Structure of chromosomal DNA coding for Pseudomonas putida S-1 salicylate hydroxylase

A gene coding for the salicylate hydroxylase has been isolated from chromosomal DNA of Pseudomonas putida S-1 and sequenced. The DNA fragment contained an open reading frame of 1266 bp encoding a polypeptide of 421 amino acid residues. The predicted amino acid sequence of the protein gave a good agreement with the sequences determined with the peptides isolated from the enzyme but methionine residue in the amino terminal was deleted in the N-terminal sequence of the enzyme protein. The nucleotide and amino acid sequences of the salicylate hydroxylase shared several common characteristics with those of the enzyme encoded on the plasmid DNA of P. putida PpG7; homology of nucleotide sequence is 58% and that of amino acid sequence is 56%. We could find two large conserved regions of the amino acid sequence at or near FAD- and NADH-binding regions. The FAD-binding site locates on the amino terminal and a lysine residue, functioning as an NADH-binding site (K. Suzuki, M. Mizuguchi, T. Gomi, and E. Itagaki, 1995, J. Biochem. 117,579-585), locates as Lys163.

[Clinical study of prulifloxacin on infectious enteritis. Japan Research Committee of Prulifloxacin, Research Group on Infectious Enteritis]

Prulifloxacin (PUFX), a new quinolone antimicrobial agent, was administered to a total of 122 patients and carriers to investigate its clinical efficacy, safety and usefulness in infectious enteritis (bacillary dysentery, enteritis caused by Salmonella spp. and enteropathogenic E. coli, cholera and so on). In addition, the minimum inhibitory concentration (MIC) of UFX (active compound) was determined against each clinical isolate, and compared with that of ciprofloxacin (CPFX), ofloxacin (OFLX), tosufloxacin (TFLX) and nalidixic acid (NA). The correlation between the concentration of UFX in feces and the change of the fecal microflora were also investigated when PUFX was administered to the patients with acute infectious enteritis. A daily dose of 400 mg of PUFX was administered orally in two divided doses (morning and evening) for 5 days, with the exception of 7 days administration against salmonella enteritis and 3 days administration against cholera. 84 cases were adapted for evaluating the usefulness. The clinical efficacy was 100% in all the enteritis except salmonella enteritis, in which it was 88.9% (8/9 cases). On the bacteriological efficacy, the elimination rate was 100% in all isolates except Salmonella spp., in which it was 75.0% (12/16 cases). As for the adverse effect, uriticaria in moderate degree was observed in 1 (0.9%) of 109 cases. Abnormal changes in laboratory findings were seen in 3 (3.0%) of 100 cases, consisting of 1 with eosinophilia and 2 with elevated S-GPT, although they were all slight in degree. The usefulness rate was 65.5% (55/84 cases) for "very useful" and 95.2% (80/84 cases) for "very useful" and "useful". MIC90 of UFX against Shigella spp., Salmonella spp., E. coli and V. cholerae, was 0.025, 0.05, 0.025 and 0.05 microgram/ml, respectively. These values were the same as those of CPFX and TFLX, and superior to OFLX and NA. UFX concentrations in feces followed by administration of PUFX in 3 cases with acute infectious enteritis were higher than that of MIC90 of UFX against Shigella spp., Salmonella spp., E. coli and V. cholerae. The changes of the fecal microflora, which influence the efficacy and safety of PUFX, were not observed.

[Determination of PIVKA-II levels in patients with small hepatocellular carcinoma--comparison of new sensitive methods]

Current EIA for PIVKA-II is not sensitive enough to detect small Hepatocellular Carcinoma (HCC). In an attempt to increase the diagnostic threshold, the current EIA was modified in two different ways: 1) immunoreaction of PIVKA-II in the sample with its monoclonal antibody was carried out overnight at 5 degrees C instead of for two hours at room temperature (the overnight method), 2) Avidin-Biotin technique was used for the second reaction(the ABC method);and their diagnostic values were determined as compared with the current EIA(2hr method) in a total of 138 patients including 36 patients with HCC. In 27 patients with HCC(< 3 cm in diameter), the rates of abnormal values obtained by the 2hr-, the overnight- and the ABC method were 14.8, 25.9 and 29.6% respectively. False positive rates of these three methods in 69 patients with liver cirrhosis were 1.4, 8.6 and 22.9% respectively. Thus, these two modifications improved the sensitivity of the current EIA and the overnight method appears to be superior to the ABC method in terms of specificity and simplicity. This conclusion was confirmed by ROC analysis.

Interferon therapy for chronic hepatitis C in habitual drinkers: comparison with chronic hepatitis C in infrequent drinkers

OBJECTIVE

To assess the efficacy of interferon therapy for chronic hepatitis C among habitual drinkers.

METHODS

Ninety-five hepatitis C virus ribonucleic acid-positive patients with chronic hepatitis were treated with four standardized regiments of interferon. Patients were divided into four groups based on the degree of daily alcohol consumption and duration of abstinence before treatment: 47 infrequent drinkers, 12 moderate drinkers who had consumed more than 23 gm but less than 69 gm of ethanol daily but stopped drinking for 39 +/- 18 months before therapy, 19 heavy drinkers I who had consumed more than 69 gm of ethanol daily but stopped drinking for 38 +/- 37 months before treatment, and 17 heavy drinkers II who consumed more than 69 gm ethanol daily soon before treatment.

RESULTS

The rate of responders; in whom serum ALT levels remained normal for 6 months after the end of treatment, was in a decreasing order of: infrequent drinkers (36.2%), moderate drinkers (33.3%), heavy drinkers I (26.3%), and heavy drinkers II (5.9%) (p < 0.05, infrequent drinkers vs heavy drinkers II). The negative rate of serum hepatitis C virus ribonucleic acid 6 months after the end of treatment was in a similar order (27.7%, 25.0%, 15.8%, and 0%, respectively) (p < 0.05, infrequent drinkers vs heavy drinkers II).

CONCLUSION

Heavy drinking will reduce the efficacy of interferon therapy for chronic hepatitis C, and the adverse effect of drinking on efficacy might be reversed, partly, by abstinence for a long period before treatment.

Determination of serum des-gamma-carboxy prothrombin levels in patients with small-sized hepatocellular carcinoma: comparison of the conventional enzyme immunoassay and two modified methods

OBJECTIVES

Currently available enzyme immunoassays for des-gamma-carboxy prothrombin (DCP) are not sensitive enough to detect hepatocellular carcinoma (HCC) at an early stage. Therefore, the objectives of this study were to enhance the sensitivity of the currently available enzyme immunoassay (EIA) for DCP and to assess the diagnostic values of the new methods compared with those of alpha-fetoprotein (AFP) in patients with small-sized HCC.

METHODS

Coded serum samples obtained from a total of 128 patients with chronic liver diseases, including 27 patients with small-sized HCC, were analyzed. DCP levels were determined in three different ways: 1) conventional EIA, 2) the overnight method, similar to the conventional EIA but the first reaction (immunoreaction of DCP with the monoclonal antibody) was proceeded overnight, and 3) the avidin-biotin complex (ABC) method.

RESULTS

In 27 patients with HCC ( < or = 3 cm in diameter), the rates of abnormal values obtained by the conventional, the overnight, and the ABC methods were 14.8, 25.9, and 29.6%, respectively. The overnight and the ABC methods comparably increased the sensitivity, whereas the ABC method gave the highest false-positive value in patients with chronic liver diseases (cirrhosis and chronic hepatitis) without HCC. The negative predictive value was 84.9% when AFP and the overnight DCP assays were combined, whereas the true positive rate by the combination assay of the ABC method for DCP and AFP (cut-off level at 200 ng/ml) was 33.3%.

CONCLUSIONS

Two modifications of the conventional EIA for DCP comparably increased the sensitivity, but the overnight method may be of more practical value in terms of specificity and ease. The rate of detection of small-sized HCC by tumor markers alone, however, is not satisfactory even when the modified DCP and AFP measurements are combined.

p53-dependent induction of WAF1 by heat treatment in human glioblastoma cells

Induction of WAF1 expression was investigated after heat treatment (44 degrees C, 30 min) in two human glioblastoma cell lines with the wild-type or a mutant p53 gene. WAF1 accumulation was induced by heat treatment in A-172 cells carrying the wild-type p53 gene but not in T98G cells carrying the mutant p53 gene. We examined whether this phenomenon was due to the induction of WAF1 expression. Northern blot analysis showed that heat treatment not only activated WAF1 but also up-regulated p53 expression only in A-172 cells carrying the wild-type p53 gene. Gel mobility shift assay indicated an increase in p53 DNA binding activity after heat treatment. These findings suggest that the WAF1 expression is heat-inducible in human glioblastoma cells and that this induction may be due to signal transduction mediated by p53 in response to heat stress.

Large neurons in the tuberomammillary nucleus in patients with Parkinson's disease and multiple system atrophy

To investigate whether the histaminergic neurons degenerate in Parkinson's disease (PD) and multiple system atrophy (MSA), we studied the number of large-sized neurons in the tuberomammillary nucleus in patients with PD, patients with MSA, and age-matched controls. The number of large-sized neurons in the tuberomammillary nucleus in PD patients was not altered compared with controls, and Lewy bodies were rarely present in the tuberomammillary nucleus. In contrast, the number of large-sized neurons in the tuberomammillary nucleus in MSA patients was significantly decreased compared with controls. Thus, the central histaminergic neurons are affected in MSA and preserved in PD.

Schistosoma mansoni infestation: an imported case of a Japanese patient

A 25-year-old male Japanese who had resided in Ethiopia, presented to our department with eosinophilia, which had been present for about 1 year. Stool examination revealed eggs of Schistosoma mansoni containing miracidia with flame cell activity, and he was diagnosed as having an infestation with this organism. He was treated with praziquantel, and a good parasitological therapeutic result was obtained. Although schistosomiasis mansoni is unfamiliar to Japanese doctors because the infecting organisms are not indigenous to Japan, doctors should be aware of this disease when they encounter patients with eosinophilia who have visited or resided in tropical developing countries.

beta-Amyloid protein-dependent nitric oxide production from microglial cells and neurotoxicity

beta-Amyloid protein (A beta) is the major component of the senile plaques in Alzheimer's disease (AD), and microglial cells have been shown to be closely associated with these plaques. However, the roles of A beta and microglial cells in pathogenesis of AD remain unclear. Incubation of rat microglial cells with A beta(1-40) caused a significant increase in nitrite, a stable metabolite of nitric oxide (NO), in culture media, while there was no detectable increase in nitrite in astrocyte-rich glial cells or cortical neurons after incubation with A beta(1-40). Nitrite production by microglial cells was also induced by A beta(1-42), but not A beta(25-35). An inhibitor of NO synthase, NG-monomethyl-L-arginine (NMMA), as well as dexamethasone and actinomycin D, dose-dependently inhibited this nitrite production. Among the various cytokines investigated such as interleukin-1, interleukin-6, tumor necrosis factor-alpha and interferon-gamma (IFN-gamma), only IFN-gamma markedly enhanced A beta-dependent nitrite production. Cultured cortical neurons were injured by microglial cells stimulated with A beta in a dose-dependent manner in the presence of IFN-gamma. Neurotoxicity caused by the A beta plus IFN-gamma-stimulated microglial cells was significantly attenuated by NMMA. Thus, although further investigations into the effect of A beta on human microglial cells are needed, it is likely that A beta-induced NO production by microglial cells is one mechanism of the neuronal death in AD.

Prognosis of small hepatocellular carcinoma (less than 3 cm) after percutaneous acetic acid injection: study of 91 cases

To assess the efficacy of ultrasound (US)-guided percutaneous acetic acid (in concentrations of 15%, 20%, 30%, 40%, and 50%) injection for small hepatocellular carcinomas (HCCs) for long-term prognosis, percutaneous acetic acid injection using 15% to 50% acetic acid was performed in 91 patients with one to four HCCs smaller than 3 cm during the past 6.5 years. During the series of treatment sessions for each patient, the same concentration of acetic acid was used. All tumors could be treated successfully with percutaneous acetic acid injection despite the differences in acetic acid concentration used. The number of treatment sessions to treat similar size of tumor was less when the higher concentration of acetic acid was used. No serious complications occurred as a direct sequela to percutaneous acetic acid injection. None of the tumor treated regrew. The 1-, 2-, 3-, 4-, and 5-year survival rates for 91 patients were 95%, 87%, 80%, 63%, and 49%, respectively. The 1-, 2-, 3-, 4-, and 5-year cancer-free survival rates of these patients were 83%, 54%, 50%, 37%, and 29%, respectively. Both liver function and size of tumor affected both survival rate and cancer-free survival rate significantly, but the number of tumors did not. The concentration of acetic acid did not affect the survival rate. Percutaneous acetic acid using 15% to 50% acetic acid will be effective therapy for small HCCs for long-term prognosis.

Crystallization and preliminary X-ray analysis of salicylate hydroxylase from Pseudomonas putida S-1

Apo-salicylate hydroxylase from Pseudomonas putida S-1 has been crystallized by the dialysis method, using ammonium sulfate as the precipitant. The crystals belong to hexagonal space group P6(2) or P6(4) with unit cell dimensions of a = b = 142.8 A and c = 63.8 A, and diffract X-rays at higher than 3.5 A resolution. A heavy-atom derivative has been prepared by soaking a crystal in an ammonium sulfate solution containing p-chloromercuriphenylsulfonate.

Expression of multidrug resistance P-glycoprotein in myeloid progenitor cells of different phenotype: comparison between normal bone marrow cells and leukaemia cells

We examined the multidrug resistant P-glycoprotein (P-gp) on normal bone marrow (BM) cells and acute myeloid leukaemia (AMI) cells, using newly devised flow cytometric multi-parameter analysis with CD33, CD34 and MRK16 monoclonal antibodies. In both normal BM cells and AML cells, CD34+CD33- cells expressed P-gp strongly, CD34+CD33- cells moderately, and CD34-CD33+ cells weakly. Acute promyelocytic leukaemia, mainly expressing CD34-CD33+ but not CD34+CD33- at diagnosis, expressed less P-gp. P-gp expression of AML cells at diagnosis was increased as compared with normal cells of the same phenotype. P-gp expression was more increased in relapsed cases, especially in immature subpopulations.

Malaria--eight years of experience in a Tokyo metropolitan hospital

Malaria patients who were admitted to the Department of Infectious Diseases of the Tokyo Metropolitan Bokutoh General Hospital during the past 8 years are reviewed. Cases included 17 patients infected with Plasmodium falciparum (14 Japanese), 13 patients infected with P. vivax (9 Japanese), 3 patients infected with P. ovale (2 Japanese) and 1 Chinese patient with a mixed infection of P. falciparum and P. vivax. About 70% of Japanese patients infected with P. falciparum contracted the disease in Africa, about 90% P. vivax-infected Japanese patients contracted the disease in Asia and all P. ovale-infected patients contracted the disease in Africa. Only 13% of all (17% of Japanese) patients infected with P. falciparum who initially contracted doctors of other Japanese hospitals were correctly diagnosed, but 78% of all (67% of Japanese) patients infected with P. vivax who initially contacted doctors of other Japanese hospitals were correctly diagnosed. At present, malaria is not a rare disease in Tokyo among travelers to or from Africa or Asia.

Flow cytometric DNA content analysis on squamous cell carcinomas according to the preceding lesions

DNA-ploidy in primary cutaneous squamous cell carcinomas which had developed from different preceding clinical lesions was examined by flow cytometry using paraffin-embedded blocks. DNA-aneuploidy was detected in none of 15 squamous cell carcinomas arising from a burn scar. On the other hand, 12 of 26 squamous cell carcinomas arising from sun-damaged skin in the elderly, and two of four arising from chronic radiodermatitis, showed aneuploid patterns. A significantly higher incidence of DNA-aneuploidy was observed in squamous cell carcinomas arising from sun-damaged skin than those from a burn scar (P < 0.01); the mean diameter size of the former was significantly smaller than that of the latter (P < 0.0001). The mean age of patients with aneuploid tumours (74.2 +/- 9.2: years +/- standard deviation (SD)) was significantly higher than that with diploid tumours (64.1 +/- 13.8) (P < 0.01).

[Basic and clinical studies of pazufloxacin on infectious enteritis research group of T-3761 on infectious enteritis]

A clinical study was carried out on pazufloxacin (PZFX) in 137 patients including shigellosis, Salmonella enteritis, enteropathogenic Esherichia coli enteritis and cholera, and carriers of these pathogens. Antibacterial activity of PZFX against clinical isolates, fecal concentration of PZFX and effects of PZFX on fecal microflora were also investigated. The overall clinical efficacy rate was 97.2%. The bacteriological efficacy rates were 98.2% against Shigella spp., 81.8% against Salmonella spp., 50% against Vibrio cholerae O1, and 100% against E. coli, V. parahaemolyticus, Aeronomas spp., Plesionomas shigelloides and V. cholerae non-O1, respectively. Side effect (epigastralgia) was observed in 1 of 130 cases (0.8%). The rate of abnormal laboratory findings was 11.2% (11/98). These were mainly elevation of GOT and/or GPT and increased eosinophils. The clinical usefulness rate was 95.2%. The MIC90 values of PZFX against Shigella spp., Salmonella spp. and E. coli were 0.025, 0.025 and 0.025 micrograms/ml, respectively. The results of fecal drug concentration and the effects on fecal microflora in one patient were compatible with those obtained in healthy volunteers.

Allergic reaction involving liver dysfunction and disseminated intravascular coagulation caused by a health food, Proporis

A 43-year-old woman was hospitalized with skin eruption and liver dysfunction complicated with disseminated intravascular coagulation (DIC) after taking Proporis, a so-called health food. Her clinical course was well correlated with discontinuation and the retaking of Proporis. No other reason for the development of DIC was detected except for allergic reaction to Proporis, as demonstrated by a patch skin test. DIC subsided after the discontinuation of Proporis and treatment with gabexate mesilate and heparin. The consumption of health foods with various ingredients is recently increasing. Thus, attention should be paid to any possible serious allergic reaction related to such foods.

Expression of granulocyte colony-stimulating factor receptor increases with differentiation in myeloid cells by a newly-devised quantitative flow-cytometric assay

In order to develop a non-isotopic quantitative assay of granulocyte colony-stimulating factor (G-CSF) receptors on human or murine cells, we devised a flow-cytometric assay using cells stained with biotin-labelled G-CSF (b-G-CSF) and a streptavidin-RED670 conjugate. For quantification, we applied the Kolmogorov-Smirnov test and calculated the D value. The D value was evaluated from the degree of shift in two fluorescence profiles according to the increase of fluorescence intensity due to the specific binding of b-G-CSF to G-CSF receptors. A good correlation was observed between the number of G-CSF receptors obtained by the radioisotopic binding assay and the number calculated from the D value by the flow-cytometric assay. Then, expression of G-CSF receptors on human bone marrow cells, peripheral blood granulocytes and blast cells from patients with acute myeloid leukaemia (AML) were studied. G-CSF receptors was expressed on CD34+CD33-, CD34+CD33+ and CD34-CD33+ cells in the following order: CD34-CD33+ > CD34+CD33+ > CD34+CD33- cells, indicating that the receptors increased with maturation. The receptor levels of CD34-CD33+ cells in bone marrow were apparently lower than those of CD34-CD33+ cells in peripheral blood granulocytes. On the other hand, an abnormal expression pattern of G-CSF receptors was noted in AML blast cells.

Monoamine oxidase-B-positive granular structures in the hippocampus of aged senescence-accelerated mouse (SAMP8)

We examined the histochemical localization of monoamine oxidase in the hippocampus of young and old senescence-accelerated mouse (SAM). We found a monoamine oxidase-B-positive granular structure (MGS) in the hippocampus of old SAMP8, an accelerated senescence-prone line of SAM. The MGS was a round-shaped granular structure of 0.5 to 5 microns diameter and usually formed a cluster, the largest diameter of which ranged from 50 to 150 microns. No MGS were found in the hippocampus of young SAMP8 or of young SAMR1, an accelerated senescence resistant line of SAM, and only few, if any, were seen in old SAMR1. A monoamine oxidase-positive astrocyte was usually observed in the central area of each cluster of MGS. Furthermore, the MGS was in close anatomical relationship with monoamine oxidase-positive astrocytic processes. The enzyme inhibition experiments showed that monoamine oxidase activities localized in the MGS and astrocytes were both predominantly of type B. These findings suggest MGS occurs at least partly in monoamine oxidase-B-positive astrocytes. Furthermore, the MGS was similar to a periodic acid-Schiff-positive granular structure, a polyglucosan body previously documented in the brains of old SAMP8 and some other aged mice strains including C57BL/6 and nude mice, in terms of their size, morphological appearances and topographical distribution in the hippocampus. Thus, the present results suggest that monoamine oxidase type B is a proteinaceous component of the periodic acid-Schiff-positive granular structure in aged mice brains, and might provide some clues for clarifying the mechanisms of age-related occurrence of periodic acid-Schiff-positive granular structures in mice brains.

Leukocytapheresis therapy with leukocyte removal filter for inflammatory bowel disease

Leukocytapheresis (LCAP) with a leukocyte removal filter was administered to 44 patients with inflammatory bowel disease (IBD), diagnosed as ulcerative colitis (UC) in 25 and Crohn's disease (CD) in 19. Clinical and blood examinations showed no side effects in any of the patients. During intensive therapy, clinical improvement was recognized in 21 of the 25 UC patients (84%), 8 of whom had an excellent response, and in 16 of the 19 CD patients (84.2%), 4 of whom had an excellent response. The clinical improvement continued throughout the maintenance therapy in 19 of the UC patients (76%) and in 12 of the CD patients (63.2%). In both the UC and the CD patients, flow cytometry study showed that those who had improved generally had high values for the percentages of HLADR+, HLADR+CD3+, HLADR+CD8+, and CD11a+CD8+ cells before the first LCAP, and that these values decreased to near the normal range after both intensive and maintenance therapy. In the patients who showed poor response, in contrast, the values had been at or near normal before the initial LCAP administration. The clinical improvement and the findings on flow cytometry suggest that LCAP exerts an immuno-modulatory effect and is an effective therapy for patients with IBD in whom conventional drug treatments have failed.

Determining surgical indications for acute type B dissection based on enlargement of aortic diameter during the chronic phase

BACKGROUND

In patients with Stanford type B dissection who have been treated successfully with medical hypotensive therapy during the acute phase, a large number have incurred the risk of surgery during their chronic phases because of enlargement of the dissected aorta. The purpose of this study was to determine the indications for surgical treatment of acute type B dissection by studying chronic-phase enlargements of aortic dissections in patients treated successfully with medical hypotensive therapy during the acute phase.

METHODS AND RESULTS

In 41 patients with type B dissection who had been treated medically during the acute phase, univariate and multivariate factor analyses were made to determine the predominant predictors for chronic-phase enlargement (> or = 60 mm) of the dissected aorta. Computed tomography was performed every 4 to 14 months to observe whether there was enlargement of the maximum aortic diameter. The predominant predictors for aortic enlargement in the chronic phase were the existence of a maximum aortic diameter of > or = 40 mm during the acute phase (P < .001) and a patent primary entry site in the thoracic aorta (P = .001). The values of actuarial freedom from aortic enlargement for the patients with a large aortic diameter (> or = 40 mm) during the acute phase and a patent primary entry site in the thorax at 1, 3, and 5 years were 70%, 29%, and 22%, respectively. No aortic enlargement was observed in the other patients throughout the entire follow-up period.

CONCLUSIONS

These data suggest that patients with acute type B dissection who have a large aortic diameter (> or = 40 mm) and a patent primary entry site in the thorax should be treated surgically during the acute phase on the condition that the surgical risk in this phase is limited.

[A surgical treatment of ruptured aortic dissection with non-opacified false lumen]

A 63-year-old woman was admitted to our intensive care unit suffering from severe chest pain and shock. Emergency CT scan demonstrated an acute type A aortic dissection with non-opacified false lumen and cardiac tamponade. The aortography showed ulcer like projection at the ascending aorta. An emergency operation was performed to replace the ascending aorta with a woven double-velour Dacron graft of 30 mm in diameter. It seems that an acute type A aortic dissection with non-opacified false lumen has good prognosis. The presence of other complications, however, suggests that surgical treatment should be decided upon at an early stage.