Vitamin B6 deficiency augments endogenous oxalogenesis after intravenous L-hydroxyproline loading in rats.

The effects of an intravenous hydroxyproline load on endogenous oxalogenesis were compared in rats fed a standard diet or a vitamin B6-deficient diet. Twelve male Wistar rats were randomized to two groups and were fed either a standard diet (control group) or a vitamin B6-deficient diet for 3 weeks. Then the animals were intravenously administered 100 mg (762.6 micromol)/ml hydroxyproline. In the control group, infusion of hydroxyproline increased the 5-h urinary oxalate and glycolate excretion above baseline to 0.27% (2.02 +/- 1.11 micromol) and 0.32% (2.43 +/- 1.60 micromol) of the administered dose (mol/mol), while it was respectively 2.01% (15.24 +/- 2.13 micromol) and 0.00% (-0.02 +/- 0.19 micromol) of the dose in the vitamin B6-deficient group. Therefore, vitamin B6 deficiency augmented endogenous synthesis of oxalate from hydroxyproline by 7.56-fold (15.24/2.02) compared with that in the control group. Urinary citrate excretion was significantly lower at baseline and all other times in the vitamin B6-deficient group compared with the control group. In conclusions, L-hydroxyproline loading augmented endogenous oxalogenesis in the vitamin B6-deficient group without causing hyperglycolic aciduria, and also led to significant hypocitraturia. These findings suggest that hydroxyproline is not metabolized to oxalate via glycolate, but rather via the 4-hydroxyglutamate to glyoxylate pathway (usually requiring vitamin B6-dependent enzymes) even in the presence of vitamin B6 deficiency.

[Primary signet ring cell carcinoma of the urinary bladder: a case report].

Gross hematuria and urinary frequency caused a 71-year-old man to visit our hospital. A non-papillary tumor was identified on the posterior wall of the urinary bladder and the pathological diagnosis was signet ring cell carcinoma. Upper gastrointestinal endoscopy, computed tomographic scanning, barium enema revealed no involvement of other organs. Radical cystectomy and creation of an ileal conduit were performed. The histopathological stage was pT4N1M0. Apart from subacute ileus, the postoperative course was uneventful. Signet ring cell carcinoma of the bladder is a rare entity and we have identified 41 cases in the Japanese literature. This tumor usually has a poor prognosis. Our patient is currently free from disease at 5 months after the surgery.

Oxalate-degrading Enterococcus faecalis.

An oxalate-degrading Enterococcus faecalis was isolated from human stools under anaerobic conditions. The bacteria required a poor nutritional environment and repeated subculturing to maintain their oxalate-degrading ability. The E. faecalis produced 3 proteins (65, 48, and 40 kDa) that were not produced by non-oxalate-degrading E. faecalis as examined by SDS-PAGE. Antibodies against oxalyl-coenzyme A decarboxylase (65 kDa) and formyl-coenzyme A transferase (48 kDa) obtained from Oxalobacter formigenes (an oxalate-degrading anaerobic bacterium in the human intestine) reacted with 2 of the proteins (65 and 48 kDa) from the E. faecalis as examined by Western blottings. This is the first report on the isolation of oxalate-degrading facultative anaerobic bacteria from humans.

Ascorbate conversion to oxalate in alkaline milieu and Proteus mirabilis culture.

BACKGROUND AND PURPOSE: Ascorbate breakdown reportedly accounts for 30% to 55% of urinary oxalate excreted. Three potential degradation routes can be postulated: bowel, endogenous, and urinary. Because the pH of normal urine ranges from 4.5 to 8.0, the urinary oxalate concentration in the presence of ascorbate may be influenced by urinary pH and environment, so we studied ascorbate conversion to oxalate in standard buffer solution and in urine. About 10% of infection stones associated with Proteus mirabilis are reportedly composed of calcium oxalate, and their pathogenesis is not well explained. Therefore, we studied whether a pH change induced by P. mirabilis contributes to ascorbate conversion to oxalate in vitro. RESULTS: Oxalate production from ascorbate increased as a function of pH (7.0-10.0) and incubation time (30 minutes-24 hours) in standard and urine specimens. Two-hour exposure to pH 10 in a urinary milieu containing approximately 3 mM ascorbate converted approximately 40% of the ascorbate to oxalate, whereas 24-hour exposure to pH 8 in a urinary milieu that was approximately 3 mM ascorbate converted approximately 20% of the ascorbate to oxalate. The pH in Proteus cultures increased to 9.0 at 24 hours of culture. The ascorbate concentration in the culture medium significantly decreased at 12 hours and 24 hours, and the oxalate concentration increased significantly at 24 hours. CONCLUSION: Urinary ascorbate, if present at a high concentration in association with Proteus mirabilis infection, appears to be locally degraded to oxalate, potentially leading to calcium oxalate deposition on infection stones.

[Fornix of vagina suspension for cystocele].

OBJECTIVE: Bladder neck hypermobility causes cystocele in middle to old elderly women. We developed an easy and useful surgical technique for cystocele. METHODS: Thirteen patients with cystocele (grade 2-4) were operated by fornix of the vagina suspension. Patients were placed on lithotomy position under general or spinal anesthesia. Lower midline or lower abdominal transverse incision was made to open the peritoneum and denuded vesicouterine pouch. Several nylon sutures were placed on the lateral side of exposed fornix of the vagina. These sutures were suspended to anterior layer of the rectus sheath. Fornix of the vagina was fixed to the rectus muscle, so the prolapsed bladder wall was pulled up in normal position. RESULTS: Operating time ranged from 15-110 minutes (average 73 minutes). Ten patients of thirteen were successful up to 2-43 months postoperatively. Cystocele recurred in three patients of thirteen. Two patients was re-operated by the same method, but one of them recurred. Two of three recurrent patients had grade 4 cystocele. CONCLUSION: Fornix of the vagina suspension for cystocele seems useful and promising because of easy procedure without serious morbidity, especially in elderly high-risk patients.

A case of diabetic muscle infarction in Japan.

Diabetic muscle infarction (DMI) is a rare complication of diabetes mellitus. We report the first recorded case in Japan. A 45-year-old Japanese woman presented with severe pain in the left antero-medial thigh. She had a 14-year history of Type 2 diabetes mellitus (DM). She had first noticed pain in her left thigh after a walk 2 weeks prior to presentation. The pain worsened progressively. She noticed a firm mass in her left thigh. T2-weighted magnetic resonance imaging (MRI) demonstrated a high-intensity signal in the muscle bulk of the anterior component of the left thigh. A needle biopsy of the mass showed necrosis. She was treated with bedrest and an antiplatelet agent. The mass disappeared 8 weeks after admission. DMI is a rare complication of poorly controlled diabetes mellitus. Twenty-seven cases with DMI have been reported in the English literature but we believe this is the first Japanese case with DMI.

[Recent features of parasites detected from clinical specimens].

It is generally considered that we have already been through with problems caused by various kinds of parasites which had once raged throughout the country. On the contrary to our common concept, we occasionally encounter some kinds of parasites in a laboratory as well as in clinical fields, which have become unfamiliar to us in these days. Parasitic diseases are in the first place, proper and limited to certain local regions, but the present situation has been greatly changed. Nowadays, specific parasites are no longer limited to polluted areas, but also they can be detected in any part of the world owing to facilitated transportations and a promoted international exchange of people. A recent gourmet boom is also one of the causes of infection as seen in anisakiasis. This study was conducted on the investigation of parasites detected from clinical specimens in our laboratory during the period from 1989 to 1993. 1) The following parasites were detected : (1) Strongyloides stercoralis, (2) Giardia lamblia, (3) Diphyllobothrium latum, (4) Schistosoma mansoni, (5) Entamoeba histolytica, (6) Necator americanus, (7) Isospora belli. 2) Strongyloides stercoralis was detected at the highest frequency. This result gives an account of high prevalence of the parasite among the inhabitants in Okinawa. In addition, the agar plate medium method which has been newly adopted has definitely led to far-advanced results for detection of this parasite. 3) Schistosoma mansoni and Necator americanus were found from foreigners one of whom was a Tanzanian and the other was a Dominican. 4) Isospora belli was found from those compromised cases such as ATL and AIDS.

Dietary effects of corn oil, oleic acid, perilla oil, and evening [corrected] primrose oil on plasma and hepatic lipid level and atherosclerosis in Japanese quail.

To compare the atherogenecity of different fats and oils, a total of forty, 40-day-old male Japanese quails were fed one of the following diets for three months: basal diet (control), a diet-containing 15% corn oil (CO) and 2% cholesterol (CH), a diet-containing 15% oleic acid (OL) and 2% CH, a diet-containing 15% perilla oil (PE) and 2% CH, a diet-containing 15% evening [corrected] primrose oil (PR) and 2% CH. A higher plasma cholesterol concentration was found in the birds in the CO and OL groups, whereas the PE and PR groups showed a much lower level of plasma cholesterol than the CO and OL groups. In proportion to the increased plasma cholesterol, both CO and OL groups showed narrowing of the lumen of the ascending aorta and its large branches due to marked lipid-rich intimal thickening. Ultrastructural changes in the ascending aorta and its large branches were correlated with the degree of intimal thickening. The major foam cell types were macrophages and fibroblastic cells. The PE and PR groups showed the fewest lipid-rich intimal thickening lesions in their ascending aorta and its large branches. These findings suggest that the alpha-linolenic acid contained in perilla oil is less atherogenic than oleic and linoleic acid, and gamma-linolenic acid contained in evening [corrected] primrose oil has a tendency to decrease the plasma lipid level.

[Evaluation of multiple Pseudomonas aeruginosa strains with different characteristics in clinical specimens; combined results from serotyping, drug susceptibility and enzyme production].

Multiple Pseudomonas aeruginosa strains with different characteristics are occasionally isolated from a clinical specimen. Therefore, more than five isolated colonies of P. aeruginosa obtained at random from each clinical specimen (47 sputa, 18 urine, 10 pus and 8 others). These were investigated for serotype, drug susceptibility to eight antimicrobial agents and productivity of enzymes, such as protease and elastase. The specimens with multiple serotype colonies were shown in 17% of the sputa, 11% of the urine and 10% of the pus. 45.7% of the specimens with single serotype colonies exhibited more than two different patterns of enzyme productivity and so did 47.1% different patterns of drug susceptibility. Single serotype strains of P. aeruginosa with different characteristics of these tests were demonstrated in 81.3% of the urine, 73.6% of the sputum, 50.0% of the pus and 66.7% of others. We conclude that it is important to recognize the possible existence of multiple P. aeruginosa strains with different patterns of the enzyme productivity and drug susceptibility, regardless of single serotype, in clinical specimens.

[Electrophysiological evaluation of human consciousness level by "Automated Fluctuation Analysis" of human high frequency EEG].

This study is done to clarify the clinical meaning of "Automated Fluctuation Analysis" of high frequency EEG in man especially focused on the fine alteration of consciousness level of the subjects. Twenty normal volunteers were utilized for this study. They were divided into two groups, the subjects who felt sleepiness (Group S; N = 8) and the subjects who denied it (Group W; N = 12), during the EEG recording. "Automated Fluctuation Analysis" of high frequency EEG had been presented in our previous paper. In short, it is made of three steps, amplification of EEG signal, A/D conversion and Fast Fourier Transform by signal processor and extraction of Lorentzian parameters. Power spectral density (PSD) was displayed on log-log graph. Then the third step is performed by the best curve fitting program to the following equation, S (f) = S1/[1 + (f/fc1)2] + S2/ [1 + (f/fc2)2], where S(f) is power spectral density at any frequency f, S1 and S2 are plateau level of initial and second Lorentz, respectively and fc1 and fc2 are the corner or half power frequency of initial and second Lorentz, respectively. The algorithm of this program to extract these parameters were mathematically based on Brown & Dennis. As results, 1. PSD of human high frequency EEG was composed of double Lorentzians and vanished into white level within 1kHz. 2. A topographical display of S1 value revealed hyperfrontal in group W, which is in accordance with the cerebral blood flow study by Ingvar.(ABSTRACT TRUNCATED AT 250 WORDS)

Recent trends in bagassosis in Japan.

The only workers presently exposed to bagasse dust in Japan are the employees of sugar refineries and lacquerware factories. A follow up study of six former cases of bagassosis from among the retired employees of a paper board factory, closed since 1973, showed that none of the subjects still had bagassosis. Examinations of 70 employees of a sugar refinery for allergic reactions also showed no case of bagassosis. Seven cases with suspicious shadows of bagassosis on chest radiographs and four cases with positive serum precipitin to stored bagasse were, however, found among those 70 subjects. The results show the disappearance of a past episode of bagassosis and the possibility of a new occurrence of bagassosis among the employees of sugar refineries and lacquerware factories in the near future in Japan.

[A case report of giant cell granuloma of the jaw].

A giant cell granuloma of the mandible seen in a 16 month-old boy was reported. Histopathology showed that the lesion consisted basically of granulation tissue with multinucleated giant cells, spindle-shaped and polygonal stromal cells. No atypia was seen in giant cells or stromal cells. Electron microscopic examination revealed that multinucleated giant cells possessed microvillous structure on their cytoplasm and were rich in organelles such as endoplasmic reticulum, mitochondria and dense bodies. Stromal cells consisted of macrophage-like and fibroblastic cells. Immunohistochemical examination demonstrated a large number of giant cells and stromal cells that were strongly positive for the antibodies of alpha-1-antitrypsin and alpha-1-antichymotrypsin. These morphological findings suggest that macrophage-like stromal cells are the precursors to giant cells.

Promotive effect of elastase on regression of aortic atherosclerosis in cholesterol-fed quails.

In order to test the anti-atherosclerotic function of elastase, 44 Japanese quails, 40 d of age, were used in this study. An atherogenic diet contained 15% corn oil and 2% cholesterol. Elaszym was orally administered at a dose of 6,000 EL units per kg body weight 3 times a week for 3 months. After 3 months feeding the atherogenic diet was discontinued. Moderate hypercholesterolemia and marked lipid-rich aortic lesions were noted in the group which was fed the atherogenic diet for 3 months. The thickened intima was composed of fibroblasts and alpha-1-anti-trypsin, S-100 protein, calmodulin and elastase were strongly demonstrated. Withdrawal of the atherogenic diet resulted in marked improvement of the serum cholesterol level, and slight reduction of the degree of the intimal thickening of the thoracic aorta. Elastase treatment after the withdrawal of atherogenic diet induced significant regression of the aortic lesions of the thoracic aorta. These results suggest that Elaszym possesses the promotive effect on regression of atherosclerotic lesions.