Kyoichi Inoue

Fulminant hepatitis B: Induction by hepatitis B virus mutants defective in the precore region and incapable of encoding E antigen

Clones of hepatitis B virus were propagated from 10 cases of fulminant hepatitis B after amplification by polymerase chain reaction and their nucleotide sequences of the precore region were determined. All 113 clones from 9 cases had a point mutation from guanine to adenine at nucleotide 83 in the precore region, which converted codon 28 for tryptophan (TGG) to a stop codon (TAG) and prohibited the synthesis and secretion of hepatitis B e antigen. Precore-region defects were not detected in any of 23 clones from the remaining 1 case. By contrast, precore-region defects were not found in any of 180 clones from 8 cases of acute hepatitis B without hepatic failure serving as controls. The source of infection was traceable in 3 cases. The same precore-region defect, along with the sequence identity of 435 nucleotides, was observed in clones from the case of a baby and his grandmother, who carried the virus and was implicated in the transmission, and also in clones from two pediatricians and the carrier patients they attended. These findings support the hypothesis that precore-defective mutants have stronger activity to induce fulminant hepatitis than nondefective viruses.

Combination therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatocellular carcinoma.

A small number of microwave electrode insertions and microwave irradiations were used to obtain complete tumor necrosis in hepatocellular carcinomas (HCC) measuring > 2.0 cm but ≤ 3.0 cm in greatest dimension. The efficacy of combining transcatheter arterial chemoembolization (TACE) with subsequent percutaneous microwave coagulation therapy (PMCT) was assessed in this study.

Heavy chain binding protein (BiP/GRP78) and endoplasmin are exported from the endoplasmic reticulum in rat exocrine pancreatic cells, similar to protein disulfide-isomerase

Previously we found that in rat exocrine pancreatic cells, protein disulfide-isomerase (PDI), one of the major resident proteins in the lumen of the endoplasmic reticulum (ER) of many cells, is localized not only in the ER but also in the Golgi apparatus, secretory granules, plasma membranes, and even in the glandular lumens, despite possessing the ER retention signal KDEL (Lys-Asp-Glu-Leu) at the carboxyl terminus. In this report, we examined whether other ER luminal proteins bearing the KDEL signal at their C-termini, such as BiP/GRP78 and endoplasmin/GRP94 are also exported from the ER. We prepared two kinds of affinity-purified polyclonal antibodies; one against a synthetic peptide with 12 amino acids which is identical to the carboxyl terminus of BiP and another against purified endoplasmin. Immunoblot analysis using these two antibodies showed that BiP and endoplasmin exist in both the plasma membrane and the microsomal fractions, similar to the intracellular distribution of PDI in rat exocrine pancreas. The ratios of the amount of the three proteins in the two fractions, however, were variable, suggesting that the KDEL-bearing proteins such as PDI, BiP, and endoplasmin are exported from the ER with different efficiencies. Postembedding protein A-immunogold electron microscopy revealed that endoplasmin was exported from the ER and secreted to the extracellular space. The secretion of PDI in rat pancreatic lobules was inhibited by Brefeldin A (BFA) and by guanidino acid esters (FOY-305), which are known to be the inhibitors of the intracellular transport. Taken together with the previous immunogold electron microscopic analyses by Akagi et al. (1988), it is strongly suggested that in rat exocrine pancreatic cells PDI and the other KDEL-bearing proteins found in the extracellular space were not artificially released by cell damage during incubation but were secreted via the normal secretory pathway.

Down-regulation of TGF-β receptors in human colorectal cancer : implications for cancer development

Many colorectal cancer cells are resistant to the anti-proliferative effects of transforming growth factor-β (TGF-β). TGF-β also acts as paracrine factor from cancer cells on their mesenchymal cells. The aim of this study was to examine the expression of TGF-β and its receptors in human colorectal cancer tissue and determine any relationship with cancer growth. In situ hybridization and Northern blot hybridization detection of TGF-β1, type I and type II receptor mRNA and immunohistochemical staining of TGF-β1 were performed using 11 human colorectal adenomas, 22 colorectal cancers and ten normal colorectal mucosas as control. TGF-β receptor mRNAs were expressed mainly by normal colorectal epithelial cells and adenoma. However, mRNAs for TGF-β receptors were only faintly, if at all, expressed in eight of 22 human colorectal cancers. In addition, intense signals of TGF-β1 mRNA and the protein were detected in all colorectal cancers. TGF-β receptor mRNAs and TGF-β1 protein were also distributed in fibroblasts and endothelial cells in the interstitium. Moreover, Smad 4 protein was translocated to nucleus in primarily cultured adenoma cells, but not in cancer cells after TGF-β stimulation. The escape of human colon cancer from TGF-β -mediated growth inhibition by down-regulation of TGF-β receptors as well as the effects of TGF-β on stroma formation and angiogenesis indicate a possible role for TGF-β in the progression of colon cancer in an intact host.

Rapid progression of hepatocellular carcinoma after transcatheter arterial chemoembolization and percutaneous radiofrequency ablation in the primary tumour region.

We report one patient who showed rapid progression of hepatocellular carcinoma (HCC) after undergoing transcatheter arterial chemoembolization (TACE) and percutaneous radiofrequency ablation (PRFA) for a small HCC measuring 2.5 cm in diameter. Enhanced magnetic resonance imaging (MRI) following treatment showed complete tumour necrosis and did not reveal the presence of a tumour around the treated area. Furthermore, the serum alpha-fetoprotein (AFP) level decreased at the completion of therapy. However, the HCC advanced in a very short time. Numerous tumours around the treated area were observed on enhanced computed tomography (CT) 50 days after PRFA. It is strongly suspected that the tumour was disseminated through the portal system because of the presence pattern of tumours. We believe this to be the first case illustrating a hepatic cancer that progressed rapidly following TACE and PRFA.

Percutaneous microwave coagulation therapy for solitary metastatic liver tumors from colorectal cancer: a pilot clinical study

Objective:Percutaneous microwave coagulation therapy (PMCT) was performed for metachronous small solitary liver tumors measuring ≤3.0 cm in diameter that had metastasized from colorectal cancer. PMCT was used for local control of the lesions, and the efficacy of this treatment was assessed.Methods:In 15 patients, a microwave electrode (specially designed for this purpose, 25 cm long and 2.0 mm thick) was inserted percutaneously into the tumor area under ultrasonic guidance. Microwaves at 80 watts were used to irradiate the tumor and the surrounding area.Results:Thirteen of the 15 metastatic tumors were radically ablated by 3–10 applications of microwave irradiation. Although the follow-up period was short (9–37 months), 10 patients survived. No recurrence has been detected in the treated area (except two foci where PMCT was insufficient), and no serious side effects or complications were encountered during or after the PMCT. In four of the five nonsurviving patients, death was due to metastases to the bone, brain, lung, or other areas of the liver despite complete local tumor control by PMCT.Conclusion:PMCT is a safe and effective treatment for metachronous small liver tumors that have metastasized from colorectal cancer.

Primary biliary cirrhosis in japan: National survey by the subcommittee on autoimmune hepatitis

SummaryA total of 280 cases of primary bijiary cirrhosis were reported from 86 institutes in Japan, of whom 208 were middle aged women. Four clinical stages (asymptomatic, pruritus, icteric and terminal stage) were set up for analysing clinical and histopathological features based on the natural course of the disease. The clinical and histopathological findings were similar to the study reported from the United States and European countries. Out of 270 cases examined, 245 (90.7%), had mitochondrial antibodies. Concerning the prognosis 37 of 120 asymptomatic patients developed symptoms and the average symptom-free period in these patients was 28.7 months. Fifty-eight cases were fatal and causes of death were hepatic failure in 27, gastrointestinal bleeding in 20 and others in 11 cases. Patients were subdivided into three groups to elucidate the survival rate in patients with different symptoms. Asymptomatic patients showed almost the same survival rate as the patients with pruritus alone, showing about 50% survival 8 years after the diagnosis, in contrast to jaundiced cases with only 13.6% surviving 8 years after the onset of this symptom.

Synergistic regulation of inducible nitric oxide synthase gene by CCAAT/enhancer-binding protein beta and nuclear factor-kappaB in hepatocytes.

Nitric oxide (NO) has diverse activities under physiological and pathophysiological conditions in many types of cells. In cultured hepatocytes, NO is produced by inducible NO synthase (iNOS) in response to interleukin (IL)‐1β. Cis‐controlling elements and transcription factors which were involved in iNOS gene expression in hepatocytes have been unclear.

Differential regulation of activin A for hepatocyte growth and fibronectin synthesis in rat liver injury

BACKGROUND/AIMS Both hepatocyte growth and production of extracellular matrix such as fibronectin are essential for liver regeneration. Although activin A is reported to inhibit DNA replication in rat hepatocytes, the role of activin A for liver regeneration after acute injury has not been fully assessed. This study investigated the mechanism by which hepatocyte growth is regulated by activin A during liver regeneration and the effects of activin A on extracellular matrix production. METHODS The mRNA for betaA subunit of activin A and activin receptors in hepatocytes and hepatic stellate cells after CCl4 administration were studied by Northern blotting. Binding of 125I-activin A was tested in these cells. Effects of activin A were examined by DNA, collagen and fibronectin synthesis. RESULTS betaA mRNA was expressed in quiescent hepatocytes, and this expression peaked 12 h after CCl4 administration. Activin receptor mRNAs and cross-linked ligand/receptor complexes were expressed in hepatocytes and hepatic stellate cells However, these levels decreased specifically in hepatocytes at 24 h and had normalized by 72 h. The down-regulation of activin receptor was also observed after partial hepatectomy. Antiproliferative response to activin A decreased in hepatocytes at 24 h. Activin A stimulated production of fibronectin by hepatic stellate cells, but the synthesis of collagen was only slightly elevated in hepatic stellate cells following activin stimulation. CONCLUSIONS The down-regulation of activin receptors in hepatocytes may be partly responsible for these cells becoming responsive to mitogenic stimuli. The increase of activin A at the early stage of liver injury has the potential to contribute to the regulation of fibronectin production in hepatic stellate cells.

Long-distance distribution of time-bin entangled photon pairs over 100 km using frequency up-conversion detectors.

We report an experimental demonstration of the distribution of time-bin entangled photon pairs over 100 km of optical fiber. In our experiment, 1.5-mum non-degenerated time-bin entangled photon pairs were generated with a periodically poled lithium niobate (PPLN) waveguide by using the parametric down conversion process. Combining this approach with ultra-low-loss filters to eliminate the pump light and separate signal and idler photons, we obtained an efficient entangled photon pair source. To detect the photons, we used single-photon detectors based on frequency up-conversion. These detectors operated in a non-gated mode so that we could use a pulse stream of time correlated entangled photon pairs at a high repetition frequency (1 GHz). Using these elements, we distributed time-bin entangled photon pairs over 100 km of dispersion shifted fiber and performed a two-photon interference experiment. We obtained a coincidence fringe of 81.6% visibility without subtracting any background noise, such as accidental coincidence or dark count, which was good enough to violate Bells inequality. Thus, we successfully distributed time-bin entangled photon pairs over 100 km.