Increased rate of spontaneous mitotic recombination in T lymphocytes from a Bloom's syndrome patient using a flow-cytometric assay at HLA-A locus

Bloom's syndrome (BS) is an autosomal recessive disorder conferring high propensity for cancer and displaying a high degree of genetic instability; the frequency of sister chromatid exchange is characteristically 10 times above background. The symmetrical four-armed chromatid interchanges are much more readily detected in peripheral blood lymphocytes of BS patients, suggesting that the frequency of somatic recombination is also increased. In the present study, the rate of spontaneous loss of HLA-A allele expression was estimated following fluctuation analysis in cultured T lymphocytes using a flow-cytometric assay. It was found to be 10 times or more higher than normal in lymphocytes from a BS patient. Molecular and chromosome analyses showed that all 13 independent variants from the patient were most likely derived from somatic recombinations. Further tests for loss of heterozygosity at a closely linked proximal locus, HLA-DQA1, showed that as many as half of the recombinants retained heterozygosity irrespective of the donor. The results suggest that the HLA region is hyperrecombinogenic in somatic cells and that the elevated recombination rate in BS cells results from the general increase at ordinary sites and not from random creation of unusual sites for recombination.

Heat shock protein produced by Helicobacter pylori

The cells of Helicobacter pylori were suspended in the medium containing 35S-methionine. After a heat shock of the cells at 42 C for 5, 10, and 30 min, the production of proteins was analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and autoradiography. Out of many proteins produced by the cells, only 66 kDa protein production was dramatically increased by heat treatment. The N-terminal amino acid sequence of 66 kDa protein was quite similar to that of 62 kDa and 54 kDa proteins previously suggested as heat shock protein (HSP) of H. pylori based on the reaction with polyclonal and monoclonal antibodies against HSP 60 family proteins produced by other bacteria. Therefore, it was concluded that H. pylori produces the 66 kDa protein as its major heat shock protein which belongs to HSP 60 family.

Immune responses to Epstein-Barr virus in atomic bomb survivors: study of precursor frequency of cytotoxic lymphocytes and titer levels of anti-Epstein-Barr virus-related antibodies

Precursor frequencies of cytotoxic lymphocytes to autologous Epstein-Barr virus-transformed B cells and serum titers of anti-Epstein-Barr virus-related antibodies were measured in 68 atomic bomb survivors to clarify the immune mechanism controlling Epstein-Barr virus infection. The precursor frequency was negatively correlated with the titer of anti-early antigen IgG, which is probably produced at the stage of viral reactivation. A positive correlation between the precursor frequency and titer of anti-Epstein-Barr virus-associated nuclear antigen antibody was also observed, indicating that the precursor frequency reflects the degree of in vivo destruction by T cells of the virus-infected cells. These results suggest that T-cell memory specific to Epstein-Barr virus keeps the virus under control and that the precursor frequency assay is useful for the evaluation of immune responses to Epstein-Barr virus. However, no significant effect of atomic bomb radiation on the precursor frequency was observed in the present study, probably due to the limited number of participants.

Capnocytophaga haemolytica sp. nov. and Capnocytophaga granulosa sp. nov., from human dental plaque

Two new Capnocytophaga species, for which we propose the names Capnocytophaga haemolytica and Capnocytophaga granulosa, were isolated from supragingival dental plaque of adults. The phenotypic characteristics of these organisms were the same as those of the genus Capnocytophaga: gram-negative rods; CO2 requirement; gliding motility; catalase negative; oxidase negative; acids produced from D-glucose, D-maltose, D-mannose, and D-sucrose; and acetate and succinate are the major end products of glucose fermentation. In addition, the cellular fatty acid contents and menaquinones of both species were similar to the cellular fatty acid contents and menaquinones of other Capnocytophaga species. Nevertheless, the levels of DNA-DNA relatedness of the two new species to each other and to other Capnocytophaga species were less than 20%. Two notable characteristics of C. haemolytica are the presence of hemolytic activity and the lack of aminopeptidase activity. C. granulosa has granular inclusions in its cells and grows aerobically. The type strains of C. haemolytica and C. granulosa are A0404 (= JCM 8565) and B0611 (= JCM 8566), respectively.

[Recurrent endometrial cancer after complete surgery]

Between 1974 and 1991, 576 patients with endometrial cancer were treated with complete surgery. 1. The overall relapse rate was 14.4%. No recurrence was observed in surgical stage Ia, whereas 56.8% relapse was noted in stage IIIc. 2. The relapse rate in cases with adenocarcinoma was 13.0%. The relapse rate increased with poorer differentiation. Five of 6 cases with serous adenocarcinoma developed recurrence. 3. Myometrial invasion, size of tumor, vessel permeation, cervical involvement, adnexal metastasis and lymph node metastasis were significant factors for relapse. 4. Distant recurrence was noted in 63.9% of recurrent cases and 28.9% developed pelvic recurrence. The most common recurrent sites were lung, peritoneal cavity, and para-aortic lymph node in distant relapse and vaginal vault and parametrium in pelvic relapse. 5. The time to relapse ranged between 106 days and 5,518 days after complete surgery. Thirty one point three % of the recurrent cases manifested relapse within the first year, 60.2% within 2 years and 93.9% within 5 years. The mean time to relapse was 561 days. It was concluded that adjuvant therapy for cases with adnexal metastasis, lymph node metastasis, cervical involvement, adenocarcinoma (G3), and serous adenocarcinoma should be established urgently.

[Lipid composition of Helicobacter pylori]

In H. pylori, we examined the composition of total lipids. In thin-layer chromatography, three kinds of glycolipids were detected, which were named as G-1, G-2 and G-3. G-3 contained phosphates in addition to sugars. Total lipids consisted of 6.0% neutral lipids (weight %), 20.6% glycolipids (G-1, G-2) and 73.4% phospholipids (including G-3). Total glycolipids were approximately 25% of total lipids. After methanolysis, cholesterol was detected in the hexane extractable fraction and glucose was detected by GLC in the methanol fraction after trimethylsilylation, in all glycolipids. Therefore, these glycolipids are cholesteryl glycosides. Cholesteryl glycosides are found very rarely in bacteria, and have been detected only in a few species of mycoplasmas and spirochetes.

[Studies on the point mutation of ras oncogene in ovarian tumor]

Thirty-five patients with ovarian tumors operated on between December, 1989 and June, 1991 were studied to detect K-ras codon 12 point mutation (PM). (1) Five of 35 ovarian tumors (14.3%) disclosed K-ras PM at codon 12 and all the PM cases were in transition from GGT to GAT. On the other hand only one case (5.3%) with K-ras oncogene amplification was found and no C-myc or erbB-2 amplification was detected. (2) The incidence of PM according to clinical stages was seen in 3 of 11 stage I cases (27.3%), in 1 of 3 stage II cases (33.3%), in 1 of 14 stage III cases (7.1%) and in neither of 2 stage IV cases. PM was therefore seen in relatively early stages. (3) The occurrence of PM according to the histologic type was found in 3 of 16 serous tumors (18.8%), in 2 of 5 mucinous tumors (40.0%) and in none of 7 clear cell carcinomas or 2 endometrioid carcinomas. (4) Concerning the relation of PM to the involvement of serosal surface of ovarian tumors and to the ascitic cytology, no particular correlation was observed in our study. (5) Regarding the cytologic findings in imprint smears of the tumors in reference to PM, such as nuclear size, shape, N/C ratio, chromatin pattern, nucleolar size and number, the cases with PM tended to have more multiple nucleoli than PM negative cases. No other findings seemed to indicate the clinical progress of cancer. In conclusion, our study indicated that PM in ovarian cancers was a relatively early event in carcinogenesis.

Establishment of radioimmunoassay for human macrophage colony-stimulating factor using recombinant human macrophage colony-stimulating factor as tracer and immunogen

A sensitive and reliable radioimmunoassay (RIA) for human macrophage colony-stimulating factor (M-CSF) was developed using recombinant human M-CSF (rhM-CSF) as tracer and immunogen. The assay was quantitative over the range of 50 pg/ml and 5.0 ng/ml for M-CSF in human urine and serum, and more sensitive and specific than the murine bone marrow assay. The average level of human M-CSF in urine from normal males (N = 71) and females (N = 46) was 3.94 +/- 1.78 ng/ml (2.85 +/- 1.15 micrograms/g creatinine), and 3.53 +/- 1.70 ng/ml (3.31 +/- 1.12 micrograms/g creatinine), respectively. The serum levels were 1.95 +/- 0.38 ng/ml for males (N = 117), and 1.93 +/- 0.49 ng/ml for females, (N = 16). The results with the urine and sera showed that there was no difference in the M-CSF levels due to age or gender.

Frequent occurrence of in vivo clonal expansion of CD4- CD8- T cells bearing T cell receptor alpha beta chains in adult humans

We have previously reported 2 cases of healthy men showing in vivo monoclonal expansion of mature CD4- CD8- alpha beta T cells. In the present study, an additional 3 adults were found to exhibit such an expansion, among a total 464 adult donors studied. These 5 individuals were otherwise physiologically normal, with no history of severe illness and autoimmune disease at the time of examination. To investigate the mechanisms of the clonal expansion, further characterization of the clonal cells was attempted. No apparent preference for usage of the T cell receptor beta chain variable region was observed in the clonal T cells. These clonal T cells showed lectin-dependent or redirected antibody-dependent cell-mediated cytotoxicities, whereas they could not lyse autologous lymphoblastoid cell lines. Failure of Fas antigen expression was not observed for any of these clones. These results suggest that clonal expansion of CD4- CD8- alpha beta T cells frequently occurs in the periphery without any T cell abnormalities.

Successful treatment of adult T-cell leukemia/lymphoma with MACOP-B, M-FEPA and VEPP-B combination chemotherapy

A 45-year-old man was referred to our department in March of 1989. Physical examination showed erythroderma, palmo-plantar hyperkeratosis, generalized lymphadenopathy, hepatosplenomegaly, and leukemic manifestation. The lymphocyte count in the peripheral blood before treatment was 1.7 x 10(4) cells/mm3. Atypical lymphocytes such as flower cells and lobulated cells were seen in the peripheral blood. A sample excised from a lymph node showed immunoblastic, pleomorphic T cells by a modified classification scheme of the Working Formulation. A high level of serum LDH was detected (2.1 times the upper normal limit). Anti HTLV-1 antibody was also detected in the serum. The atypical lymphocytes were positive for CD3, CD4, CD5, CD7 and HLA-DR, and negative for CD8. Thus, the clinical, pathologic and immunologic features were those of typical acute-type ATL. The patient was treated with VEPA-M for three months starting in March of 1989. Because of poor response, the patient was then treated with MACOP-B, M-FEPA, and VEPP-B for about one year from June of 1989 and has been free of disease up to the time of writing, March of 1993.

Immunohistochemical and immunoelectron microscopic study of cytochrome P-450 of human fetal livers (P-450HFLa): implications for an onco-feto-placental enzyme

Cytochrome P-450 of human fetal livers (P-450HFLa) was demonstrated by the avidin-biotin immunoperoxidase technique in tissue samples as follows: human fetal organs, adult livers, human and cynomolgus placenta, and gynecologic organs which were obtained from 40 patients with gynecologic malignancies and 32 patients with benign diseases. P-450HFLa was clearly localized in the cytoplasm and membranes of the hepatocytes, and the fact was confirmed by an immunoelectron microscopic examination. In addition, a semiquantitative assay of staining intensity demonstrated that this enzyme tended to decrease with advancing age. These findings suggest that hepatic P-450HFLa synthesis is inversely proportional to age, and that this enzyme is one of the differentiation antigens. P-450HFLa was also detected immunohistochemically in other fetal organs. The present study thus confirms that P-450HFLa is not specific to the liver and is ubiquitous even in the fetus. Marked positive staining for P-450HFLa was demonstrated in villous syncytiotrophoblasts. In contrast, no positive staining was found in the cynomolgus-monkey placenta, unlike the case for many other placental antigens. These findings lead to the tentative conclusion that P-450HFLa is a feto-placental enzyme peculiar to humans. P-450HFLa was demonstrated to occur very frequently in gynecologic malignancies. The mean positivity rate for all gynecologic malignancies was 85%, while the rate was below 25% for benign gynecologic diseases, indicating that P-450HFLa is one of the onco-feto-placental enzymes. The present study thus suggests that this enzyme could be a promising new tumor marker for gynecologic malignancies.

Abdominal wall fat index, estimated by ultrasonography, for assessment of the ratio of visceral fat to subcutaneous fat in the abdomen

PURPOSE

To establish a new index of regional fat distribution using ultrasonography for assessment of the ratio of the visceral fat area (V) to the subcutaneous fat area (S) (V/S ratio).

SUBJECTS AND METHODS

The subjects examined were 62 patients (23 males and 39 females); 51 patients had hyperlipidemia and 11 patients had glucose intolerance. The mean body mass indices ranged from 20.3 to 42.9. The mean age of the patients was 44 +/- 13 years. The thicknesses of the preperitoneal fat layer (P) and subcutaneous fat layer (S) in the abdomen were measured by ultrasonography and the P/S ratio was calculated. The V/S ratio was obtained with radiographic computed tomography.

RESULTS

Of the various P/S ratios examined, the ratio of the maximum thickness of preperitoneal fat to the minimum thickness of subcutaneous fat was most closely correlated with the V/S ratio (r = 0.746, p < 0.0001). This ratio was termed the abdominal wall fat index (AFI). AFI was positively correlated with serum triglyceride levels and negatively correlated with high-density lipoprotein cholesterol (r = -0.312, p < 0.05), whereas the V/S ratio was correlated with triglyceride levels. AFI was positively correlated with basal insulin levels in both men and women.

CONCLUSION

These results suggest that AFI measured by ultrasonography may be a new indicator of visceral fat deposition, and may reflect metabolic disorders such as lipid metabolism and glucose metabolism disorders.

Growth potentiating activity of endogenous production of interleukin-1 and tumor necrosis factor alpha in blast cells of acute myeloblastic leukemia

For the optimal growth of clonogenic cells in acute myeloblastic leukemia (AML), several cytokines such as tumor necrosis factor alpha (TNF-alpha), interleukin-1 (IL-1) and IL-6 are required in addition to colony-stimulating factor (CSF), which may be produced by blast cells themselves. In the present study, we addressed the potential role of endogenous production of TNF-alpha and/or IL-1 in the in vitro growth of AML clonogenic cells supported by IL-3. Addition of a specific neutralizing antibody against TNF-alpha (anti-TNF-alpha) to the culture significantly reduced the growth-stimulating effect of IL-3 on the cells in 11 of 14 patients. Simultaneous addition of anti-IL-1 alpha and anti-IL-1 beta also partly affected the growth, although to a much lesser extent when compared to the effect observed with anti-TNF-alpha. In 3 patients, the growth-stimulating effect of IL-3 was completely abrogated by anti-TNF-alpha or a combination of all three antibodies. Constitutive TNF-alpha transcript was observed in 5 patients and TNF-alpha protein was present in culture supernatant. Following in vitro culture, a transient but profound increase in c-fos, c-jun, TNF-alpha and IL-1 beta mRNA levels was observed. Anti-TNF-alpha inhibited the accumulation of TNF-alpha transcript, suggesting that membrane-integrated TNF-alpha may be partly responsible for the induction of TNF-alpha mRNA. It seems likely that the accumulation of these genes occurs through a protein kinase C-independent signaling pathway.

A positive correlation between the precursor frequency of cytotoxic lymphocytes to autologous Epstein-Barr virus-transformed B cells and antibody titer level against Epstein-Barr virus-associated nuclear antigen in healthy seropositive individuals

A limiting dilution analysis was established to determine the precursor frequency (PF) of cytotoxic lymphocytes against autologous B cells transformed with the Epstein-Barr virus (EBV). This method was found to detect mainly self-restricted T-cell activity and little non-self-restricted cytotoxicity. The mean PF in 21 healthy EBV-seropositive persons was 1.4 x 10(-3) (range: 0.03 x 10(-3) to 8.7 x 10(-3)) for peripheral blood mononuclear cells, whereas 4 samples of mononuclear cells obtained from umbilical cord blood had PFs below 0.007 x 10(-3). A positive correlation was observed between the PF and serum antibody titers against EBV-associated nuclear antigen among the seropositive persons.

Purification and characterization of recombinant human macrophage colony-stimulating factor expressed in Chinese hamster ovary cells

We expressed human macrophage colony-stimulating factor (M-CSF) in Chinese hamster ovary (CHO) cells by introducing an expression plasmid coding for a 554-amino-acid M-CSF precursor and dihydrofolate reductase (DHFR) gene, and by amplifying the sequence. A cell line was obtained that secreted approximately 200,000 units/ml after 6 days in culture. The expressed recombinant human M-CSF (rhM-CSF) primarily consisted of two molecular species, a main 80-90 kD M-CSF as a homodimer and a molecular form higher than 150 kD. Purification of a main rhM-CSF gave an apparently homogeneous protein disulfide-bonded from 42-kD subunits, but one of the purified rhM-CSFs was composed of two subunit species with molecular masses of 44 and 42 kD. These purified rhM-CSFs had substantially the same specific activity (1 to 4 x 10(7) units/mg protein). Deglycosylation experiments with the latter rhM-CSF using chemical (trifluoromethanesulfonic acid) and enzymatic methods found a terminal neuraminic acid in addition to N- and O-glycosylation, but the two subunit species did not coalesce into a single molecule.

[Chemotherapy of ovarian cancer with a combination of low-dose consecutive CDDP and cyclophosphamide]

Sixty-six patients with ovarian cancer were treated with low-dose consecutive CP (LDC-CP) consisting of cyclophosphamide (CPM: 500 mg/m2, day 1) and CDDP (10 mg/m2, days 1-7). Two-9 (median: 4) courses of LDC-CP were given following reduction surgery (42 cases) or preceding primary debulking (24 cases). Among 66 cases, 12 with stage Ic were not evaluable (NE). The response rate (CR + PR/evaluable) for stages II-IV was 57.4% (12 + 19/54). Histologically, serous and endometrioid type showed a significantly (p < 0.001) higher response rate (77.5% among 40 evaluable) compared to the other histologic type (0% among 14). Toxicities including nausea/vomiting and renal impairment were markedly mild or almost absent despite the lack of any particular care. Grade 3 leucopenia and thrombocytopenia were observed only in 4.2%, and 2.5% of total 284 courses, respectively. Mean survival time by stage was 1,309 days for stage I, 809 days for stage II, 1,180 days for stage III, and 691 days for stage IV, with a significant difference among stages (p = 0.0452). In stages III and IV disease, significant prognostic factors included 1) response to chemotherapy, 2) no. of LDC-CP courses, 3) histologic subtype, 4) performance status, and 5) tumor size. Thus, LDC-CP is considered to be a useful chemotherapeutic regimen for serous and endometrioid type ovarian cancer.

Molecular cloning of human epimorphin: identification of isoforms and their unique properties

Epithelial-mesenchymal interactions are crucial for various epithelial tissue organizations and epimorphin is one of the important signaling molecules from the mesenchyme. The sequence analysis of a human homologue revealed that both of primary and predicted secondary structures of epimorphin are highly conserved among species and this molecule has some isoforms including a putative soluble type. I found that human epimorphins also have a large discrepancy in molecular masses as the case of mouse (around 33kD are predicted by the sequences whereas two protein bands of 60-70kD and 150kD are detected in the cells), and it can be explained, at least in part, by the SDS-resistant complexes formed in the microsomal membranes.

[Sequential MR images of the uterus after Gd-DTPA injection--studies of normal volunteers and uterine endometrial malignant tumors]

To investigate the sequential changes in signal intensity (SI) of normal and abnormal uteri, T1 WIs were taken repeatedly after the injection of Gd-DTPA. Six volunteers and 19 patients with known uterine body malignancy (18 carcinomas, one carcinosarcoma) were examined. The results in volunteers were as follows. In the secretory phase, SI of the endometrium was stronger in the late images than in the early ones, whereas in the proliferative phase, SI was stronger in the early images. SI of the myometrium decreased rapidly and there were no differences in SI between menstrual phases. In 17 of 18 endometrial carcinomas, the tumors showed hypointensity relative to the myometrium, and the contrast between the tumor and the myometrium was better in the early images. In the remaining two cases, the tumor showed hyperintensity and the contrast was better in the late images. After the injection of Gd-DTPA, the endometrium appeared differently according to the menstrual cycle in normal volunteers, and the appearance of uterine structures and endometrial malignant tumors changed sequentially. These findings must be kept in mind when evaluating uterine diseases by Gd-DTPA enhanced MRI.

Comparative studies on the constituents of ophiopogonis tuber and its congeners. VIII. Studies on the glycosides of the subterranean part of Ophiopogon japonicus Ker-Gawler cv. Nanus

Two monoterpene glycosides, tentatively named OJV-I (1) and OJV-II (2), and eight steroidal glycosides, tentatively named OJV-III (3), OJV-IV (4), OJV-V (5), OJV-VI (6), OJV-VII (7), OJV-VIII (8), OJV-IX (9) and OJV-X (10), were isolated from the butanol-soluble fraction of the fresh subterranean part of Ophiopogon japonicus KER-GAWLER cv. Nanus. Among these compounds, 1, 2, 3, 4, 5, 6 and 7 were identified as l-borneo1 O-beta-D-glucopyranoside, l-borneo1 O-beta-D-apiofuranosyl (1-->6)-beta-D-glucopyranoside, ophiopogonin B, glycoside C, ophiopogonin D, Ls-10, and ruscogenin 1-O-sulfate, respectively. The structures of compounds 8, 9, and 10 were established to be (23S,24S,25S)-23,24-dihydroxyruscogenin 1-O-[ alpha-L-rhamnopyranosyl(1-->2)] [beta-D-xylopyranosyl(1-->3)]-alpha-L-arabinopyranoside 24-O-beta-D-fucopyranoside, (23S,24S,25S)-23,24-dihydroxyruscogenin I-O-[alpha-L-2,3,4-tri-O-acetylrhamnopyranosyl(1-->2)][beta-D-xylo pyranosyl(1-->3)]-alpha-L-arabinopyranoside 24-O-beta-D-fucopyranoside, and (23S,24S,25S)-23,24-dihydroxyruscogenin 1-O-[alpha-L-2,3,4-tri-O-acetylrhamnopyranosyl(1-->2)] [beta-D-xylopyranosyl(1-->3)]=alpha-L-arabinopyranoside 24-O-beta-D-fucopyranoside, respectively.

[Increase in CDDP therapeutic index by lower concentration and longer infusion time--home chemotherapy for ovarian cancer]

Twenty-two patients with ovarian cancer stage III and IV received combination chemotherapy with CDDP, adriamycin (ADM) and cyclophosphamide (CPM), and were studied for response and side-effects. Patients were divided into two groups according to the following CDDP infusion schedules. (CAP 1) CDDP 7mg/sqm/8 hrs/saline 500 ml/d1-d10, ADM 35 mg/sqm/d1, CPM 350 mg/sqm/d1: 8 cases; (CAP 2) CDDP 70 mg/sqm/2 hrs/d1, ADM 35 mg/sqm/d1, CPM 350 mg/sqm/d1: 14 cases. The overall response rate (CR + PR) was 62.5% in CAP 1, and 50% in CAP 2 (on statistical difference: NS). The 3-year survival rate was 54.7% in CAP 1 and 38.5% in CAP 2 (NS). Side effects of nausea, vomiting and nephrotoxicities were remarkably reduced in CAP 1. These data suggest that lower concentration and longer infusion time of CDDP administration increases the therapeutic index. This infusion schedule is suitable for chemotherapy at home or on an outpatient clinic basis, especially in patients with ovarian cancer.