検索

The contribution of age groups and causes of death to the sex difference in life expectancy (SDLE) at birth in Japan and Scotland was estimated for the period 1965-1990. The purpose was to determine the particular age groups and causes of death responsible for the opposite trend of SDLE in the two countries. SDLE has been widening and narrowing in Japan and Scotland, respectively. The availability of complete and reliable data for these two developed countries facilitated the study. A method of decomposing the total SDLE into age and cause of death components was employed. About 40-60% contribution to SDLE was observed for ages after 65 years. Marked increase in the contribution of the 75+ age group and marked decrease in the contribution of ages 45-64 for Japan and Scotland, respectively, had a major effect on the widening and narrowing of SDLE in the two countries, respectively. The contribution of diseases of the circulatory system was the maximum until 1980 in Japan (< or = 1.8 years or 33.6%; cerebrovascular disease alone < or = 23.4%) and until 1990 in Scotland (< or = 3.1 years or 47.0%; ischemic heart disease alone < or = 42.0%). In Japan, the contribution of malignancy had a marked increased from 0.7 year (12.3%) to 2.0 years (32.6%), particularly for the trachea, bronchus and lung, while there was only a small increase in Scotland from 1.0 year (16.6%) to 1.2 years (19.8%) with an increase in the negative contribution of female breast malignancy. In Japan, the contribution of diseases of the respiratory system increased considerably from 0.5 year (8.5%) to 1.1 years (18.1%) while it decreased in Scotland from 1.0 year (16.5%) to 0.6 year (10.7%). About 60-75% of SDLE is due to the above three groups of causes of death. Malignancy and diseases of the respiratory system had a persistently increased contribution in Japan with resultant widening of SDLE by 0.9 year. Diseases of the circulatory system have always had a high contribution. On the contrary, in Scotland the contribution of diseases of the circulatory system and malignancy was practically unchanged and diseases of the respiratory system had a decrease with a consequent narrowing of SDLE by 0.4 year. Further epidemiological study is necessary to detect and analyze in detail the internal gradients (environmental and genetic-biological) of major contributor diseases to SDLE in Japan and Scotland.

A study of 1,254 laparoscopic cholecystectomies performed at 17 hospitals affiliated with the Liver, Gallbladder, and Pancreas Research Group of the First Department of Surgery at Okayama University was undertaken to assess the current status and safety of this procedure. The data for 336 patients, comprising the initial 20 laparoscopic cholecystectomies performed at each institution, were compared with the data from the remaining 918 patients. Comparison of the two groups revealed the following: 1. the rates of intraoperative conversion to open cholecystectomy were 11.3% and 5.1% (P < 0.05), 2. the complication rates were 5.7% and 3.4%, and 3. the rates of bile duct injury were 2.4% and 1.1%, respectively. Compared with the first group, the bile duct injuries resulting from a lack of experience decreased in the second group, however, the incidence of these injuries occurring during avulsion of the gallbladder in difficult cases increased. These results suggest that the experience acquired during the initial 20 laparoscopic cholecystectomies led to a reduction in the rate of intraoperative conversion to open cholecystectomy, but it did not reduce the rate of complications, and that the risk of bile duct injury was always present.

Chinese ant extract preparations (CAEP) are a Chinese traditional medicine which is mainly used as a health food or drink for the treatment of rheumatism, rheumatoid arthritis, chronic hepatitis, sexual hypofunction, and antiaging in China. The effects on free radicals were examined by electron spin resonance spectrometry using the spin trapping agent 5.5-dimethyl-1-pyrroline-1-oxide (DMPO). Superoxide radicals (3.35 x 10(15) spins/ml) were quenched 50% by the extract at 0.5 mg/ml. The CAEP extract at 0.7 mg/ml inhibited 50% of hydroxyl radicals (52.0 x 10(15) spins/ml) generated by the Fenton reaction. Against DPPH radical, the scavenging action of CAEP was observed at 1.8 mg/ml of the extract and 50% of the DPPH radicals (8.14 x 10(15) spins/ml) were quenched. In vitro tests showed that CAEP inhibited the production of thiobarbituric acid-reactive substances, an index of lipid peroxidation, in rat brain homogenate.

Localization of the glycosaminoglycans (GAG) was examined in the synovial membranes of patients with osteoarthritis under light microscopy using a fine cationic colloidal iron staining method combined with enzymatic digestion. Our staining method was very useful for demonstrating the difference in the localization of GAG in regions of the inflammatory site in the osteoarthritic synovial membrane. Hyaluronic acid was mainly located in connective tissues in the surface intercellular and perivascular spaces, chondroitin sulfate A/C in the highly fibrous part of and connective tissue around blood vessels, dermatan sulfate (chondroitin sulfate B) in the subsurface interstitium and vascular endothelial cells and heparan sulfate in part of vascular endothelial cells. No keratan sulfate was detected. GAG is reported to have an important role in cell movement, adherence and aggregation in the inflammatory sites. These findings should be useful for understanding the role of GAG in physiological and pathologic processes of secondary synovitis.

Etoposide (VP-16), one of the topoisomerase II (TopoII) inhibitors, interferes with TopoII by inducing the formation of and stabilizing a cleavable enzyme-DNA complex. VP-16 has been demonstrated to induce apoptosis in murine thymocytes. To clarify the mechanism of action of VP-16, we examined the in vitro effect of a non-cleavable-complex-forming type TopoII inhibitor, ICRF-193 which inhibits the DNA strand breakage induced by VP-16, on murine thymocytes in which apoptosis had been induced with VP-16. DNA fragmentation is characteristic of apoptosis. In the early stages, ICRF-193 decreased DNA fragmentation induced by VP-16, although this inhibitory effect decreased in the later. These data suggest that TopoII inhibitors induce apoptosis in murine thymocytes in two ways: with DNA-strand breaks in the early stage or without them. ICRF-193 itself induced apoptosis in murine thymocytes. The time course of DNA fragmentation caused by ICRF-193 was different from that of VP-16.

In this study, we measured free radicals and thiobarbituric acid-reactive substances (TBARS) in hepatocellular carcinoma and in non-cancerous liver parenchyma. There was a higher concentration of free radicals in malignant tissue than in non-cancerous tissue. In contrast, the level of TBARS was significantly (P < 0.01) lower than non-cancerous liver parenchyma. These paradoxical results suggested that antioxidative enzyme activity and/or inhibition of lipid peroxidation were higher in hepatocellular carcinoma.

Many of Helicobacter species have been found to have novel cholesteryl glucosides (CGs). To study the biosynthetic mechanism of CGs, the lipid profiles of H. pylori and H. mustelae grown in serum-supplemented and cholesterol-restricted serum-free media were investigated. In contrast to the serum-supplemented state, helicobacters had less CGs in the serum-free state; a trace amount of CGs and no CG was detected in H. pylori and H. mustelae, respectively. The proportion of total and individual phospholipid also showed significant alteration. Unknown lipids which did not contain phosphate and sugar were detected in the serum-free state, but not in the serum-supplemented state. The CGs were found to be distributed mainly in the membrane fractions, and one of the unknown lipids was found exclusively in the cytosol fraction. Based on these data, it is apparent that the CGs of helicobacters are synthesized by de novo uptake of cholesterol from the media. The unknown lipids detected in the serum-free state may be storage lipids, appearing in response to depletion of nutrients, especially cholesterol, or other factors in the media.

Fas antigen (ag) is a cell surface protein known to trigger apoptosis in a variety of cells upon specific antibody binding. On the other hand, Bcl-2 protein, an oncogene product located at the mitochondrial inner surface, prolongs cell survival by blocking apoptosis. In this study we examined the expression of Fas ag and bcl-2 protein in 17 cases of hepatocellular carcinoma (HCC) to determine their role on HCC. By flow cytometric analysis, mean (SD) value of the expression of Fas ag on hepatocytes derived from normal liver, diseased liver (chronic hepatitis or liver cirrhosis) and HCC was 5.8 (4.7)%, 10.3 (6.9)%, and 24.0 (18.2)%, respectively. Fas ag expression on hepatoma cells was significantly greater than normal and diseased liver cells. The expression of Bcl-2 protein in normal liver, diseased liver and HCC was 4.3 (8.5)%, 0.8 (2.5)% and 2.1 (3.4)%, respectively, and the difference was not significant. These results suggest that induction of apoptosis may be a possible therapy against HCC.

Neuroprotective therapy for Parkinson's disease (PD) is a treatment intended to prevent or reduce neuronal degeneration. Since clinical studies to evaluate such an effect would be prolonged, the choice of agents for use as possible neuroprotective therapy is based on the results of in vitro and animal experiments. Free radicals are currently regarded as the most important factor in the progression of PD. One current possible neuroprotective therapy is reduction of levodopa dose, since levodopa is a source of free radical formation. Dopamine (DA) metabolism inhibition, and administration of the DA agonist bromocriptine that eliminates hydroxyl free radicals have neuroprotective effects experimentally. The other candidates for neuroprotective agents are still under development. However, those whose clinical use is permitted should be considered for use, since patients with long-standing PD cannot wait until the neuroprotective efficacy of these agents is confirmed by clinical study.

Although a strong association has been established between chronic Helicobacter pylori infection and peptic ulcers, the role of H. pylori is not necessarily causative because there are many patients infected with H. pylori who do not develop peptic ulcer. Therefore, we studied the relationship between the gastric mucosal environment and the development of peptic ulcers. We examined 165 endoscopic biopsy specimens from the gastric mucosa of 33 patients with peptic ulcers using the 5-point gastric biopsy method. The follow-up biopsies done within 3 weeks were well correlated with the first biopsy samples. We also reviewed the clinicohistopathological findings of 2250 endoscopic biopsy specimens from 450 patients with active gastric and/or duodenal ulcers. Over 90% of the patients with duodenal ulcer, with or without gastric ulcer, had no fundic gland atrophy, and a high incidence of intestinal metaplasia and pyloric mucosal atrophy was found in the patients with gastric ulcer. These findings suggest that patients with concomitant active gastric and duodenal ulcers exhibit severe atrophic changes in the antral mucosa but not in the fundic mucosa.

We recently reported that stimulation of the arginine vasopressin (AVP) V1-receptor enhanced the pressor response in spontaneously hypertensive rats (SHR). In the present study, we investigated acute changes in systolic blood pressure (SBP) and heart rate (HR) after intravenous injections of AVP, OPC-21268 (a V1-receptor antagonist), and OPC-31260 (a V2-receptor antagonist), in anesthetized DOCA-salt hypertensive rats (DOCA) and age-matched sham-operated Wistar rats (control) to determine whether the pressor effect is specific to SHR or is present in other hypertensive animal models. SBP increased significantly in DOCA rats 9 min after injection of AVP 5 ng/kg without a concomitant increase in HR. Neither OPC-21268 3mg/kg nor OPC-31260 3mg/kg caused significant changes in SBP or HR. SBP tended to increase when AVP was administered after injection of OPC-31260. HR increased significantly 15 min after the combined treatment with OPC-31260 and AVP in DOCA rats compared with control rats. SBP did not change significantly when AVP was administered after injection of OPC-21268 in DOCA or control rats, but HR decreased significantly from 1 to 4 min after injection of AVP in DOCA rats. Our results suggest that V1-receptor stimulation does not enhance the pressor response in the DOCA rat, which is a model of volume-dependent hypertension, suggesting that the AVP system, especially V1-receptor, is not as important in the development or maintenance of hypertension in DOCA rats as in SHR.

The results of rotationplasty for patients with osteosarcoma around the knee joint are presented. After an average observation period of 13.3 months, there has been no local recurrence or metastasis. The ankle joints (the new knee joints) of the patients were able to support their body weight with an average range of motion of 75 degrees. All patients could walk well without crutches and without risk of the giving way phenomenon. The average rate of the functional evaluation according to the re-modified system by Enneking was 84.5% (range, 80.0-86.7%). No patient had psychological trouble in accepting the shortened and rotated extremity. The results show that rotationplasty is a useful reconstructive method for the treatment of osteosarcoma around the knee joint.

It has previously been confirmed that the guinea pig has aggregations of 10-20 lymphoid follicles at the junction of the nasal cavity and the nasopharyngeal duct. The vascular architecture of this nasal-associated lymphoid tissue (NALT) was studied by the corrosion cast/scanning electron microscope method. The NALT was supplied by branches of the inferior nasal artery. These afferent arterial branches gave off arterioles to the follicles and the interfollicular regions, where the arterioles ramified into capillaries. Some of these arterioles reached the subepithelial region to form a single-layer dense capillary network. The subepithelial capillaries gathered into short collecting venules, which in turn drained into high endothelial venules (HEV) in the interfollicular region. The HEV, which also receives tributaries from the follicular and interfollicular capillary plexuses, descended in the interfollicular regions and finally flowed into the efferent veins at the bottom of the NALT. Indentations impressed by high endothelial cells (HEC) were prominent on the surface of the HEV casts, and their frequency was larger in the upper course or segments than in the lower. This suggests that the incidence of HEC in the upper segments is higher than in the lower segments, and these findings are consistent with the hypothesis that some substances which are taken up into the subepithelial capillaries and transported to the venules induce differentiation and maintain of HEVs.

Three patients with severe halothane-induced liver injury are described. All patients received halothane anesthesia twice within a short period. High fever and jaundice were noticed soon after the second operation. The prothrombin time was less than 40%, and eosinophilia was greater than 7% prior to these symptoms. Other causes of liver injury were excluded. Diagnostic criteria for halothane-induced liver injury are proposed.

The effect of coenzyme Q10 (Co Q10) was examined on the survival time and lipid peroxidation of adriamycin (ADM)-treated ICR mice. Co Q10 showed a protective effect against a subacute toxicity in mice induced by two intraperitoneal administrations of ADM (15 mg/kg). The group treated orally with 10 mg/kg of Co Q10 showed the longest survival time of all the groups studied (16.81 +/- 10.29 days, mean +/- S.D.) and a significantly longer survival time (p less than 0.001) than the ADM-alone group (7.48 +/- 1.99 days). The inhibitory effect of Co Q10 on the plasma and tissue lipid peroxidation levels did not correlate with the effect of prolonging the survival time of mice. Co Q10 tended to inhibit rises in plasma and liver lipid peroxidation levels induced by ADM administration, but there was no statistically significant difference between treatments. There was a statistically significant different inhibitory effect in the kidney lipid peroxidation levels, but was not in those of the heart.

Childhood leukemia, especially acute lymphocytic leukemia, can now be completely cured by a multimodality approach in one out of every two patients. Since prolonged maintenance therapy with anti-cancer agents for three years is required for complete cure, a significant problem during this course of treatment is death due to secondary infection. Those with childhood leukemia receiving anti-cancer chemotherapy who became secondarily injected with chicken pox can now be treated successfully with interferon in the four cases reported here. Chicken pox was cured even while one of them was in relapse. Therefore, it can be said that a bright prospect, namely interferon, is on the horizon in the treatment of secondary viral diseases associated with acute leukemia.

The whole body including extended processes of Ito's fat-storing cells was observed by scanning electron microscopy in rat liver injured with lithocholic acid (LCA). Necrotic foci developed in the midlobular zone 48 h after LCA administration. Demonstration of Ito cell bodies around the foci was probably facilitated by easy detachment of hepatocytes from Ito cells. The body and the processes were located mainly between the sinusoidal endothelium and hepatocytes; sometimes they were between hepatocytes. Ito cells often were proximate to collagen fiber bundles and sometimes were attached to them. The cell body was flatly round or elliptic, 7 to 12 micron in diameter. Its surface was finely undulated with microvillous projections about 0.1 micron in length. Branching patterns of the processes resembled a fern-leaf mantling the sinusoidal endothelium. The trunks of the processes were about 2 micron in diameter and 20-30 micron in length. These processes tapered, branching into thinner processes, with the most peripheral being 0.1 micron in diameter. Ito cells and their branching processes likely strengthen sinusoidal walls and control blood flow in the sinusoids.

Rat Kupffer cells were observed and counted under a scanning electron microscope after a single dose of zymosan. The cell number increased after 24 h and reached 2 times the control after 72 h. The percentage of cells presenting numerous microvilli increased from 24% to 86% over the same period. Carbon clearance, a measure of phagocytic activity, decreased temporarily, regained control values after 12 h, and attained a 4-fold elevation at 72 h. Phagocytic activity paralleled Kupffer cell number, but increased more relatively. This result probably reflected activation of resident Kupffer cells as noted by numerous thick microvilli.

We report a case of a right buccal cavernous hemangioma with two phleboliths in a 23-year-old man. Consideration of the literature on the cases of hemangioma with phlebolithiasis in the maxillofacial and oral regions in Japan is given in this report.

Using C3H/He mice, the antitumor effect of lipopolysaccharide (LPS) alone and in combination with Lentinan extracted from Lentinus edodes was studied. The influence of LPS on cellular immunity and the antitumor effect of the tumor necrosis factor (TNF) were also examined. LPS, which was administered into mice with tumor, induced hemorrhagic necrosis of the tumor within 48 h, demonstrating a high antitumor effect. When LPS was used in combination with Lentinan, the tumor growth was significantly inhibited as compared to that in the control mice. The combination of LPS and Lentinan prevented a decrease in the delayed type hypersensitivity in tumor bearing mice. Application of rabbit serum containing TNF resulted in hemorrhagic necrosis of the tumor within 48 h, as with LPS.