Classification of the distribution of cavernous nerve fibers around the prostate by intraoperative electrical stimulation during laparoscopic radical prostatectomy.

We investigated the distribution of cavernous nerve (CN) fibers around the prostate by electrical nerve stimulation during laparoscopic radical prostatectomy to classify the distribution of the CN fibers. Electrical stimulation was performed on 30 consecutive patients with localized prostate cancer; middle of the neurovascular bundle (NVB, point A), base of the NVB (point B), the rectal wall 1 cm posterolateral to the NVB (point C) and the lateral aspect of the prostate (point D). We measured the intraurethral pressure at the midportion to detect the changes in intracavernosal pressure. The mean maximum changes were 10.5 ± 7.9, 11.6 ± 8.8, 9.6 ± 7.4 and 6.7 ± 7.0 cm H(2)O at points A, B, C and D, respectively. The patterns of CN fiber distribution were divided into four groups: type 1 (23%), the bundle corresponding to the NVB; type 2 (7%), the bundle from the rectal wall to the prostate; type 3 (27%), the plate including NVB and posterolateral to NVB; and type 4 (43%), the plate between the rectal wall posterolateral to the NVB and the lateral aspect of the prostate. Distribution of the CNs in a bundle-like formation was considered to account for 30%, whereas a plate-like formation accounted for 70%. Understanding these four patterns of CN fiber distribution should facilitate accurate CN-sparing radical prostatectomy.

Alteration of T-cell receptor repertoires during thymic T-cell development.

The majority of thymocytes die in the thymus, whereas small populations of T cells that are able to specifically recognize an antigen are considered to survive. Although the thymic selection is thought to have a profound effect on T-cell receptor (TCR) repertoire, little is known how TCR repertoire is formed during the thymocyte developmental process. We examined TCRalpha- and beta-chain variable regions (TCRAV and TCRBV) repertoire in thymic T-cell subpopulations from mice bearing different major histocompatibility (MHC) haplotypes. In Balb/c mice, but not C57BL/6, remarkable alterations of the TCR repertoire were observed in mature T-cell subpopulations as previously reported. In contrast, there were no significant differences of TCRBV repertoire between DN3 (CD25(+)CD44(-)) and DN4 (CD25(-)CD44(-)), and between DN4 and DP. These results suggest that (1) TCR repertoire of mature T cells was formed mainly under the influence of endogenous superantigens, while MHC haplotypes played the least role; (2) the 'beta-selection' process during immature stages had little impact on TCRBV repertoire formation; and (3) TCR repertoire in immature T-cell subpopulations was extremely similar between different strains of mice. We thus consider that pre-selection TCR repertoire in immature T cells could be determined by some genetic factors conserved among different strains.

Establishment of a mouse thymic epithelial cell line, IT-76MHC and a brief review on cultured thymic epithelial cells.

Interactions between thymocytes and thymic stromal cells are essential for thymocyte differentiation, but little evidence has been presented to directly show in vivo functions or interactions of the stromal cells. Among the stromal cells, the thymic epithelial cell has been considered to have profound effect on thymocyte differentiation and maturation. The calcium-depleted medium, originally developed for the culture of mouse epidermal cells, was applied for the culture of the mouse thymic epithelial cells, and successfully, an epithelial cell line, IT-76MHC was obtained from the mouse thymus. IT-76MHC cells were identified as distinct mouse thymic epithelial cells by 1/ mosaic-like arrangement, 2/ presence of well-developed desmosome and 3/ tonofilaments, 4/ positivity for cytokeratin, and 5/ induced expression of MHC class I and II by IFN-gamma treatment. IGF-1, IGF-2, oxytocin and vasopressin were also detected immunohistochemically in IT-76MHC cells. Furthermore, the IT-76MHC thymic epithelial cells, when injected intrathymically in the allogeneic mouse, prolonged the survival of skin graft from the same donor strain that IT-76MHC cells were derived. These results demonstrate that the thymic epithelial cell line IT-76MHC produces modest thymocyte survival factors as well as a growth suppressor, and that IT-76MHC cells have the ability to induce transplantation tolerance probably through their expression of MHC class I and II molecules. Taken altogether, the IT-76MHC thymic epithelial cells have been proved to be useful tools to better understand the in vivo functions of thymic epithelial cells, and to gain a deep insight into their involvement in the critical selection process of thymocytes which still remains obscure. Finally and additionally, literatures so far reported on thymic epithelial cells in culture, especially lines and clones, are reviewed and their identity as well as their functions are discussed.

A novel activating mutation of the K-ras gene in human primary colon adenocarcinoma.

We identified a novel type of point mutation at the 22nd codon of the K-ras gene in a primary colon cancer. The mutation was C to A transversion substituting lysine (AAG) for normal glutamine (CAG) codon. Biological activity of this mutant K-ras gene was tested by expression of full-length cDNA clones in NIH3T3 cells. Most of the K-ras Lys22-transfected cells exhibited an increased saturation density, a lower serum requirement, and transformed morphology reminiscent to the typical K-ras Val12 transformants. However, the tumorigenicity of K-ras Lys22 transformants in nude mice was significantly less potent than that of K-ras Val12 transformants; only a high copy number transformant produced tumors. Even though the activation is incomplete, the finding that the majority of tumor cells in the specimen carried the K-ras Lys22 mutation suggests that this mutation might be advantageous for growth of tumor cells in vivo.

Enhanced neutrophilic granulopoiesis in rheumatoid arthritis. Involvement of neutrophils in disease progression.

OBJECTIVE: To investigate enhanced granulopoiesis in bone marrow of patients with rheumatoid arthritis (RA), and the role of neutrophils in RA pathogenesis. METHODS: Aspirated bone marrow cells and peripheral blood leukocytes from patients with RA and non-RA patient controls were analyzed morphologically and by 2 color flow cytometry. Thirteen iliac bones (8 RA, 5 non-RA) were examined by light and transmission electron microscope (TEM). RESULTS: The percentage of CD15+CD16- cells (immature neutrophils) in RA bone marrow (64.3+/-13.4%, mean +/- SD) increased significantly compared to that of non-RA controls (43.2+/-14.3%), whereas the fraction of CD15+CD]6+ cells (mature neutrophils)was greatly decreased (RA 21.8+/-10.1%; non-RA 38.1+/-8.9%). The absolute number of CD15+CD16- cells also increased markedly in RA bone marrow. The ratio of immature cells to the total granulocytes (% CD15+CD16- to % CD15+) correlated with the Lansbury Index score (R = 0.76, p<0.0001). TEM observations revealed that abundant immature neutrophils adhered closely to the trabeculae of the iliac bone. Margins of trabeculae were mostly irregular, especially in severe RA, and collagenous fibers frequently disappeared in those trabeculae with ragged margins. CONCLUSION: In RA bone marrow, immature neutrophils (CD15+CD16-) were markedly increased in number; by contrast, no changes were found for mature cells. Augmented production of immature neutrophils (at the promyelocyte-to-myelocyte stage) might lead to the destruction of collagenous fibers in RA bone trabeculae, as revealed by TEM. Generalized bone destruction in RA might, at least in part, be caused by enhanced production of immature neutrophils.

Immunosuppressant FTY720 inhibits thymocyte emigration.

One major role of the thymus is to provide the peripheral immune system with mature T cells, but the mechanisms involving the cellular export are not fully understood. In this study, we examined the ability of a novel immunosuppressive reagent, FTY720, to inhibit T cell export from the thymus. Daily administration of FTY720 at a dose of 1 mg / kg resulted in a marked decrease in the number of peripheral blood T lymphocytes. In the thymus, long-term daily administration of FTY720 caused a three- to fourfold increase in the proportion of mature medullary thymocytes (CD4(+)CD8(-) and CD4(-)CD8(+)) as well as a slight decrease in the double-positive cell (CD4(+)CD8(+)) ratio. Phenotypic analysis (TCRalpha beta, H-2K(d), CD44, CD69 and CD24) revealed that these increased subsets represent possible peripheral recent thymic emigrants. High level expression of L-selectin by these subsets further suggests that they were prevented from leaving the thymus. By intrathymic labeling with fluorescein isothiocyanate, only one fourth of labeled cells could be detected in the lymph nodes and in the spleen of FTY720-treated mice compared to saline-treated control mice. Taken together, these results suggest that the immunosuppressive action of FTY720, at least in part, could be due to its inhibitory effect on T cell emigration from the thymus to the periphery.

Cloning and characterization of a gene complementing the mutation of an ethanol-sensitive mutant of sake yeast.

Ethanol-sensitive mutants (esl to es10) were isolated from sake yeast, Saccharomyces cerevisiae SY-32. These mutants were unable to grow at 7% ethanol at which the wild type strain SY-32 does grow. The mutants had a variety of fermentation rates and viabilities in the presence of ethanol. The gene ERG6, complementing the ethanol-sensitive mutation of es5, was cloned from an SY-32 gene library. ERG6 encodes S-adenosylmethionine: delta 24-sterol-C-methyltransferase (EC 2.1.1.41) in the ergosterol synthetic pathway. Mutant es5 had a reduced ability to synthesize ergosterol. An erg6 disruptant was also ethanol-sensitive. These results suggested that ERG6 plays an important role in the ethanol tolerance of S. cerevisiae.

[Case report of a patient with invading bladder cancer and lymph node swelling which decreased following 5'-DFUR treatment].

We report a 75-year-old man with invading bladder cancer and enlarged lymph nodes, which decreased following 5'-DFUR treatment. A postoperative abdominal CT showed lymph node swelling around the great vessels. The patient refused aggressive chemotherapy, so he was given a 5-FU derivative, 5'-DFUR, 800 mg/day orally. The enlarged lymph node had decreased in size by the 22nd day after the treatment, and the patient has maintained a near CR.

Psoas abscess associated with iliac vein thrombosis and piriformis and gluteal abscesses.

BACKGROUND: A 14-year-old boy was admitted because of lumbago and high fever. METHODS/RESULTS: Computed tomography scans revealed psoas, piriformis and gluteal abscesses as well as right iliac vein thrombus. A right femoral venogram demonstrated compression from the psoas abscess and thrombosis of the common iliac vein. Appropriate surgical drainage, administration of antibiotics and anticoagulant therapy were effective in the present case. CONCLUSIONS: This is the first report of primary psoas abscess associated with vein thrombosis and is also unique in that abscesses were multiple without predisposing diseases or trauma.

[A case of pyelitis cystica diagnosed with utilization of ureterofiberscope].

We herein report a case of pyelitis cystica in 65-year-old woman. She was referred to our hospital in order to have a treatment for a stone in the ureter on left side. Excretory urogram showed hydronephrosis on left, and multiple, small, smooth and round filling defects in the renal pelvis on right side. ESWL was performed to the ureteral stone, and the stone was discharged completely in 4 days. Then further examinations were made for the filling defects of right renal pelvis. Nonopaque calculi were ruled out on retrograde pyelogram and CT scan. Urinary cytology from the renal pelvis was class I. Our impression was pyelitis cystica of right kidney. Under spinal anesthesia, ureterofiberscopy was performed. Multiple small cysts were observed in the pelvis and calyx, as well as cystitis cystica. Cold cup biopsy was also done and histopathological finding ws pyelitis cystica, without malignancy. We compared endoscopic findings with radiographic findings in 18 cases of pyloureteritis cystica from the Japanese literature. The radiographic findings were multiple small, in a uniform size, and round filling defects with regular contour, and the endoscopic findings were multiple white or ocher colored, half sphere or sphere shaped, and small cyst with smooth surface in 15 of 18 cases. We thought these findings were characteristic ones in pyloureteritis cystica. Endoscopy and biopsy are mandatory for diagnosis of pyeloureteritis cystica.

The suppression of postoperative liver metastasis caused by the continuous intraportal infusion of angiogenesis inhibitor FR-118487 in a rabbit colon cancer model.

The inhibitory effect of FR-118487, a potent angiogenesis inhibitor, on neovascularization induced by the VX2 tumor was confirmed in a rabbit corneal assay. The antimetastatic effect of FR-118487 was also investigated in 21 rabbits. Spontaneous liver metastases were induced by VX2 tumor cell implantation into the ascending colonic wall. FR-118487 was then infused continuously into the portal vein for 7 days after resection of the primary lesion at a dose of 1 mg/kg/day (FR-1 group) or 3 mg/kg/day (FR-3 group). The incidence of liver metastases was 71.4%, occurring in 5 of 7 rabbits, in each of the FR-1 and FR-3 groups, compared with 100%, being all of 7 rabbits, in the control group. The number of metastatic foci tended to be less in the FR-1 (31.0 +/- 36.0) and FR-3 (24.6 +/- 45.1) groups than in the control group (83.7 +/- 73.9) and the weight of metastatic foci was significantly less in the FR-1 (1.4 +/- 1.8 g) and FR-3 (1.3 +/- 2.0 g) groups than in the control group (6.5 +/- 4.9 g) (P < 0.05). However, leakage of the colonic anastomosis and body weight loss were limited to the FR-3 group. These results suggest that the continuous intraportal infusion of FR-118487 at 1 mg/kg/day suppressed liver metastases by inhibiting angiogenesis, without producing any adverse effects.

DNA fragmentation is not the primary event in glucocorticoid-induced thymocyte death in vivo.

Thymocyte death has been recognized as one of the best models for studying apoptosis. Our recent study, however, indicated that most thymocytes die without DNA fragmentation and become terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-biotin nick end-labeling-positive (TUNEL+) only after being phagocytosed by macrophages. In this study, we used histological techniques using the TUNEL method, histochemistry, immunohistochemistry, and transmission electron microscopy as well as flow cytometry to examine in vivo the effect of glucocorticoid (GC), a well-known agent for inducing thymocyte apoptosis in vitro, on thymocyte death to determine whether or not DNA fragmentation was the first event of GC-induced thymocyte death. At 2 h and 4 h after GC injection, a large number of cortical thymocytes were TUNEL+. Most TUNEL+ cells were aggregated to form clusters. Double staining of the section showed that the TUNEL+ thymocytes were phagocytosed by acid phosphatase+ and Mac-2+ macrophages. An ultrastructural study indicated that a far greater number of small pyknotic thymocytes were present in the cortex of the GC-treated thymus than were observed in the control thymus, that all those pyknotic thymocytes were TUNEL-, and moreover, that at the electron microscopic level, TUNEL+ cells were all phagocytosed by macrophages. Flow cytometric analysis did not detect a single TUNEL+ thymocyte even 4 h after the GC treatment, suggesting that virtually no free dead thymocytes were present after DNA fragmentation. These results indicate that, consistent with our previous findings with normal thymocyte death and B cell death in the germinal centers, DNA fragmentation is not involved in the cell death process of the GC-induced rapid thymocyte death in vivo.

Heterogeneity of mouse thymic macrophages: I. Immunohistochemical analysis.

As the first step toward understanding the identity and functions of thymic macrophages in situ, we examined the phenotypic heterogeneity of mouse thymic macrophages in tissue sections by the immunohistochemical double staining method with four monoclonal antibodies (F4/80, Mac-2, anti-CD32/16 and anti-I-A antibodies) as macrophage markers. Morphologically, three types of macrophages were identified: dendritic, round and flat-shaped. Dendritic macrophages were scattered throughout the thymus, and most of them were stained by all four markers. Among these macrophages, those at the cortico-medullary region (CMR) expressed a high intensity of CD32/16 antigen. Round macrophages were also distributed throughout the thymus; most of them, however, were localized in the cortico-medullary region to the medulla. These cells were F4/80-negative, Mac-2-positive, CD32/16-negative and I-A-positive. In contrast, round macrophages located at the cortex expressed F4/80. Flat-shaped macrophages were localized at the subcapsular region of the cortex where active lymphopoiesis was observed. This type was positive for F4/80 and CD32/16, but negative for Mac-2. Furthermore, most of the three types of thymic macrophages showed intense reactions of the I-A antigen within the cytoplasm in addition to the expression of I-A antigen on the cell membrane. These results indicate that morphological characteristics of thymic macrophages at different locations reflect phenotypic variations detected in immunohistochemistry, and suggest that these different type macrophages may play distinct roles at various locations in thymocyte development in the thymus.

Glucocorticoid-induced thymocyte death in the murine thymus: the effect at later stages.

SUMMARY: Although glucocorticoid has been considered to cause thymocyte apoptosis in vitro, few studies have presented its in vivo effect. We report here on kinetics of glucocorticoid-induced murine thymocyte death in vivo by the TUNEL method. TUNEL-positive cells were observed as early as at 2 h after intraperitoneal injection of glucocorticoid. Most TUNEL-positive thymocytes were phagocytosed by acid phosphatase positive macrophages. "Free" (not phagocytosed) TUNEL-positive cells were not detected at early stages (by 4 h). At 6 to 8 h after the injection, the number of phagocytosed thymocytes per individual macrophage had reached its maximum, and at 8 to 12 h many ruptured macrophages ingesting too many dying thymocytes became noticeable. During the process, no additional macrophages appeared to be mobilized to the thymus. At 6 to 8 h after the injection, however, coincidentally with the fact that macrophages had become unable to further ingest dying lymphocytes, dead cells were left unphagocytosed, and ultimately became "free" positive cells, probably due to some proteolytic process ongoing within the thymus. As late as at 12 h, morphological examination revealed that epithelial cells seemed to begin engulfing thymocytes, almost simultaneously with the start of rupture of the macrophages due to the ingestion of too many thymocytes. Epithelial cells were readily identified by desmosomes and tonofilaments, in addition to euchromatic nuclei. Altogether, these results suggest that: 1) even though thymocytes were exposed to glucocorticoid in vivo, most of them were not TUNEL-positive unless they were phagocytosed; 2) even after most macrophages had ingested too many cells at later stages, macrophages in other locations did not migrate to the thymus; and finally, 3) deletion of damaged thymocytes was also carried out by thymic epithelial cells, though not frequently, at around 12 h and later.

Endothelin-1 levels in portal venous blood in relation to hepatic tissue microcirculation disturbance and hepatic cell injury after ischemia/reperfusion.

This study was conducted to clarify the role of endothelin-1 in the portal vein after hepatic ischemia/ reperfusion and to ascertain whether it is related to hepatic microcirculation disturbance. Using a canine ischemic liver model, the portal and systemic endothelin-1 levels were measured before ischemia, then after 1 h and 2 h of reperfusion, and comparatively evaluated with the serum levels of GOT and lactic dehydrogenase (LDH). As an indicator of liver tissue microcirculation, tissue blood flow volume (TBF) was also measured in the site subjected to ischemia. The animals were divided into: group 1, which received ischemia for 30 min; group 2, which received ischemia for 60 min; and group 3, which received a sequence repeated four times of 15 min ischemia and 10 min reperfusion. The portal endothelin-1 level became significantly elevated after reperfusion compared to that before ischemia in all groups, being significantly higher in group 2 than in the other groups. The systemic endothelin-1 level also increased after reperfusion; significantly in group 2. The portal endothelin-1 level was generally higher than the systemic level, which again was statistically significant in group 2. After 2 h of reperfusion, a significant positive correlation was found between the portal endothelin-I level and serum LDH, whereas a significant negative correlation was found between the portal endothelin-1 level and TBF. The finding that the portal endothelin-1 level became elevated after hepatic ischemia/reperfusion suggests that it probably plays an essential role in hepatic ischemia/ reperfusion injury by adversely influencing tissue microcirculation.

Continuous measurement of tissue oxygen and carbon dioxide gas tensions in dog liver in ischemia/reperfusion.

An experiment was conducted to determine whether the oxygen and carbon dioxide gas tensions in liver tissue (PtO2 and PtCO2, respectively) reflect the state of microcirculation and/or metabolism in the ischemic liver. Subjects were divided into three groups: group 1, 30 min ischemia; group 2, 60 min ischemia; group 3, four times of intermittent 15 min ischemia after every 10 min of reperfusion. PtO2, PtCO2 and tissue blood flow (TBF) were measured by mass spectrometry, comparatively studied with the serum GOT level as an indicator of liver tissue damage. Furthermore, the time point at which the PtCO2 increase for 1 min initially became less than 1/2 of the maximum value was located on the transit curve of PtCO2, referred to as the critically anaerobic (CA) point, with which new indices of critically anaerobic score (CAS) and time (CAT) (see details in text) were developed. The profiles of PtO2 and PtCO2 during ischemia and reperfusion were clearly demonstrated, and the CA point was observed 12.7 +/- 2.9 min after induction of ischemia. PtO2 was positively correlated with TBF and negatively with the serum GOT level. Furthermore, not only CAS but also CAT were significantly correlated with PtO2, TBF, and the serum GOT level. It was concluded that PtCO2 reflects the state of anaerobic tissue metabolism during ischemia and PtO2 reflects the magnitude of microcirculatory disturbance and tissue injury caused by ischemia/reperfusion. Therefore, continuous monitoring of not only PtO2 but also PtCO2 is beneficial for patients undergoing hepatic surgery with ischemia.

Possible role of protein kinase C in the regulation of intracellular stability of focal adhesion kinase in mouse 3T3 cells.

Effects of various types of protein kinase inhibitor on the adhesion and spreading of BALB/c mouse 3T3 cells and on the phosphorylation and stability of focal adhesion kinase (FAK) in the cells were studied. Inhibitors of protein tyrosine kinases, methyl 2,5-dihydroxycinnamate and herbimycin A, inhibited tyrosine-phosphorylation of FAK and the adhesion of 3T3 cells to fibronectin. Among inhibitors of serine/threonine kinases tested, calphostin C, a specific inhibitor of protein kinase C, inhibited cell spreading rather than cell adhesion, and it induced the decrease of intracellular FAK within 30 min. Inhibitors of tyrosine kinase, A kinase, G kinase, and myosin light chain kinase did not induce such a rapid and specific decrease of FAK. When calphostin C (20 microM) was added to sub-confluent monolayer cultures, serine-phosphorylation of FAK was inhibited by 67% within 2 h, and decrease in the amount of FAK and rounding up of the cells began after 4 h. Label-chase experiments indicated that about 60% of 35S-labeled FAK degraded within 1-2 h after addition of calphostin C to monolayer cultures. These results indicated that serine-phosphorylation of FAK induced by protein kinase C was important in the regulation of metabolic stability of FAK.

[Suppression of postoperative liver metastases from colon cancer by continuous intraportal infusion of an angiogenesis inhibitor FR-118487].

A rabbit VX2 colon cancer model with spontaneous liver metastases was used to evaluate the antitumor effect of an angiogenesis inhibitor, FR-118487. FR-118487 (1 mg/kg/day) was infused continuously into the portal vein for a week after resection of primary colon cancer lesions (FR group). The incidence of liver metastases was 71.4% (5/7) in FR group, and 100% (7/7) in control group. The number and the weight of liver metastatic nodules were 31.0 +/0 36.0 and 1.4 +/- 1.8 g in FR group versus 83.7 +/- 73.9 and 6.5 +/- 4.9 g in control group, respectively. The metastases in FR group were significantly decreased in weight compared with those in control group (p < 0.05). No anastomotic leakage was recognized in either group. No side effects of FR-118487 such as body weight loss were found. Continuous intraportal infusion of FR-118487 in the early postoperative period may be effective to suppress liver metastases from colon cancer by inhibiting the angiogenesis concerning liver metastases.

The presentation of a double aortic arch in adulthood in association with congestive heart failure attributed to a previously silent aortic regurgitation.

This paper describes an adult case of a double aortic arch (DAA; Edwards type IA). The patient had been asymptomatic for DAA but presented difficulty in swallowing in association with congestive heart failure, which she experienced as the result of attending to her sick husband while she apparently suffered from a silent aortic regurgitation. The symptoms disappeared and the patient recovered from heart failure following medical treatment. The patient soon discontinued the outpatient treatment and, after 2 years, the identical symptoms recurred under similar circumstances. In this paper we demonstrate that an asymptomatic case of DAA has the potential to clinically manifest itself.