Application of the trimethylsilyl trifluoromethanesulfonate deprotecting procedure for the synthesis of porcine peptide YY (PYY)

A 36-residue peptide amide corresponding to the entire amino acid sequence of porcine peptide YY (PYY) was synthesized by assembling eight peptide fragments of established purity, followed by hard acid deprotection with 1m trimethylsilyl trifluoromethanesulfonate in trifluoroacetic acid. β-Cycloheptylaspartate, Asp(OChp), was employed to minimize the base-catalyzed succinimide formation. When administered to dogs, synthetic PYY was active as natural peptide in its effects on exocrine pancreatic secretion and pancreatic tissue blood flow.     

Vitamin B12 treatment for delayed sleep phase syndrome: A multi-center double-blind study

Abstract  The active form of vitamin B₁₂ (methylcobalamin) has been reported to be effective on sleep-wake rhythm disorders. Previous studies, however, were performed under open trial, and the effect of vitamin B₁₂ has not been properly evaluated. The aim of this double-blind study was to investigate the efficacy of methylcobalamin on delayed sleep phase syndrome (DSPS). Methylcobalamin (3 mg/day) or placebo was administered for 4 weeks. The subjects were 50 patients with DSPS aged 13–55 years (26.8 ± 1.3), 27 of whom received the active drug while 23 received the placebo. No significant differences were observed between the 2 groups in subjective evaluations of mood or drowsiness during the daytime or in night sleep by sleep-log evaluation. These results indicate that 3 mg methylcobalamin administered over 4 weeks is not an effective treatment for DSPS.     

The Internal Thoracic Artery and Its Branches After Coronary Artery Anastomoses in Pediatric Patients

The internal thoracic artery has been favored because of its superior early and late patency for coronary artery bypass grafting (CABG) in pediatric patients. We have studied the angiographic changes of the internal thoracic artery and its side branches before and after CABG with internal thoracic artery to the left anterior descending artery. The internal thoracic artery with remaining thymic or pericardial branches was patent but showed enlargement of the branches in the early period after the operation, and a postoperative exercise test suggested a remaining ischemic lesion in the bypass. Angiogram taken 1 year after CABG demonstrated the grown internal thoracic artery with disappearance of most of the side branches, which had been enlarged 1 month after the operation. Our findings suggest the importance of ligation of the whole proximal internal thoracic artery branches to maintain good early and late patency.     

Quantitative analysis of interferon α/β receptor mRNA in the liver of patients with chronic hepatitis C: Correlation with serum hepatitis C virus-RNA levels and response to treatment with interferon

We analysed the expression of interferon (IFN) α/β receptor mRNA in the liver of patients with chronic hepatitis C and examined the relationship between the expression of this receptor gene and the level of hepatitis C virus (HCV)-RNA as well as the response to 16 weeks of 6 × 10⁶ units IFN. The mean level of IFNα/β receptor mRNA in patients with chronic HCV infection (expressed as δ cycle; 10.8±1.9 (mean±SD); n = 39) was significantly higher than that of control subjects (9.4±0.5; n=6; P<0.01). There was a significant negative correlation between the level of IFNα/β receptor mRNA and serum HCV-RNA in 39 patients with chronic hepatitis C (R=-0.546; P<0.01). The mean level of IFNα/β receptor mRNA in six patients who showed a complete response to IFN therapy (12.3±1.6) was higher than that of 15 patients who failed to respond to therapy (10.1±1.5; P< 0.01). Our results are consistent with the suggestion that the anti-viral activity of IFN depends on the level of the IFNα/β receptor on hepatocytes in patients with chronic hepatitis C.     

The curative role of radiotherapy in patients with isolated para-aortic node recurrence from cervical cancer and value of squamous cell carcinoma antigen for early detection

The objective of this study was to examine the clinical benefits of routine squamous cell carcinoma antigen (SCC-ag) monitoring of patients with locally advanced cervical cancer. Recurrent disease occurred in 99 uterine cervical cancer patients with elevated pretreatment SCC-ag before primary radiotherapy. Elevated SCC-ag levels persisted in 23 patients after primary radiotherapy (group 1), and SCC-ag was normalized in 76 patients after primary radiotherapy (group 2). The overall survival (OS) rate was higher for patients with SCC-ag elevation as the first sign than for patients with recurrence predicted by other modalities for group 2 patients (P = 0.033). The prediction of isolated para-aortic node recurrence significantly correlated with SCC-ag elevation as an initial sign (P = 0.001). The SCC-ag level before primary radiotherapy (> or = 10.8 ng/mL) significantly affected recurrence predicted by SCC-ag elevation as an initial sign (P = 0.002). For multivariate analysis, the presence of para-aortic node recurrence was statistically significant in OS (P < 0.0001). Routine SCC-ag monitoring of patients with carcinoma of the uterine cervix can lead to the early diagnosis of isolated para-aortic lymph node recurrence, and prolonged survival can be achieved by applying radiation therapy to the para-aortic region. To reduce the number of patients monitored for SCC-ag, we recommend monitoring group 2 patients with pretreatment SCC-ag level before primary radiotherapy > or = 10.8 ng/mL.     

Squamous Cell Papilloma of the Esophagus -A Report of Two Cases and a Review of the Literature-

We present two cases of squamous cell papilloma of the esophagus (SPE) diagnosed by panendoscopy and confirmed by histology. In one case the SPE was removed by endoscopy, and in the other, the SPE detached during severe vomiting. Our patients both had a previous history of heartburn and repeated vomiting. An immunological study for human papilloma virus (HPV) was conducted in both cases, with negative results.     

Papillary renal cell carcinoma: A clinicopathological study of 35 cases

AIM: The objective of the present study was to characterize the clinicopathological features of histologically defined papillary renal cell carcinoma (RCC). METHODS: The present study included a total of 35 patients who were treated by radical surgery and subsequently diagnosed as having papillary RCC between April 1995 and June 2004. Clinicopathological data of these patients were retrospectively reviewed according to the previously reported classification system (Mod. Pathol. 1997; 10: 537-44). RESULTS: Of these 35 patients, 23 (65.7%) and 12 (34.3%) were diagnosed as type 1 and type 2 papillary RCC, respectively. Despite the lack of significant differences in clinical parameters between these two groups, including age, gender, clinical stage and metastasis, the incidence of symptomatic disease in patients with type 2 papillary RCC was significantly higher than that in those with type 1 papillary RCC. Pathological examinations demonstrated that there were no significant differences between these two groups in pathological stage, tumor grade or vascular invasion. Furthermore, there was no significant difference between these two groups in overall or recurrence-free survival. CONCLUSIONS: Although the present study included a small number of patients with short follow-up period, the clinicopathological features including prognoses were almost similar between patients with type 1 and type 2 papillary RCC; therefore, careful postoperative follow-up should be considered for patients with papillary RCC irrespective of morphological subtype.     

Ultrasonic Tactile Sensor: An Experimental Study to Evaluate the Depth of Invasion in Esophageal Squamous Cell Carcinomas

Abstract: To date, an objective scale for evaluation of tissue stiffness has been lacking. A new instrument, the “ultrasonic tactile sensor (UTS)”, allows objective evaluation of stiffness. For the purpose of evaluating cancer stiffness, we first introduce an experimental study on tissue stiffness using surgically resected specimens of esophageal squamous cell carcinomas with no special preoperative treatment. From November 1995 to January 1996, the authors examined 11 esophageal cancer specimens. Although this experiment revealed no differences between normal mucosa and mucosal cancer in the esophagus, significant differences between mucosal and submucosal cancers in terms of tissue stiffness were clearly demonstrated. Therefore, UTS examination is useful for assessing malignant invasion, thereby providing valuable information for determining appropriate indications for endoscopic mucosal resection. We currently perform this UTS examination using a miniature probe during preoperative endoscopy. We anticipate that this new method will become an essential tool for evaluating the depth of invasion in esophageal cancer preoperatively.     

Delayed elevation of plasma endothelin-1 during unilateral alveolar hypoxia without systemic hypoxemia in humans

Background: The mechanisms by which acute alveolar hypoxia induces pulmonary vasoconstriction remain unclear. We investigated whether endothelin-1 (ET-1) could be detected in plasma during pulmonary alveolar hypoxia without systemic hypoxemia (one-lung hypoxia) and whether the levels could be related to hemodynamic status in humans.
Methods: Thirteen adult patients with primary lung carcinoma were studied prior to surgery. Anesthesia was induced with fentanyl, diazepam, and pancuronium iv. Differential lung ventilation was performed for 40 min. The right lung was ventilated with a mixture of 6% O₂, 5% CO₂ and 89% N₂ and the left lung ventilated with 100% O₂. Blood gas values, hemodynamic parameters, and plasma ET-1 levels were measured.
Results: Mean pulmonary artery pressure increased from 13.±3.5 to 17.·3.2mm Hg ( P <0.01) after 20 min of one-lung hypoxia. The plasma ET-1 levels in arterial blood and wedged right pulmonary arterial blood increased from 1.69M.61 to 2.13 ±0.48 μg/ml ( P <0.01) and from 1.75±.47 to 2.26±.40 μg/ ml ( P <0.001), respectively, after 40 min of one-lung hypoxia.
Conclusions: We concluded that ET-1 may play a supporting, but not a primary, role in human hypoxic pulmonary vasoconstriction.