Combined correction of an adult scimitar syndrome and coronary artery bypass grafting

Combined scimitar syndrome and coronary artery disease is a rare combination of congenital and acquired cardiac disease in adults. Hence, no guidelines for surgical correction are available. We report on the case of a 60-year-old man with coronary artery disease and scimitar syndrome. The patient underwent arterial coronary revascularization and simultaneous correction of the scimitar syndrome utilizing a new surgical approach with a modified pericardium-baffle reconstruction of the anomalous right pulmonary vein.     

A case-control study of risk factors for development of type 2 diabetes: emphasis on physical activity

The aim of this case-control study was to evaluate the association between the lifestyle risk factors, especially physical activity, and the prevalence of type 2 diabetes and the comorbidity of type 2 diabetes and dyslipidemia in middle-aged Japanese urban population. Subjects (279 males and 119 females, 53.5+/-6.8 years old) were selected from one city office in Tokyo and consisted of type 2 diabetes cases (n=53), dyslipidemia cases (n=130), the comorbidity cases (n=58) and sex- and age-matched controls (n=155). A self-administered questionnaire was used to collect physical activity data using Baecke's questionnaire translated and other lifestyle data. Our results revealed that physical activity was significantly associated with the reduction of the prevalence of type 2 diabetes and the comorbidity, and the sex- and age-adjusted odds ratios of the fourth quartile to the lowest one were 0.31 (95%CI:0.12-0.81) and 0.32 (95%CI:0.13-0.81), respectively. Family history of diabetes and smoking were independent risk factors for the prevalence of type 2 diabetes and the comorbidity.     

Involvement of human heat shock protein 90 alpha in nicotine-induced apoptosis

There have been conflicting reports of the apoptotic effects of nicotine on human cells and those studies reporting nicotine-induced apoptosis have not unequivocally clarified the molecular mechanisms underlying the effect. However, we found here that human RSa cells, established from embryonic fibroblastic cells doubly infected with Rous sarcoma virus and Simian virus 40, underwent apoptosis when cultured with medium containing 0.06-0.6 microM nicotine. The apoptosis was assessed by cellular DNA fragmentation and caspase-3 protease activation. Viability of RSa cells was reduced by nicotine treatment, as analyzed by MTT assay and the reduction was lessened by combination treatment with a caspase-3 inhibitor, acetyl-L-aspartyl-L-glutamyl-L-valyl-L-aspart-1-al (Ac-DEVD-CHO). Levels of expression of heat shock protein 90 alpha (Hsp90 alpha) were found to be increased 20 min after the nicotine treatment, as analyzed by polymerase chain reaction-based mRNA differential display after Northern blotting analysis of mRNA amounts. Cellular contents of Hsp90 alpha were furthermore increased in the nicotine-treated RSa cells, as quantitated by Western immunoblot analysis. By contrast, in RSa cells treated with nicotine in combination with geldanamycin (GA), an inhibitor of Hsp90 alpha function, DNA fragmentation was not detected and caspase-3 protease activity levels were the same as those of mock-treated cells. Nicotine-induced caspase-3 activation and Hsp90 alpha expression, as well as suppression of the induction by GA, were also observed in a xeroderma pigmentosum patient-derived cell line, XP2OS cells. Thus, it was suggested that nicotine induces apoptosis, possibly via Hsp90 alpha expression, in human cells tested.     

Stem-cell leukemia: p53 deficiency mediated suppression of leukemic differentiation in C3H/He myeloid leukemia

C3H/He mice produce myeloid leukemias after whole body irradiation of 1–3 Gy as compared with non-irradiated controls that produce fewer than 1% of leukemia [Radiatiton Research 127 (1991) 146]. Thus, p53-deficient C57BL/6 strain, a malignant lymphoma prone, was crossed back into C3H/He strain. Lethally irradiated wild-type mice to which p53-deficient bone marrow cells were transplanted (transplantation assay) showed dramatic change in the propensity of leukemia of myeloid lineages, the cells lacking CD3, Thy1.2, sIgM, B220, Mac-1, Gr-1, but being positive for c-Kit and CD44. Furthermore, transplanted mice subjected to 3 Gy irradiation gave rise to a faster development of leukemia and a higher frequency of double-lineage leukemias than the non-irradiated control.     

The relationship between spinal and appendicular bone mass modified by physical, historical, and lifestyle factors

Spinal, radial, and calcaneal bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and calcaneal bone mass measured by quantitative ultrasound densitometry (QUS) were compared in 83 healthy Japanese female volunteers. A significant and strong correlation was found within the same methods (r = 0.619 for lumbar spine and radius by DXA, r = 0.760 for lumbar spine and calcaneus by DXA, and r = 0.644 for calcaneus and radius by DXA), and within the same site (r = 0.758 for calcaneus by DXA and QUS). A lesser correlation was found when both the method and site were different (r = 0.521 for radius by DXA and calcaneus by QUS, and r = 0.583 for lumbar spine by DXA and calcaneus by QUS). Relations of spinal and appendicular bone mass were examined together with physical, historical, and lifestyle factors. Multiple correlation coefficients between bone mass at the lumbar spine and appendicular bone were 0.754 to 0.782, and all these increased after modification by physical, historical, and lifestyle factors in whichever appendicular bone. In the correlation between lumbar spine and radial BMD, past weight-bearing activity, age at menarche, family history of fractures, and body weight were chosen. Menstrual status, body weight, past weight-bearing activity, and present arm-using activity were chosen to determine the correlation between lumbar spine BMD and calcaneal bone mass by QUS. These results suggest that the incorporation of those factors improved the correlation between lumbar spine BMD and appendicular bone mass, especially in cases of lumbar spine BMD versus radial BMD or calcaneal bone mass by QUS. Received: Aug. 7, 1999 / Accepted: Oct. 29, 1999     

Dietary soy and increased risk of bladder cancer: the Singapore Chinese Health Study.

The association between soyfood consumption and subsequent bladder cancer risk was investigated in a population-based cohort study, the Singapore Chinese Health Study. As of December 31, 2000, 329,848 person-years of follow-up were accrued. Sixty-one histologically confirmed incident bladder cancer cases were identified. Information on soyfood consumption at baseline was obtained through in-person interviews using a validated dietary questionnaire. Relative risks and 95% confidence intervals were calculated using the Cox proportional hazard regression method. High intake of soyfood was statistically significantly related to an elevated risk of bladder cancer. Relative to the lowest quartile of energy-adjusted total soy intake (<36.9 g/1000 Kcal), the highest quartile of total soy intake (> or =92.5 g/1000 Kcal) was associated with a 2.3-fold increase in bladder cancer risk (95% confidence interval = 1.1-5.1) after adjustment for cigarette smoking and level of education. Similar results were obtained for intakes of soy protein and soy isoflavones. The soyfood-bladder cancer risk association did not differ significantly between men and women and was not explained by other dietary factors. The soy-cancer relationship became stronger when the analysis was restricted to subjects with longer (> or =3 years) duration of follow-up. To our knowledge, this is the first epidemiological report on the effect of dietary soy on bladder cancer risk.     

Effect of steroid on antiemetic for side effect of anticancer chemotherapy

The side effect of anticancer agents such as nausea and vomiting frequently interrupt chemotherapy. To reduce these side effects, 5-hydroxytryptamine (5-HT3) receptor antagonist or metoclopramide is administered combined with steroid. In this study, we examined the effect of 5-HT3 receptor antagonist on the frequency of nausea and vomiting in a male cancer patient treated with/without steroid. This patient in his sixties had esophageal cancer (stage IV). He was administered nedaplatin 100 mg/day for 1 day and then 5-fluorouracil (5-FU) 750 mg/day for 5 days combined with radiotherapy (60 Gy) as one cycle of this chemotherapy. In the first cycle, 5-HT3 receptor antagonist was administered, and in the second, the antagonist was administered after treatment with steroid. The blood levels of total bilirubin, GOT, GPT, BUN, Cre, Na, K and Cl were stable normally during both cycles of the chemotherapy, indicating that the hepatopathy and nephropathy which cause nausea and vomiting did not occur in these periods. The frequency and period of the nausea and vomiting were one-third decreased, respectively, by the combination of 5-HT3 receptor antagonist and steroid.     

Immunological evaluation of personalized peptide vaccination for patients with pancreatic cancer

The prognosis of pancreatic cancer is extremely poor, and development of new treatment modalities is needed. One such treatment could be specific immunotherapy. To evaluate safety and immunological responses, we conducted a phase I study of personalized peptide vaccination for pancreatic cancer patients (n=11). Namely, pre-vaccination peripheral blood mononuclear cells were screened for their reactivity in vitro to each of 14 or 16 peptides in HLA-A24(+) or -A2(+) patients, and only the reactive peptides (maximum: 4) were vaccinated in vivo. This regimen was generally well tolerated, although inflammatory reactions at the injection site were observed in 7 patients. Delayed-type hypersensitivity to peptides used for vaccination was observed in 7 patients. Increased cellular and humoral immune responses to at least one of peptides used for vaccination were observed in the post-vaccination PBMCs and sera from 4 of 8 patients and 4 of 10 patients tested, respectively. The 6- and 12-month survival rates for patients who received >3 vaccinations (n=10) were 80% and 20%, respectively. Due to tolerability and capability of inducing specific immunity, further development of personalized peptide-based immunotherapy for pancreatic cancer patients is warranted.     

Possible effects of diets on serum lipids,fatty acids and blood pressure levels in male and female Japanese university students

Objectives  To prepare a dietary recommendation for young Japanese for the prevention of coronary heart disease, we surveyed the dietary habits, serum lipids, serum fatty acids and blood pressure levels among male and female students. Methods  In this study, 175 male and 246 female university students were interviewed for the frequency of consumption of selected food items and the habit of skipping breakfast. Serum fatty acids were analyzed by gas chromatography. Results  The frequencies of consumption of dishes cooked with oil and intake of vegetables were higher in female students than in male students. Serum n-6 polyunsaturated fatty acids were slightly higher in females students than in male students while that of serum n-3 polyunsaturated fatty acids was 6.4% in both sexes. For both males and females, those who skipped breakfast at least once a week were less likely to consume vegetables and fruits than those who did not. Female students who skipped breakfast were also less likely to consume fish and had lower composition of n-3 polyunsaturated fatty acid and higher systolic and diastolic blood pressure levels than males. For female, the intake of milk and dairy products correlated inversely with systolic blood pressure levels and the intake of n-3 polyunsaturated fatty acids correlated inversely with diastolic blood pressure levels. For males, the intake of fruits and consumption of dishes cooked with oil correlated inversely with systolic and diastolic blood pressure levels. Conclusion  Our findings suggest that increased intake of fish, milk and dairy products, fruits and vegetables from early adulthood and a regular dietary pattern are important to reduce the risk factors for coronary heart disease.