Demonstration of Somatostatin Production in Medullary Carcinoma of the Thyroid

The localization and release of somatostatin in seven casesof medullary carcinoma of the thyroid were investigated by meansof specific anti-somatostatin antibody. In all four patientsexamined high concentrations of plasma somatostatin (125–400pg/ml) and calcitonin (1,917–82,000 pg/ml) were shown.Primary and metastatic tumor tissues obtained from three patientscontained higher amounts of somatostatin (13.1–350.0 ng/gwet wt) than the surrounding tissues. Immunohistochemically,somatostatin-immuno-reactive (IR) cells and calcitonin-IR cellswere shown to compose the majority of tumor cells, leaving asmall number of nonreactive cells in primary and metastatictumors of the seven cases, but in general calcitonin-IR cellswere more numerous than somatostatin-IR cells. The numbers ofcalcitonin-IR and somatostatin-IR cells were not markedly differentfrom case to case, but their population density did not alwayscorrespond to the concentrations of plasma and tissue somatostatin.These data indicate that medullary carcinoma of the thyroidis one of the somatostatin-producing tumors.     

Activation of complement in C-reactive protein positive sera by phosphorylcholine-bearing component isolated from parasite extract

Summary Phosphorylcholine-bearing component levels in extracts of various parasites were determined by a capillary precipitin test using anti-phosphorylcho-line Ig A myeloma protein, TEPC-15. Phosphorylcholine was demonstrated as a structural component not only in nematodes but also in trematodes and cestodes. The phosphorylcholine-bearing component was isolated from an extract of Toxocara canis larvae using a TEPC-15-Sepharose 4B column. The component reacted with C-reactive protein in sera to form one precipitin line in Immunoelectrophoresis. The component provided two Brilliant Coomassie Blue positive bands in SDS-polyacrylamide gel electrophoresis. It reacted with C-reactive protein to activate complement in serum.     

Stage–specific antigens of Hymenolepis microstoma recognized in BALB/c mice

Antigenicity of eggs (oncospheres), cysticercoids and adults (with immature segments only) of the bile duct tapeworm Hymenolepsis microstoma was analysed using immunoblotting techniques and indirect immunofluorescent antibody (IFA) techniques with immune sera of BALB/c mice (i) infected with different doses of cysticercoids, (ii) during patent or prepatent infection with the lumen phase of the parasite or (iii) sensitized with live or dead eggs. Antibody responses detected by IFA test and immunoblotting showed that antigenicity of eggs (oncospheres) differed from that of cysticercoids and adults. Single worm infections were sufficient to stimulate antibody responses. Mice which had patent infection showed strong antibody responses to all three (egg (oncosphere), cysticercoid, adult) antigens, while mice given two prepatent infections showed some antibody responses to cysticercoid and adult antigens only. Although the normal intermediate hosts of this parasite are arthropods, antibodies to some major egg (oncosphere) antigens were produced in mice given eggs of this parasite orally, either through inoculation of eggs or ingestion of faeces contaminated with eggs. Antibodies were not produced in mice dosed with non-viable eggs. The results are consistent with the hypothesis that cestode parasites express phase- (or stage-) specific antigens.     

Prediction of Optimal Atrioventricular Delay in Patients with Implanted DDD Pacemakers

In patients with an implanted DDD pacemaker (PM), the atrial contribution may be interrupted by too short an atrioventricular (AV) delay, and filling time may be shortened by too long an AV delay. The AV delay at which the end of the A wave on transmitral flow coincides with complete closure of the mitral valve may be optimal. The subjects were 15 patients [70.3+/-12.3 (SD) years old] with an implanted DDD PM. Cardiac output (CO) and pulmonary capillary wedge pressure (PCWP) were measured by Swan-Ganz catheter. Transmitral flow was recorded by pulsed Doppler echocardiography. AV delay was prolonged stepwise by 25 msc. When the AV delay was set at 155+/-26 ms, the end of the A wave coincided with complete closure of the mitral valve. When the AV delay was prolonged 25, 50, 75, and 100 ms from this AV delay, the interval between the end of the A wave and complete closure of mitral the valve was prolonged 16+/-5, 39+/-6, 65+/-4 and 88+/-5 ms, respectively (r = 0.97, P<0.0001) and diastolic mitral regurgitation was observed during this period. Thus, the optimal AV delay may be predicted as follows: the slightly prolonged AV delay minus the interval between the end of the A wave and complete closure of the mitral valve. When the AV delay was set at 215 ms, there was a significant positive correlation between the predicted optimal AV delay (166+/-23 ms) and the optimal AV delay (CO: 161+/-26 msec, r = 0.93, P<0.0001, PCWP: 161+/-28 msec, r = 0.95, P<0.0001). In conclusion, optimal AV delay can be predicted by this simple formula: slightly prolonged AV delay minus the interval between end of A wave and complete closure of mitral valve at the AV delay setting.     

Possible correlation between polymorphism in the tumor necrosis factor-beta gene and the clinicopathological features of bladder cancer in Japanese patients

OBJECTIVES: In a variety of cancers, several polymorphisms of the tumor necrosis factor (TNF) genes have been reported to result in different clinical outcomes. We investigated whether a polymorphism of the TNF gene is associated with a susceptibility to bladder cancer and its disease status. METHODS: Polymorphisms in the TNF-alpha gene promoter (-308 bp) and the NcoI site in the first intron of the TNF-beta gene were analyzed in 141 Japanese patients with bladder cancer and 173 Japanese controls by polymerase chain reaction-restriction fragment length polymorphism. The correlations between the polymorphisms of the TNF genes and the clinicopathological features were analyzed. RESULTS: The number of cases and controls with TNF-alpha2 was too small to be assessable. In contrast, the TNF-beta1/2 genotype at the NcoI site in the first intron conferred a 1.71-fold increased risk of bladder cancer compared to the TNF-beta2/2 genotype. In the bladder cancer group, patients with the TNF-beta1 allele had a significantly higher risk for a high-grade tumor (grade 3) or carcinoma in situ (CIS) than those without the TNF-beta1 allele. Moreover, in the superficial bladder cancers, patients with the TNF-beta1 allele showed a significantly higher intravesical recurrence rate than those without the TNF-beta1 allele. CONCLUSION: This polymorphism in the TNF-beta gene appears to be associated with tumor occurrence and disease status, such as the tumor grade and the presence of CIS. Further study with an increased sample size is warranted.     

Effectiveness of tonsillectomy in adult sleep apnea syndrome

Abstract Tonsillectomy was performed on 10 adult sleep apnea patients (five males, five females; average age, 39 years old; average body mass index, 24.8 kg/m²). Tonsillectomy alone was indicated if tonsillar hypertrophy was moderate to severe and the length of the soft palate was less than 35 mm according to cephalometry. Remarkable improvements were observed in all cases following surgery. The average weight of the resected tonsils was 11 g. The patients demonstrated a preoperative apnea + hypopnea index (AHI) of 14.4/h. This decreased to 2.9/h postoperatively. The intraesophageal pressure change improved from -36.6 to -15.7 cmH₂O following surgery. A significant correlation between preoperative AHI and the degree of obesity ( r = 0.684, P < 0.05) was found. Although uvulopalatopharyngoplasty has been used extensively to treat sleep apnea, the present results suggests that certain subjects can be effectively treated through only tonsillectomy.     

Surgical Treatment of Partial Anomalous Pulmonary Venous Connection of the Left Lung (It-PAPVC)

Between January 1981 and December 1983, 4 patients, aged 6 to 50 years, with It-PAPVC were operated upon at the Kokura Memorial Hospital, by a new technique of anastomosis between the left anomalous PV and the left auricular appendage. One patient, a 9-year-old male, had unilateral anomalous pulmonary venous connection of the entire left lung to the innominate vein. The other three patients had partial anomalous pulmonary venous connection from the left upper lobe to the innominate vein. Two patients has pulmonary valvular stenosis, and the other two had ASD. All patients were operated upon through a midsternal incision. After cardiopulmonary bypass was established, the anomalous vein was divided as high as was reachable. The present operative method involved the use of an oval pericardial gusset extending from the left auricular appendage into the split anomalous vein so as to obtain a wide anastomotic orifice. Other associated congenital anomalies were simultaneously corrected. All patients had uneventful recovery and at postoperative cardiac catheterization and angiography, the anastomosis between the pulmonary vein and the left auricular appendage was widely patent.     

Cyclic peptides

In order to explore the route for the preparation of cyclodepsipeptide by cyclization through an ester bond formation, two analogs of AM-toxin II, cyclotetradepsipeptide, were synthesized. As a preliminary experiment, synthesis of [L-Phe³, L-Ser(Bzl)⁴]-AM-toxin II, containing L-Phe and L-Ser(Bzl) in place of L-App (2-amino-5-phenyl-pentanoic acid) and ΔAla (α,β-dehydroalanine), respectively, was attempted. Cyclization of H-L-Hmb-L-Phe-L-Ser(Bzl)-L-Ala-OH in CH₂CI₂ at 10mM concentration using water-soluble carbodiimide (EDC) and 4-dimethylaminopyridine (DMAP) successfully gave a cyclic monomer in 16% yield. Cyclization of H-L-Hmb-L-App-L-Ser(Bzl)-L-Ala-OH under the same conditions also afforded a cyclic monomer, [L-Ser(Bzl)⁴]AM-toxin II, in 19% yield. Analytical parameters of these cyclic monomers obtained were identical to those of the authentic samples obtained by cyclization through a peptide bond formation.     

Prolonged polysomnography in a case with recurrent hypersomnia

Abstract An 18-year-old male patient with recurrent hypersomnia (RH) was evaluated using prolonged polysomnography (PSG). During symptomatic period (SMP), the patient showed both 'dissociated stage REM' (DREM), REM sleep without muscle atonia and 'dissociated stage 1' (DSt-1), and stage 1 sleep with rapid eye movement. These stages were observed in the morning or following daytime record. They decreased during asymptomatic period (ASMP). It has been said that RH is caused by dysfunction of the hypothalamus and midbrain limbic system. The present result suggests also that RH involves dysfunction of the brain stem.