Short communication: expression of human endogenous retrovirus-R gene links to differentiation of squamous cells.

To investigate the biological roles of human endogenous retrovirus-R (HERV-R) in vivo, we established transgenic rats carrying the full sequence of the viral genome with control of its own long terminal repeat promoter. The Env protein was expressed on the surface of the epidermis of fetal HERV-R transgenic rats on day 10 of gestation. The epidermal Env expression disappeared by day 18 of gestation. After day 18 of gestation, the Env protein was detected in the prickle layer of the esophageal epithelium of transgenic rats. Interestingly, it was not detected in the basal layer of the epithelium, and the expression in the granular layer was weaker than in the prickle layer. These findings suggest that expression of HERV-R is linked not only to the development but also to the differentiation of squamous cells. Next, we examined alterations in the expression of the HERV-R env gene in cultured human squamous cells after exposure to all-trans retinoic acids (ATRA). The env expression was increased by ATRA in a dose-dependent manner, while the expression of transglutaminase 1 (TGM1), a terminal marker for squamous differentiation, was decreased. TGM1 is expressed in the granular layer of the squamous epithelium, and ATRA suppresses the differentiation of cultured squamous cells. Thus, these in vitro data also suggest that HERV-R expression is regulated by a mechanism closely related to the differentiation of squamous cells. This study is the first to demonstrate the association of HERV-R expression and differentiation of squamous cells.

Correlation between the levels of circulating adhesion molecules and PR3-ANCA in Wegener's granulomatosis.

OBJECTIVE: The adhesion of neutrophils to the vascular endothelial cells appears to be important for the pathogenesis of vasculitis in Wegener's granulomatosis (WG). To determine the pathological significance of the neutrophil adhesion, we have examined and evaluated the relationships between the levels of adhesion molecules and proteinase-3 anti-neutrophil cytoplasmic antibodies (PR3-ANCA), and between the levels of TNF-alpha and disease activities in WG. METHODS: sELAM-1 and sICAM-1 in sera from WG and healthy donors were detected by ELISA. SLex and LFA-1 on neutrophils were detected by flow cytometry. RESULTS: The level of sICAM-1 was significantly higher in active WG than in inactive WG, tending to reflect individual disease activities. There was no difference in the level of sELAM-1 between WG patients and healthy donors. CONCLUSION: Our study suggests that the adhesion of neutrophils to the vascular endothelium is significant for the pathogenesis of the vasculitis in WG.

An experimental study of the combined effect of radiotherapy and chemotherapy on head and neck squamous cell carcinoma cell line.

OBJECTIVE: We have reported clinical effects of radiotherapy combined with either CDDP or CBDCA for head and neck cancer. In this study, we examined the combined effects of either CDDP or CBDCA with irradiation on the cell lines established from tongue SCC. METHODS: The effects of irradiation, chemotherapy and the combined therapy on growth of the cell lines were examined respectively by the Alamar Blue assay. RESULTS: The combination of 0.1 and 0.25 microg/ml CDDP with four times exposure to I Gy 60Co. which did not affect the growth of the cell lines, suppressed the growth synergistically. The combination of 1.0 and 2.0 ) microg/ml of CBDCA with four times exposure to 1 Gy 60Co showed synergistically suppressive effects on the growth of the cell lines. CONCLUSION: It was suggested that the radiotherapy combined with the platium coordination complexes had a clinical usefulness in patients with head and neck cancer.

An autopsy case of familial idiopathic dilatation of bilateral atria.

A 59-year-old male patient was followed up for congestive heart failure. Echo cardiogram showed no abnormal findings other than a remarkable dilatation of the bilateral atria. The coronary arteries and left ventricular contraction were normal. Left ventricular endomyocardial biopsy showed no significant abnormal findings. Further, we examined his siblings using dynamic magnetic resonance imaging (MRI) and found that they all also had dilated bilateral atria. After several hospitalizations, the proband died from cardiogenic shock. Pathological findings showed nonspecific change in bilateral atria and ventricles. This is a very rare case of familial idiopathic dilatation of bilateral atria.

[Decision-making style among hemodialysis patients].

UNLABELLED: The purpose of this descriptive study was to identify the decision-making style among the dialysis patients. Subjects were a Convenience sample of hemodialysis patients who agreed to participate this study. The data was collected through semi-structured interviews. The interviews were recorded on the tape and transcribed. Decision-making episodes were picked and interpreted by searchers. Data was analyzed based on the Inductive Theory Approach. RESULT: Subject were 21 patients from 4 hospitals. The mean age was 51.1 and the mean duration after they started the hemodialysis was 9.1 years. The 16 decision-making styles were identified: accept, unvacillate, resignation, compromise, perseverance, challenge, self-activation, groupie, crisis-avoidance, withdrawal, prudent, reserve, escape, refusal, dogmatic, and entrust. These 16 decision-making styles were characterized by the reality oriented perception, the constructive regimes, the higher quality of social support. On the other hand, the passive decision-making styles were characterized by the distorted perception, the passive regimes, and the poor social support. DISCUSSION: The reality orientation, energy, openness, values system were discussed as key factors which determined the decision-making style among hemodialysis patients. The nursing approach supporting the patients to make their decision were discussed.

[Components of decision-making among hemodialysis patients].

UNLABELLED: The purpose of this descriptive study was to identify the components of decision-making among the dialysis patients. Subjects were a Convenience sample of hemodialysis patients who agreed to participate this study. The data was collected through semi-structured interviews was recorded on the tape and transcribed. Decision-making episodes were picked and interpreted by researchers. Data was analysed based on the Grounded Theory Approach. RESULT: Subject were 21 patients from 4 hospitals. The mean age was 51.1 and the mean duration after the hemodialysis was 9.1 years. The number of episode of decision-making were 136. Six components of decision-making were extracted such as . The subject were making decision by examining and judging the situation and oneself, and then setting the goal. They were selecting situation and themselves. After all, the outcomes of decision-making were evaluating. Seven type of decision-making, erection type, reality-oriented type, elaborate type, dogmatic type, passive type, chance type, resistant type were extracted. DISCUSSION: The factors which were related to the quality of decision-making were discussed such as the ability to examine the reality and control own wishes and needs, and the commitment for the decision-making. The nursing approach to facilitate the patients to make the decision were mentioned.

Adenosine mediates the antiarrhythmic effect of ischemic preconditioning in isolated rat hearts.

Adenosine appears to mediate the preconditioning-induced reduction in infarct size in rabbits and dogs, but little is known about the role of adenosine in preconditioning-induced protection against ischemia-induced arrhythmias. We compared the effects of preconditioning induced by 2 cycles of 5 min of global ischemia and 2 cycles of 5 min of perfusion with either adenosine (100 mumol/L) or the adenosine A1-selective agonist 2-chloro-N6-cyclopentyladenosine (CCPA, 100 nmol/L) in protecting against ischemia-induced arrhythmias in Langendorff-perfused rat hearts. Preconditioning reduced the incidence of ventricular tachycardia (VT) from 100 to 58% and the incidence of sustained VT or ventricular fibrillation (VF) from 92 to 33%. Perfusion with adenosine reduced the incidence of VT from 100 to 55%, the incidence of VF from 67 to 9% and the incidence of sustained VT or VF from 92 to 9%. CCPA reduced the incidence of sustained VT or VF from 92 to 25%. These interventions provided a true reduction in the severity of arrhythmias, rather than merely a delay in the onset. Our results suggest that the stimulation of A1 receptor by adenosine is involved in triggering ischemic preconditioning-induced protection against ischemia-induced arrhythmias in rats.

Prognostic indicators of major cardiac events in patients with asymptomatic coronary artery disease.

We investigated the role of myocardial ischemia in acute myocardial infarction and cardiac death in 253 patients with asymptomatic coronary disease (206 men, 47 women, mean age: 55 +/- 8 years). Patients were divided into two groups: those with angina pectoris with no history of myocardial infarction (AP group, 93 patients) and those with a history of myocardial infarction (MI group, 160 patients). We also examined the usefulness of exercise electrocardiographic and Holter electrocardiographic findings as prognostic indicators of cardiac events. After 24-hour Holter electrocardiograms were obtained in both groups, patients were assigned to subgroups with or without silent myocardial ischemia (SMI) based on the presence or absence of transient ST-segment depression. Prognostic indicators were evaluated by multiple regression analysis. Cardiac events occurred in 26 (10.3%) of 253 patients; in 6 patients these events were fatal. The incidence of cardiac events was significantly higher in the SMI group than in the non-SMI group (16.4% versus 5.6%, p < 0.05). SMI was identified as a significant prognostic indicator in the overall population (p = 0.0088), as were the number of diseased coronary arteries in the AP group (p = 0.0152), and SMI (p = 0.0022) in the MI group. There were 3 deaths related to cardiac events in each group. The mean time from onset of angina pectoris to death was 73 +/- 41 months compared with 33 +/- 43 months in the MI group. Our findings suggest that the severity of the coronary lesion and SMI were important predictors of major cardiac events, and that the mechanism of the onset of cardiac events was different in the AP and MI groups.

[Antineutrophil cytoplasmic antibody (C-ANCA) levels in relation to the treatment of Wegener's granulomatosis].

We assessed the clinical significance of cANCA in relation to the diagnosis and follow-up of Wegener's granulomatosis patients using NephroScholor C-ANC, the ELISA kit for the detection of cANCA. The NephroScholor C-ANC test for cANCA was revealed to be useful for the diagnosis of Wegener's granulomatosis, but slightly less sensitive than the indirect immunofluorescence assay using human neutrophils, which has been in widespread use for the detection of ANCAs. With NephroScholor C-ANC, the cANCA titer can be estimated conveniently and expressed quantitatively. When conventional immunosuppressive therapy with prednisolone and cyclophosphamide was applied, the patients' symptoms subsided as the cANCA titer decreased, and thus it also seemed useful for the follow-up of Wegener's granulomatosis patients. However, a rising ANCA titer during the course of the disease was not always correlated with the occurrence of a relapse as previously reported. Based on these findings, it is not recommended that treatment be changed immediately because of elevation of the ANCA titer alone, and it never seemed too late to increase immunosuppressive therapy, even after a clinical exacerbation was observed. Several treatments other than the conventional immunosuppressive therapy have often been applied for our patients, especially in the limited type of this disease, and these treatments, including sulfamethoxazole-trimethoprim alone, low-dose prednisolone alone, and cyclophosphamide alone, have often been useful. We conclude that the choice of therapy must depend on the severity or the condition of the individual patient, and this therapeutic policy should reduce unnecessary side effects of potentially toxic drugs.

Vasoactive intestinal peptide induces differentiation and MAP kinase activation in PC12h cells.

Vasoactive intestinal peptide (VIP), a neuropeptide coupled with adenylate cyclase, was found to induce neurite extension of PC12h cells. Neurites appeared within 1 h after addition of VIP and extended for at least 24 h. The half-maximal concentration for the effect of VIP was 50 nM. In addition to the morphological change, VIP induced expression of VGF protein, a neuron-specific protein associated with neuronal differentiation. Western blotting with anti-phosphotyrosine antibody showed that VIP stimulated tyrosine phosphorylation of two proteins of 42 and 44 kDa, which may be two isoforms of MAP kinase, erk1 and erk2. Activation of MAP kinases was confirmed by ion-exchange chromatography on a Mono Q column, from which VIP-induced kinase activity was co-eluted with MAP kinase-immunoreactivity. Tyrosine-phosphorylation of MAP kinases was also stimulated by forskolin or dibutyryl cAMP, indicating that activation of MAP kinases by VIP might be mediated by cAMP. These results suggest that VIP-induced differentiation of PC12 cells is associated with cAMP-dependent activation of MAP kinases.

The signal transduction pathway for VGF expression due to NGF is different from that due to bFGF in PC12h cell.

Using a polyclonal antibody against VGF, we examined the effects of various agents for its expression in PC12h cells. The results obtained were follows; 1) Basic fibroblast growth factor (bFGF), forskolin, dibutyryl cyclic AMP (dbcAMP), and nerve growth factor (NGF) induced the VGF protein. 2) The induction of VGF protein by NGF was inhibited by methylthioadenosine (MTA), but its induction by bFGF was not. 3) The induction of VGF protein by NGF was blocked by staurosporine, but its induction by bFGF was not. These findings suggest that the induction of VGF by NGF is distinct from that by bFGF in terms of sensitivities to MTA and staurosporine.

Desmoplastic fibroma of bone.

We present a rare case of benign intraosseous desmoplastic fibroma, occurring in the tibial bone of a 48-year-old woman. The plain film features consist of a lytic, expansile lesion, in the metaphysis and epiphysis of the bone. We present a case involving the long bone in which the correct diagnosis was suggested by CT and MRI. The appearance of the lesion on CT and MR is described.

Genetic analysis of functional differences among distinct ferredoxins in Rhodobacter capsulatus.

Rhodobacter capsulatus has been known to possess two ferredoxins (I and II) with distinct physicochemical and structural properties: ferredoxin I is a 2[4Fe-4S] type and the other is a [3Fe-4S] [4Fe-4S] type. To analyze their possible functional differences, their genes (fdxN and fdxA) were cloned, sequenced, and subjected to interposon mutagenesis experiments. The former gene was adjacent to a gene encoding a chloroplast-type [2Fe-2S] ferredoxin (fdxC). Mutants with inactivated fdxN and/or fdxC were obtained, and they showed virtually no growth under nitrogen-fixing conditions. Complementation experiments confirmed that both fdxN and fdxC were required for nitrogen fixation. On the other hand, we have not been able to disrupt fdxA under the screening conditions surveyed, including conditions that do not require nitrogenase activity for growth, suggesting that ferredoxin II could have an unknown essential role(s). These indicate functional differences among multiple ferredoxins in one bacterium other than in cyanobacterial heterocysts and indispensability of certain ferredoxins in nitrogen fixation other than Rhizobium meliloti FdxN.

Lumbar degenerative kyphosis. Clinical, radiological and epidemiological studies.

We suggest that lumbar degenerative kyphosis be included as one of the abnormal sagittal curvatures in which a kyphosis or a marked loss of lordosis is seen in the lumbar spine, caused by degenerative changes in middle-aged and elderly. One hundred and five consecutive patients were investigated, most of whom complained of low-back pain, often with a long history. They all walked in a forward bending posture, either all the time or only when exhausted. In roentgenograms, most cases showed a marked loss of the sacral inclination, as well as multiple disc narrowing and/or vertebral wedging in the lumbar region. These subjects showed a definite weakness of the lumbar extensors compared to the flexors, and therefore a reversed ratio of extensors/flexors muscle power compared with normal controls and other types of spinal curvatures. Weakness of the lumbar extensors was clearly shown by isokinetic measurement and a marked atrophy of these muscles with fatty infiltration was demonstrated by CT scanning.

New modified activated partial thromboplastin time and prothrombin time methods using a synthetic chromogenic substrate in combination with diazotization.

A chromogenic substrate, H-D-Phe-Pip-Arg-pNA (S-2238) is a highly specific substrate to thrombin and releases p-nitroaniline (pNA) by the action of thrombin. We describe new modified APTT and PT methods using S-2238 in combination with the diazotization of pNA. In the modified APTT method, 100 microliter citrated plasma (diluted to 10-fold), 90 microliter 1 mM S-2238, 100 microliter 20 mM CaCl2 and 100 microliter Actin were mixed in an ice-bath, then incubated for 8 min at 37 degrees C. The reaction was stopped, and the generated pNA was diazotized by adding the following solutions sequentially: 975 microliter 0.04% sodium nitrite, 975 microliter 0.3% ammonium sulfamate and 975 microliter 0.07% N-(l-naphthyl)-ethylenediamine dihydrochloride. Diazotization changed pNA from yellow to pink. Then, absorbance at 545 nm was read, and values were expressed as thrombin units/ml plasma. In the modified PT method, 100 microliter citrated plasma (diluted to 20-fold), 90 microliter 1 mM S-2238 and 200 microliter tissue thromboplastin-C solution were mixed and processed as above. Correlations of the present modified APTT and APTT methods, and of modified PT and PT methods were significant (r = 0.426, p less than 0.01 and r = 0.561, p less than 0.01, respectively).

[Synovial osteochondromatosis of the metatarsophalangeal joint of the great toe].

Synovial osteochondromatosis is an uncommon lesion in the metatarsophalangeal joint of the great toe. The condition is usually monoarticular, involving a large joint. Common locations include the knee, elbow, shoulder, hip and ankle. The histopathology is one of apparent cartilaginous bodies. Since these cartilage cells often display nuclear atypism, an accurate diagnosis is essential to avoid the erroneous diagnosis of chondrosarcoma. A case of synovial osteochondromatosis as it occurs in the metatarsophalangeal joint is presented, and this condition is discussed with a review of the literature.