Staphylococcus pseudintermedius biofilms secrete factors that induce inflammatory reactions in vitro.

Biofilms, composed of bacterial cells embedded in a secreted polysaccharide and protein matrix, often cause problems such as chronic and refractory infections. Staphylococcus pseudintermedius, which is an important pathogen in veterinary medicine, has a high rate of biofilm production. Although it is considered that S. pseudintermedius biofilms are associated with prolonged inflammatory disorders, there are no reports that S. pseudintermedius biofilm directly regulates inflammatory reactions. In this study, we focused on the metabolites derived from biofilm cultures of S. pseudintermedius and evaluated their inflammatory effects in vitro. Expression levels of interleukin-1 beta and interleukin-6 mRNA significantly increased in RAW264.7 cells that were cultured with biofilm-conditioned medium (BCM). The secreted proteins in BCM were heat resistance and activated a Toll-like receptor (TLR) signalling pathway. Moreover, based on SDS-PAGE analysis, isolates with stronger biofilm-forming capabilities induced more inflammatory reactions and had specific banding patterns compared with those of weak biofilm producers. Collectively, our results suggest that the proteins derived from S. pseudintermedius biofilm induce a host inflammatory response via a TLR pathway. Furthermore, the severity of inflammation depends on the biofilm formation capacity of the S. pseudintermedius strain. SIGNIFICANCE AND IMPACT OF THE STUDY: Staphylococcus pseudintermedius is a biofilm-forming bacterium. We identified some biofilm secreted heat-resistant proteins that induce inflammatory reactions through Toll-like receptor signalling. The expression of the secreted protein varied depending on the potency of biofilm production. Our data suggest that these proteins may be the factors causing biofilm-related inflammation during S. pseudintermedius infections. Identification of these proteins may lead to the development of novel medications to prevent the exacerbation of infections caused by S. pseudintermedius.

Scanning microbeam small-angle X-ray diffraction study of interfacial heterogeneous crystallization of fat crystals in oil-in-water emulsion droplets.

We performed scanning microbeam small-angle X-ray diffraction (micro-SAXD) experiments, differential scanning calorimetry (DSC) analysis, and optical microscopic observation of palm mid fraction (PMF) crystals in oil-in-water emulsion droplets. The scanning micro-SAXD experiment was performed by irradiating a synchrotron radiation X-ray microbeam having an area of 5 x 5 microm(2) onto different positions on a 50 microm diameter emulsion droplet after the crystallization of PMF by chilling the emulsion at 5 degrees C. The micro-SAXD patterns were recorded with a two-dimensional (2D) detector, which enabled spatial analysis of polymorphic structures and the orientation of lamella planes of PMF crystals at different positions inside the emulsion droplet. Particular attention was paid to compare the crystallization of PMF in two types of emulsion droplets, hydrophilic polyoxyethylene sorbitan mono-oleate (Tween 80) alone (Tween 80 emulsion) and Tween 80 and hydrophobic sucrose palmitic acid oligoester (P-170) (Tween 80+P-170 emulsion). The DSC study revealed that the PMF crystallization temperature in the Tween 80+P-170 emulsion droplets increased by 3 degrees C compared to that of the Tween 80 emulsion because of the effects of the P-170 additive in promoting PMF crystallization. The micro-SAXD studies revealed the following results. (1) The lamella planes of PMF crystals near the outer edges of the droplet in the Tween 80+P-170 emulsion were mostly parallel to an oil-water interface, whereas the lamella planes of PMF crystals were not always aligned with the oil-water interface in the Tween 80 emulsion droplet. (2) The degree of orientation of the lamellar planes of PMF crystals, which was evaluated from the values of full width at half-maximum of 2D micro-SAXD patterns with respect to azimuthal angle extension, was remarkably higher in the Tween 80+P-170 emulsion than in the Tween 80 emulsion. (3) Polymorphic transformation of PMF from alpha to beta' in the Tween 80+P-170 emulsion was retarded compared to that in the Tween 80 emulsion. These results confirmed that the P-170 additive caused interfacial heterogeneous nucleation through hydrophobic interactions at the oil-water interfaces in the emulsion, which subsequently influenced the arrangements of fat crystals so that the lamellar planes of fat crystals were parallel to the oil-water interface.

Endogenous erythropoietin and a single bolus of 40,000 IU of epoetin alpha do not protect the heart from ischaemia-reperfusion injury during extracorporeal circulation for cardiac surgery.

Erythropoietin (EPO) exerts a tissue-protective activity in several non-haematopoietic tissues such as heart, brain, spinal cord and muscle. We evaluated the relationship between pre-operative endogenous EPO blood levels and myocardial damage in patients undergoing cardiopulmonary bypass (CPB). Furthermore, we investigated whether pre-operative administration of a single bolus of 40,000 IU epoetin alpha (EPOalpha) would reduce troponin I or creatine kinase isoenzyme (CK-MB) after on-pump coronary artery bypass graft (CABG) surgery. Sixty-seven patients (45 CABG, 22 valvular surgery) were enrolled. EPO was measured in the pre-surgical period and correlated to post-surgical troponin I and CK-MB peaks. Subsequently, forty patients scheduled for CABG were randomized into two groups, receiving, respectively, a) standard medical and surgical treatment (20 patients) and b) the same treatment plus 40,000 IU of EPOalpha in a single bolus injection in the immediate pre-surgical period (20 patients). In our population, we did not find any correlation between pre-surgical EPO and post-surgical troponin I or CK-MB peaks (p Pearson > 0.05). Furthermore, patients treated with EPOalpha did not show differences compared to the control group in either troponin I (1.7+/-1.8 vs 2.6+/-3.4, p>0.05) or CK-MB (19.6 +/-13.2 vs 17.1+/-12.6, p>0.05) peaks measured in the post-surgical period.

Immunohistochemical expression of thymidylate synthase as a prognostic factor and as a chemotherapeutic efficacy index in patients with colorectal carcinoma.

BACKGROUND: We assessed the importance of Thymidylate Synthase (TS) expression as a prognostic factor and as an index of therapeutic efficacy in patients with colorectal carcinoma. PATIENTS AND METHODS: TS expression in 66 patients with colorectal carcinoma was immunohistochemically assessed using the anti-TS antibody. TS expression, TS activity, clinicopathological characteristics and survival were evaluated and the correlation among them was studied. RESULTS: The cases studied included 53 patients with low grade positive/negative and 13 patients with high grade positive TS expression. TS levels were 8.69 +/- 10.01 pmol/g and 14.82 +/- 11.38 pmol/g, respectively. There was not correlation between clinicopathological characteristics and TS expression. Considering TS expression, the 5-year survival rate was significantly better for the 75.5% of the patients with low grade positive/negative TS than for the 38.5% of the patients with high grade positive TS (p < 0.01). CONCLUSION: The immunohistochemical expression of TS should be further investigated as a prognostic factor of survival and as an index of chemotherapeutic efficacy in colorectal carcinoma.

[Study on endoscopic sinus surgery management of chronic sinusitis with nasal polyps].

Endoscopic sinus surgery is commonly used to treat chronic sinusitis. Subjects were 79 chronic sinusitis patients--50 men and 29 women aged 17 to 79 years (average: 50.6 years) undergoing endoscopic sinus surgery in our department from January 1993 to December 1997. Mean follow-up was 17.5 months. We evaluated preoperative staging of chronic sinusitis based on Kennedy staging. Most were stage 3. This type of staging was not effective in predicting nasal polyp relapse. We found that cases with diffuse polyposis and associated disease such as bronchial asthma or aspirin-induced asthma tended to experience a polyp relapse. Our results suggest that postoperative treatment is important in maintaining patency of the ostiomeatal complex, nasal polyp or edematous mucosa relapse must be treated early in on in occurrence.

Suppression of rat thromboxane synthase gene transcription by peroxisome proliferator-activated receptor gamma in macrophages via an interaction with NRF2.

We have studied the transcription regulation of the rat thromboxane synthase (TXS) gene by peroxisome proliferator-activated receptor gamma (PPARgamma) in macrophages. The transcription activity of a cloned 5'-flanking region (1.6 kilobases) of the rat TXS gene (5'FL-TXS) was examined by luciferase reporter gene assay. TXS mRNA expression and the transcription activity of 5'FL-TXS were inhibited by PPARgamma ligands, 15-deoxy-Delta(12,14)-prostaglandin J(2) (PGJ(2)), and the thiazolidinedione troglitazone (TRO) in a dose-dependent manner. Overexpression of PPARgamma also significantly suppressed transcription, and further addition of PGJ(2) or TRO augmented the suppression. Deletion analysis showed that the element responsible for the PPARgamma effect is located in a region containing the nuclear factor E2 (NF-E2)/AP-1 site (-98/-88), which was indicated to be the major promoter of the TXS gene. By electrophoretic mobility shift assay using the NF-E2/AP-1 site and nuclear extracts from macrophages, we observed a specific protein-DNA complex formation, which was inhibited by a specific antibody against the transcription factor NRF2 (NF-E2-related factor 2). Moreover, the complex was decreased with PGJ(2), TRO, or in vitro translated PPARgamma. The transcription suppression by PPARgamma was confirmed using this truncated NRF2-binding element (-98/-88) by the reporter gene assay. Finally, a direct interaction between PPARgamma and NRF2 was confirmed by glutathione S-transferase pull-down assay. In conclusion, the NRF2-binding site (-98/-88) is the major promoter of 5'FL-TXS which can be suppressed by activated PPARgamma via a protein-protein interaction with NRF2 in macrophages.

[Thymidylate synthase activity after preoperative administration of 5-FU in patients with gastric or colorectal cancer].

Continuous intravenous injection of 5-FU was given at 300 mg/m2 to patients with gastric or colorectal cancer for consecutive 3 days preoperatively, and the relationships between the time until collection of samples (from final administration of 5-FU to excision of tissue samples) and total thymidylate synthase (TS total) activity, free thymidylate synthase (TS free) activity, thymidylate synthase inhibition rate (TSIR), thimidine kinase (TK) activity, and tissue 5-FU and FdUMP concentrations investigated. TS total was shown to gradually reduce with time, but the relationship between time and the other assay items could not be identified due to large variability in the data. TS total and TK also proved to be affected also by the sites at which the samples were collected, and exhibited significantly higher enzyme activity in tumor tissue than that in normal tissue.

Do the expression of CD44, apoptosis and thymidylate synthase inhibition rate correlate with the efficacy of chemotherapy in colorectal cancer?

BACKGROUND: Tegafur-uracil(UFT;TAIHO Pharmaceutical Co.Ltd, Tokyo, Japan) is commonly used to treat digestive cancers. However, the inhibitors of metastasis in this agent have not been fully examined. To investigate a cell adhesion molecule, CD44, which may very well contribute to the pathogenesis of metastasis, we examined the association of CD44 and the thymidylate synthase inhibition rate(TSIR) with prognosis, and examined the expression of apoptosis in patients who were administrated tegafur-uracil before surgery for colorectal cancer. MATERIALS AND METHODS: This study included 66 patients who underwent curative resection of colorectal cancer. In these patients, tegafur-uracil(600 mg) was orally administered every day for 3 to 7 days before surgery, and Tegafur-uracil (400 mg) was orally administered every day for 2 years after surgery. CD44 and apoptosis were detected immunohistochemically and by the TUNNEL method, respectively. The TSIR was calculated from the total TS level, and free TS levels by modified Spears' method using fresh tumor tissue specimens. RESULTS: The TSIR of non-recurrent patients was significantly higher than that of recurrent patients(p < 0.05). The 5-year survival rate in CD44-low grade positive/negative patients (81.6%) was significantly higher than that in CD44-high grade positive patients (46.4%) (p < 0.005). The 5-year survival rate in apoptosis-high grade positive patients (89.7%) was significantly higher than that in apoptosis-low grade positive/negative patients(46.4%) (p < 0.001). With respect to the relationship between CD44 and apoptosis, the proportion of apoptosis-high grade positive patients among CD44-low grade positive/negative patients (55.3%) was significantly higher than that among CD44-high grade positive patients(28.6%) (p < 0.05). In the multivariate analysis, the CD44 expression was suggestive of an independent prognostic factor. CONCLUSION: Based on our results for TSIR, Tegafur-uracil may induce apoptosis of tumor cells in patients by the inhibition of thymidylate synthase. It was suggested that CD44 expression could be used as a possible independent predictor of survival. In addition, it was suggested that UFT, via the inhibition of CD44 expression caused the inhibition of distant metastasis.

Phlebosclerotic colitis: value of radiography in diagnosis--report of three cases.

Three cases sharing the following radiologic features are reported: (a) abdominal conventional radiography-vascular calcifications at the right hemicolon, (b) abdominal computed tomography-colonic wall thickening and venous calcifications, and (c) barium enema examination-luminal narrowing of the right hemicolon and thumbprinting. There were no clinical or laboratory findings suggestive of portal hypertension. The disease entity, "phlebosclerotic colitis," should be differentiated from ordinary ischemic colitis.

An evaluation of malignancy and prognostic factors based on mode of lymph node metastasis in esophageal carcinoma.

This study was conducted to evaluate lymph node metastasis as a key prognostic factor in esophageal cancer. Metastatic lesions in lymph nodes were grouped by histological morphology as intracapsular or extracapsular, and the significance of lymph node metastasis was evaluated by relating metastatic lesions to clinical pathologic factors and patient prognosis. In our hospital, 46 of 81 patients who underwent resection of esophageal cancer developed lymph node metastasis. These 46 patients were enrolled in a study analyzing the relationship between the metastatic mode and the clinicopathological factors. The frequency of extracapsular metastasis was significantly high in patients with a profound depth of cancer, three or more metastases, distant metastasis (n3 and n4), or severe lymphatic invasion. The prognosis was significantly worse in patients with extracapsular metastasis, and this tendency was also seen even in patients with three or more metastases, limited metastasis (n1 and n2), or mild lymphatic invasion (ly0 and ly1). These findings suggest that the metastatic mode reflects the degree of esophageal cancer progression and is an important prognostic factor.

[Effect of adenosine on isolated afferent arterioles].

We investigated the direct effect of adenosine on afferent arterioles (Af-Arts) and the receptor subtype that mediates the constrictor or dilator action of adenosine. Af-Arts were isolated from the superficial cortex of rabbit kidney and perfused in vitro. Adenosine added to either the lumen or bath constricted the Af-Arts in a dose-dependent manner. This constriction was blocked by the A1 receptor antagonist, 6-oxo-3-(2-phenylpyrazole(1,5-a)pyridin-3-yl)-1 (6H)-pyridazinebutyric acid (FK838) or 8-cyclopentyl-1, 3-dipropylxanthine(DPCPX). We also examined the effect of adenosine on preconstricted Af-Arts with norepinephrine. Adenosine added to either the lumen or bath further constricted the preconstricted Af-Arts. In the presence of FK838, adenosine added to either the lumen or bath dilated the preconstricted Af-Arts, but in a different dose-dependent manner. Adenosine-induced dilation was inhibited by the A2 receptor antagonist, 3, 7-dimetyl-1-propargylxanthine(DMPX). These data indicate that adenosine constricts Af-Arts via A1 receptors and that adenosine dilates preconstricted Af-Arts via A2 receptors when A1 receptors are blocked.

Evaluation of malignancy and the prognosis of esophageal cancer based on an immunohistochemical study (p53, E-cadherin, epidermal growth factor receptor).

The subjects in this study consisted of 40 preoperative untreated esophageal squamous cell carcinoma patients. While p53 did not significantly correlate with the clinicopathological factors, E-cadherin significantly correlated with lymphatic invasion, vascular invasion, the depth of invasion, the degree of lymph node metastasis, the histological stage, and the number of lymph node metastases. Epidermal growth factor receptor (EGFR) significantly correlated with age, the depth of invasion, and the number of lymph node metastases. The 5-year cumulative survival rate was 45.7% in the p53-positive cases and 61.9% in the p53-negative cases, with no significant difference, and 87.8% in the E-cadherin-positive cases and 19.1% in the -negative cases, and the difference was significant. The prognosis was significantly poor in EGFR-positive subjects: the 5-year survival rate was 38.6% in EGFR-positive cases and 68% in -negative cases. The 5-year survival rate in E-cadherin-negative, EGFR-positive cases was 0%, while it was 91.7% in the reverse pattern, and this difference was significant. These findings suggest that both E-cadherin and EGFR are important prognostic factors, and a more precise prognosis can thus be obtained by combining them. Such a combined technique may be very useful as an indicator for grading the biological malignancy of esophageal cancer.

Neuronal differentiation of neuro 2a cells by inhibitors of cell cycle progression, trichostatin A and butyrolactone I.

Trichostatin A (TSA, 17 nM), a specific and reversible inhibitor of histone deacetylase induced neurite network formation at and after 4 days. The networks were preserved for at least 3 weeks in the presence of TSA. Butyrolactone I (BLI, 23.6 microM), an inhibitor of cdc2 and cdk2 kinases, also induced neurite extension. Both compounds enhanced the acetylcholinesterase activity of the cells. Cell cycle progression of the cells was blocked by TSA (17 nM) at G1 phase alone. Furthermore, the level of histone hyperacetylation and p21(WAF1) expression in TSA-treated cells increased transiently. These findings suggest that the induction of the neuronal differentiation in Neuro 2a cells by these agents requires the cell cycle arrest at G1 phase, which is caused by inhibition of cycline dependent kinase, a target molecule of BLI and p21(WAF1).

Effects of mucokinetic drugs on rheological properties of reconstituted human nasal mucus.

OBJECTIVE: To investigate the effects of mucokinetic drugs on the rheological properties of human nasal mucus in patients with chronic sinusitis. DESIGN: We reconstituted human nasal mucus obtained from 74 patients with chronic sinusitis and determined the effects of 4 mucokinetic drugs, including acetylcysteine, deoxynuclease I, 2% sodium bicarbonate, and a combination product containing tyloxapol (Alevaire), on rheological properties of reconstituted human nasal mucus (RHNM). We used 5% RHNM dissolved in phosphate-buffered solution as the optimal buffer and concentration of RHNM for the study because it showed a viscoelastic response similar to that of freshly collected nasal mucus from patients with chronic sinusitis. METHODS: Four experiments were performed to determine the influence of each drug on dynamic viscosity and elasticity of 5% RHNM. Distilled water was used as a control. RESULTS: Acetylcysteine and deoxynuclease I significantly decreased both dynamic viscosity and elastic modulus, while distilled water had no effect on rheological properties of 5% RHNM in vitro. Alevaire significantly reduced both dynamic viscosity and elastic modulus. Sodium bicarbonate significantly reduced elastic modulus but not dynamic viscosity. Reduction of elastic modulus by Alevaire was significantly greater than that by sodium bicarbonate, while there was no difference in reduction of dynamic viscosity between them. CONCLUSION: Our results indicate that RHNM may be useful for studying the topical effects of various drugs on nasal mucus from patients with chronic sinusitis.

Endogenous TNF induction therapy using rTNF-SAM2 in patients with pulmonary metastases from colorectal cancer.

BACKGROUND: Distant metastases from colorectal cancer are generally refractory to conventional therapies, with the exception of surgical resection. The aim of this study was to evaluate the clinical application of endogenous TNF induction therapy by using a mutant TNF (rTNF-SAM2) as a primer in endogenous/exogenous TNF therapy (EET therapy) in patients with pulmonary metastases from colorectal cancer. METHODS: The subjects were 17 patients, 5 of whom underwent EET therapy alone and 12 of whom underwent EET therapy and the administration of anticancer agents. RESULTS: Partial response was observed in 6 patients (50%) who underwent EET therapy with anticancer agents. In seven (53.8%) of 13 patients who showed a high serum CEA value, their CEA levels were considered to be improved. Severe toxic effects occurred in 3 of the patients studied (17.6%). The mean survival was 26.0 months among those with a partial response and 16.6 months among those with no change. No significant difference was observed between these two groups. Histological assessments indicated that tumor necrosis, fibrosis and cellular infiltration tended to intensify in cases treated with EET therapy compared with the cases who received surgery alone. CONCLUSION: EET therapy with anticancer agents is well-tolerated and effective for pulmonary metastases from colorectal cancer.

Usefulness of adenosine triphosphate-atropine stress echocardiography for detecting coronary artery stenosis.

There have been few studies on adenosine triphosphate (AT) stress echocardiography. The AT stress test may have fewer adverse effects than the adenosine stress test. The addition of atropine to AT echocardiography may enhance the sensitivity for detection of coronary artery disease (CAD). The purpose of this study was to determine the utility of AT-atropine echocardiography for detection of CAD. The group studied consisted of 112 patients with suspected CAD. Sixty-one patients did not have a history of prior myocardial infarction (group I) and 51 patients did (group II). AT was infused intravenously at 180 microg/kg/min for 14 minutes. Atropine (0.25 mg intravenously, repeated up to maximum total dose of 1 mg) was administered starting after 8 minutes of AT infusion. Ischemic response was defined as new or worsening wall motion abnormality occurring during the infusion. The sensitivity and specificity for detection of CAD were assessed using the representative echocardiograms during single AT infusion and AT-atropine infusion. Sixty-two patients had CAD. Fifty-eight patients (52%) developed minor side effects that resolved promptly. The rate-pressure product (10(3)/mm Hg beats/min) was significantly increased at 12 minutes of infusion (12.4+/-3.2) compared with that at baseline (9.1+/-2.3) and that at 6 minutes of infusion (9.4+/-2.1). The sensitivity for detection of CAD was 45% for AT echocardiography and 74% for AT-atropine echocardiography. The specificity was 94% for AT echocardiography and 90% for AT-atropine echocardiography. The sensitivity and specificity of AT-atropine echocardiography was 78% and 93%, respectively, in group I, and 70% and 86%, respectively, in group II. In conclusion, AT-atropine stress echocardiography seems to be well tolerated, safe, and useful for detection of CAD.

Coronary artery aneurysm repaired with saphenous vein patch plasty.

The presence of atherosclerotic coronary artery aneurysms is not always considered to be an operative indication. However, progressively expanded coronary artery aneurysms may have the potential for complications such as rupture or embolism. We present a case of successful repair of a coronary artery aneurysm located above the first septal perforator in the left anterior descending coronary artery using a saphenous vein patch and simultaneous construction of a right gastroepiploic artery graft to the occluded right coronary artery. Follow-up angiography at 6 months after operation revealed complete disappearance of the aneurysm with no luminal stenosis and a preserved large septal branch. The right gastroepiploic artery graft was also found to be widely patent.

Assessment of blood flow in the small intestine by laser Doppler flowmetry: comparison of healthy small intestine and small intestine in Crohn's disease.

Blood flow and blood distribution were investigated in 40 patients with normal small intestine and the relation between blood flow and the morphological features of Crohn's disease was examined in 11 patients with Crohn's disease by laser Doppler flowmetry from the serosal side during surgery. In normal small intestine, blood flow was measured at six points: upper, middle, and lower small intestine, each of the mesenteric borders, and the antimesenteric surface. In Crohn's disease, macroscopically normal tissue and affected lesions were observed in detail by intraoperative endoscopy after blood flow measurement. The blood flow values in the normal small intestine gradually decreased from the upper to the lower small intestine. As the level of inflammation progressed in Crohn's disease the blood flow values gradually decreased; the exudative stage of Crohn's disease (aphthoid ulcer) showed blood flow values that were slightly below those in macroscopically normal tissue. These results are the first to demonstrate decreased blood flow in affected lesions in Crohn's disease and changes in blood flow according to the degree of inflammation in vivo.

[Crescentic glomerulonephritis in a patient with rheumatoid arthritis].

A 56-year-old female with rheumatoid arthritis was admitted because of bilateral hip pain. In a few months of her hospitalization, a relatively abrupt renal dysfunction was emerged besides complement breakdown, and renal biopsy revealed crescentic glomerulonephritis. Immunofluorescence study showed peripheral granular deposits of IgG, IgM, and C3 in the glomeruli. Cresents were predominantly composed of macrophages and glomerular epithelial cells. Amyloid nephropathy, renal vasuculitis, and association of other collagen vascular diseases were negligible for the causative factor. It was suggested that immune complexes were formed in the glomeruli, in which both humoral and cellular immune responses were to be induced, that brought cescents formation in the lesions. Crescentic glomerulonephritis in patients with rheumatoid arthritis is rare and a possible pathogenetic mechanisms involved in the development of renal dysfunction are discussed with the special reference to immune complex-induced inflammation.