The plasminogen activation system reduces fibrosis in the lung by a hepatocyte growth factor-dependent mechanism

Mice deficient in the plasminogen activator inhibitor-1 gene (PAI-1-/- mice) are relatively protected from developing pulmonary fibrosis from bleomycin administration. We hypothesized that one of the protective mechanisms may be the ability of the plasminogen system to enhance hepatocyte growth factor (HGF) effects, which have been reported to be anti-fibrotic in the lung. HGF is known to be sequestered in tissues by binding to extracellular matrix components. Following bleomycin administration, we found that HGF protein levels were higher in bronchoalveolar lavage fluid from PAI-1-/- mice compared to wild-type (PAI-1+/+) mice. This increase could be suppressed by administering tranexamic acid, which inhibits plasmin activity. Conversely, intratracheal instillation of urokinase into bleomycin-injured PAI-1+/+ mice to activate plasminogen caused a significant increase in HGF within bronchoalveolar lavage and caused less collagen accumulation in the lungs. Administration of an anti-HGF neutralizing antibody markedly increased collagen accumulation in the lungs of bleomycin-injured PAI-1-/- mice. These results support the hypothesis that increasing the availability of HGF, possibly by enhancing its release from extracellular matrix by a plasmin-dependent mechanism, is an important means by which activation of the plasminogen system can limit pulmonary fibrosis.     

Representation of the tensor veli palatini muscle in the trigeminal motor nucleus of the Japanese monkey (Macaca fuscata)

Distribution of motoneurons supplying the tensor veli palatini (TVP) muscle was examined in the Japanese monkey (Macaca fuscata) by the retrograde horseradish peroxidase (HRP) method. Neurons labeled with HRP which was injected into the tensor veli palatini muscle were seen in the ventromedial aspects of the dorsolateral division of the trigeminal motor nucleus, at all rostrocaudal levels of the trigeminal motor nucleus. The vast majority of these TVP motoneurons were distributed around the margin, especially the dorsal margin, of the cluster of motoneurons which innervate the lateral pterygoid muscle.     

Isolation and Hypoglycemic Activity of Ephedrans A, B, C, D and E, Glycans of Ephedra distachya Herbs1.

Administration of an aqueous methanol/water extract of the Oriental crude drug "maō" (Ephedra), EPHEDRA DISTACHYA herbs, caused transient hyperglycemia followed by long lasting hypoglycemia in mice. Activity-guided fractionation of the extract led to isolation of five glycans, ephedrans A, B, C, D and E, which exhibited significant hypoglycemic effects in normal and alloxan-induced hyperglycemic mice.     

Isolation and Hypoglycemic Activity of Lithospermans A, B and C, Glycans of Lithospermum erythrorhizon Roots1.

A water extract of the Oriental crude drug "shikon", LITHOSPERMUM ERYTHRORHIZON roots, remarkably diminished the plasma sugar level in mice. Fractionation of the extract by monitoring the activity yielded three glycans, lithospermans A, B and C. These glycans exerted marked hypoglycemic effects in normal and alloxan-induced hyperglycemic mice.     

Induction of spheroid cytoplasmic bodies in a rat muscle by local tetanus

The term "cytoplasmic body" or "spheroid body" myopathy refers to a heterogeneous group of familial or sporadic diseases characterized primarily by the presence of abundant spheroid or cytoplasmic bodies in the muscles. The morphogenesis of these inclusions remains unclear. This article describes the induction and evolution of spheroid cytoplasmic bodies (SCBs) in the rat plantaris muscle (PL) with local tetanus, which was induced in rats by the injection of a minute amount of tetanus toxin. In contrast to the tetanized soleus muscle (SOL), which developed core fibers (central cores, minicore, target fiber, targetoid fiber, and rods), the tetanized PL produced numerous SCBs with a predictable time course. They were induced in both type 1 and 2 fibers of PL, which is composed predominantly (95%) of type 2 fibers, in contrast to SOL (85% type 1 fibers). Factors inducing SCBs may include immobilization, shortening, intact innervation, and disuse atrophy.     

Can random bladder biopsies be eliminated after bacillus Calmette–Guérin therapy against carcinoma in situ?

Purpose

Intravesical bacillus Calmette–Guérin (BCG) is the standard of care for bladder carcinoma in situ (CIS). The response to BCG therapy against CIS is generally assessed by random bladder biopsy (RBB). In this study, we examined the necessity of routine RBB after BCG therapy.

Methods

We retrospectively identified 102 patients who were initially diagnosed with CIS with or without papillary tumor and received subsequent 6–8-week BCG therapy. Thereafter, all patients underwent voiding cytology analysis, cystoscopy, and RBB to evaluate the effects of BCG therapy. We evaluated the association between clinical parameters (voiding cytology and cystoscopy findings) and the final pathological results by RBB specimens.

Results

According to the pathological results of RBB, 30 (29%) patients had BCG-unresponsive disease (remaining urothelial carcinoma was confirmed pathologically) and 20 were diagnosed with CIS. Positive/suspicious voiding cytology and positive cystoscopy findings were well observed in patients who had BCG-unresponsive disease compared with their counterparts (p?=?0.116, and p?<?0.001, respectively). The sensitivity (Sen.), specificity (Spe.), positive predictive value (PPV), and negative predictive value (NPV) of voiding cytology were 50%, 68%, 39%, and 77%, respectively. The values for cystoscopy findings were as follows: Sen.: 87%, Spe.: 57%, PPV: 46%, and NPV: 91%. The values for their combination (having either of them) were as follows: Sen.: 100%, Spe.: 44%, PPV: 43%, and NPV: 100%.

Conclusion

RBB after BCG therapy for patients with negative voiding cytology and negative cystoscopy may be omitted because their risk of BCG-unresponsive disease is significantly low (NPV: 100%).

     

Isolated avulsion fracture of the lesser tuberosity of the humerus: A case report

Isolated avulsion fractures of the lesser tuberosity are extremely rare. A 24-year-old woman fell on her back as her arm was forcibly extended and adducted. Radiographs revealed a small fragment of bone beneath the glenoid. Axillary radiography showed the bone fragment and a bone defect of the lesser tuberosity. Computed tomography scan clearly demonstrated those findings. Surgery was performed 3 weeks after the occurrence of the injury. The bone fragment was reduced and fixed by means of two screws. After 3 weeks, light exercise was started. At follow-up 7 months later she had no complaints. Most reported cases involved sudden contraction of the subscapularis tendon. This type of fracture is sometimes misdiagnosed; computed tomography scan is useful for diagnosis. Previously reported cases have similarly demonstrated a good outcome after surgery, except in cases involving children.     

Spontaneous pneumothorax without any detectable pulmonary metastases in a patient with osteosarcoma

An 11-year-old girl with osteosarcoma in the left distal femur, developed unilateral spontaneous pneumothorax. Pneumothorax was found at the initial presentation, but chest CT failed to reveal pulmonary metastases, bullae or blebs.

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Résumé  Une fillette de 11 ans présentant un ostéosarcome de la région distale du fémur, chez qui est apparu un pneumothorax spontané. Le pneumothorax a été constatéà la première visite, mais la tomographie par reconstruction d’image n’a permis de révéler ni métastases pulmonaires, ni bulles pulmonaires ou sous-pleurales.

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Accepted: 7 October 1999     

Efficacy of the axially loaded pivot shift test for the diagnosis of a meniscal tear

Although magnetic resonance imaging (MRI) has improved the diagnostic accuracy of meniscal pathology, the authors believe that physical examination remains essential to the evaluation of knee pathology. In this study, the diagnostic accuracy of five clinical tests for meniscal pathology was prospectively evaluated in 160 patients, who thereafter underwent arthroscopy. 69% (109 knees) of the knees tested had associated ACL deficiency. There were 144 meniscal lesions in 130 of the 160 knees which were examined. The sensitivity of the tests was lower than the specificity. Conventional tests such as McMurray and Apley tests showed a low accuracy rate of 45% and 28% respectively. The diagnostic value of the axially loaded pivot shift test was significantly higher, indicating that this remains a useful diagnostic aid.