Evaluation of chitin and chitosan on open would healing in dogs

Analysis on the accelerating effects of open wound healing by chitin and chitosan were carried out in dogs. Two, square, full-thickness wounds of skin (2 x 2 cm2) were created on the each dog's both sides of dorsal midline at 0, 14, 21, and 24 days. In one dog, one wound (left side) was treated with chitin (chitin group) and the other wound (right side) was not treated (control group). In another dog, one wound (left side) was treated with chitosan (chitosan group) and the other wound (right side) was not treated (control group). At 28 days after initial wounding, each wound site including surrounding tissue was taken for macroscopic and histological observations. Reepithelialization tended to be greater in chitin and chitosan groups than in the control group. However, when the scores of reepithelialization and granulation tissue were evaluated statistically, there was no significant differences in three groups during experimental period. Number of inflammatory cells was greater statistically in level in the control group than those in chitin and chitosan groups at 28 days after wounding. Many rete ridges were observed in the control group but very few in the another groups.

Effects of chitosan on experimental abscess with Staphylococcus aureus in dogs

An abscess was developed experimentally by a subcutaneous inoculation of Stapylococcus (S.) aureus T-6 with a 4-cm silk suture in dogs. After draining the pus, the abscess was treated with a suspension of finely granulated chitosan (chitosan group), ampicillin (ampicillin group), or saline (control group) (Day 0). The chitosan group was further divided into 3 subgroups (0.01, 0.1, and 1.0 mg/subgroups). Similar treatment was repeated after 4 days (Day 4), followed by euthanasia on Day 8. The wound cavity contraction rate was calculated by measuring the wound cavity diameter by a sound on Days 0, 4 and 8. The wound cavity contraction rate was significantly higher in the ampicillin, 0.1 mg chitosan, and 1.0 mg chitosan groups than in the 0.01 mg chitosan and control groups on Days 4 and 8 (p < 0.05). In the 0.1 and 1.0 mg chitosan groups, the abscess healed completely in 6 out of 11 (55%), and 9 out of 10 cases (90%), respectively, by Day 8. In the ampicillin group, 4 out of 10 cases (40%) healed completely by Day 8. No healing occurred in the 0.01 mg chitosan and control groups. Histologically, the granulation tissue formed had abundant vascularization in the 0.1 and 1.0 mg chitosan groups on Day 8.

[Clinical value of rapid clearance in resting sestamibi cardiac SPECT in patients with acute myocardial infarction]

Resting 99mTc sestamibi (MIBI) SPECT and exercise-reinjection thallium-201 (T1) SPECT were performed in fourteen patients with acute myocardial infarction (AMI). MIBI SPECT were obtained 90 min (MIBI-90) and 300 min (MIBI-300) after injection of 370 MBq of MIBI at rest. MIBI-90 and MIBI-300 were compared with exercise T1 imaging (T1-EX) and T1 reinjection imaging (REINJ). Each SPECT image was divided into 22 segments and myocardial uptake was scored visually. Abnormal perfusion defects were observed in 94 myocardial regions. Worsening of the score was observed in 79 segments (84%) on MIBI-300 compared with MIBI-90. Total MIBI-300 uptake score per person was significantly greater than that at MIBI-90 (14.8 +/- 8.6 vs. 7.7 +/- 7.9, p = 0.001). The concordance rate of defect score between MIBI-90 and REINJ was significantly higher than that between MIBI-300 and REINJ (55% vs. 17%, p = 0.001). In nine patients without recanalization of an infarct-related artery, perfusion defects were seen in 74 segments. The concordance rate of defect scores between MIBI-300 and T1-EX was significantly higher than that between MIBI-90 and T1-EX (45% vs. 16%, p = 0.001). In conclusion, rapid clearance of MIBI was observed frequently in patients with AMI. MIBI-90 and MIBI-300 may reflect myocardial viability and areas at risk for AMI, respectively.

Diurnal variation in luteinizing hormone-releasing hormone and beta-endorphin release in pituitary portal plasma during the rat estrous cycle

In this study, we investigated the pattern of both LHRH and beta-endorphin (beta-EP) secretion from the median eminence of cyclic female rats during the estrous cycle by collecting pituitary portal blood for hormone measurements by RIA. On diestrus, proestrus, or estrus (0900 h or 1300 h), rats were hypophysectomized (in order to prevent contamination of portal beta-EP with pituitary beta-EP) and were given a 50-60-min resting period of postsurgical recovery prior to blood sampling. Between 1000 h and 1800 h of the same day, pituitary portal blood samples were collected at 10-min intervals from these animals under Saffan anesthesia. Hormone RIA data revealed that LHRH and beta-EP levels in the portal plasma ranged from 25 to 600 pg/ml and from 0.6 to 4.6 ng/ml, respectively, whereas no discernible amounts of these hormones were detected in the peripheral plasma. Analysis further revealed that secretion of both LHRH and beta-EP showed a diurnal rhythmicity and that both neuropeptides were secreted in a pulsatile manner on each day of the cycle, with most dramatic changes seen in female rats on proestrus. In proestrus rats, portal plasma levels of beta-EP were highest during 1000-1500 h and lower around 1600-1800 h. In contrast, morning and early afternoon values of LHRH were obviously higher in rats on proestrus than in animals on other days of the cycle, and an even greater rise in portal plasma levels of LHRH occurred in late afternoon on proestrus, when beta-EP values were lowest.(ABSTRACT TRUNCATED AT 250 WORDS)

Caloric intake stimulates growth hormone secretion in food-deprived rats with anterolateral deafferentation of the medial basal hypothalamus or administered antiserum to somatostatin

In rats, food deprivation inhibits episodic growth hormone (GH) secretion. On the basis of previous studies, we hypothesized that during a recovery from prolonged fasting, caloric intake stimulates the release of GH-releasing factor (GRF) and this process does not depend on the specific macronutrients in the meal, while protein in the meal acts to restore characteristic ultradian rhythmicity of GH secretion. To test this hypothesis, the effect of caloric intake on GH secretion was examined in fasted adult male Wistar rats devoid of somatostatin (SS) influence on GH secretion either by anterolateral deafferentation (ALC) of the medial basal hypothalamus (MBH) or administration of anti-SS goat serum (ASS). Rats were provided with an indwelling right atrial cannula and were deprived of food for 72 h. ALC was performed 2 weeks prior to the study. ASS was given i.v. 8 h and 7 h prior to refeeding, respectively. Serial blood specimens were collected every 10 min. In rats with ALC (ALC rats) or rats given ASS (ASS rats), the blood GH level revealed irregularly occurring small fluctuations, instead of the usual high bursts and low trough level. The baseline GH level and the mean GH level of fasted ALC rats or fasted ASS rats were significantly lower than those of fed ALC rats or fed ASS rats. Feeding the isocaloric mixed meal, the protein meal or the protein-deficient meal increased the GH pulse frequency, the pulse amplitude, the baseline GH level and the mean GH level in 72-h fasted ALC rats. These changes in GH secretory pattern persisted during the period of observation and were independent of the type of meal ingested. Following feeding the mixed meal, similar changes in the GH secretory pattern demonstrated in 72-h fasted ALC rats were also observed in 72-h fasted ASS rats, suggesting that the stimulation of GH secretion following caloric intake is not limited to ALC rats. Since the influence of SS on GH secretion has been largely eliminated in ALC or ASS rats, it is highly unlikely that the augmentation of GH secretion following feeding after prolonged food deprivation was the consequence of inhibition of SS secretion. Although GRF measurement was not performed, it is conceivable that the signal of caloric intake is conveyed to the MBH and acts to stimulate GRF release.

[Serum protein binding of T-3761]

We investigated the extent of the binding of T-3761 to serum protein and obtained the following results. 1. The binding rates of T-3761 to serum protein from various animals and human were 16.9-27.7%, and a little higher than those of ciprofloxacin and ofloxacin. 2. The binding rates of T-3761 to human serum protein were 19.1-23.8% at concentrations of 0.25-20 micrograms/ml. 3. The binding rates of T-3761 lowered as the decrease of protein concentration. 4. The binding rates of T-3761 (2 micrograms/ml) to human serum protein were 12.4, 21.3 and 32.1% at pH 7.0, 7.4 and 8.0, respectively, showing the effect of the pH. 5. The binding of T-3761 to human serum protein was reversible. 6. In vivo binding rates of T-3761 in rabbits after a single oral administration of 20 mg/kg were 26.1-33.2%, which were similar to those obtained in vitro.

Increase of intracellular free [Ca2+] in single human motile spermatozoa treated with human follicular fluid

The intracellular free [Ca2+] concentration ([Ca2+]i) in individual human sperm was measured using a fluorescent Ca2+ indicator. In 18 of 23 motile sperm (78.3%), [Ca2+]i increased significantly and promptly after addition of 20% human follicular fluid (hFF), but in the others it did not increase. The mean resting [Ca2+]i level of sperm in which [Ca2+]i increased after addition of 20% hFF (the influx group) was significantly lower than those in which it did not increase (112.8 +/- 40.1 nM vs. 156.9 +/- 13.5 nM, p < .05). After addition of 20% hFF, the mean [Ca2+]i in the influx group reached a peak value of 210.7 +/- 24.7 nM within 30 s and then decreased slowly; the mean [Ca2+]i values 1, 5, 10, and 15 min after addition of 20% hFF were 179.3 +/- 31.4, 174.3 +/- 30.2, 172.5 +/- 27.8, and 175.1 +/- 27.2 nM, and all values were significantly higher than the resting level (p < .01). The frequency distribution of [Ca2+]i after addition of 20% hFF was shifted toward higher concentrations (p < .01). However, the addition of 20% hFF did not increase the percentage of live acrosome reaction (before 3.8 +/- 0.9% vs. after 2.9 +/- 0.5%, respectively). Thus, hFF increased [Ca2+]i in about 80% of the motile sperm. Relatively high [Ca2+]i levels persisted for at least 10-15 min after its addition. However, hFF did not trigger a rapid response in acrosome reaction.

[Absorption, distribution, metabolism and excretion of T-3761, a new quinolone derivative, in experimental animals]

We studied the absorption, distribution, metabolism and excretion of T-3761, a new quinolone derivative, in experimental animals. The following results were obtained. 1. The peak serum levels of T-3761 after a single oral administration to various fasting animals at a dose of 5 mg/kg were high in the order of rats, dogs, mice and rabbits, showing favorable absorption in all animals except for rabbits. In mice and rats, T-3761 showed higher peak serum levels than ofloxacin and ciprofloxacin but T-3761 were more rapidly eliminated from serum than ofloxacin and ciprofloxacin. 2. Tissue concentrations of T-3761 in rats were similar to those of ofloxacin but its ratio of tissue to serum levels were lower than those of ofloxacin. 3. Urinary excretion of T-3761 as active form until 24 hours after oral administration was 27.3%, 63.1%, 41.0% and 63.3% in mice, rats, rabbits and dogs, respectively. Only unchanged T-3761 was detected as active form in urine of all animals tested. In rats, urinary concentrations until 2 hours after administration were higher than those of ofloxacin. 4. Biliary excretion of T-3761 in mice and rats were 2.9% and 1.4% as active form. 5. The absorption of T-3761 was not different in male and female rats or 8 and 14 weeks old rats. The meal lowered absorption of T-3761 in rats. There was no significant difference in serum levels, urinary excretion and distribution to tissues after multiple administration of T-3761 comparing with its single administration. 6. In rats with liver dysfunction induced by D-galactosamine, the serum levels and urinary excretion were slightly higher than in normal rats. On the other hands, in rats with kidney dysfunction induced by HgCl2, the serum levels were significantly higher and urinary excretion of T-3761 was significantly lower than in normal rats. Above results show that T-3761 has unique characteristics in absorption, excretion and distribution after oral administration to animals among new quinolones, i.e., T-3761 was eliminated rapidly and poorly distributed to tissues but showed superior absorption and high peak serum levels.

[Microbiological assay method for T-3761 concentration in body fluids]

A microbiological assay method for measurement of T-3761 and its stability in body fluids were investigated. The paper disc method proved suitable for this assay using Escherichia coli Kp as a test organism and commercially available heart infusion agar as a test medium. When using the paper disc method, lower detection limit of T-3761 was approximately 0.05 microgram/ml and 0.1 microgram/ml for 1/15M phosphate buffer (pH 7.0) and human serum, respectively. T-3761 in human serum and urine was stable under freezing -20 degrees C for at least 28 days.

Polymeric N-acetyl-D-glucosamine (chitin) induces prostaglandin E2 in dogs

The level of prostaglandin E2 (PGE2) in the exudate induced by subcutaneous implantation of a complex formed from non-woven fabric of polyester (NWF) and polymeric N-acetyl-D-glucosamine (chitin) (chitin/NWF) or by implantation of NWF in dogs was measured by radioimmunoassay. The amount of PGE2 in the exudate induced by chitin/NWF was about five times as high as that in the exudate induced by NWF (p < 0.05), while the level of PGE2 in the exudate was similar to that in serum.

Biosynthesis of a biologically active single peptide chain containing the human common alpha and chorionic gonadotropin beta subunits in tandem

One of the distinguishing features of the gonadotropin and thyrotropin hormone family is their heterodimeric structure, consisting of a common alpha subunit and a hormone-specific beta subunit. Subunit assembly is vital to the function of these hormones: The conformation of the heterodimer is essential for controlling secretion, hormone-specific posttranslational modifications, and signal transduction. To address whether alpha and beta subunits can be synthesized as one chain and also maintain biological activity, a chimera composed of the human chorionic gonadotropin (hCG) beta subunit genetically fused to the alpha subunit was constructed. The resulting polypeptide hCG molecule not only was efficiently secreted but also displayed an increased biological activity in vitro and in vivo. These data show that the alpha and hCG beta subunits encoded as a single chain retain a biologically active conformation similar to that seen in the heterodimer. This approach can be used to investigate structure-function relationships of the glycoprotein hormone family that were previously not tractable because of the absolute dependence on assembly for the biological response. Moreover, other bioactive multisubunit ligands can be engineered where the combination efficiency and specificity of heterodimers and homodimers are otherwise difficult to control.

Sources of inhibin in early pregnancy

Inhibin is a glycoprotein which suppresses the release of follicle stimulating hormone (FSH) from the pituitary. Plasma immunoreactive inhibin levels during pregnancy have been reported to be higher than those during the normal menstrual cycle. In the present study, we investigated the cellular localization of inhibin alpha-, beta A-, and beta B-subunits in the human corpus luteum and placenta during early pregnancy. Luteal cells and theca luteal cells in the corpus luteum of pregnancy exhibited positive staining for all three inhibin subunits. We also observed positive staining with antisera against each inhibin subunit in the syncytiotrophoblast, but not in the cytotrophoblast, in the villi during early pregnancy. The staining with antisera against inhibin alpha- and beta A-subunits was clearly observed, whereas the staining for the beta B-subunit was faint. These results suggest that the gestational corpus luteum and the villous tissue may be major sources of inhibin during early pregnancy.

Immunohistochemical localization of inhibin alpha- and beta A-subunits in the ovary of immature female rats

Immunohistochemical localization of inhibin alpha- and beta A-subunits was examined in the ovaries of immature female rats. The granulosa cells in various sized ovarian follicles obtained from rats that were 10-24 days old exhibited positive staining for inhibin alpha- and beta A-subunits. The relative intensities of immunostaining for alpha- and beta A-subunits increased during follicular growth and maturation. Ova and internal thecal cells did not show any immunostaining for inhibin alpha- and/or beta A-subunits. These results suggest that granulosa cells of immature rat ovaries may produce inhibin from the 10th day after birth, and that an increase in the number of mature ovarian follicles results in an increase in inhibin production in the immature rat ovary during prepubertal development.

Increased platelet aggregability in patients with vertigo, sudden deafness and facial palsy

Many patients suffering from episodic vertigo have no cochlear symptoms. These patients have so far been diagnosed as having Meniere's disease of the vestibular type. However, the underlying mechanisms are still to be established. In the present study, we investigated platelet aggregability in patients with dizziness, Meniere's disease, sudden deafness and facial palsy, to examine whether abnormalities in platelet aggregation is one of the causes of episodic vertigo. In 36 patients with dizziness, in 13 with Meniere's disease, in 7 sudden deafness, and in 7 facial palsy, platelet aggregability to adenosine diphosphate (ADP) was assessed by optometric technique. It was found that platelet aggregability was increased in the patients with dizziness as well as with Meniere's disease, sudden deafness and facial palsy and only the two former patient groups showed a tendency of hyperlipidemia. The administration of antiplatelet and lipidemia drugs resulted in no recurrence of vertigo during at least 3 months' follow-up. Hence, the results of our study suggest that a possible initializing factor of vertigo without cochlear symptoms might be disturbed microcirculation due to platelet hyperaggregability.

Growth hormone induces expression of the c-fos gene on hypothalamic neuropeptide-Y and somatostatin neurons in hypophysectomized rats

The neuronal expression of the protooncogene c-fos may serve as a marker of neural activity. We previously examined brain sites upon which GH exerts an immediate early influence in rats and determined that the c-fos gene was transiently expressed in the hypothalamic periventricular nucleus (PeV) and arcuate nucleus (ARC) after recombinant human GH (rhGH) administration. As the distribution of c-fos messenger RNA (mRNA)-containing cells appeared to overlap with that of somatostatin (SS) neurons in both the PeV and ARC, we hypothesized that GH exerts a feedback effect on hypothalamic SS neurons. To extend this hypothesis, we characterized the neurons expressing the c-fos gene in response to rhGH administration in hypophysectomized rats. Adult male Wistar rats were hypophysectomized 10 days before use. After hypophysectomy, rats received daily sc injections of cortisone acetate (0.5 mg/kg BW) and L-T4 (20 micrograms/kg BW). Four international units (1.33 mg) of rhGH were given iv through an indwelling right atrial cannula. The vehicle was given to the control animals. Coronal sections of the hypothalamus were processed for in situ hybridization after rhGH or vehicle administration. To estimate the localization of neurons expressing the c-fos gene, the adjacent hypothalamic sections, 30 microns in thickness, were processed for hybridization histochemistry for SS, neuropeptide-Y (NPY), or GRF mRNA. In the ARC, the distribution of c-fos mRNA-containing cells appeared to overlap with that of NPY and partially with that of SS mRNA-containing cells, but it clearly differed from the distribution of GRF mRNA-containing cells. In the PeV, distribution of the cells expressing the c-fos gene was comparable to that of SS mRNA-containing cells. To further ascertain the distribution, hypothalamic sections, 6 microns in thickness, were processed by double label in situ hybridization using a 35S-labeled c-fos cRNA probe and a digoxigenin-labeled NPY or SS cRNA probe. In the ARC, 65% of the c-fos gene-expressing cells were NPY neurons. In the PeV, 60% of the c-fos gene-expressing cells were SS neurons. NPY is known to act within the hypothalamus and inhibit GH secretion via SS in rats, and the NPY neurons in the ARC have been shown to project to SS neurons in the PeV. Our findings suggest that the feedback effect of GH on the hypothalamus is mediated not only by SS neurons in the PeV, but also by NPY neurons in the ARC.

Migration of canine neutrophils to chitin and chitosan

Suspension of chitin and chitosan particles (mean size of 1 micron) were found to attract canine neutrophils chemotactically as determined by a checkerboard assay through polycarbonate filter with 5 microns pore size in Blind well chamber. Suspension of chitin induced chemokinetic migrations of the neutrophils. These evidences might reflect accumulation of neutrophils to chitin- and chitosan-implanted regions in dogs.

[Effect of nicardipine cardioplegia on A-V conduction system in coronary bypass surgery]

The effect of diltiazem and nicardipine cardioplegia on A-V conduction system was analyzed in 75 patients undergoing coronary bypass operation. The dose of these drugs into the crystalloid cardioplegia was 10 micrograms/kg in nicardipine group (n = 29) and 100 micrograms/kg in diltiazem group (n = 46). Among these patients, there was no operative death and no patient required IABP after surgery and there was no difference on the post operative CK-MB level, on the cardiac index and on the pulmonary pressure between two groups. The number of patients who had complete A-V block after release of aortic cross clamping was significantly smaller in nicardipine group than in diltiazem group: 45.7% in diltiazem group vs. 6.9% in nicardipine group at 30 minutes and 21.7% vs. 6.9% at 60 minutes. We conclude that the suppressive effect on A-V conduction system was significantly lower in nicardipine cardioplegia than in diltiazem cardioplegia in the patients undergoing coronary bypass operation.

Postantibiotic effects and postantibiotic sub-MIC effects of benzylpenicillin on viridans streptococci isolated from patients with infective endocarditis

We investigated the postantibiotic effects (PAEs) and the postantibiotic sub-MIC effects of benzylpenicillin on three strains of viridans streptococci isolated from infective endocarditis patients. The PAEs of benzylpenicillin on penicillin tolerant Streptococcus sanguis TW-70 (0.4-3.9 h), penicillin tolerant S. sanguis TW-80 (0.3-6.3 h) and nontolerant Streptococcus oralis TW-186 (0.5-3.1 h) were dependent on exposure time. The PAEs were not concentration dependent for S. sanguis TW-70 and S. sanguis TW-80 above the MIC, and for S. oralis TW-186 above 16 x MIC. The antimicrobial effects of benzylpenicillin at sub-MIC concentrations were examined in bacteria pretreated with benzylpenicillin (8 x MIC) for 2 h and compared with untreated bacteria. At the sub-MICs tested, the regrowth of pretreated S. oralis TW-186 cells was more prolonged than that of untreated cells and bactericidal action was seen only in pretreated cells. These effects (so-called 'postantibiotic' sub-MIC effects') were not observed in penicillin tolerant S. sanguis TW-70. The presence of the postantibiotic sub-MIC effect may be an important factor in determining the dosing regimen for infective endocarditis.

Effect of D-Ala-D-beta Nal-Ala-Trp-D-Phe-Lys-NH2 (KP-102) on GH secretion in urethan-anesthetized rats

The effect of a newly developed growth hormone (GH)-releasing hexapeptide (KP-102) on GH secretion was studied in urethan-anesthetized adult male rats. Although KP-102 alone exerted a small influence on GH secretion, it produced a large plasma GH response in the presence of exogenous GH-releasing factor (GRF). During the continuous infusion of GRF, the somatotropes became refractory to a large bolus dose of GRF, but KP-102 induced a marked increase of plasma GH. The GH response to KP-102 alone or KP-102 with GRF was significantly augmented when antiserum to somatostatin (ASS) was previously administered. Although KP-102 and GRF acted synergistically on GH secretion in control animals, they acted additively in ASS-administered rats. The KP-102 effect on plasma GH was significantly attenuated in control animals and ASS-administered rats by prior i.v. injection of antiserum to GRF. Taken together, KP-102 stimulates GH secretion dependent on GRF and appears to act synergistically with GRF by antagonizing the SS effect.

Serum biochemical changes and chemiluminescent responses of whole blood in Holstein cattle with leukocyte adhesion deficiency

Serum biochemical profile and whole blood chemiluminescent (CL) responses in 8 Holstein cattle affected with leukocyte adhesion deficiency (LAD) were evaluated. Concentrations of sodium, chloride and calcium in serum from cattle affected with LAD were significantly (p < 0.05) decreased as compared with controls. The characteristic changes in serum proteins were hypoalbuminemia and hyperglobulinemia, and the concentrations of albumin and gammaglobulin in serum from normal cattle and cattle affected with LAD were significantly (p < 0.01) different. Significantly (p < 0.01) diminished CL indices and prolonged peak time of CL responses in whole blood were detected in cattle affected with LAD. These findings indicate that the CL response associated with iC3b receptor mediated phagocytic activity is impaired in cattle affected with LAD. The whole blood CL assay appeared to be practical and useful for routine evaluation of blood samples from cattle affected with LAD.

[Bone marrow transplantation from donors other than HLA matched siblings for hematological malignancies. Nagoya Bone Marrow Transplantation Group and Tokai Marrow Donor Bank]

One hundred and fourteen patients with hematological malignancies received bone marrow transplantation from donors other than HLA-identical siblings. Sixty-three patients received transplantations from related donors; 20 were phenotypically identical for HLA-A, B, D/DR (RM0). 32 differed at one locus (RM1) and 11 differed at more than one loci (RM2). Fifty-one transplantations were from unrelated donors; 37 were phenotypically identical and mixed lymphocyte culture (MLC) negative (UR0) and 14 were MLC positive (UR1). One hundred and four patients had durable engraftment. Four (RM1(1), RM2(2), UR0(1)) failed to achieve engraftment. In terms of the probability of > or = Grade II acute graft-versus-host disease (GVHD), there was no significant difference among the groups according to HLA disparity (RM0:25%, UR0:33%, UR1:39%, RM1:47%, and RM2:50%). The probability of chronic GVHD was significantly higher in UR0 and UR1 than RM0 (71%, 75% vs 28%, p < 0.05). The disease-free survival at 3 years was 45% (RM0), 50% (RM1) and 42% (UR0). More than 50% of patients other than RM0 died of fatal complications including GVHD within 60 days after grafting. In conclusion, unrelated donor and related donor mismatched at one locus could be selected for marrow graft in the case of the absence of an HLA-matched related donor. However, more advances in post-transplant management and in histocompatibility testing should be required.

[Secondary leukemia after etoposide treatment involved MLL gene rearrangement]

The 11q23 chromosomal abnormality is frequently observed in infantile leukemia and secondary leukemia, and the translocation associated gene in infantile leukemia is called mixed-lineage leukemia (MLL) gene. A 50-year-old man was admitted because of left axillary lymphadenopathy and IBL like T cell lymphoma was diagnosed by lymph node biopsy. The patient responded to the LSG-9 protocol with complete remission. After 10 months he was readmitted because of fever and was diagnosed acute myeloblastic leukemia by bone marrow aspiration. Chromosome analysis revealed 11q23 abnormality, suggesting that the leukemia was induced by etoposide treatment. Southern blot analysis demonstrated DNA rearrangement in the MLL gene at 11q23. It was suggested that the breakpoint region of the MLL gene in secondary leukemia is the same as that of infantile leukemia.

A double-blind controlled study of granulocyte colony-stimulating factor started two days before induction chemotherapy in refractory acute myeloid leukemia. Kohseisho Leukemia Study Group

We conducted a prospective, double-blind controlled study to determine the efficacy of a recombinant granulocyte colony-stimulating factor (G-CSF, 200 microgram/m2) starting daily from 2 days before an induction therapy until neutrophils recovered to above 1,500/microL or until 35 days after the therapy in 58 patients with relapsed or refractory acute myeloid leukemia (AML). Twenty-eight patients in the G-CSF group showed significantly faster recovery of neutrophils (P < .001) than 30 patients in the placebo group. The incidence of febrile episodes and of documented infections was almost the same in both groups. However, among 39 patients who did not show any infectious episodes during the 2-week period after the start of chemotherapy, the incidence of documented infections after the third week tended to be lower in the G-CSF group, but not statistically significantly. There was no evidence that G-CSF stimulated the growth of AML cells in the bone marrow during the 2-day period before the chemotherapy, nor that G-CSF accelerated the regrowth of AML cells during the 5-week period after the therapy. Fifty percent of patients in the G-CSF group and 37% in the placebo group had complete remission (CR). Although the rate was higher in the G-CSF group, the difference was not statistically significant (P = .306). There was no difference between the two groups in event-free survival of all patients and in disease-free survival of patients who had achieved CR.