Effects of elevated d-alpha(RRR)-tocopherol dosage in man

A study was conducted to investigate the effects of a megadosage of free RRR-alpha-tocopherol in healthy college student volunteers. Of 19 volunteers, 14 were given daily doses of 600 mg (900 IU) of RRR-alpha-tocopherol for 12 weeks, and the remaining 5 were given identical placebo capsules. The investigation was performed by the single-blind method. Alpha-tocopherol levels were measured in plasma, red blood cells (RBCs), platelets, leucocytes (WBCs), and buccal mucosal cells. Alpha-tocopherol in plasma, RBCs, and WBCs rose, reached a maximum level 4 weeks after commencement of administration, and then remained at a plateau, while platelet and buccal cell levels reached a maximum level after 12 weeks of administration. The maximum levels in all the subjects were 2.5 to 3 times the baseline values. During the study, there were no changes in laboratory values for thyroid, liver, or kidney functions, and coagulation activity (including the vitamin K-dependent Hepaplastin test and PIVKA-II) or immunoglobulin levels. Healthy status continued without any abnormal symptoms, and without any subjective complaints on the questionnaire. In the control group also, no changes occurred during the investigation. Gamma-tocopherol changes were measured in plasma and RBCs. As plasma and RBC tocopherol levels rose after administration, the isomer levels were suppressed in both plasma and RBCs.     

Old pulmonary embolism causing intrabronchial bleeding

A 51-year-old man was admitted because of hemoptysis. Physical examinations and chest XP revealed no abnormal findings. Fiberoptic bronchoscopy showed pulsatile bleeding at the orifice of right B6. Right bronchial arteriography showed a markedly dilated and tortous bronchial artery and shunting to the pulmonary arterial system in the middle and lower lobes. Pulmonary arteriography showed complete obstruction of the right middle lobar and lower lobe segmental arteries (A6, 9, 10). The hemoptysis was thought to be due to increased blood flow of the right bronchial artery, which compensated for reduced right pulmonary arterial flow. Right middle and lower lobe resection was done to prevent further hemoptysis. The resected specimen revealed old thromboemboli in the right middle and lower lobe pulmonary arteries. In this case old pulmonary embolism should be considered as a cause of intrabronchial bleeding.     

An elderly case of systemic lupus erythematosus associated with herpes zoster, anemia, and hemiparesis]

An elderly case of systemic lupus erythematosus (SLE) with suspected hemolytic anemia was experienced. A 70 year-old female was admitted to our hospital on December 31 with complaints of herpetic eruption. She complained of arthralgia since 3 month prior to her admission. The positive findings on examination were skin eruption in the left chest, a systolic heart murmur and a palpable elastic hard liver. Laboratory data showed raised erythrocyte sedimentation rate of 149 mm per hour, decreased Hb (10.1 g/dl), decreased hematocrit (30.0%), increased reticulocytes (33%1000), decreased thrombocytes (73,000/mm3), increased gamma-globulin (33%) and positive rheumatoid factor. During admission, she developed anemia. A stool test for occult blood was negative. The haptoglobin was 38.8 mg/dl and bone marrow aspiration showed increased erythropoiesis, suggesting features of immune hemolytic anemia, except she was negative on Coomb'test. Eye fundi were similar to case of typical bleeding observed in SLE. Concerning immunological findings, the antinuclear factor was x 1280 and the anti-dsDNA antibody was x 80, on which a diagnosis of SLE was based. She experienced numbness of the left arm and developed left hemiparesis 2 days later. Therapy with 15 mg/day prednisone obtained a good response and anemia, abnormal immunological findings and hemiparesis disappeared.     

Susceptibility of neonatal lipoproteins to oxidative stress

We compared peroxidizability of neonatal and adult lipoproteins exposed to oxidative stress initiated by an azo-compound. Oxygen uptake showed a two-phase pattern, with slow oxygen uptake in the first phase and faster uptake in the second phase. During the first phase, tocopherol was consumed progressively, inhibiting lipid peroxidation by scavenging peroxy radicals. After the tocopherol concentration fell below a critical level, extensive propagation of chain oxidative reactions produced the rapid oxygen uptake in the second phase. In the first phase of neonatal lipoprotein oxidation, a faster oxygen uptake was observed and the length of this phase was shorter than in adults. The oxygen uptake rate in the second phase was smaller in the neonatal lipoproteins. In other words, neonatal lipoproteins were more susceptible to oxidative stress than were adult ones when tocopherol remained in lipoproteins, but after tocopherol depletion the reverse was true. These results were consistent with the finding that in neonatal lipoproteins the tocopherol/lipid ratio was significantly lower (length of the inhibitory phase was closely correlated to the lipoprotein tocopherol content). In addition, the average number of active bisallylic hydrogen atoms, which are considered to determine the relative susceptibility of polyunsaturated fatty acids to oxidation, was significantly smaller (oxygen uptake rate in the second phase was closely correlated to the active bisallylic hydrogen number) in neonatal lipoproteins, and the ratio of active bisallylic hydrogen to tocopherol content (which closely correlated to oxygen uptake rate in the first phase) was also significantly lower compared with the adult ratio. Under physiologic conditions, an intensive oxidation of lipoproteins sufficient to cause lipoprotein tocopherol to fall below critical levels is unlikely to occur.(ABSTRACT TRUNCATED AT 250 WORDS)     

In vivo inhibition of superoxide production and protein kinase C activity in macrophages from vitamin E-treated rats

Rat peritoneal macrophages, which were induced by intraperitoneal injection of vitamin E for 6 successive days, contained 387.6 to 569.0 ng alpha-tocopherol/10(6) cells and produced 0.9 to 1.5 nmol O2-/min/10(6) cells following stimulation by phorbol myristate acetate (PMA). On the other hand, control macrophages contained 1.7 ng alpha-tocopherol/10(6) cells and produced 3.9 to 4.5 nmol O2-/min/10(6) cells. The particulate fraction of macrophages from vitamin E-treated rats contained 285.2 to 294.4 ng alpha-tocopherol/10(6) cells and showed scarcely any protein kinase C activity, whereas the specific activity of control rats showed 323 to 357 pmol/min/mg protein. From these results, we concluded that vitamin E seems to decrease O2- production from macrophages stimulated with PMA through inhibition of protein kinase C.     

Five-year follow-up study of mother-to-child transmission of Helicobacter pylori infection detected by a random amplified polymorphic DNA fingerprinting method

Recent studies have speculated on the possible role of the mother in transmitting Helicobacter pylori infection to their children. In an attempt to either prove or disprove this supposition, we investigated the rates of infection of children born to H. pylori-positive mothers from birth to 5 years of age using serology and the stool antigen test. When infection of the children did occur, the strains from the children were compared to those of their mothers using DNA analysis. Sixty-nine of the 350 pregnant mothers (19.7%) had a positive serology for H. pylori. Fifty-one children underwent serological examinations and stool antigen tests at 4 to 6 days after birth, followed by 1, 3, and 6 months. They were continuously given the stool antigen test at 4- to 6-month intervals until the age of 5 years. Gastric juice samples were collected from the infected children and their mothers for culture and DNA analyses using a random amplified polymorphic DNA fingerprinting method. None of the 51 children acquired H. pylori infection during the first year of life. Of the 44 children enrolled in a 5-year follow-up study, five (11%) acquired H. pylori infection. They acquired the infection at the age of 1 year 2 months, 1 year 3 months, 1 year 6 months, 1 year 8 months, and 4 years 4 months. Random amplified polymorphic DNA fingerprinting confirmed that the strains of the five children exhibited DNA fingerprinting patterns identical to those of their mothers. These findings suggest that mother-to-child transmission is the most probable cause of intrafamilial spread of H. pylori.     

Ultrastructural localization of laminin-5 (gamma2 chain) in the rat peri-implant oral mucosa around a titanium-dental implant by immuno-electron microscopy

Laminin-5 (Ln-5) is an important molecule associated with epithelial cell adhesion and migration. In the gingiva around the tooth, Ln-5 localizes within basement membranes between the junctional epithelium (JE) and the tooth or connective tissue. Recently, we reported that in the oral mucosa around a dental implant, Ln-5 is expressed within the basement membranes at the implant-peri-implant epithelium (PIE) interface, and at the PIE-connective tissue interface. However, the ultrastructural localization of Ln-5 within or along the PIE has not yet been reported. Therefore, peri-implant oral mucosa was treated with anti-Ln-5 (gamma2 chain) antibody and examined using immuno-electron microscopy. Ln-5 was localized in the cells of the innermost-third layer and basal layer of the PIE. A 100-nm-wide Ln-5-positive internal basal lamina (basement membrane) and hemidesmosomes as adhesion structures were formed at the apical portion of the implant-PIE interface. However, at the upper-middle portion of the interface, these adhesion structures were not observed. Furthermore, at the PIE-connective tissue interface, the Ln-5-positive external basal lamina (basement membrane) and hemidesmosomes were partially deficient. Judging from these findings, we concluded that Ln-5 contributes to the attachment of the PIE to the titanium surface, and that PIE attached to titanium at the apical portion of the dental implant-PIE interface.     

Elévation de la tension artérielle lors de chirurgie sous garrot pneumatique: un mécanisme indépendant de la rénine?

Le but de ce travail a été d’évaluer l’efficacité du captopril dans la prévention de l’élévation de la pression artérielle lors de chirurgie du membre inférieur sous garrot pneumatique en anesthésie balancée. Vingt patients consécutifs ont été inclus dans cette étude et randomisés en deux groupes. L’un (n = 10), recevant un comprimé de captopril de 50 mg avec la prémédication, l’autre (n = 10), recevant un comprimé de placebo au même moment. Les différentes variables étudiées (tension artérielle, fréquence cardiaque) ont été mesurées continuellement. Cette étude a démontré, que le prétraitement par du captopril ne permet pas de prévenir une augmentation de la pression artérielle pendant la durée de gonflage d’un garrot pneumatique, les moyennes des tensions artérielles systoliques et diastoliques, à la fin de la période de gonflage du garrot, s’élèvent à 128 /86 et 128/81 dans le groupe captopril et dans le groupe placebo, respectivement. Ce résultat montre que le système rénine-angiotensine n’intervient pas, ou que peu, dans le phénomène d’augmentation des valeurs tensionnelles induite par un garrot pneumatique. The aim of this study was to evaluate the effectiveness of captopril for the prevention of the increase of arterial pressure during orthopaedic surgery requiring the application of lower limb tourniquets with balanced anaesthesia. Twenty consecutive patients were included in the study and were randomly divided into two groups. The first (n = 10) received 50 mg captopril orally together with the preanaesthetic medication, the second (n = 10) received a placebo at the same time. The different variables studied (arterial pressure, heart rale) were continuously measured. This study demonstrated that the pretreatment with captopril did not prevent an increase of the arterial pressure during the application of a tourniquet. The means of the systolic and diastolic arterial pressures at the end of the application of the tourniquet were 128/86 and 128/81 in the captopril group and the placebo group, respectively. This result shows that the renin-angiotensin system does not significantly contribute to the increase of the arterial pressure induced by a tourniquet.     

The role of perceived job stress in the relationship between smoking and the development of peptic ulcers

Although smoking has been considered a risk factor in causing pepticulcers, no study has examined the effects of job stress on the relationship between peptic ulcers and smoking. To establish a link between gastric or duodenal ulcers over two years and a state of perceived job stress, a questionnaire, including questions on demographics, smoking, history of peptic ulcer and perceived job stress was conducted. Follow-up surveys were carried out every six months to accumulate the data for this analysis and the time span of this follow up study was two years. To examine the role of perceived job stress on the relationship between smoking and peptic ulcers, stratified analyses were performed. Some specific causes of perceived job stress such as "Too much competition," "Schedule is too tight or pressed to work too hard" had high estimated relative risks: 2.13 with 95% confidence interval (CI) of 1.09-4.16 and 2.50 with 95% CI of 0.98-6.40, respectively. Stratified analyses suggested an effect-measure modification of perceived job stress in the relationship between peptic ulcers and smoking. Multiplicative and additive models suggest positive interaction between perceived job stress and smoking. These results suggest that specific perceived job stress is an effect modifier in the relationship between the history of the peptic ulcer and smoking.