Cardiac phenotypes in the acute-phase of microscopic polyangiitis involves dilatation of the left atrium caused by LV diastolic dysfunction

Background

Microscopic polyangiitis (MPA) is a type of primary systemic vasculitis that affects various organs, especially the lungs and kidneys. However, few reports regarding cardiac features of MPA patients were found.

Purpose

We aim to investigate the echocardiographic parameters of acute-phase MPA.

Methods and results

This single-center retrospective study included 15 patients with MPA (Mean age at 72.2±7.1 years, women 73.3%) who underwent echocardiography within two weeks of commencing steroid therapy for induction or reinduction. The echocardiography parameters of the patients were compared with those of 30 age and sex-matched controls. In the MPA group, the commonly affected organs were kidneys (93.3%) and lungs (46.7%); 5 patients (33.3%) had a history of hypertension, which had a similar frequency as the control group. No significant difference in left ventricular (LV) diameter, LV ejection fraction, e', or inferior vena cava diameter was observed between the two groups. However, the MPA group showed significantly higher left atrial (LA) diameter (p=0.033) and LA volume index (p=0.001), as well as higher early diastolic filling velocity (E-wave, p=0.015; E/A, p=0.043; E/e', p=0.041), diastolic pulmonary venous flow velocity (p=0.013), trans-tricuspid pressure gradient (p=0.019), and shorter deceleration time (p=0.038), associated with mildly thicker ventricular walls of left ventricle (LV) than the control group. Moreover, serum levels of C-reactive protein showed significant correlation between E wave (r=0.58, p=0.023), E/A (r=0.67, p=0.006), and deceleration time (r=−0.69, p=0.005) in the MPA group. These results may indicate that in MPA, increased LV stiffness, rather than impairment of LV relaxation was contributed to LV diastolic function, resulting in LA enlargement.

Conclusion

Patients with acute-phase MPA had LA dilatation associated with LV diastolic dysfunction. This finding indicates the importance of cardiac assessment in patients with MPA.

Funding Acknowledgement

Type of funding sources: None.

Effects of nitrogen on caesium allocation in rice plants (Oryza sativa)

After the nuclear accident in Fukushima Prefecture, Japan, in 2011, ¹³⁷ Caesium (Cs) contaminated nearby agricultural regions. Studies in these rice fields found that low K and high N fertilizer application enhanced Cs uptake in rice shoots. However, the influence of root and soil physics on these findings, as well as precise nutrient levels, remain to be clarified. We sought to analyse these relationships utilizing hydroponically grown rice plants. The rice plants were subjected to various concentrations of K and N nutrient solutions. We measured Cs allocation within the plants and performed transcript analyses using root tissues. Under low-K conditions, low-N plants accumulated less Cs in shoots and more in roots when compared to control-N conditions, even though overall Cs uptake remained unchanged. Expression analyses of root mRNAs showed that low-N plants accumulated reduced levels of OsAKT1 mRNA, encoding a K transporter. We also found a negative relationship between shoot Cs and K status in control-N but not in low-N conditions. Our results suggest that the application of N shifts Cs from roots into the shoots and that OsAKT1 in root vascular tissues influences Cs allocation. In practice, fine tuning N/K application and targeted breeding of K transporters might mitigate Cs contamination in rice plants.

60Fe and 244Pu deposited on Earth constrain the r-process yields of recent nearby supernovae

Half of the chemical elements heavier than iron are produced by the rapid neutron capture process (r-process). The sites and yields of this process are disputed, with candidates including some types of supernovae (SNe) and mergers of neutron stars. We search for two isotopic signatures in a sample of Pacific Ocean crust-iron-60 (⁶⁰Fe) (half-life, 2.6 million years), which is predominantly produced in massive stars and ejected in supernova explosions, and plutonium-244 (²⁴⁴Pu) (half-life, 80.6 million years), which is produced solely in r-process events. We detect two distinct influxes of ⁶⁰Fe to Earth in the last 10 million years and accompanying lower quantities of ²⁴⁴Pu. The ²⁴⁴Pu/⁶⁰Fe influx ratios are similar for both events. The ²⁴⁴Pu influx is lower than expected if SNe dominate r-process nucleosynthesis, which implies some contribution from other sources.

Quantitative analysis of the isolation area after larger-size laser balloon ablation

Background

The visually guided laser balloon ablation is a balloon-based catheter ablation technology used for atrial fibrillation (AF) ablation in recent years. This balloon catheter consists of a compliant balloon that has the capability of real-time endoscopic visualization of the targeted pulmonary vein (PV). The sizeable balloon is usually inflated to obtain optimal PV occlusion. The isolation area after laser balloon (LB) ablation was reported to be smaller than that after cryoballoon ablation. However, when LB is inflated with its maximum pressure, it can visualize wide-area PV antrum. Thereby, we suspected that larger-size LB can create wider isolation area.

Purpose

The aim of this study is to quantitatively evaluate the isolation area after LB ablation at the size larger than appropriate size for ablation in the pulmonary vein carina region.

Methods

We assessed 66 patients with AF who underwent LB ablation at the larger inflation size in our hospital during the period from July 2018 to July 2019. After LB ablation, we created voltage maps with a circular mapping catheter and calculated isolation areas with CARTO system.

Results

Figure shows a larger LB with its maximum pressure. PV antrum isolation was extended to the posterior wall in all patients. The left- and right-sided pulmonary vein antrum isolation area were 15.1±3.9 and 19.4±4.3 cm2, respectively.

Conclusion

LB at the larger inflation size with its maximum pressure can isolate wider-area circumferential PV antrum than previously reported. This method may be a new way of pulmonary vein antrum isolation.

Left atrial voltage mapping after PVI.

Funding Acknowledgement

Type of funding source: None

Serum immunoglobulin G antibody titer to Fusobacterium nucleatum is associated with unfavorable outcome after stroke

Stroke can be a cause of death, while in non-fatal cases it is a common cause of various disabilities resulting from associated brain damage. However, whether a specific periodontal pathogen is associated with increased risk of unfavorable outcome after stroke remains unknown. We examined risk factors for unfavorable outcome following stroke occurrence, including serum antibody titers to periodontal pathogens. The enrolled cohort included 534 patients who had experienced an acute stroke, who were divided into favorable (n = 337) and unfavorable (n = 197) outcome groups according to modified ranking scale (mRS) score determined at 3 months after onset (favorable = score 0 or 1; unfavorable = score 2-6). The associations of risk factors with unfavorable outcome, including serum titers of IgG antibodies to 16 periodontal pathogens, were examined. Logistic regression analysis showed that the initial National Institutes of Health stroke scale score [odds ratio (OR) = 1·24, 95% confidence interval (CI) = 1·18-1·31, P < 0·001] and C-reactive protein (OR = 1·29, 95% CI = 1·10-1·51, P = 0·002) were independently associated with unfavorable outcome after stroke. Following adjustment with those, detection of the antibody for Fusobacterium nucleatum ATCC 10953 in serum remained an independent predictor of unfavorable outcome (OR = 3·12, 95% CI = 1·55-6·29, P = 0·002). Determination of the antibody titer to F. nucleatum ATCC 10953 in serum may be useful as a predictor of unfavorable outcome after stroke.

Abstract P2-01-31: Validation of novel diagnostic kits using the semi-dry dot-blot method for detecting metastatic lymph nodes in breast cancer; distinguishing macrometastases and micrometastases

Background: The semi-dry dot-blot (SDB) method is a diagnostic procedure for detecting lymph node (LN) metastases. Metastases are confirmed by the presence of cytokeratin (CK) in lavage fluid of sectioned LNs that contain anti-pancytokeratin antibody, based on the theory that epithelial components such as CK are not found in normal LNs. We evaluated two novel SDB kits that use the newly developed anti-CK19 antibody for diagnosing LN metastases in breast cancer.

Methods: We obtained 159 LNs dissected from 93 breast cancer patients from July 2013 to December 2015 at Nagasaki University Hospital, including 38 dissected axillary LNs and 121 sentinel LNs, sliced at 2-mm intervals and washed with phosphate-buffered saline. The suspended cells in the lavage fluid of sliced LNs were centrifuged and lysed to extract protein. This extracted protein was used with a low-power and a high-power kit to diagnose LN metastasis. The washed LNs were blindly diagnosed by pathologists using hematoxylin and eosin (H&E) stain. Diagnoses based on the kit were compared with their H&E counterparts.

Results: Of the 159 LNs, 68 were assessed as positive and 91 as negative by permanent pathological examination with H&E. Sensitivity, specificity, and accuracy of the low-power kit for detecting LN metastases was 83.8%, 100%, and 93.1%, respectively. In 11 false-negative cases, there were nine micrometastases, producing a sensitivity of 96.4% for detecting macrometastases. Sensitivity, specificity, and accuracy of the high-power kit for detecting LN metastases was 92.6%, 92.3%, and 92.5%, respectively. Combining the low- and high-power kit results, sensitivity, specificity and accuracy for distinguishing macrometastases from micrometastases was 94.5%, 95.2%, and 95.0%, respectively. Diagnosis was achieved in approximately 20 min using the kits, at a cost of less than 25 USD.

Conclusions: The kits in our study were accurate, quick, and cost-effective in diagnosing LN metastases without the loss of LN tissue. The kits' ability to distinguish macrometastases from micrometastases was excellent, which is important, clinically.

Citation Format: Otsubo R, Hirakawa H, Oikawa M, Inamasu E, Baba M, Matsumoto M, Yano H, Kinoshita N, Abe K, Fukuoka J, Nagayasu T. Validation of novel diagnostic kits using the semi-dry dot-blot method for detecting metastatic lymph nodes in breast cancer; distinguishing macrometastases and micrometastases [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-01-31.

Effects of Concentration Reduction and Partial Replacement of Paraquat by Diquat on Human Toxicity: A Clinical Survey

Paraquat poisoning was studied in 174 patients over a 12-month period when a new, low concentration paraquat product (4.5% w/v paraquat ion mixed with 4.5% w/v diquat ion; 6 3 cases) replaced the original high concentration paraquat product (20% w/v paraquat ion only; 111 cases).

In both groups approximately 60% of the patients died from circulatory failure accompanied by multiple organ failure within a week of ingesting the products. However, a remarkable reduction in late deaths from respiratory failure was noted in the new product group (17.1% vs 6.3%). This was reflected in this group's improved survival (23.4% vs 34.9%).

The improvement in survival seems to be attributable to the dilution of paraquat with diquat which seems to have a different toxicological profile to paraquat.

Abstract P4-04-14: A novel diagnostic method targeting genomic instability in breast intracystic tumors

Background:

In breast lesions, indication for surgery is usually determined by pathological diagnosis together with radiological findings. However, differential preoperative diagnoses of intracystic papillary carcinomas vs. papillomas are very challenging even after needle biopsy, because of their non-specific radiological characteristics, and modest cytological and histological appearance. Hence, surgical excisional biopsy is recommended in the clinical management of these lesions, especially when associated with risk factors for malignancy, such as age (≥50years) and the presence of microcalcifications. Meanwhile, genomic instability (GIN) is an important hallmark of cancer, which may be useful for distinguishing cancers from benign tumors. Specifically, intracystic papillary carcinoma harbors significant GIN compared with intracystic papilloma.We have recently reported that genome-wide copy number aberrations can easily be detected by array comparative genomic hybridization (aCGH), which can then be used to quantify GIN. The aim of this study is to investigate a novel diagnostic method, targeting GIN in breast intracystic tumors, using tumor DNA from samples obtained by fine-needle aspiration biopsy (FNAB).

Material and Methods:

Thirteen consecutive breast intracystic tumors resected at Nagasaki University Hospital between August 2010 and March 2012, which included five cancers (four invasive carcinomas and one non-invasive carcinoma) and eight benign tumors (five papilloma, two ductal adenoma and one sclerosing papilloma), were studied. FNABs were performed by an experienced surgeon using a 22-gauge aspiration needle, who performed three FNAB passages per tumor. Tumor DNA was extracted using the QIAmp DNA Mini Kit (Qiagen), followed by aCGH analysis using a high-density oligonucleotide microarray (Agilent® SurePrint G3 8×60k microarray). The frequency of aberrant chromosomal regions in the total genome was used as an indicator of GIN. Tumor DNA from the main tumor, taken from FFPE blocks corresponding to FNAB samples, was also analyzed to assess the similarity of cytogenetic profiles.

Results:

After three FNAB passages, sufficient amounts of DNA were obtained with an average of 7.09 μg (0.24-16.1 μg). The quality of the DNA and the aCGH data was excellent, as judged by the mean derivative log ratio spread (DLRSpread) of 0.22 (0.15-0.29), which estimates the log ratio noise by calculating the spread of log ratio differences between consecutive probes along all chromosomes. Further, the cytogenetic profile of paired FNAB and main tumor FFPE samples were highly similar, with an average concordance rate, defined as the ratio of the length of same copy number within pairs, of 97.7% (81.2-100%). aCGH analysis from FNAB samples showed that cancers harbored significantly more GIN than benign tumors, with mean frequencies of aberrant chromosomal regions of 17.5% and 0.34%, respectively (Wilcoxon's rank sum test, P = 0.0016).

Conclusions:

Our novel diagnostic method, which targets genomic instability, can clearly distinguish cancers from benign tumors of breast intracystic lesions with minimum invasion, thereby avoiding the need for surgical excisional biopsy.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-04-14.

Aggressive pulmonary calcification developed after living donor kidney transplantation in a patient with primary hyperparathyroidism

Metastatic pulmonary calcification, defined as calcium deposition in the intact lung, is commonly seen in patients with chronic renal failure, and it is known to be a benign clinical condition when detected by chance in an asymptomatic patient. Here we report the case of a 33-year-old woman who developed rapid and aggressive metastatic pulmonary calcification shortly after a living donor kidney transplantation, which induced acute antibody-mediated rejection. The patient's metastatic pulmonary calcification was successfully improved by extensive treatment for graft rejection, the correction of her accompanying primary hyperparathyroidism, and medical treatment with a bisphosphonate and sodium thiosulfate. Aggressive pulmonary calcification is reported as a rare complication seen in patients who have undergone a failed renal transplantation. A failed renal graft and accompanying secondary hyperparathyroidism seem to accelerate metastatic calcification. Most of the patients who develop aggressive pulmonary calcification suffer from the rapid progression of dyspnea and occasionally fever, and they die of respiratory failure. Pulmonary calcification should be considered in a patient developing dyspnea and unexplained pulmonary infiltrate, especially in the context of renal graft rejection; otherwise the prognosis of the patient will be very poor.

Periodontal disease and gene-expression levels of metalloendopeptidases in human buccal mucosal epithelium

BACKGROUND AND OBJECTIVE

Endopeptidases, such as neutral endopeptidase (NEP), endothelin-converting enzyme-1 (ECE-1) and a disintegrin and metalloprotease 17 (ADAM17), are believed to have various important roles in oral mucosal and epidermal tissue for the regulation of defensive biological responses in the oral cavity, and their expression and activity are influenced by various factors, including oral diseases. However, knowledge concerning these endopeptidases in the oral cavity has been minimal until now. This study focused on three metalloendopeptidases - NEP, ECE-1 and ADAM17 - in the oral buccal mucosal epithelium of patients with periodontal diseases and investigated the relationship between their gene-expression levels and periodontal disease.

MATERIAL AND METHODS

The levels of expression of NEP, ECE-1 and ADAM17 mRNAs in tissue samples collected from the oral buccal mucosal epithelium of 61 patients were investigated by relative quantification using real-time RT-PCR analysis. information on oral and systemic health was obtained from the clinical record of each patient.

RESULTS

Among the three groups, classified based on the diagnosis of periodontal diseases (healthy/gingivitis, early periodontitis and moderate/advanced periodontitis), the relative expression level of NEP mRNA was significantly increased in the early periodontitis group and in the moderate/advanced periodontitis group compared with that in the healthy/gingivitis group. Moreover, the relative expression levels of ECE1 and ADAM17 mRNAs were significantly increased in the moderate/advanced periodontitis group compared with those in the healthy/gingivitis group. The correlation coefficients between the mean relative expression levels of NEP and ECE1 mRNAs, NEP and ADAM17 mRNAs, and ECE1 and ADAM17 mRNAs were r = 0.758, r = 0.707 and r = 0.934, respectively (p < 0.001). Furthermore, among the oral-related factors, there was a significant correlation between the number of sites with probing pocket depths of more than 4 mm and of more than 6 mm and the relative expression levels of NEP, ECE1 and ADAM17 mRNAs. In stepwise logistic regression models, high relative expression levels of ECE1 and ADAM17 mRNAs were significantly associated with moderate/advanced periodontitis.

CONCLUSION

The present study suggests that the severity of periodontal disease may be associated with the expression of metalloendopeptidase genes, including NEP, ECE1 and ADAM17, in the buccal mucosal epithelium.

Abstract P1-01-27: Novel diagnostic procedure of metastasis to the sentinel lymph node of breast cancer using a semi-dry dot-blot method

Background: Sentinel lymph node (SLN) biopsy is a common surgical procedure. However, novel diagnostic modalities are required because of a shortage of pathology specialists in Japan and discordance between the intraoperative and final pathological diagnosis of SLN metastasis. Efficient methods that use molecular markers for detecting SLN metastasis, such as one-step nucleic acid amplification, are commercially available, but special equipment (e.g., thermal cycler) is costly and the problem of false-negatives for CK19 non-expressing cells remains unresolved. Recently, we developed an easy, quick and cost-effective method for detection of cancer cells in lymph nodes by applying dot-blot analysis technology, called the “semi-dry dot-blot method (SDB method)”. The SDB method visualizes the presence of cancer cells with washing of sectioned lymph nodes by anti-pancytokeratin antibody (AE1/AE3) and chromogen on a dot-blot membrane. This method can detect 0.01 mg/mL protein extracted from cancer tissue and 20 suspension cells (MCF-7) in approximately 20 minutes. The current study evaluated the efficacy of our SDB method in the diagnosis of SLN metastasis in breast cancer.

Methods: (I) One hundred eighty dissected lymph nodes from 29 cases, including breast, lung, gastric and colorectal cancer, were analyzed. Each lymph node was sliced at the maximum diameter and washed by phosphate-buffered saline (PBS), and this lavage fluid (PBS) was used for diagnosis of LN metastasis by the SDB method, and washed lymph node was sent to pathological section for pathological diagnosis. The sensitivity, specificity and accuracy of the SDB method were determined to compare with the final pathology report.

(II) A multicenter prospective clinical trial was conducted, where 132 SLN samples from 78 cases of clinically node-negative breast cancer were analyzed. Each SLN was sliced at 2-mm intervals and washed by PBS. Lavage fluid of sliced SLNs was used for the diagnosis of SLN metastasis by the SDB method in a blinded manner. The sensitivity, specificity, accuracy and the time required for the SDB method were determined and compared with the intra-operative pathology report.

Results: (I) Lymph node metastasis was detected in 35 lymph nodes (19.4%). Comparison of the results between the final pathology and the SDB method showed complete concordance (accuracy: 100%).

(II) Of the 132 lymph nodes eligible for analysis, 13 (10.0%) were assessed as positive and 114 as negative by the SDB method and intra-operative pathological examination, with an accuracy of 96.2%. All pathologically positive nodes, which included one micro metastasis, were also detected by the SDB method; (sensitivity: 100%). One hundred fourteen of the 119 pathologically negative nodes were assessed as negative with the SDB method (specificity: 95.8%). The mean required times of 16 cases for intra-operative pathological diagnosis and simultaneous SDB method were 43.5 and 42.2 minutes, respectively.

Conclusions: The SDB method is simple, fast, accurate and cost-effective for the intra-operative diagnosis of SLN metastasis. Because there is no loss of lymph node tissue, the SDB method and pathological investigation can be performed simultaneously.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-01-27.

A Shorter 146 Sm Half-Life Measured and Implications for 146 Sm- 142 Nd Chronology in the Solar System

The extinct p-process nuclide (146)Sm serves as an astrophysical and geochemical chronometer through measurements of isotopic anomalies of its α-decay daughter (142)Nd. Based on analyses of (146)Sm/(147)Sm α-activity and atom ratios, we determined the half-life of (146)Sm to be 68 ± 7 (1σ) million years, which is shorter than the currently used value of 103 ± 5 million years. This half-life value implies a higher initial (146)Sm abundance in the early solar system, ((146)Sm/(144)Sm)(0) = 0.0094 ± 0.0005 (2σ), than previously estimated. Terrestrial, lunar, and martian planetary silicate mantle differentiation events dated with (146)Sm-(142)Nd converge to a shorter time span and in general to earlier times, due to the combined effect of the new (146)Sm half-life and ((146)Sm/(144)Sm)(0) values.

Superconductivity of κ-(BEDT–TTF)2 Cu[N(CN) 2]Br: Isotope Effect Revisited

In 1991, we reported a normal isotope effect in organic superconductor κ-(BEDT–TTF)2Cu[N(CN)2]Br, when all the hydrogen atoms of BEDT – TTF were replaced with deuterium. In other words, Tc was depressed by as much as 0.9 K, in contrast to the “inverse isotope effect” commonly observed in 10K-class organic superconductors. Recently, it was reported that the deuterated κ-(BEDT–TTF)2Cu[N(CN)2]Br shows an insulating nature when cooled very rapidly. Therefore, it is necessary for us to reexamine the superconducting transition of both deuterated and undeuterated κ- (BEDT – TTF)2Cu[N(CN)2]Br by SQUID measurements with special attention to the cooling speed. We studied the effect of cooling rate ranging from 10 K/min down to as slow as 0.02 K/min, and observed a significant effect not only on the superconducting transition temperature Tc but also on the superconducting volume fraction.

Tenascin‐C levels in pseudosynovial fluid of loose hip prostheses

OBJECTIVE

Aseptic loosening is one of the most important problems that can occur after total hip arthroplasty (THA). In this study, we analysed levels of large tenascin-C (TN-C) variants and compared them in pseudosynovial fluid from patients with aseptic loosening after THA with those in synovial fluid from patients undergoing primary THA (control).

METHODS

Pseudosynovial fluid samples (n = 24) were obtained by aspiration at the time of revision THA performed due to aseptic loosening. Synovial fluid samples (n = 12) were obtained by aspiration at the time of primary THA. Expression of TN-C splice variants was examined using immunoblotting. TN-C levels were measured using an enzyme-linked immunosorbent assay (ELISA) system that we developed previously.

RESULTS

Western blotting showed the presence of large TN-C variants in pseudosynovial fluid of artificial joints with loosening. TN-C levels were approximately three times higher in pseudosynovial fluid of loose artificial joints (median 151.9 ng/mL) than in synovial fluid controls (median 50.1 ng/mL) (p = 0.035).

CONCLUSION

Levels of TN-C including large variant subunits are elevated in pseudosynovial fluid of loose artificial joints, indicating that TN-C is a useful novel biochemical marker of loose hip prostheses.

Protein phosphatases and cell division cycle control

Fission yeast has at least ten protein phosphatase genes that appear to play distinct roles in cell cycle control. Because of functional overlap, a clear lethal phenotype can be obtained only after multiple genetic alterations. Cells that have lost the protein phosphatase 1 (PP1)-like dis2/sds21 phosphatase activities prematurely enter mitosis and remain in a defective mitotic state with high H1 kinase activity and without sister chromatid disjunction. The same phenotype can be obtained in the presence of hydroxyurea. Overexpression of PP1-like phosphatase, on the other hand, delays the entry into mitosis. Cells that have lost PP2A-like ppa2 phosphatase activity also prematurely enter mitosis with a reduction in cell size. This semi-wee phenotype is enhanced in delta ppa2 mutants treated with the phosphatase inhibitor, okadaic acid. Genetic interactions between ppa2 and mitotic regulators suggest that ppa1/ppa2 phosphatase may directly or indirectly inhibit p34cdc2/cyclin kinase. Thus both PP1- and PP2A-like phosphatases in fission yeast may negatively regulate entry into mitosis. The major property of the dis2/sds21 mutant which is distinct from those of the ppa2/ppa1 mutant is its failure to inactivate the p34cdc2/cyclin complex after entry into mitosis. A novel phosphatase regulator encoded by sds22+ binds to dis2 phosphatase and controls the substrate specificity which appears to become essential in the progression from metaphase to anaphase.

Nicorandil improves diabetes and rat islet beta-cell damage induced by streptozotocin in vivo and in vitro

OBJECTIVE

N-(2-hydroxyethyl)-nicotinamide nitrate (nicorandil) is a unique anti-anginal agent, reported to act as both an ATP-sensitive K(+) channel opener (PCO) and a nitric oxide donor. It also has an anti-oxidant action. We examined the effects of nicorandil on streptozotocin (STZ)-induced islet beta-cell damage both in vivo and in vitro.

DESIGN AND METHODS

STZ-induced diabetic Brown Norway rats (STZ-DM) were fed with nicorandil-containing chow from day 2 (STZ-DM-N48), 3 (STZ-DM-N72), and 4 (STZ-DM-N96) to day 30. Body weight, blood glucose, and plasma insulin were measured every week. For the in vitro assay, neonatal rat islet-rich cultures were performed and cells were treated with nicorandil from 1 h before to 2 h after exposure to STZ for 30 min. Insulin secretion from islet cells was assayed after an additional 24 h of culture. We also observed the effect of nicorandil on the generation of reactive oxygen species (ROS) from rat inslinoma cells (RINm5F).

RESULTS

Body weight loss and blood glucose levels of STZ-DM-N48 rats were significantly lower than those of STZ-DM rats. Immunohistochemical staining of insulin showed preservation of insulin-secreting islet beta-cells in STZ-DM-N48 rats. Nicorandil also dose-dependently recovered the insulin release from neonatal rat islet cells treated with STZ in in vitro experiments. Nicorandil did not act as a PCO on neonatal rat islet beta-cells or RINm5F cells, and did not show an inhibitory effect on poly(ADP-ribose) polymerase-1. However, the drug inhibited the production of ROS stimulated by high glucose (22.0 mmol/l) in RINm5F cells.

CONCLUSIONS

These results suggested that nicorandil improves diabetes and rat islet beta-cell damage induced by STZ in vivo and in vitro. It protects islet beta-cells, at least partly, via a radical scavenging effect.

A new form of retinopathy associated with myocardial infarction treated with percutaneous coronary intervention

AIM

To report a new form of retinopathy that was observed in patients who had undergone percutaneous coronary intervention (PCI) following acute myocardial infarction (AMI).

METHODS

Serial ophthalmological examinations were conducted in 40 patients who underwent PCI. Thirty patients were diagnosed with AMI, and another 10 had stable angina pectoris.

RESULTS

Cotton wool spots developed in 17 (57%) patients from the group with AMI undergoing PCI (n = 30) within 2 months. Of these, 41% (seven patients) also developed superficial haemorrhages. Retinopathy was most prominent 1-2 months after AMI and then tended to become quiescent afterwards, without treatment.

CONCLUSION

We have identified a new form of retinopathy in patients with AMI that spontaneously subsides without treatment.

Recognition of left ventricular hypertrophy in new recruits of professional sumo wrestling

The efficacy of electrocardiography (ECG) in the diagnosis of left ventricular (LV) hypertrophy in 890 males, newly recruited to Japanese professional sumo wrestling (15.9 +/- 1.8 years of age, 177.8 +/- 4.7cm, 107.3 +/- 4.7kg), was tested by comparing simple, widely employed ECG criteria (Sokolow-Lyon chest and limb lead voltages and Cornell voltage with repolarisation criteria) with echocardiographic evaluations of LV mass indexed to body surface area. LV hypertrophy was defined as a LV mass index > 2 SD above the mean value obtained from 115 age-matched, normotensive, sedentary, male controls. The prevalence of LV hypertrophy as determined by echocardiography was 9.0% the entire group and was 8.3% among the 484 normotensives. The sensitivities of the three ECG criteria were < or = 36.0%, and their specificities were 70.0-99.0%. In contrast to the Sokolow-Lyon chest lead criteria, the diagnostic performance of the Cornell criteria was little affected by body mass index (BMI), and stepwise regression revealed that BMI did not significantly correlate with Cornell voltage. Still, the diagnostic efficacy of ECG was not sufficient to merit its use for primary recognition of LV hypertrophy among professional sumo wrestlers. Indeed, LV hypertrophy will likely go undetected by ECG in most overweight muscular athletes.

Autocrine IL-15 mediates intestinal epithelial cell death via the activation of neighboring intraepithelial NK cells

Intestinal intraepithelial lymphocytes (IELs), which reside between the basolateral faces of intestinal epithelial cells (IECs), provide a first-line defense against pathogens via their cytotoxic activity. Although IEC-derived IL-7 and IL-15 are key regulatory cytokines for the development and activation of IELs, we report here that IL-15 but not IL-7 mediates the reciprocal interaction between IELs and IECs, an important interaction for the regulation of appropriate mucosal immunohomeostasis. IL-15-treated IELs induced cell death in IECs via the cytotoxic activity in vitro. Among the different subsets of IL-15-treated IELs, CD4(-)CD8(-)TCR(-) IELs, which express NK marker (DX5 or NK1.1), showed the most potent syngenic IEC killing activity. These intraepithelial NK cells expressed Ly-49 molecules, NKG2 receptors, and perforin. These results suggest the possibility that the cell death program of IECs could be regulated by self-produced IL-15 through the activation of intraepithelial NK cells.

Initiation of NALT organogenesis is independent of the IL-7R, LTbetaR, and NIK signaling pathways but requires the Id2 gene and CD3(-)CD4(+)CD45(+) cells

Initiation of nasopharyngeal-associated lymphoid tissue (NALT) development is independent of the programmed cytokine cascade necessary for the formation of Peyer's patches (PP) and peripheral lymph nodes (PLN), a cytokine cascade which consists of IL-7R, LTalpha1beta2/LTbetaR, and NIK. However, the subsequent organization of NALT seems to be controlled by these cytokine signaling cascades since the maturation of NALT structure is generally incomplete in those cytokine cascade-deficient mice. NALT as well as PP and PLN are completely absent in Id2(-/-) mice. NALT organogenesis is initiated following the adoptive transfer of CD3(-)CD4(+)CD45(+) cells into Id2(-/-) mice, constituting direct evidence that CD3(-)CD4(+)CD45(+) inducer cells can provide an IL-7R-, LTalpha1beta2/LTbetaR-, and NIK-independent tissue organogenesis pathway for secondary lymphoid tissue development.

IL-15-dependent activation-induced cell death-resistant Th1 type CD8 alpha beta+NK1.1+ T cells for the development of small intestinal inflammation

To clarify the role of IL-15 at local sites, we engineered a transgenic (Tg) mouse (T3(b)-IL-15 Tg) to overexpress human IL-15 preferentially in intestinal epithelial cells by the use of T3(b)-promoter. Although IL-15 was expressed in the entire small intestine (SI) and large intestines of the Tg mice, localized inflammation developed in the proximal SI only. Histopathologic study revealed reduced villus length, marked infiltration of lymphocytes, and vacuolar degeneration of the villus epithelium, beginning at approximately 3-4 mo of age. The numbers of CD8(+) T cells, especially CD8alphabeta(+) T cells expressing NK1.1, were dramatically increased in the lamina propria of the involved SI. The severity of inflammation corresponded to increased numbers of CD8alphabeta(+)NK1.1(+) T cells and levels of production of the Th1-type cytokines IFN-gamma and TNF-alpha. Locally overexpressed IL-15 was accompanied by increased resistance of CD8alphabeta(+) NK1.1(+) T cells to activation-induced cell death. Our results suggest that chronic inflammation in the SI in this murine model is mediated by dysregulation of epithelial cell-derived IL-15. The model may contribute to understanding the role of CD8(+) T cells in human Crohn's disease involving the SI.

Effective and selective prevention of retinal leukostasis in streptozotocin-induced diabetic rats using gliclazide

AIMS/HYPOTHESIS

Early stage leukocyte entrapment in the retinal microcirculation (retinal leukostasis) is considered to be one of the important pathogenetic events in diabetic retinopathy. Gliclazide, a sulphonylurea, was reported to reduce leukocyte adhesion to endothelial cells in hyperglycaemia in vitro, thus suggesting possible selective efficacy of this sulphonylurea in preventing leukostasis in diabetic patients. This study evaluated the effectiveness and selectivity of gliclazide treatment on retinal leukostasis of diabetic rats in vivo.

METHODS

Streptozotocin (STZ) (65 mg/kg)-induced diabetic rats were divided into three groups (n = 8 each): an untreated diabetic group, a gliclazide-treated diabetic group, and a glibenclamide-treated diabetic group. Gliclazide or glibenclamide was administered orally during a 3-week period. Non-diabetic rats were used as a control (n = 8). Retinal leukostasis was quantitatively evaluated in vivo by acridine orange leukocyte fluorography using a scanning laser ophthalmoscope.

RESULTS

The number of leukocytes trapped in the area around the optic disc in the untreated diabetic group (36.9 +/- 5.1 cells) increased significantly compared with the non-diabetic control group (21.9 +/- 2.9 cells; p = 0.0007). The number of leukocytes trapped in the gliclazide-treated diabetic group (23.5 +/- 4.0 cells) decreased significantly compared with untreated diabetic group ( p = 0.0008). In contrast, no reduction of retinal leukostasis was found in the glibenclamide-treated diabetic group (37.8 +/- 5.8 cells; p = 0.7923).

CONCLUSION/INTERPRETATION

This suggests that gliclazide could directly improve abnormalities in the retinal microcirculation independent of blood glucose control and possibly have selective therapeutic benefits in preventing early, critical events in diabetic retinopathy compared with other sulphonylurea drugs.

Regulation of cell proliferation using tissue engineering in MIN6 cells

Pancreatic islet transplantation for patients with diabetes mellitus has been hindered by the problem of donor shortage, as is the case for transplantation of other organs. Among several measures to overcome this problem, cell transplantation using xenogenic cell lines has been considered. For the treatment of diabetic patients, a murine pancreatic beta-cell line MIN6 is a potential source of cell transplant. In order to restrict otherwise unlimited proliferation of transplanted MIN6 cells, cells are rendered to form spheroidal aggregates (SMIN6) on nonadherent culture dishes. SMIN6 stopped its growth around day 7 with a diameter of 220 +/- 40 microm and kept its size almost constant at least until day 28. SMIN6 cells, however, had reduced responsiveness of insulin secretion to glucose concentration compared with MIN6 cells cultured in a monolayer. On the other hand, spheroid MIN6 cells formed in the presence of extracellular matrix gel (SMIN6E) possessed the capacity for glucose-dependent insulin secretion comparable with conventional MIN6 cells. SMIN6E encapsulated in agarose beads (SMIN6E-B) was also viable for at least 1 month in vitro with a constant diameter and favorable glucose responsiveness. The development of spheroid-type MIN6 may contribute to the future clinical application of MIN6 or other beta-cell lines for treatment of diabetes mellitus.

Tyropeptins A and B, new proteasome inhibitors produced by Kitasatospora sp. MK993-dF2. I. Taxonomy, isolation, physico-chemical properties and biological activities

Tyropeptins A and B, new proteasome inhibitors, were isolated from the culture broth of Kitasatospora sp. MK993-dF2. They were purified using ethyl acetate extraction, silica gel column chromatography, Sephadex LH-20 column chromatography and HPLC. Tyropeptin A inhibited the chymotrypsin-like (ChT-L) and trypsin-like (T-L) activities of 20S proteasome with IC50 values of 0.1 microg/ml and 1.5 microg/ml respectively, but did not inhibit the peptidylglutamyl-peptide hydrolyzing (PGPH) activity of 20S proteasome at a concentration of 100 microg/ml. The inhibitory activities of tyropeptin A were about two times as strong as that of tyropeptin B. Taxonomy of the producing strain is also described.

Decreased expression of Bcl-x protein during hepatocarcinogenesis induced exogenously and endogenously in rats

Dysregulations of apoptosis have been widely recognized as important events in multi-stage carcinogenesis. Bcl-x, a member of the Bcl-2 family, is known to act as a regulator of apoptosis. The present study was conducted to assess the role of altered Bcl-x protein expression in exogenous and endogenous hepatocarcinogenesis in rats. In the short-term exogenous models, male Fischer 344 rats, 6 weeks old, were given a single intraperitoneal injection of diethylnitrosamine (DEN) at a dose of 200 mg / kg body weight, partially hepatectomized at the end of week 3, administered phenobarbital at a concentration of 0.05% from the end of week 2 for 6 weeks, and sacrificed. In the livers, glutathione S-transferase (GST-P)-positive, putative preneoplastic lesions were induced, and Bcl-x protein expression was decreased in 24.7% of such lesions. The incidence of GST-P-positive lesions with decreased Bcl-x increased depending on the size of the lesions; 18.9%, 32.4% and 86.5% in the lesions smaller than 0.03, between 0.03 and 0.3, and larger than 0.3 mm(2), respectively. In GST-P-positive lesions larger than 0.3 mm(2), both apoptosis induction and cell proliferation activity were enhanced when Bcl-x protein expression was decreased. In the long-term exogenous models, rats were given 10 mg / kg of DEN, partially hepatectomized 4 h after treatment, administered 0.5 mg / kg of colchicine at the end of days 1 and 3, subjected to a selection procedure, and sacrificed at the end of week 45. Hepatocellular carcinomas were induced with the decreased Bcl-x protein expression. In the endogenous model, rats were fed a choline-deficient, L-amino acid-defined diet for 16 or 80 weeks and sacrificed. Bcl-x protein expression was decreased both in GST-P-positive lesions and hepatocellular carcinoma. These results suggest that this decrease of Bcl-x protein might serve as an indicator of the advanced form of preneoplastic lesions, and that this decrease could also be associated with a potential to progress into carcinoma in both exogenous and endogenous hepatocarcinogenesis of rats.

A Ca(2+)-dependent protein kinase that endows rice plants with cold- and salt-stress tolerance functions in vascular bundles

A rice Ca(2+)-dependent protein kinase, OsCDPK7, is a positive regulator commonly involved in the tolerance to cold and salt/drought. We carried out in situ detection of the transcript and immunolocalization of the protein. In the wild-type rice plants under both stress conditions, OsCDPK7 was expressed predominantly in vascular tissues of crowns and roots, vascular bundles and central cylinder, respectively, where water stress occurs most severely. This enzyme was also expressed in the peripheral cylinder of crown vascular bundles and root sclerenchyma. Similar localization patterns with stronger signals were observed in stress-tolerant OsCDPK7 over-expressing transformants with the cauliflower mosaic virus 35S promoter. The transcript of a putative target gene of the OsCDPK7 signaling pathway, rab16A, was also detected essentially in the same tissues upon salt stress, suggesting that the OsCDPK7 pathway operates predominantly in these regions. We propose that the use of the 35S promoter fortuitously strengthened the localized expression of OsCDPK7, resulting in enhancement of the stress signaling in the inherently operating regions leading to improved stress tolerance.

Isolation and structural determination of phepropeptins A, B, C, and D, new proteasome inhibitors, produced by Streptomyces sp

We have isolated four related compounds named phepropeptins A, B, C, and D, as inhibitors of proteasome proposed to regulate many cellular functions. From an NMR analysis, the phepropeptins appeared as cyclic hexapeptides, differing in the two residues of the constituent amino acids from one another, with four conserved amino acid moieties. Based on an amino acid analysis, we synthesized two possible cyclic peptides to phepropeptin B that differ in the configurations. A comparison of the properties between the natural and synthesized compounds revealed that the structure of phepropeptin B was cyclo(-L-Leu-D-Phe-L-Pro-L-Phe-D-Leu-L-Val-). The phepropeptins showed inhibition to the proteasomal chymotrypsin-like activity but not to alpha-chymotrypsin.

Cause-specific mortality risk among male alcoholics residing in the Osaka metropolitan area

We evaluated the mortality risk among 306 male alcoholics living in Osaka, Japan, at the time of initial diagnosis between 1972 and 1983, with regard to the cause of death, length of time from diagnosis, and participation in an alcohol abstinence self-help group. By the closing date on 1 March 1992, 110 of the 306 alcoholics had died, yielding an observed-to-expected (O/E) ratio of 4.5 [95% confidence interval (CI) = 3.7-5.4]. The alcoholics had significantly elevated mortality risks from all malignant neoplasms (O/E = 2.1, 95%CI = 1.2-3.3), esophageal cancer (O/E = 8.4, 95%CI = 1.7-24.5), diseases of the circulatory system (O/E = 4.4, 95%CI = 3.0-6.2), liver cirrhosis (O/E = 15.9, 95%CI = 10.2-23.6), diseases of the genitourinary system (O/E = 6.3, 95%CI = 1.3-18.5), and external death (O/E = 10.3, 95%CI = 6.3-15.8). The mortality risk from all causes still remained significantly high beyond the tenth year following initial diagnosis (O/E = 2.6, 95%CI = 1.0-6.2). The mortality risks from liver cirrhosis and external death (such as suicide) were highest within the first year following diagnosis, and were still high beyond the tenth year. A significantly high mortality risk from diseases of the circulatory system was observed between the first and ninth years, and the mortality risk from all malignant neoplasms was significantly elevated beyond 10 years following diagnosis. Alcoholics who did not join a self-help group soon after the initial institutional treatment had different cause-specific and time-specific mortality risks from those who did join a self-help group. These findings show the importance of long-term clinical follow-up of male alcoholics, taking into consideration the cause-specific mortality.

"Schistotaxis" in cerebral blood flow on 99mTc-HMPAO single-photon emission computed tomography during a seizure following a stroke

We describe a patient with seizures following a stroke in whom on ictal 99mTc-HMPAO single-photon emission computed tomography demonstrated cerebral blood flow "schistotaxis", i.e., focal hyperaemia corresponding to an epileptogenic focus together with an extensive hypoperfused area in the same hemisphere. This phenomenon may have been caused by haemodynamic alternation and a remote transneural effect during the seizures.

Fortuitously discovered persistent left superior vena cava in young competitive athletes. Clinical implications of sports physicians

This report describes two athletes with persistent left superior vena cava (PLSVC) accidentally identified during preparticipation medical evaluation. The clinical implications of PLSVC for sports physicians are also discussed. A 16-year-old male ice hockey player and an 18-year-old male high-level field hockey player visited our institute for medical evaluation prior to participating in competition. Neither complained of palpitation, faintness or syncope, which would have suggested a possible cardiac rhythm disturbance, or had been informed of any abnormalities in previous physical examinations. Nonetheless, echocardiography revealed dilated coronary sinuses, and venography confirmed PLSVC and, in one case, showed the absence of the right superior vena cava. Electrocardiograms showed the field hockey player to have an ectopic atrial rhythm with left axis deviation of the frontal plane P-wave and the ice hockey player to have normal sinus rhythm. Symptom-limited treadmill testing revealed nothing abnormal, and after explaining the possible rhythm instability and the potential risk associated with cardiac surgery, the subjects were permitted full participation in competitive sports. Although information is scarce, available data on PLSVC suggest it is benign for competitive athletes. Nevertheless, complications arising from other cardiovascular anomalies, from potential cardiac rhythm disturbances, and from cardiac surgery necessitated by major injuries should be considered prior to participation in competitive sports.

Diminished reserve for cerebral vasomotor response to L-arginine in the elderly: evaluation by transcranial Doppler sonography

BACKGROUND

Nitric oxide is pivotal in endothelially dependent vasodilatory regulation. An association of endothelial dysfunction with aging has been documented in the forearm and coronary vascular beds. However, the influence of aging in the human cerebral circulation, where regulation is particularly complex, is incompletely understood.

OBJECTIVE

We systematically administered L-arginine, a precursor of nitric oxide, to evaluate the influence of aging on nitric oxide-mediated cerebral vasomotor regulation.

METHODS

Among healthy volunteers, 20 older subjects (10 men, 10 women; age: 70.2 +/- 2.8 years) and 22 younger subjects (10 men, 12 women; age: 28.8 +/- 1.9 years) received intravenous infusions of L-arginine monochloride (500 mg/kg) over 30 min. Hemodynamic parameters were monitored continuously during and after infusion. The cerebral vasomotor response was estimated by transcranial Doppler sonography of the right middle cerebral artery.

RESULTS

Infusion of saline as a control brought little change in the mean blood pressure, heart rate or cerebral blood flow velocity in either group. On administration of L-arginine, cerebral blood flow velocity increased and mean blood pressure decreased. After completion of infusion, both parameters rapidly normalized. While reduction of mean blood pressure did not differ between older and younger groups, the cerebral circulation in the older group showed a blunted, smaller, and more easily saturated vasomotor response compared to the younger group, though both groups had similar baseline values.

CONCLUSION

Our results indicate a diminished nitric oxide-mediated cerebral vasomotor response in aging subjects. Additionally, transcranial Doppler sonography can be used to reliably evaluate age-related changes in the physiologic responses of the human cerebral circulation.