Detection of latent varicella-zoster virus infection in human vestibular and spiral ganglia

Varicella-zoster virus (VZV) becomes latent in the sensory ganglia after primary infection and VZV DNA has been found in human trigeminal, thoracic, and geniculate ganglia. In this study, human vestibular and spiral ganglia, which do not received innervation from the skin, were examined for VZV DNA using the polymerase chain reaction. VZV DNA was detected in 2 of 10 (20%) vestibular ganglia and in 2 of 10 (20%) spiral ganglia from five adults. VZV DNA was undetectable in either type of ganglion from a newborn and from two of the five adults. These two adults were VZV seronegative. The results indicate that VZV becomes latent in several types of sensory ganglion after primary infection and suggest the possibility that reactivation of the virus from the vestibular and spiral ganglia may cause disorders in the labyrinth.

Clinical significance of serum c-erbB-2 protein in patients with primary breast cancer

We measured serum c-erbB-2 protein concentration in 167 patients with primary breast cancer. The rate of positive results was 6%. The positivity rate of serum c-erbB-2 protein did not differ among stages I, II, IIIa and IIIb. However the positivity rate on stage IV was 50% (3/6) and significantly higher than the other stages (p=0.0006). The rate of;positive results correlated significantly with lymph node status (p=0.0037). We concluded that the level of serum c-erbB-2 protein reflected the malignant characteristics of primary breast cancer and its measurement may be useful for a preoperative evaluation of primary breast cancer.

Propagation of the human polyomavirus, JCV, in human neuroblastoma cell lines

Susceptibility to infection by the human polyomavirus, JCV, is determined by intracellular mechanisms which control transcription and replication. Originally thought to propagate well only in human cells of oligodendroglial lineage, JCV has recently been shown to infect astrocytes, astrogliomas, and a neuroblastoma cell line. The data reported here describe two cell types that have been subcultured from a human neuroblastoma cell line, SK-N-SH. The SH-SY5Y subclone displays neuronal phenotypes and is not susceptible to JCV infection, while the SH-EP subclone displays glial cell phenotypes and is susceptible to infection. Binding of nuclear proteins from the permissive SH-EP cells to the nuclear factor-1 (NF-1) site in the JCV regulatory DNA sequences results in a gel shift pattern that is different from the nonpermissive SH-SY5Y cell proteins. Northern analysis of mRNA for the four classes of NF-1 proteins showed a predominance of the NF-1/X class in SH-EP cells similar to the highly permissive human fetal glial cells. Very low levels of mRNA for NF-1/X were seen in the nonpermissive SH-SY5Y cells, similar to that seen for the nonpermissive HeLa cells. Several other cell lines tested that were permissive for JCV infection also showed synthesis of the NF-1/X class of proteins. SH-EP cells represent a cell line in a glial cell lineage which is susceptible to JCV multiplication. These cells may be a useful cell culture system for the investigation of DNA binding factors which correlates with viral susceptibility.

Protein composition and morphology of human foamy virus intracellular cores and extracellular particles

Characterization of human foamy virus (HFV) gag-encoded precursors and the search for a Gag-Pol polyprotein and mature proteins derived from proteolytic processing were carried out in HFV-infected cells and with purified preassembled cores and extracellular virus by Western blotting and radioimmunoprecipitation using antisera against synthetic peptides corresponding to putative Gag and protease proteins. Precursor proteins, Pr78gag/74gag and Pr135pol, were found in the nucleus of epithelial and fibroblast cells 3-4 days after HFV infection. Kinetic analysis of HFV Pr78gag and Pr74gag indicated that Pr78gag is a precursor to Pr74gag. South-Western blot analysis indicated that Pr78gag and Pr74gag have properties associated with nucleic acid binding protein although they lack the typical zinc-finger motifs found in retroviral nucleocapsid proteins. Western blot analyses of preassembled HFV cores isolated from the cytoplasm of infected cells and purified by sucrose gradient centrifugation demonstrated the presence of Pr78gag/74gag and Pr135pol, but no proteolytically processed Gag proteins were observed. The majority of extracellular HFV particles were found to have pentagon-shaped cores, as observed intracellularly, and are believed to be the immature extracellular form of the virus. The highest concentration of extracellular particles, estimated by EM, Western blot, and reverse transcriptase assays were found in sucrose gradient fractions having a density of 1.21-1.24 g/cm3. Western blot analysis revealed that Pr78gag/74gag and Pr135pol were the major viral proteins associated with these extracellular particles, as only small amounts of putative proteolytically cleaved capsid (p32) were observed. Our results support the notion that Pol is translated independent of Gag in HFV-infected cells.

Multiple hilar cysts of the liver in patients with alcoholic cirrhosis: report of three cases

The present report concerns the clinicopathological study of three patients with alcoholic cirrhosis (a 40-year-old man, a 52-year-old woman and a 48-year-old man) who had multiple cysts along their intrahepatic bile ducts. The cysts were visible on gross examination of the liver and, in two cases, an enlargement of the cysts had been detected in abdominal computed tomography scans performed 1 year apart. Histologically, the cysts consisted of proliferating and dilated peribiliary glands. The cysts occasionally compressed the original bile ducts. The latter showed mucosal hyperplasia with antral-type gland metaplasia. Neoplastic changes and necroinflammation were not seen. Immunohistochemical assays revealed that the peribiliary glands and antral-type glands expressed not only cytokeratin and carbohydrate antigen 19-9, but also c-MET protein, the hepatocyte growth factor receptor which may be related, at least in part, to the cystic dilatation of the peribiliary glands.

Lack of evidence for the transmission of JC polyomavirus between human populations

Human polyomavirus JC virus (JCV), the causative agent of progressive multifocal leukoencephalopathy, is ubiquitous in humans, infecting children asymptomatically then persisting in renal tissue. Since JCV DNA can readily be detected from urine, it should be a useful tool with which to study the mode of virus transmission in humans. Based on this notion, we examined the extent to which JCV was transmitted from the American to Japanese populations in Okinawa Island, Japan. (A population of about 50 000 American soldiers and families have been stationed in Okinawa since 1945.) Four JCV types (A to D) were identified in American populations in U.S.A., whereas only type B was prevalent in elder Japanese in Okinawa who had reached adulthood by 1945. Thus, types A, C, and D served as indicators of the transmission of JCV from American to Japanese populations. We then examined whether types A, C, and D were detectable in Japanese in Okinawa aged 30-50 years who may have been in contact with Americans during childhood. However, all the 125 isolates from the younger Japanese population were type B without exception. From this finding, we concluded that JCV is rarely transmitted between human populations.

[Mechanism of neuronal damage in AIDS]

Neurologic problems in AIDS are usually caused by opportunistic infections or secondary malignancy of the central nervous system (CNS), but brain damage occurs primarily as the result of HIV infection in CNS. In one of the typical opportunistic virus infections of CNS, progressive multifocal leukoencephalopathy (PML), oligodendroglial cells which maintain and support myelin sheaths are specifically attacked by JC virus. As the consequence, demyelination occurred, which could well explain the neuronal deficits. In contrast, in HIV the viral target cells are not neuronal cells, but infiltrating macrophages in CNS. Thus, the indirect injury such as HIV-related neurotoxic substances and macrophage-released cytokines would be augmented to induce diffuse neuronal damage in HIV infected brains. Recent discovery of co-receptor, chemokine receptor (CCR5) which is expressed in macrophages, may give a clue to understand the mechanism of HIV encephalopathy more precisely.

Clival chordoma presenting as acute esotropia due to bilateral abducens palsy

A case involving a 14-year-old girl having clival chordoma with symptoms of diplopia, acute esotropia, and bilateral abducens palsy is reported. Magnetic resonance imaging revealed a clival tumor invading the posterior edges of the bilateral cavernous sinuses. After removal of the tumor, no ocular manifestations were noted. The importance of acute esotropia as a sign indicating a possible brainstem mass is emphasized.

Childhood bronchial mucoepidermoid tumors

A very rare case of a childhood bronchial mucoepidermoid tumor is presented. A 4-year-old girl was hospitalized with prolonged pneumonia. Computed tomography of the chest showed a tumor with calcifications in the right upper lobe. Subsequently, the patient underwent right upper lobectomy. Histologically, the tumor was a low-grade mucoepidermoid tumor originating from the bronchus. Three years postoperatively there has been no evidence of disease. A review of the literature indicates that 30 cases of bronchial mucoepidermoid tumors in children have been reported. Symptoms result from associated bronchial obstruction. Children with recurrent or prolonged pneumonia should undergo aggressive diagnostic investigation by chest tomography or bronchoscopy. Appropriate therapy for childhood bronchial mucoepidermoid tumor is total resection of the lesion while sacrificing as little of the normal lung tissue as possible.

Clinicopathological study of choroid plexus tumors: immunohistochemical features and evaluation of proliferative potential by PCNA and Ki-67 immunostaining

This report concerns the retrospective immunohistochemical characterization and evaluation of the proliferative potential of eight choroid plexus tumors (CPTs) that included six cases of choroid plexus papilloma (CPP), one of whom had a recurrence, and two cases of choroid plexus carcinoma (CPC). Antibodies to prealbumin, glial fibrillary acidic protein (GFAP), vimentin, keratin, and carcinoembryonic antigen (CEA) were used to determine the immunohistochemical features of interest. The proliferative potential was evaluated with antibodies to proliferating cell nuclear antigen (PCNA) and Ki-67. Antibody binding was visualized by the avidin-biotin-peroxidase complex (ABC) method. Immunoreactivity was scored on a-to 4+ scale, and in the case of PCNA and Ki-67, expected as staining index (SI). All seven CPP specimens were immunostained for prealbumin, but not for CEA. Expression of GFAP, vimentin and keratin varied from one CPP case to another. Both CPCs expressed CEA, but not prealbumin, GFAP and keratin; one of them was vimentin-positive. As determined by immunostaining for Ki-67, the proliferative potential was lower in the CPPs than in the CPCs. Among the former, the highest Ki-67 SI was seen in the primary lesion of a recurring papilloma. On the other hand, immunostaining for PCNA gave less consistent SI values. Our results show that immunohistochemical assays for prealbumin and CEA expression are of significant value for the differential diagnosis of CPPs and CPCs, and that high Ki-67 SI values may serve as an indicator of CPP recurrence, even if the primary lesion is benign.

[A patient with Sjögren syndrome with central pontine myelinolysis and hypokalemic myopathy]

We report a 42-year-old woman who presented with intermittent episodes of muscular weakness lasting approximate 7 to 10 days, about once a year, since 1985. During these episodes of weakness, hypokalemia and elevation of serum creatine kinase were noted. On admission, xerostomia, keratoconjunctivitis sicca (positive Schirmer test), abnormal sialographic findings (apple tree-like appearance), and positive serum autoantibodies against ss-A and nucleus were noted. These findings were compatible with Sjögren syndrome. She also had hyperchloremic metabolic acidosis with normal anion gap, hypokalemia and renal calcifications. Therefore, she had renal tubular acidosis (type 1) in addition to Sjögren syndrome. Brain magnetic resonance imaging (MRI) demonstrated a symmetrical circumscribed lesion in the ventral part of the central pons. We considered this lesion to be central pontine myelinolysis (CPM), because of its typical location and characteristic MRI appearance. This CPM was clinically silent. Pathogenesis and etiology of CPM are obscure, and CPM associated with hypokalemia without hyponatremia has rarely been reported in the literature. However, this is the first report of CPM associated with Sjögren syndrome and hypokalemic myopathy complicated with renal tubular acidosis.

Role of human cytochrome P4502A6 in C-oxidation of nicotine

Nicotine is primarily metabolized to cotinine in humans. In this study, human cytochrome P450 (CYP) isoform involved in cotinine formation was identified. The formation of cotinine in 16 human liver microsomes was determined with a 50 microM nicotine concentration and with a cytosol preparation as a source of aldehyde oxidase. Cotinine formation in human liver microsomes significantly correlated with immunochemically determined CYP2A6 levels (r = 0.663, p < 0.05), coumarin 7-hydroxylase activities (r = 0.831, p < 0.01), and cotinine 3'-hydroxylase activities (r = 0.735, p < 0.01) that are responsible for CYP2A6. In inhibition studies, cotinine formation in human liver microsomes was inhibited by coumarin and rabbit anti-rat CYP2A1 antibody specifically. When the capability of microsomes of B-lymphoblastoid cells expressing human CYPs to perform biotransformation of nicotine to cotinine was determined, cDNA-expressed CYP2A6 exhibited the highest cotinine formation. The KMapp values from microsome expressing CYP2A6 cDNA were similar to the value obtained from human liver microsomes. The large interindividual variabilities in cotinine formation and immunochemically determined CYP2A6 levels were observed in human liver microsomes, suggesting genetic polymorphism of CYP2A6. Nicotine is a new in vivo probe for phenotyping of CYP2A6 in humans.

Immunologic and Ultrastructural Characterization of HIV Pseudovirions Containing Gag and Env Precursor Proteins Engineered in Insect Cells

Expression of human immunodeficiency virus (HIV) Gag precursor protein (Pr55) by recombinant baculoviruses in insect cells results in the assembly and budding of Pr55 as virus-like particles, or Gag pseudovirions. The ultrastructural morphology, size, and sucrose sedimentation rate of Gag pseudovirions are indistinguishable from immature lentivirus particles produced by HIV-infected human cells. Recombinant baculoviruses were engineered to express individually Pr55 and HIV Env glycoprotein precursor (gp160). These recombinant baculoviruses were used to co-infect insect cells to produce chimeric HIV Gag pseudovirions containing gp160 in experiments to develop methodologies for producing complex noninfectious particulate vaccines for HIV. Coexpression of HIV Pr55 and gp160 resulted in the apparent incorporation of gp160 into Gag pseudovirions as determined by immunoblotting with envelope-specific monoclonal antibodies. Furthermore, results from indirect immunogold electron microscopy using monoclonal antibodies to HIV gp120, a component of the Env glycoprotein precursor, suggested that HIV gp160 was specifically incorporated during the budding process into the outer surface of chimeric Gag pseudovirions. Parallel labeling experiments to localize gp120 and Pr55 epitopes on HIV-infected H9 lymphocytes provided results similar to those obtained with chimeric Gag pseudovirions producing recombinant baculovirus-infected insect cells. Parameters influencing immunoelectron microscopy results in cell-surface and postembedding labeling experiments are discussed.

Cranial fasciitis

We report a case of cranial fasciitis in a 14-month-old boy. The lesion grew at the site of a previous head trauma, rapidly destroying the skull. Surgery disclosed that the lesion was highly vascular and adhered to the dura. Because histopathological study of a frozen section did not show malignancy, the authors decided not to perform dural excision after total removal of the lesion. No recurrence of the lesion was seen. The authors stress that this rate fibroblastic lesion must be included in the differential diagnosis of pediatric skull tumors and that careful histopathological observation is needed to avoid extensively invasive surgery.

Localization of annexin I (lipocortin I, p35) mRNA in normal and diseased human skin by in situ hybridization

Annexin I is a calcium- and phospholipid-binding protein that is involved in the regulation of cellular differentiation. The aim of the present study was to determine the localization of annexin I mRNA expression in normal and diseased human skin. In situ hybridization with a specific digoxigenin-labelled RNA probe was used throughout. We detected no annexin I mRNA signals in basal and suprabasal cells of normal epidermis, but positive signals were evident in the sudoriferous ducts. Annexin I mRNA expression was detected in the keratinizing squamous cells in keratotic type seborrhoeic keratosis and in keratinocytes at the periphery of the horn pearl in well-differentiated squamous cell carcinoma. Positive signals were also seen at the border between involved and noninvolved skin in psoriasis vulgaris and in dyskeratotic epidermal keratinocytes in keratosis follicularis Darier. By contrast, no annexin I mRNA signals were detected in tumour cells in basal cell carcinoma. The present results suggest that annexin I expression is related to, and may play a role in, keratinization disorders.

[Sarcoidosis in a patient with autoimmune hemolytic anemia]

A 65-year-old woman was admitted to our hospital because of severe anemia. A skin biopsy was done in January 1994 and sarcoidosis was diagnosed. Diffuse reticular shadows were seen in both lung fields on a chest X-ray film and mediastinal lymph node swelling was seen on a chest CT scan. She was followed as an outpatient and was not treated. She suddenly experienced vertigo and general fatigue in March 1995. Laboratory findings on admission were as follows: Hb 6.2 g/dl, MCV 115.9 fl, Ret 198%, LDH 732 IU/L, I-Bil 1.9 mg/dl, and Coombs' test was positive. Autoimmune hemolytic anemia was diagnosed, and she was treated with prednisolone (1 mg/kg). As of the time of this writing, she has no relapse of hemolytic anemia though prednisolone was discontinued 6 months ago.

Effect of gamma knife irradiation on relaxation and contraction responses of the common carotid artery in the rat

This report concerns a pilot study of the short- and long-term effects of gamma knife radiosurgery on vascular responses. The investigation was carried out on male Sprague-Dawley rats, and the relaxation and contraction responses of the right common carotid artery (CCA) were assessed following irradiation (100 Gy). The non-treated CCA of the same animals served as internal controls. Non-irradiated rats were used to control the effect of normal aging on vascular function. Isometric tension was determined on in vitro preparations of arterial rings. Acetylcholine-mediated, endothelium-dependent relaxation was impaired one month after radiosurgery, as was endothelium-independent relaxation induced by sodium nitroprusside, but the effect on the latter was minimal. The irradiated CCA was also impaired with respect to contraction responses induced by norepinephrine, endothelin-1 or phorbol dibutyrate. This impairment appeared to be biphasic, as it was evident one day after radiosurgery, followed by a partial recovery one week later, and again manifest after one month. At the light microscope level, the carotid arteries appeared to be well preserved throughout the experiment. However, obvious ultrastructural changes were noted in endothelial and smooth muscle cells of specimens obtained three months after radiosurgery. The present data indicate that high dose gamma knife radiosurgery affects the functions of both, the vascular endothelium and the vascular smooth muscles in an apparent time-dependent fashion. Because of its increasing application to patients, there is the need for studying the effects of gamma knife radiosurgery on cerebral arteries, since functional vascular changes may occur in the absence of obvious histological alterations. Our results on CCAs point to the feasibility of such experimental investigations.

[A case of progressive multifocal leukoencephalopathy with methionine uptake demonstrated by PET]

We report here a 55-year-old man with progressive multifocal leukoencephalopathy (PML) associated with chronic adult T cell leukemia (ATL). Neurological examination revealed mild dementia, right homonymous hemianopsia and visual agnosia. Serologically anti-HTLV-I antibody was positive. Peripheral blood analysis showed ATL cells up to 23% in white blood cells. Because he did not have symptoms or signs directly related to ATL, it was considered that he had chronic ATL. T2-weighted cranial MRI demonstrated multiple hyperintensity lesions confined to the white matter from the bilateral occipital to parietal lobes, without enhancement after gadolinium administration or mass effect. We performed stereotactic biopsy of the left occipitoparietal white matter. Histological examination of the biopsied specimens showed demyelinated lesions, containing foamy macrophages and bizarre astrocytes. Oligodendrocytes contained nuclear inclusions which reacted with an antibody against the JC virus (JCV) antigen. These findings were consistent with those of PML. The genomic analysis of JCV from the biopsied brain revealed deletions in the regulatory region. We investigated cerebral blood flow, glucose and amino acid metabolism in this patient using positron emission tomography, and obtained the following three characteristic findings in the lesions: 1) luxury perfusion state, 2) decreased fluorodeoxyglucose (FDG) uptake, and 3) increased methionine (Met) uptake. These findings resembled those of low grade tumors.

Effects of KW-3902 (8-(noradamantan-3-yl)-1,3-dipropylxanthine), an adenosine A1-receptor antagonist, on urinary excretions of various electrolytes in rats

We examined the effects of KW-3902 (8-(noradamantan-3-yl)-1,3-dipropylxanthine), an adenosine A1-receptor antagonist, on urine volume and urinary excretions of various electrolytes in saline-loaded rats, as compared with those of furosemide, trichlormethiazide (TCM), acetazolamide and amiloride. KW-3902 at doses of 0.001-1 mg/kg (p.o.) significantly increased urine volume and excretions of sodium, calcium, magnesium, chloride and bicarbonate. In addition, KW-3902 shifted urine pH to alkaline and decreased free water reabsorption. KW-3902 did not induce kaliuresis, whereas furosemide (30 mg/kg, p.o.), TCM (1 mg/kg, p.o.) and acetazolamide (25 mg/kg, p.o.) induced kaliuresis. In the KW-3902-treated group, the increases in bicarbonate excretion and urine pH were less prominent than those induced by acetazolamide, and the excretions of sodium, calcium, magnesium and chloride were similar to those induced by furosemide. The present results suggest that the adenosine A1-receptor antagonist exhibits diuresis by the inhibited reabsorption of electrolytes, not only at the proximal tubule but also at the distal tubule.

Modulation of erythropoietin production by selective adenosine agonists and antagonists in normal and anemic rats

Hypoxia or anemia is the fundamental stimulus for erythropoietin (EPO) production. Recent in vitro studies suggest that EPO secretion in response to hypoxia is regulated by adenosine in the kidney. In order to examine the in vivo effect of adenosine on EPO production, we determined the effects of adenosine receptor agonists and antagonists on serum EPO concentration in normal and anemic rats. In normal rats, intravenous injection of adenosine agonists (NECA, CHA and CGS-21680) dose-dependently stimulated EPO production. Pretreatment with KW-3902, an adenosine A1 antagonist with modest A2b antagonistic action, or KF17837, an adenosine A2a antagonist, inhibited the NECA (0.1 mg/kg, i.v.)-stimulated EPO production. Anemic hypoxia, induced by 2% (v/w body weight) blood withdrawal, increased serum EPO concentration from 38 +/- 2 to 352 +/- 76 mU/ml, with the increased serum adenosine concentration in the renal vein. KF17837 (0.1 mg/kg, i.v.), but not KW-3902 (0.1 mg/kg, i.v.), inhibited the anemic hypoxia-induced increase in EPO production. The present findings support the notion that adenosine mediates the EPO production in response to hypoxia in the kidney.

Senescence-accelerated mouse. Neurochemical studies on aging

Senescence-accelerated mouse (SAMP8) is known as a murine model of accelerated aging and memory dysfunction. The binding activity of [3H] 1-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinolinecarboxam ide (PK-11195) as a neurochemical marker of gliosis markedly increased with aging in the cerebral cortex and hippocampus of SAMP8. Immunoreactivity for glial fibrillary acidic protein (GFAP) was also enhanced. A beta-amyloid precursor protein (APP)-like immunoreactivity and 27-kDa-carboxyl terminal fragments of APP increased in SAMP8 brain. In addition, anti-APP antibody stained reactive astrocytes surrounding spongy degeneration in brain stern of SAMP8. These results suggest that astrocytosis and production of APP-derived fragments occur markedly in SAMP8 brains.

Interaction between the amino-terminal SH3 domain of CRK and its natural target proteins

CRK is a human homolog of chichen v-Crk, which is an adaptor protein. The SH2 domain of CRK binds to several tyrosine-phosphorylated proteins, including the epidermal growth factor receptor, p130(Cas), Shc, and paxillin. The SH3 domain, in turn, binds to cytosolic proteins of 135-145, 160, 180, and 220 kDa. We screened expression libraries by Far Western blotting, using CRK SH3 as a probe, and identified partial cDNA sequences of four distinct proteins, including C3G, DOCK180, EPS15, and clone ST12. The consensus sequence of the CRK SH3 binding sites as deduced from their amino acid sequences was Pro+3-Pro+2-X+1-Leu0-Pro-1-X-2-Lys-3. The interaction of the CRK SH3 domain with the DOCK180 peptide was examined with an optical biosensor, based on the principles of surface plasmon resonance. A low dissociation constant of the order of 10(-7) resulted from a high association rate constant (kassoc = 3 x 10(4)) and low dissociation rate constant (kdiss = 3 x 10(-3)). All CRK-binding proteins except clone ST12 also bound to another adaptor protein, Grb2. Mutational analysis revealed that glycine at position +1 of ST12 inhibited the binding to Grb2 while retaining the high affinity binding to CRK SH3. The result suggests that the amino acid at position +1 also contributes to the high affinity binding of the peptides to the SH3 domain of Grb2, but not to that of CRK.