Molecular species of prostaglandins involved in modulating luteinising hormone pulses of female rats under infectious stress conditions.

Mammalian reproductive function is controlled by the hypothalamic-pituitary-gonadal (HPG) axis, which is suppressed under infectious stress conditions. By analysing the pulsatility of luteinising hormone (LH), we have previously demonstrated that prostaglandins (PGs) in the central nervous system mediate infectious stress to suppress the activity of the HPG axis. The present study aimed to characterise the types of PGs responsible for suppression of the HPG axis. We focused on three major types of PGs: PGE2 , PGD2 and PGF2α . We used female rats overiectomised bilaterally 1 week before the experiments. Lipopolysaccharide (100 µg kg-1 ) suppressed LH pulses at the same time as enhancing the concentration of all three PGs in the cerebrospinal fluid, which was restored by indomethacin (10 mg kg-1 ). Subsequently, we observed LH pulsatility after a single injection of each PG and after co-injection of PGE2 with PGF2α into the third cerebral ventricle. A single injection of PGE2 dose-dependently induced a transient increase in mean LH concentration and LH pulse amplitude, and PGD2 significantly increased the amplitude of LH pulses, wereas PGF2α did not affect LH pulsatility. On the other hand, co-injection of PGE2 and PGF2α induced a significant suppression of both the frequency and amplitude of LH pulses. These results suggest that PGE2 and PGF2α can represent two of the mediators that suppress the HPG axis in situations of infectious stress. Moreover, the results imply that there are two contradictory effects of PGE2 on LH pulsatility: (i) enhancive when working alone and (ii) suppressive when working together with PGF2α .

Nucleases from Prevotella intermedia can degrade neutrophil extracellular traps.

Periodontitis is an inflammatory disease caused by periodontal bacteria in subgingival plaque. These bacteria are able to colonize the periodontal region by evading the host immune response. Neutrophils, the host's first line of defense against infection, use various strategies to kill invading pathogens, including neutrophil extracellular traps (NETs). These are extracellular net-like fibers comprising DNA and antimicrobial components such as histones, LL-37, defensins, myeloperoxidase, and neutrophil elastase from neutrophils that disarm and kill bacteria extracellularly. Bacterial nuclease degrades the NETs to escape NET killing. It has now been shown that extracellular nucleases enable bacteria to evade this host antimicrobial mechanism, leading to increased pathogenicity. Here, we compared the DNA degradation activity of major Gram-negative periodontopathogenic bacteria, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans. We found that Pr. intermedia showed the highest DNA degradation activity. A genome search of Pr. intermedia revealed the presence of two genes, nucA and nucD, putatively encoding secreted nucleases, although their enzymatic and biological activities are unknown. We cloned nucA- and nucD-encoding nucleases from Pr. intermedia ATCC 25611 and characterized their gene products. Recombinant NucA and NucD digested DNA and RNA, which required both Mg2+ and Ca2+ for optimal activity. In addition, NucA and NucD were able to degrade the DNA matrix comprising NETs.

[Surgical analysis for metastatic lung tumor from renal cell carcinoma].

Metastatic lung tumor from renal cell carcinoma were studied in 29 cases. Eighteen patients were treated surgically, 11 were treated non-surgically. The overall 5-year survival rate with the patients of pulmonary resection was 53.5%, and that with those of conservative therapy was 0%, and this difference is statistically significant (p < 0.05). There was no significant difference in any characteristics such as sex, age, stage, grade, disease free interval, metastatic pattern and combination with or without interferon therapy. There was no significant difference in surgically treated patients with pulmonary metastasis in terms of any factors such as age, sex, stage, grade, disease free interval, pulmonary metastasis pattern, metastatic number, surgical procedure, combination with or without interferon therapy statistically. Analysis for the surgically treated patients with pulmonary metastasis from renal cell carcinoma shows no significant difference in prognosis with any characteristics. This result shows efficacy of surgery even if for the patients with synchronous bilateral multiple pulmonary metastasis from renal cell carcinoma.

[A case report on surgery for chylothorax after anterior spinal fusion: usefulness and effectiveness of intraoperative milk administration and postoperative OK-432 administration].

A 75-year-old man of chylothorax after anterior spinal fusion successfully underwent thoracoabdominal operation in order to ligate chyloleakage. Not only preoperative milk intake but also intraoperative administration of milk through nasogastric tube was useful for identification of the site of leakage. OK-432 was administered through locally placed and chest tube after operation, after which residual chyloleakage was stopped. lntraoperative administration of milk through nasogastric tube was useful and OK-432 injection through topical and chest tube may be effective, these should be recommended for management of chylothorax.

[Surgical analysis for lung cancer in patients younger than 40 years].

Sixteen cases of primary lung cancer in patients younger than 40 years old had been operated on at the department. There were 8 males and 8 females and the male-to-female ratio was 1:1 that was closer than the ratio in elder patients over 40 years. Histologic types were adenocarcinoma in 7 cases, squamous carcinoma in 5 cases, carcinoid in 2 cases, and small cell carcinoma in 2 cases. In younger patients, adenocarcinomas, small cell carcinomas, and carcinoids were more commonly found than squamous cell carcinomas. Patients in stage I, II, and IIIA and those undergoing a curative resection were predominant in cases without any symptoms preoperatively. The 5-year survival rate of the 16 patients younger than 40 years was 42.9%, that was not significantly different from that of elder patients over 40 years old. This relatively better prognosis might be owing to a fact that operated patients were dominantly composed of asymptomatic patients. In younger patients who have good physical status and respiratory function compared with elder patients, aggressive surgical diagnosis followed by resection, if the definitive diagnosis of malignancy is established may contribute to the improvement of prognosis for patients who was suspected of having malignancy.

Value of intraoperative intrathoracic ultrasonography during video-assisted thoracoscopic pulmonary resection.

Recent advances in endoscopic surgical equipment, video monitoring, and endoscopic surgical techniques have expanded the application of thoracoscopic surgery to pulmonary resection. One of the major limitations of this technique is the difficulty in identifying invisible pulmonary nodules in which manual palpation is not possible. To resolve this problem, we employed intraoperative intrathoracic ultrasonography during video-assisted thoracoscopic pulmonary resection. We conclude that intraoperative ultrasonography during thoracoscopic pulmonary resection is useful to identify pulmonary nodules, except inflammatory lesions.

[A case of carcinoma of the pancreas head associated with celiac axis compression syndrome].

We report a 51-year-old woman with pancreas head cancer associated with celiac axis compression syndrome (CACS). Angiography demonstrated that the inferior pancreatico-duodenal artery and the posterior superior pancreaticoduodenal artery dilated significantly. The lateral view of aortography showed compression of the celiac axis. We performed pancreatoduodenectomy safely with cutting the median arcuate ligament. Postoperative course was uneventful. Postoperative angiography demonstrated improvement of the compression. In CACS, celiac axis is compressed by the median arcuate ligament (seichu kyujo jintai in Japanese), not by the medial arcuate ligament (naisoku kyujo jintai in Japanese).

[Transendoscopic microvascular Doppler sonography for the assessment of hemodynamics of esophageal and gastric varices].

The importance of unravel hemodynamics at the stomach and esophagus in patients with portal hypertension has been described for understanding pathophysiology and treatment of varices associated with portal hypertension. Microvascular Doppler sonogrlaphy (MF20) is a pulse Doppler method with 20 MHz which is able to measure velocity and direction of blood flow in microvessel. We invented transendoscopic microvascular Doppler sonography (EMDS) by connecting a tiny probe of one mm in diameter with an endoscopy. We evaluated direction of blood flow in the esophageal and gastric varices by EMDS and angiography in 21 untreated and 26 shunt-operated patients with portal hypertension. In all of untreated patients direction of blood flow in the varices was toward the probe (forward). Results obtained with EMDS were consistent with angiographic results available in 13 patients. Direction of blood flow after shunt operation was away from the probe in 21 out of 26 patients. The comparison with angiography revealed that post-operative patients with "away" blood flow in varices had maintained satisfactory shunt selectivity without hepatofugal collateral and it proved that the direction of blood flow was toward the shunt at lower pressure. In conclusion EMDS is useful as an evaluation method for hemodynamics in varices of the esophagus and stomach.

[Clinical study on reoperation for recurrent pulmonary metastasis].

Ninety seven patients with metastatic lung tumors were treated surgically in our department. Second pulmonary resections were performed in 13 patients. They consists of 9 males and 4 females, their age ranged from 12 to 75 years old (average 54.4 years old). Tumors originate from sarcoma in 5 cases, laryngeal cancer, colorectal cancer, renal cell cancer in 2 cases respectively, oral cavity cancer and transitional cell cancer in 1 case respectively. No second pulmonary resection was performed in patients with metastatic lung tumors originating from lung cancer or breast cancer, because they metastatize not only lung but also general organs. No second pulmonary resection was required in patients with testicular tumor and choriocarcinoma, because chemotherapy take good effect on them.

Diagnosis of Tay-Sachs disease by estimation of beta-N-acetylhexosaminidase activity using a radiolabeled hyaluronic acid-derived trisaccharide substrate.

We have prepared a new radiolabeled substrate (N-[3H]acetylglucosamine-glucuronic acid-N-[3H]acetylglucosamine), from hyaluronic acid, for an assay of beta-N-acetylhexosaminidase activity. Using this substrate, we found a striking deficiency of beta-N-acetylhexosaminidase activity in cultured skin fibroblasts and in liver homogenates from patients with Tay-Sachs disease. DEAE-cellulose chromatography at pH 6.0 revealed that both isoenzymes A and B of beta-N-acetylhexosaminidase from normal liver participated in the catabolism of hyaluronic acid. There were, however, major differences in substrate specificities between isoenzymes A and B. Our results indicate that this substrate should be useful for enzymatic diagnosis of Tay-Sachs disease.