Three-Dimensional Display of Liver, Spleen, Hepatoma, and Blood Vessels by MR Imaging and Computer Graphics

The technique of generating 3-D images from CT and MR data has made progress. Manipulation of the images has become simpler, the processing time shorter, and the quality better. Clinical application of this technique has been performed for images of brain (5, 7, 8) and bone (1, 2, 6), but only a few studies have been done of abdominal organs (3, 4).

The fixed herbal drug composition "Saikokaryukotsuboreito" prevents bone loss with an association of serum IL-6 reductions in ovariectomized mice model

PURPOSE

Saikokaryukotsuboreito (SRB) is a traditional Japanese herbal medicine that has been used to treat hyperlipidemia. As some studies have shown that lipid-lowering drugs reduce osteoporosis, we investigated the effect of SRB on bone metabolism in the postmenopausal period using an ovariectomized (OVX) murine model.

MATERIAL AND METHODS

Fifteen aged 9 weeks female mice were divided into three groups (n=5 each). The OVX group and SRB group underwent bilateral ovariectomy, after which the OVX group was fed a normal diet and the SRB group fed a normal diet containing 2% SRB. The sham group underwent sham surgery and was then fed a normal diet. Eight weeks after surgery, all mice were sacrificed, and bone volume, bone histomorphometric parameters, and bone-associated phenotype were compared among the groups.

RESULTS

Compared with the OVX group, the SRB group showed suppression of bone volume loss at the tibia (SRB group: 12.7+/-0.7%, OVX group: 9.8+/-0.4%; p=0.005, ANOVA) and lumbar spine (SRB group: 15.1+/-0.9%, OVX group: 11.3+/-0.1%; p=0.031, ANOVA). A significant decrease in eroded surface was also observed in SRB-treated ovariectomized mice compared with the OVX group (p=0.022, ANOVA). We also found that serum levels of interleukin (IL)-6, a primary mediator of bone resorption, in the SRB group were significantly lower than in the OVX group (SRB: 52.5+/-6.8pg/ml; OVX: 138.0+/-23.1pg/ml; p=0.011, ANOVA). However, unexpectedly, SRB did not affect estradiol and total cholesterol in ovariectomized mice.

CONCLUSION

SRB can prevent loss of bone volume and suppress serum IL-6 levels in this postmenopausal model and is a promising candidate for treatment of postmenopausal osteoporosis.

Therapeutic effects of Saireito (TJ-114), a traditional Japanese herbal medicine, on postoperative edema and inflammation after total hip arthroplasty

Saireito (TJ-114) is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in diseases such as nephritic disease. This study investigates the effect of TJ-114 on postoperative edema and inflammation after total hip arthroplasty (THA). Patients who underwent cementless THA were randomly divided into two groups: Group A consisted of 8 hips of 8 patients who were treated with TJ-114 at a dose of 9 g/day 2 days before surgery and for 2 weeks after surgery; Group B consisted of 9 hips of 9 patients who did not take TJ-114. Although no significant difference was observed between the two groups for lower extremity edema, it was found that swelling of the proximal leg in Group A was less than that in Group B. Furthermore, 3 weeks after surgery, every measuring point in the lower extremity showed that TJ-114 tended to decrease postoperative swelling compared to measurements of swelling of patients who did not take TJ-114. Serum C-reactive protein (CRP) levels of 6 out of 8 patients in Group A decreased and became negative 2 weeks after surgery; however, there were no patients in Group B whose CRP levels became negative after 2 weeks. In conclusion, TJ-114 is safe and useful for the prevention and early recovery of postoperative leg edema after THA with an association of rapid CRP reduction.

Alcoholic fermentation and its prevention by Lactobacillus buchneri in whole crop rice silage

AIMS

To evaluate the fermentation characteristics and the effects of Lactobacillus buchneri inoculation in ensiling whole crop rice.

METHODS AND RESULTS

Laboratory-scale silages were prepared from whole crop rice harvested at yellow-ripe stage. The crop was ensiled for 2 months with and without inoculation of L. buchneri at 10(4), 10(5) and 10(6) CFU g(-1). The effect of prolonged ensiling was also studied by using the same crop; the silos were opened at 1, 3, 6 and 12 months, while the inoculation was made at 10(5) CFU g(-1). Enhanced alcoholic fermentation was found in untreated silage; the sum of ethanol and 2,3-butanediol were seven times higher at 2 months than those of lactic and volatile fatty acids, while the differences were diminished at 12 months owing to the reduction of ethanol in the late ensiling period. Inoculation of L. buchneri inhibited the alcohols; however, ethanol yet prevailed over the fermentation until 6 months, after which acetic acid became the main product in the inoculated silage. Regardless of inoculation and ensiling period, yeasts were not found in whole crop rice silage.

CONCLUSIONS

Substantial amounts of ethanol and 2,3-butanediol would be produced in silage prepared from whole crop rice. The alcoholic fermentation can be suppressed when inoculated with L. buchneri.

SIGNIFICANCE AND IMPACT OF THE STUDY

Inoculation of L. buchneri could be an option to prevent ethanol fermentation in silage.

Adolescents' attachment style and early experiences: a gender difference

We examined gender differences in perceived rearing and adult attachment style in adolescents. A total of 3,912 senior college students (1,149 men and 2,763 women) ages 18-23 (men's M = 20.1 years, women's M = 20.0 years) were administered a set of questionnaires including Relationship Questionnaire (to measure adult attachment), the Parental Bonding Instrument (perceived rearing), and a list of early life events. In the men, positive adult total attachment style was predicted by the scores of paternal care and low scores on maternal overprotection in a hierarchical regression analysis. On the other hand, in the women, positive adult total attachment style was predicted by the scores of paternal and maternal care, and low score on maternal overprotection. Adult attachment was also predicted by fewer Peer Victimization experience as a child in both men and women. However, while men's adult attachment was predicted by Self Disease experiences, women's adult attachment was predicted by Top Star experiences and fewer Relocation experiences. The adult attachment style was predictable from early experiences but there existed some gender differences.

Linear IgA bullous dermatosis of neonatal onset: case report and review of the literature

Several small blisters were noticed on the forehead and the trunk of a newborn boy on day 1. The blisters gradually enlarged and spread over the whole body including the oral mucosa. A skin biopsy was performed twice and subepidermal bullae with polymorphonuclear and mononuclear cell infiltration were demonstrated. Direct immunofluorescence showed linear IgA, IgG and C3 depositions along the basement membrane zone and this finding led to a diagnosis of linear IgA bullous dermatosis. So far, internationally, only one case has ever been reported on the disease at neonatal onset. The skin lesions spontaneously regressed and the mucosal lesions were controlled with diaminodiphenylsulfone.

CONCLUSION

In neonates with prolonged blistering, autoimmune disease such as linear IgA bullous dermatosis should be considered within the differential diagnosis and an immunofluorescence study must be performed.

Preservation of the bone mineral density of the femur after surface replacement of the hip

We investigated the effect of the Birmingham hip resurfacing (BHR) arthroplasty on the bone mineral density (BMD) of the femur. A comparative study was carried out on 26 hips in 25 patients. Group A consisted of 13 patients (13 hips) who had undergone resurfacing hip arthroplasty with the BHR system and group B of 12 patients (13 hips) who had had cementless total hip arthroplasty with a proximal circumferential plasma-spray titanium-coated anatomic Ti6A14V stem. Patients were matched for gender, state of disease and age at the time of surgery. The periprosthetic BMD of the femur was measured using dual-energy x-ray absorptiomentry of the Gruen zones at two years in patients in groups A and B.

The median values of the BMD in zones 1 and 7 were 99% and 111%, respectively. The post-operative loss of the BMD in the proximal femur was significantly greater in group B than in group A. These findings show that the BHR system preserves the bone stock of the proximal femur after surgery.

Quantitative changes in nuclear pores and chromatoid bodies induced by neuropeptides during cell differentiation in the planarian Dugesia japonica

Neuropeptides were used in experiments to assess their effects on planarian cells. Intact and decapitated planarians exposed to 10(-6) M neuropeptides for two days were examined electron microscopically and quantitative changes in the nuclear pores and chromatoid bodies in various types of cells were ascertained. The data clearly indicated the diversity of effects produced in planarian cells by neuropeptide treatments. The number of nuclear pores increased considerably in each cell type treated with neuropeptides. In particular, the effects of neuropeptides were strongest in differentiating cells which were forming the regeneration blastema. Neuropeptide-treated cells also experienced a dramatic increase in the number of chromatoid bodies. The results obtained in this study suggest that synthesis of RNAs leading to increases in the numbers of nuclear pores and chromatoid bodies is facilitated in neuropeptide-treated cells which are undergoing cell differentiation. The different mechanisms of the effects induced in undifferentiated cells by neuropeptides are discussed.

Small intestinal metastasis from renal cell carcinoma exhibiting rare findings

Small intestinal metastasis from renal cell carcinoma (RCC) has only rarely been described. We report two patients who developed small bowel metastases from RCC showing different clinicopathological characteristics. Both patients underwent hemilateral nephrectomy for RCC and developed lung metastases metachronously or simultaneously. One patient developed occlusive ileus caused by multiple polypoid tumours composed of sarcomatoid tissue in the jejunum shortly after nephrectomy. The other patient presented melaena due to bleeding from a Borrmann 2-like tumour in the jejunum six years after nephrectomy. Clinically, his disease was slow-growing. Sarcomatoid histology and Borrmann 2-like tumour in this report are rare findings in metastatic tumour of RCC in the small bowel.

Complete genomic sequence of the filamentous nitrogen-fixing cyanobacterium Anabaena sp. strain PCC 7120

The nucleotide sequence of the entire genome of a filamentous cyanobacterium, Anabaena sp. strain PCC 7120, was determined. The genome of Anabaena consisted of a single chromosome (6,413,771 bp) and six plasmids, designated pCC7120alpha (408,101 bp), pCC7120beta (186,614 bp), pCC7120gamma (101,965 bp), pCC7120delta (55,414 bp), pCC7120epsilon (40,340 bp), and pCC7120zeta (5,584 bp). The chromosome bears 5368 potential protein-encoding genes, four sets of rRNA genes, 48 tRNA genes representing 42 tRNA species, and 4 genes for small structural RNAs. The predicted products of 45% of the potential protein-encoding genes showed sequence similarity to known and predicted proteins of known function, and 27% to translated products of hypothetical genes. The remaining 28% lacked significant similarity to genes for known and predicted proteins in the public DNA databases. More than 60 genes involved in various processes of heterocyst formation and nitrogen fixation were assigned to the chromosome based on their similarity to the reported genes. One hundred and ninety-five genes coding for components of two-component signal transduction systems, nearly 2.5 times as many as those in Synechocystis sp. PCC 6803, were identified on the chromosome. Only 37% of the Anabaena genes showed significant sequence similarity to those of Synechocystis, indicating a high degree of divergence of the gene information between the two cyanobacterial strains.

Full weight-bearing after cementless total hip arthroplasty

In a prospective study of cementless total hip arthroplasty, 19 hips in 17 patients (Group A) were allowed full weight-bearing immediately after the operation while 18 hips in 16 patients (Group B) were first allowed weight-bearing after 6 weeks. Patients were matched for sex, age at surgery, height, weight, and follow-up period and there were no significant differences in hip scores between the two groups. Rehabilitation to gain walking ability with a cane lasted 5.8 days for Group A and 44.8 days for Group B (P = 0.0001). The hospital stay after surgery was 30.1 days for Group A and 46.7 days for Group B (P = 0.006). All patients showed bone ingrowth radiographically. There were no complications in either group.

Anxiety in Japanese women after elective abortion

OBJECTIVE

To examine women's anxiety levels after elective abortion.

DESIGN AND SETTING

Women seeking elective abortion at six clinics in Japan were solicited to participate in a questionnaire survey.

PARTICIPANTS

Sixty-six Japanese women requesting abortion participated in this survey.

MAIN OUTCOME MEASURES

State anxiety was measured using Spielberger's State Trait Anxiety Inventory before and after abortion.

RESULTS

Multiple regression analyses using predictor variables with a significant link to postabortion anxiety level showed that among potential predictors, a conservative attitude toward abortion was the most significant predictor of postabortion anxiety after controlling for the level of preabortion anxiety.

CONCLUSION

These findings suggest that a woman's attitude toward abortion and reproductive rights is an important but neglected factor influencing postelective abortion anxiety. Medical and nursing professionals should, therefore, take note of a woman's attitude toward abortion as a part of her mental health care.

Gastric cancer with Virchow's and multiple lung metastases showing a remarkable response to preoperative chemotherapy: report of a case

We report herein a rare case with advanced gastric cancer combined with group 4 lymph node and lung metastases that responded remarkably to neoadjuvant chemotherapy. A 65-year-old man was found to have a well-differentiated type 3 gastric cancer that invaded the duodenum locally and was accompanied with Virchow's, para-aortic lymph nodes, and multiple lung metastases based on physical, endoscopic, and radiological examinations. In addition, his carbohydrate antigen (CA) 19-9 was elevated to 3965U/ml, and CA72-4 to 46U/ml. Prior to surgery, he was treated with 5-fluorouracil (5-FU; 500mg/body per day) and low-dose cisplatinum (CDDP; 10mg/body per day) as neoadjuvant chemotherapy for 6 weeks. As a result, a partial response was obtained in all lesions, and CA19-9 and CA72-4 decreased to 463U/ml and 9.4U/ml, respectively. Four weeks after the completion of neoadjuvant chemotherapy, a distal gastrectomy was performed, and a histopathological examination of the resected specimen showed a grade 2 response to chemotherapy. Immunohistochemically, the thymidylate synthase expression level was very low in the tumor tissues, which might account for the good response to the combination chemotherapy with 5-FU and CDDP observed in the present case.

SEA0400, a novel and selective inhibitor of the Na+-Ca2+ exchanger, attenuates reperfusion injury in the in vitro and in vivo cerebral ischemic models

The effect of the newly synthesized compound 2-[4-[(2,5-difluorophenyl)methoxy]phenoxy]-5-ethoxyaniline (SEA0400) on the Na+-Ca2+ exchanger (NCX) was investigated and compared against that of 2-[2-[4-(4-nitrobenzyloxy)phenyl]ethyl]isothiourea (KB-R7943). In addition, the effects of SEA0400 on reperfusion injury in vitro and in vivo were examined. SEA0400 was extremely more potent than KB-R7943 in inhibiting Na+-dependent Ca2+ uptake in cultured neurons, astrocytes, and microglia: IC50s of SEA0400 and KB-R7943 were 5 to 33 nM and 2 to 4 microM, respectively. SEA0400 at the concentration range that inhibited NCX exhibited negligible affinities for the Ca2+ channels, Na+ channels, K+ channels, norepinephrine transporter, and 14 receptors, and did not affect the activities of the Na+/H+ exchanger, Na+,K+-ATPase, Ca2+-ATPase, and five enzymes. SEA0400, unlike KB-R7943, did not inhibit the store-operated Ca2+ entry in cultured astrocytes. SEA0400 attenuated dose- dependently paradoxical Ca2+ challenge-induced production of reactive oxygen species, DNA ladder formation, and nuclear condensation in cultured astrocytes, whereas it did not affect thapsigargin-induced cell injury. Furthermore, administration of SEA0400 reduced infarct volumes after a transient middle cerebral artery occlusion in rat cerebral cortex and striatum. These results indicate that SEA0400 is the most potent and selective inhibitor of NCX, and suggest that the compound may exert protective effects on postischemic brain damage.

Complete genome structure of the nitrogen-fixing symbiotic bacterium Mesorhizobium loti

The complete nucleotide sequence of the genome of a symbiotic bacterium Mesorhizobium loti strain MAFF303099 was determined. The genome of M. loti consisted of a single chromosome (7,036,071 bp) and two plasmids, designated as pMLa (351,911 bp) and pMLb (208, 315 bp). The chromosome comprises 6752 potential protein-coding genes, two sets of rRNA genes and 50 tRNA genes representing 47 tRNA species. Fifty-four percent of the potential protein genes showed sequence similarity to genes of known function, 21% to hypothetical genes, and the remaining 25% had no apparent similarity to reported genes. A 611-kb DNA segment, a highly probable candidate of a symbiotic island, was identified, and 30 genes for nitrogen fixation and 24 genes for nodulation were assigned in this region. Codon usage analysis suggested that the symbiotic island as well as the plasmids originated and were transmitted from other genetic systems. The genomes of two plasmids, pMLa and pMLb, contained 320 and 209 potential protein-coding genes, respectively, for a variety of biological functions. These include genes for the ABC-transporter system, phosphate assimilation, two-component system, DNA replication and conjugation, but only one gene for nodulation was identified.

Sequence and analysis of chromosome 3 of the plant Arabidopsis thaliana

Arabidopsis thaliana is an important model system for plant biologists. In 1996 an international collaboration (the Arabidopsis Genome Initiative) was formed to sequence the whole genome of Arabidopsis and in 1999 the sequence of the first two chromosomes was reported. The sequence of the last three chromosomes and an analysis of the whole genome are reported in this issue. Here we present the sequence of chromosome 3, organized into four sequence segments (contigs). The two largest (13.5 and 9.2 Mb) correspond to the top (long) and the bottom (short) arms of chromosome 3, and the two small contigs are located in the genetically defined centromere. This chromosome encodes 5,220 of the roughly 25,500 predicted protein-coding genes in the genome. About 20% of the predicted proteins have significant homology to proteins in eukaryotic genomes for which the complete sequence is available, pointing to important conserved cellular functions among eukaryotes.

Renin-producing adrenal tumor: report of a case

A 19-year-old man with an adrenal tumor associated with hypertension is herein described. The plasma renin activity (PRA) was markedly elevated and the plasma aldosterone level was also increased. The catecholamine level was within the normal range and the glucagone-regitine test was negative. An angiogram revealed the left renal artery to have no stenotic segments, but instead was curved caudally. Magnetic resonance imaging showed a tumor measuring about 8 cm in diameter to be clearly recognized from the left kidney. The blood pressure did not drop when a calcium-channel blocker was used, but was gradually stabilized with the angiotensin converting enzyme (ACE) antagonist. The adrenal tumor was then removed surgically. Normal adrenal tissue was scarcely recognized to the left of the tumor. After surgery, the PRA decreased and blood pressure stabilized rapidly without the ACE antagonist. The possibility of massive renal renin secretion due to suppression by the adrenal tumor was excluded by a method using an antibody to purified human renin.

Involvement of calcineurin in Ca2+ paradox-like injury of cultured rat astrocytes

The Ca2+/calmodulin-dependent phosphatase calcineurin may have physiological and pathological roles in neurons, but little is known about the roles of the enzyme in glial cells. We have previously reported that reperfusion of cultured astrocytes in Ca2+-containing medium after exposure to Ca2+-free medium caused Ca2+ influx followed by delayed cell death. In this study, we examined if calcineurin is involved in this Ca2+-mediated astrocytic injury. FK506, an inhibitor of calcineurin, protected cultured rat astrocytes against paradoxical Ca2+ challenge-induced injury in a dose-dependent manner (10(-10)-10(-8) M). Cyclosporin A at 1 microM mimicked the effect of FK506. Rapamycin (1 microM) did not affect astrocyte injury, but it blocked the protective effect of FK506. Deltamethrin (20 nM), another calcineurin inhibitor, had a similar protective effect, whereas okadaic acid did not. FK506 affected neither paradoxical Ca2+ challenge-induced increase in cytosolic Ca2+ level nor Na+-Ca2+ exchange activity in the cells, suggesting that the calcineurin is involved in processes downstream of increased cytosolic Ca2+ level. Immunochemical studies showed that both calcineurin A (probably the A beta2 isoform) and B subunits were expressed in the cells. It is concluded that calcineurin is present in cultured astrocytes and it has a pathological role in the cells.

Role of Na(+)-Ca2+ exchanger in agonist-induced Ca2+ signaling in cultured rat astrocytes

We have previously demonstrated that activation of the Na(+)-Ca2+ exchanger in the reverse mode causes Ca2+ influx in astrocytes. In addition, we showed that the exchange activity was stimulated by nitric oxide (NO)/cyclic GMP and inhibited by ascorbic acid. The present study demonstrates that the Na(+)-Ca2+ exchanger is involved in agonist-induced Ca2+ signaling in cultured rat astrocytes. The astrocytic intracellular Ca2+ concentration ([Ca2+]i) was increased by L-glutamate, noradrenaline (NA), and ATP, and the increases were all attenuated by the NO generator sodium nitroprusside (SNP). SNP also reduced the ionomycin-induced increase in [Ca2+]i. The NA-induced Ca2+ signal was also attenuated by S-nitroso-L-cysteine and 8-bromo cyclic GMP, whereas it was enhanced by 3,4-dichlorobenzamil, an inhibitor of the Na(+)-Ca2+ exchanger. Treatment of astrocytes with antisense, but not sense, deoxynucleotides to the sequence encoding the Na(+)-Ca2+ exchanger enhanced the ionomycin-induced increase in [Ca2+]i and blocked the effects of SNP and 8-bromo cyclic GMP in reducing the NA-induced Ca2+ signal. Furthermore, the ionomycin-induced Ca2+ signal was enhanced by removal of extracellular Na+ and pretreatment with ascorbic acid. These findings indicate that the Na(+)-Ca2+ exchanger is a target for NO modulation of elevated [Ca2+]i and that the exchanger plays a role in Ca2+ efflux when [Ca2+]i is raised above basal levels in astrocytes.

Heat shock protects cultured rat astrocytes in a model of reperfusion injury

We have previously found that incubation of cultured rat astrocytes in Ca(2+)-free medium caused an increase in intracellular Ca2+ ([Ca2+]i) followed by delayed cell death. Here, we examined whether thermal stress protects astrocytes from cell death in this model system of reperfusion injury. Cultured astrocytes were preincubated at 40-44 degrees C for 10-20 min in fetal calf serum-free medium, incubated at 37 degrees C for 24 h in serum-containing medium, and subjected to the in vitro reperfusion experiment. Thermal stress attenuated reperfusion-induced cell toxicity. Furthermore, the stress increased cell viability after incubation with serum-free medium containing Ca2+. These effects of heat shock required incubation in serum-containing medium for at least 12 h after heat shock, and it was blocked by the protein synthesis inhibitor cycloheximide. Thermal stress increased synthesis of several proteins, and one of the inducible proteins was identified as the 72-kDa heat shock protein by an immunoblot analysis. Neither the increase in [Ca2+]i nor the Na(+)-Ca2+ exchange activity in astrocytes induced in this model were affected by thermal stress. These findings suggest that heat shock proteins protect astrocytes from cell death in a model of reperfusion injury and they may affect processes down stream of the increase in [Ca2+]i.

Ca2+ depletion facilitates taurine release in cultured rat astrocytes

Removal of external Ca2+ facilitated endogenous taurine release in cultured rat astrocytes. The stimulated release was not affected by furosemide, sucrose, tetrodotoxin and 3,4-dichlorobenzamil, but partially inhibited by nifedipine. Omission of external Na+ increased basal taurine release, and the effects of Na+ removal and Ca2+ depletion on the release were additive. The Na(+)-free condition did not affect Ca2+ paradox-induced cell death in astrocytes. These findings suggest that Ca2+ depletion facilitates taurine release in a mechanism independent of volume and the Na+ gradient and that the release is not involved in Ca2+ paradox-induced delayed cell toxicity in astrocytes.

Protective effect of taurine against reperfusion injury in cultured rat astrocytes

Reperfusion of cultured rat astrocytes with Ca(2+)-containing medium after exposure to Ca(2+)-free medium for a short time caused an increase in intracellular Ca2+ ([Ca2+]i), and delayed cell death (Ca2+ paradox-like injury). Exposure of astrocytes to Ca(2+)-free medium caused a marked release of taurine. Taurine (3-30 mM) reduced the reperfusion-induced increase in [Ca2+]i and attenuated the delayed glial cell death. Glycine, GABA and beta-alanine did not affect reperfusion-induced cell toxicity. The protective effect of taurine required addition at an early time during reperfusion. Ouabain and monensin mimicked reperfusion injury and their toxicity was also reduced by taurine. Taurine (3-30 mM) inhibited dose-dependently 45Ca2+ uptake stimulated by ouabain and monensin in astrocytes. These findings suggest that taurine has a protective effect against reperfusion injury via an inhibition of Na+/Ca2+ exchange activity in the reverse mode.

Predictive factors for efficacy of interferon therapy in chronic hepatitis type C

BACKGROUND/AIMS

It has recently become possible to quantify HCV-RNA in serum and to analyze the HCV-RNA genotype. In this study, we investigated the relationship among the response to interferon therapy, the HCV-RNA concentration, genotype and histological findings of the liver.

PATIENTS AND METHODS

Sixty-three patients with chronic hepatitis type C received interferon alfa therapy for 24 weeks. The HCV-RNA concentration in serum was measured semiquantitatively with reverse transcript semi-nested polymerase chain reaction and classified as negative to +3. HCV-RNA genotype was analyzed using a mixture of four type specific primers.

RESULTS

HCV-RNA concentration was significantly higher in patients with genotype II and CAH2B than genotype III, CPH and CAH2A (p < 0.05). At 24 weeks after the end of interferon therapy, HCV-RNA in serum disappeared in 24 of 63 patients (38%). Strong resistance to the therapy was noted in patients with both genotype II and a high concentration of HCV-RNA in serum (the efficacy was only 7%). Therapy efficacy decreased with the severity of liver histological findings, reaching only 20% in those with CAH2B.

CONCLUSION

Both the concentration and genotype of HCV-RNA seem to be important factors in determining the efficacy of interferon therapy.

Ability of prolonged interferon treatment to suppress relapse after cessation of therapy in patients with chronic hepatitis C: a multicenter randomized controlled trial

The aim of this study was to determine whether 12 months course of interferon alfa (IFN-alpha) therapy could improve the beneficial effect of IFN in chronic hepatitis C. Eighty-eight patients were treated with natural IFN-alpha for either 28 weeks (45 cases) or 52 weeks (43 cases). Sustained response was achieved in 15 (33.3%) of 45 cases treated for 28 weeks and in 23 (53.5%) of 43 cases treated for 52 weeks. Transient response with relapse of alanine transaminase (ALT) after completion of therapy was observed in 13 cases (28.9%) treated for 28 weeks and in 4 cases (9.3%) treated for 52 weeks. Thus, ALT relapse was suppressed by prolonged IFN treatment. No response was found in 17 cases (37.8%) treated for 28 weeks and in 16 cases (37.2%) treated for 52 weeks, indicating that approximately 38% of the patients with chronic hepatitis C were resistant to IFN therapy even with prolonged treatment. The rate of sustained response was significantly higher in patients with type 2a or 2b than in those with type 1b. Even in type 1b cases, it was higher in the 52-week treatment group than in the 28-week treatment group, and the rate of transient response was lower in the 52-week treatment group, indicating that relapse in type 1b cases was suppressed by prolonged IFN therapy. IFN therapy was not effective for patients with advanced liver fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Three-dimensional display of liver, spleen, hepatoma, and blood vessels by MR imaging and computer graphics

The technique of generating 3-D images from CT and MR data has made progress. Manipulation of the images has become simpler, the processing time shorter, and the quality better. Clinical application of this technique has been performed for images of brain (5, 7, 8) and bone (1, 2, 6), but only a few studies have been done of abdominal organs (3, 4).

Pulmonary venoocclusive disease in a patient with systemic lupus erythematosus

A 26-year-old woman with systemic lupus erythematosus (SLE) developed dyspnea and hypoxemia on exertion. She died from rapidly progressive respiratory failure. Autopsy revealed right ventricular hypertrophy and occlusion of the pulmonary veins compatible with pulmonary venoocclusive disease (PVOD). Although PVOD has been reported in patients with suspected collagen vascular disease, this appears to be the first reported case of PVOD occurring in a patient with SLE.

Prevalence of hepatitis C virus in family members of patients with hepatitis C

To investigate the prevalence of hepatitis C virus in the family members of patients with hepatitis C, we examined antibody to hepatitis C virus with a second-generation enzyme-linked immunosorbent assay and viral RNA with a combined assay of reverse transcription and polymerase chain reaction in sera. Among 219 (75 spouses, 110 children, and 34 others), 26 (12%) were antibody positive. The positive rate of antibody to hepatitis C virus was significantly higher than that of the control group (2.0%) and of volunteer blood donors in our district (1.5%), and it increased with age. In particular, the positive rate of antibody to hepatitis C virus among spouses was high (24%). Among family members with elevated ALT, 59% were antibody positive, which was significantly higher than that of the control group (11%). Of the 26 who were antibody positive, 21 (81%) had viral RNA, whereas of the 70 who were antibody negative, only one (1.4%) had viral RNA. These data suggest that hepatitis C virus was transmitted by the infrafamilial route during long duration of contact with patients or sexual transmission. In family members, hepatitis C viral infection is the main cause of liver disorder, and many who were antibody-positive with a second-generation enzyme-linked immunosorbent assay had viremia in the sera.

[Research and development of pravastatin]

The attempts to find a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase which catalyzes the rate limiting step of cholesterol biosynthesis were started from 1971. The first potent inhibitor, ML-236B (compactin), was found from the culture broth of Penicillium citrinum. Among many derivatives of ML-236B, pravastatin sodium (hereafter refer to pravastatin) was finally selected because of its potency and tissue selectivity. Since pravastatin has a hydroxyl group at 6 beta position in the skeleton of decaline of ML-236B, the microbial hydroxylation was adopted for the production of pravastatin. Streptomyces carbophilus was finally chosen as a potent converter with the formation of a lesser amount of by-products. For the sake of industrial production of pravastatin, many devices and improvements were performed for selecting high potent strains and for culturing conditions both with ML-236B and pravastatin. Pravastatin strongly inhibited the sterol synthesis in freshly isolated rat hepatocytes, but only weakly inhibited in the cells from nonhepatic tissues. This selective inhibition of pravastatin in sterol synthesis was further confirmed by ex vivo and in vivo experiments by using rats and mice. Pravastatin markedly reduced serum cholesterol levels in dogs, monkeys and rabbits, including Watanabe heritable hyperlipidemic (WHHL) rabbits, an animal model for familial hypercholesterolemia. Pravastatin showed the preventive effect on the development of coronary atherosclerosis and xanthoma in young WHHL rabbits in consequence of maintaining the serum cholesterol levels low. In the clinical trials, pravastatin significantly reduced serum cholesterol and low density lipoprotein cholesterol levels, whereas inversely increased high density lipoprotein cholesterol levels.

Management of congenital diaphragmatic hernia by extracorporeal membrane oxygenation (ECMO)

The purpose of this study was to evaluate the efficacy of extracorporeal membrane oxygenation (ECMO) for patients with congenital diaphragmatic hernia (CDH). Ten patients whose mortality was predicted to be more than 80% with previous therapeutics, were selected to use ECMO over the past five years. Patients were placed on ECMO by cannulating the right jugular vein and the right carotid artery. ECMO was started at 34.3 hours after birth on an average, and the average time on ECMO was 96.3 hours. Seven patients (70%) survived, and six out of them are in good health without any sequelae. In particular, all five patients whose pathological condition needing ECMO was persistent fetal circulation (PFC), survived. Therefore we believe ECMO is highly beneficial to overcome the condition of PFC. The survival rate of CDH patients under 24 hours of age in our hospital is 76.2% (16/21 cases) over the last 5 years, and it has improved compared with 57.1% (12/21 cases) before then. The fact that some of the critical patients who were lethal with conventional management, have been successfully treated by ECMO, played a great role in this improvement.

Fv-1 restriction of endogenous feline C-type RD114 virus genome phenotypically mixed with ecotropic murine leukemia viruses

Endogenous feline leukemia RD114 virus genome rendered capable of infecting mouse cells by phenotypic mixing with an ecotropic murine leukemia virus (MuLV) exhibited the Fv-1 restriction pattern of the ecotropic murine virus. However, RD114 genomes phenotypically mixed with ecotropic MuLV showed one-hit dose-response kinetics, even when titrated with murine cells with the restricted Fv-1 phenotype.

Mutational analysis of the human immunodeficiency virus vpr open reading frame

Mutations were introduced by recombinant DNA techniques into the vpr open reading frame of an infectious molecular clone of human immunodeficiency virus type 1. The effect of these changes on the replicative and cytopathologic properties of the virus recovered from transfected cells was studied in several human CD4+ lymphocyte cell lines. In all cases, mutant viruses were infectious and cytopathic. However, when a low-input dose was used, mutants grew significantly more slowly than the wild-type virus. The growth kinetics of vpr mutants were distinct from those of vif and vpu mutants.