Endothelin synthesis and receptors in human endometrium throughout the normal menstrual cycle

This study was undertaken to investigate the presence of messengerRNA (mRNA) for prepro-endothelin-I (ET-1) and the known receptorsubtypes (ETA and ETB) in human endometrium at different stagesof the menstrual cycle obtained at hysterectomy. Northern blotanalysis revealed expression of ET-1 mRNA in human endometriumduring the normal menstrual cycle. The concentration of ET-1mRNA in endometrial tissue was greater during the menstrualand proliferative phases than during the ovulatory and secretoryphases. Immunoreactive ET-1 was secreted into the medium ofisolated endometrial stromal cells. Oestradiol and progesteronesignificantly attenuated ET-1 release in endometrial stromalcells cultured for 6 days. ETA and ETB mRNA were also presentin endometrial tissue of the normal cycle. The concentrationof ETA receptor mRNA was greater in the proliferative phasethan in the secretory phase, whereas expression of ETB mRNAincreased in menstrual phase. ET-1 significantly increased extracellularaccumulation of cyclic AMP (cAMP), intracellular generationof inositol phosphates and significantly enhanced DNA synthesisin cultured endometrial stromal cells from the proliferativephase. Our results showed that human endometrial cells synthesizedand released ET-1, and contained ETA and ETB receptors whichwere functionally coupled to phosphoinositide breakdown andto adenylate cyclase with the increase of cAMP by ET-1 stimulation.Our findings suggest that ET-1 may have a potential autocrineand/or paracrine function in human endometrial stromal cells.     

Chronological variation of adrenal surgery for the past 28 years--experience with 140 adrenal operations

The author experienced 140 adrenal operations from April, 1958 to March, 1986. Surgery was performed in 54 cases of primary aldosteronism (adenoma - 52, hyperplasia - 2), 46 cases of Cushing's syndrome (carcinoma - 3, adenoma - 22, primary nodular hyperplasia - 1, hyperplasia - 20), 26 cases of pheochromocytoma (tumor - 25, hyperplasia - 1) and 11 other adrenal tumors. During the study period of 28 years, remarkable strides have been made in the image diagnostic procedures such as RI scinti-scan, ultrasonography and CT and the hormonal assay. The effect of this progress appeared mainly in the cases after 1972. Therefore, the 140 adrenal operations were studied by dividing the period into the early 14 and the late 14 years. During the period of the early 14 years, 77 operations were carried out, while 63 were performed in the late period. The decreased number of operations during the late 14 years was due to the fact that Cushing's disease came to be treated mostly by transsphenoidal hypophysectomy. Surgical approaches to the adrenal gland are usually classified as anterior transperitoneal and extraperitoneal including translumbar and posterior incisions. In the former period, the transperitoneal approach was indicated in 40 operations, while the extraperitoneal approach was indicated in 37. On the other hand, 53 operations were performed by the extraperitoneal procedure with only 10 transperitoneal surgical interventions in the latter period. The decreased frequency of the transperitoneal surgery in the latter period was considered due to improved preoperative techniques to localize the adrenal lesion. Operative and postoperative complications such as spleen injury, delayed wound healing and intestinal paralysis were compared with regards to the transperitoneal and extraperitoneal approaches. More complications were noted in the transperitoneal approach.(ABSTRACT TRUNCATED AT 250 WORDS)     

Diagnosis of incomplete Kawasaki disease

We defined incomplete Kawasaki disease (KD) as those having less than 5 principal symptoms of KD in this article. Japanese Nationwide KD surveys revealed that the prevalence of coronary artery lesion in incomplete KD is almost the same as that of complete KD. Thus, incomplete KD should not be equated with mild KD. However, there is no royal way to make the correct diagnosis of incomplete KD. We have to remind that incomplete KD is not uncommon (around 15%) and is not mild KD when we work-up patients with few principal symptoms of KD. We have to pay attention also to other significant symptoms or findings of the guideline, especially to the skin changes at the site of BCG inoculation.     

Toll-like receptor 9 is expressed on follicle-associated epithelia containing M cells in swine Peyer's patches

The precise distribution and expression of Toll-like receptor (TLR) 9 in gut-associated lymphoid tissues (GALTs) has not been elucidated. In this study, we investigated the expression pattern of TLR9 in adult and neonatal swine GALTs by real-time quantitative PCR, western blot, confocal laser microscopy and flow cytometric analysis. The swine TLR9 gene was preferentially expressed in adult Peyer's patches (Pps) and mesenteric lymph nodes (MLNs), which contained approximately three times higher TLR9 than the spleen. Other tissues exhibited only weak expression of TLR9. In neonatal swine, elevated expression of TLR9 was detected only in MLNs. We firstly showed that highly expressive (TLR9(+)) cells were formed in Pps and MLNs. In addition, TLR9(+) cells were present not only in immune cells such as dendritic cells and B cells but also in follicle-associated epithelia (FAE) including membranous cells (M cells) in Pps. These results suggest that Pps and MLNs provide the host defense with the ability to respond to a variety of bioactive oligonucleotides (ODNs) from bacteria at a conductive site of initial immune responses.     

Molecular cloning and functional characterization of porcine MyD88 essential for TLR signaling

We isolated cDNA encoding porcine MyD88 （poMyD88） from Peyer＇s patches （Pps） of GALT. The complete open reading frame （ORF） of poMyD88 contains 879 bp encoding a deduced 293 aa residues. The amino acid sequence of poMyD88 was characterized by N-terminal death, intermediate and C-terminal Toll/IL-1 receptor （TIR） domains. The putative poMyD88 protein shares a higher level of homology with its human （87.2% amino acid identity） than with its mouse （77.4% amino acid identity） counterpart. Overexpression of poMyD88 participated in the further enhanced activation of NF-w.B in human embryonic kidney （HEK） 293 cells expressing porcine TLR2 and porcine TLR4/MD-2, but not porcine RP105/MD-1 after stimulation with the corresponding ligands. The expression levels of MyD88 were highest in the spleen and mesenteric lymph nodes （MLNs）, and lower in digestive tissues of newborn swine. In adult swine, the expression levels in the digestive tissues were lower than those in MLNs and the spleen. These results suggest that an MyD88-dependent signaling pathway is present in newborn as well as in adult swine and that it is involved in the innate immune system of these animals.     

Primary signet ring cell carcinoma of the urinary bladder successfully treated with intra-arterial chemotherapy alone

A 65-year-old man presented with the complaint of gross hematuria. Cystoscopy revealed a sessile tumor on the left bladder wall. It was diagnosed as primary signet ring cell carcinoma of the bladder (T3bN0M0). The patient did not want surgical treatment. Therefore, three courses of arterial infusion of carboplatin were administered at 3-week intervals. Complete remission was obtained and has been maintained for 44 months. Our case appears to be the first report of successful treatment with chemotherapy alone of an infiltrating signet ring cell carcinoma of the bladder.     

Habitual intake of lactic acid bacteria and risk reduction of bladder cancer

INTRODUCTION: A kind of lactic acid bacteria, Lactobacillus casei strain Shirota, shows antitumor activity in experimental animals. One clinical trial using L. casei showed a significant decrease in the recurrence of superficial bladder cancer. So, to assess the preventive effect of the intake of L. casei, widely taken as fermented milk products in Japan, against bladder cancer, we conducted a case-control study. METHODS: A total of 180 cases (mean age: 67 years, SD 10) were selected from 7 hospitals, and 445 population-based controls matched by gender and age were also selected. Interviewers asked them 81 items. The conditional logistic regression was used to estimate adjusted odds ratios (OR). RESULTS: The OR of smoking was 1.61 (95% confidence interval: 1.10-2.36). Those of previous (10-15 years ago) intake of fermented milk products were 0.46 (0.27-0.79) for 1-2 times/week and 0.61 (0.38-0.99) for 3-4 or more times/week, respectively. CONCLUSION: It was strongly suggested that the habitual intake of lactic acid bacteria reduces the risk of bladder cancer.     

Two cases of thoracopancreatic fistula in alcoholic pancreatitis: clinical and CT findings

We report two patients who were long-time habitual consumers of alcohol and suffered from thoracopancreatic fistula. The first patient, a 52-year-old man with no symptoms, underwent chest CT scan for a medical check-up and was revealed to have left small pleural effusion. A month later, he suddenly experienced severe cough and back pain. The immediate CT scan showed massive pleural effusion and mediastinal pseudocyst, and the amylase level in the aspirated pleural effusion proved to be elevated. He was successfully treated with medication and drainage of the effusion. The second patient, a 39-year-old woman, underwent CT scan for a medical check-up, and it disclosed that she had a small pleural effusion in the left lower thorax. Follow-up CT two months later revealed the pleural effusion to be resolved, however, it demonstrated that a narrow tract derived from the pancreatic secretion located just posterior to the pancreatic tail extended to the mediastinum along the left hemidiaphragmatic crus. She experienced severe cough and sputum four months later. CT scan showed massive pleural effusion in the left thorax and revealed that the pancreaticopleural fistula was located in the same position as the small tract that had been detected by the previous CT scan. The patient received conservative treatment and eventually recovered from the severe chest complications. We consider that asymptomatic left small pleural effusion in these patients who were habitual drinkers is a potential precursor to symptomatic pancreatitis. The patients developed mediastinal pseudocyst and pancreaticopleural fistula in association with chronic pancreatitis within a few months, and therefore intensive follow-up should be undertaken to minimize or prevent chest complications in association with the subsequent symptomatic pancreatitis.