular ATP.

Mucinous colorectal carcinoma: clinical pathology and prognosis

Mucinous carcinomas accounted for 37 (6.4%) of 540 cases of colorectal carcinoma. The clinical and pathological features of these mucinous carcinomas were compared with those of the 510 well or moderately differentiated adenocarcinomas. Mucinous carcinoma was more common in the patients 39 years of age or under (P less than 0.05) and was more frequent in the female patients. A large number of mucinous carcinomas were located in the rectum, followed by the right colon. However, the right colon showed a higher relative incidence (40.5% vs 12.5%, P less than 0.005). Mucinous carcinoma was characterized by infiltration of the surrounding tissues (24.3% vs 7.8%, P less than 0.005), positive lymph node involvement (75.7% vs 48.6%, P less than 0.005), and peritoneal implant (21.6% vs 4.1%, P less than 0.005). The cumulative five and ten year survival rates after resection of mucinous carcinoma were 45.5 per cent and 39.8 per cent, respectively, and those after curative resection, 72.4 per cent and 63.5 per cent, respectively. These survival rates were lower, without significant differences, than those for the well or moderately differentiated adenocarcinomas. The results suggest the need for aggressive lymph node dissection and wide excision of the surrounding tissues for mucinous carcinoma, with special attention paid to local recurrence.

Colorectal carcinoma in young adults

Charts of 570 patients with colorectal carcinoma surgically treated in one institution during a 13 year period were retrospectively reviewed to evaluate clinicopathologic patterns and surgical results of those 39 years of age or under. Of the 570 patients, 57 (10 percent) were 39 years of age or under, and this group included more female patients than the older control group. Mucinous carcinoma was frequently found on histologic examination, with significantly high incidences of lymph node involvement, peritoneal dissemination, and advanced tumor stages by Dukes' classification in the young patients. The overall cumulative 5 year survival rate in the younger group was significantly lower than that in the control group (41 percent and 55.9 percent, respectively), whereas the difference in rates among the two groups for curative resection was not statistically significant (71.6 percent and 76.3 percent, respectively). Early diagnosis and attempts at curative resection are of utmost importance in the treatment of young patients with colorectal carcinoma.

Effects of nystatin on intracellular contents and membrane transport of alkali cations, and cell volume in HeLa cells

Nystatin (50 micrograms/ml) had strong influence on the intracellular contents and membrane transports of monovalent ions and water in HeLa cells. The nystatin-induced changes in the intracellular ion content and cell volume were inhibited by sucrose, and Donnan and osmotic equilibria were attained. Using cells under conditions for these equilibria, the concentrations of intracellular impermeant solutes, their mean valence, the differences of their intra- and extracellular osmotic concentrations, and the circumferential tension of the cell membrane were determined. Stimulation by nystatin of the influx of one cation species, e.g. Rb, was inhibited by another cation species, e.g. Na. The stimulatory effect of nystatin on cation fluxes was reversible within 1 hr after ionophore addition, and after 1-hr treatment the intracellular contents of Na and K became proportional to their extracellular concentrations, provided that the sum of these concentrations was constant (300 mM). Similar proportionality was also observed in the presence of choline, provided that the choline concentration was less than those of the alkali cations. The implications of these results in relation to the osmotic properties of cultured cells, and the experimental regulation of alkali cations in the cells, are discussed.

Pyloric stenosis: an unusual complication of Behçet's disease

A 20-yr-old Japanese man with longstanding Behçet's disease had pyloric stenosis and multiple duodenal ulcers. The pyloric stenosis was due to edematous hypertrophy of the pyloric ring and was unrelated to duodenal ulceration. The evidence suggests that the pyloric stenosis and multiple duodenal ulceration were a manifestation of Behçet's syndrome and not merely incidental peptic ulcer disease.

Kinetic mechanism of Na+, K+, Cl--cotransport as studied by Rb+ influx into HeLa cells: effects of extracellular monovalent ions

Ouabain-insensitive, furosemide-sensitive Rb+ influx (JRb) into HeLa cells was examined as functions of the extracellular Rb+, Na+ and Cl- concentrations. Rate equations and kinetic parameters, including the apparent maximum JRb, the apparent values of Km for the three ions and the apparent Ki for K+, were derived. Results suggested that one unit molecule of this transport system has one Na+, one K+ and two Cl- sites with different affinities, one of the Cl- sites related with binding of Na+, and the other with binding of K+(Rb+). A 1:1 stoichiometry was demonstrated between ouabain-insensitive, furosemide-sensitive influxes of 22Na+ and Rb+, and a 1:2 stoichiometry between those of Rb+ and 36Cl-. The influx of either one of these ions was inhibited in the absence of any one of the other two ions. Monovalent anions such as nitrate, acetate, thiocyanate and lactate as substitutes for Cl- inhibited ouabain-insensitive Rb+ influx, whereas sulfamate and probably also gluconate did not inhibit JRb. From the present results, a general model and a specialized cotransport model were proposed: In HeLa cells, one Na+ and one Cl- bind concurrently to their sites and then one K+(Rb+) and another Cl- bind concurrently. After completion of ion bindings Na+, K+(Rb+) and Cl- in a ratio of 1:1:2 show synchronous transmembrane movements.