Acceptance of primary skin graft after treatment with anti-intercellular adhesion molecule-1 and anti-leukocyte function-associated antigen-1 monoclonal antibodies in mice

Although a short-term blockade of intercellular adhesion molecule-1 (ICAM-1) and leukocyte function-associated antigen-1 (LFA-1) adhesion allows induction of specific tolerance to solid organs, their effect on primary skin allografts is not yet known. Effects of anti-ICAM-1 and anti-LFA-1 monoclonal antibodies (mAb) on primary skin allograft survival were investigated. Recipient mice were treated with either a combination of anti-ICAM-1 and anti-LFA-1 mAbs or a control mAb for the first 22 days. The survival of BALB/c skin in the C3H/He recipient was not prolonged. Subsequently, MHC class I (bm1)- or class II (bm12)-disparate skin grafts were transplanted into C57BL/6 mice. Remarkable prolongation was observed in these combinations. Four of 10 bm12 grafts and 4 of 9 bm1 grafts were accepted for more than 120 days. These results suggest that mouse strain combination is an important factor for skin graft acceptance. We suggest that unique immunogenicity and a lack of vascularization of skin allografts account for the weak immunosuppression produced by anti-adhesion molecule mAbs.

[Crystal forms, improvements of dissolution and absorption of poorly water-soluble (R)-1-[2,3-dihydro-1-(2'-methylphenacyl)-2-oxo-5-phenyl-1H-1, 4-benzodiazepin-3-yl]-3-(3-methylphenyl)urea (YM022)]

Polymorphs of (R)-1-[2,3-dihydro-1-(2'-methylphenacyl)-2-oxo-5-phenyl-1H-1,4- benzodiazepin-3-yl]-3-(3-methylphenyl)urea (YM022) were investigated. Two crystalline forms (alpha- and beta-forms) of YM022 were confirmed by powder X-ray diffractometry and differential scanning calorimetry. alpha- And beta-forms were obtained by recrystallization from ethanol and ethanol: water (5:1), respectively. Amorphous YM022 was obtained by spray drying of YM022 methanol solution. Since both crystalline and amorphous YM022 were sparingly soluble in water, solubilization of YM022 by solid dispersion and wet grinding methods were performed. In vitro dissolution study and in vivo absorption study in dogs were carried out using spray-dried solid dispersion, heat-treated solid dispersion and mechanical mixture. Spray-dried solid dispersion and heat-treated solid dispersion showed enhanced bioavailability, whereas mechanical mixture showed no improvement.

Common carotid artery wall properties in Takayasu's arteritis

The vessel wall properties of the common carotid artery have been noninvasively and quantitatively assessed with an ultrasonic instrument. Stiffness parameter beta, which represents the mechanical properties of the vessel, was calculated from the relationship between blood pressure and the diameter of the artery. There are no reports that quantitatively assess wall properties in Takayasu's arteritis. The authors compared, in vivo, the vessel wall properties of the common carotid artery in 14 patients with Takayasu's arteritis versus those in 60 normal subjects (controls). They measured changes in the inner diameter of the artery between systole and diastole with an ultrasonic, phase-locked, echo-tracking system. Beta was significantly higher in Takayasu's arteritis than in normal subjects (better than a 99% confidence interval). The findings for each decade were as follows: 3rd decade (20s): 35.7 +/- 28.9 vs 5.01-6.46, P=0.0001; 4th decade (30s): 19.5 +/- 9.71 vs 6.09-7.80, P=0.02; 5th decade (40s): 26.2 +/- 11.3 vs 7.26-9.28, P = 0.0001; 6th decade (50s): 19.1 +/- 4.27 vs 8.66-11.25, P = 0.0001. Takayasu's arteritis significantly impaired the mechanical performance of the common carotid artery. Thus, beta shows promise as a useful diagnostic indicator of Takayasu's arteritis.

[A 4-week intravenous toxicity study of the active metabolite (NM394) of prulifloxacin (NM441) in rats followed by a 4-week recovery test]

A repeated dose toxicity study of ( +/- )-6- fluoro-1-methyl-4-oxo-7-(1-piperazinyl)-4H- [1,3]thiazeto[3,2-a]quinoline-3-carboxylic acid (NM394), the active metabolite of a new antibacterial agent, prulifloxacin, was conducted in Sprague-Dawley rats. Male and female rats were given the test material intravenously for 4 weeks at doses of 0 (control), 3, 10 and 30 mg/kg. After discontinuation of the treatment, a 4-week recovery test was also conducted. There were no treatment-related effects on survival, clinical signs, body weight and food consumption. Ophthalmoscopic and hematologic examinations failed to show any abnormalities related to the treatment. Increased water consumption was observed in the 10 and 30 mg/kg groups. In these dose groups, increased urine volume and lowered urine specific gravity, and crystalline substance and small epithelial cells in urinary sediments were seen. Cloudy urine was also seen in the 30 mg/kg group. Blood chemical examination showed decreased gamma-globulin in the 10 and 30 mg/kg groups and increased BUN and creatinine in the 30 mg/kg group. Pathological changes caused by the treatment were as follows. In kidney, tubular nephrosis with crystalline substance was observed in the 10 and 30 mg/kg groups and its organ weight was increased in the 30 mg/kg group. Cecal weight was increased in the 30 mg/kg group. The above-mentioned changes were reversible except for decreased gamma-globulin. Plasma levels and urinary concentrations of the test material were increased in all dose groups with dose-related manner, whereby no sex differences were observed. No effects caused by the repeated dosing were seen in the plasma concentrations. Toxicological findings were not observed in the 3 mg/kg group. The results show that the NOAEL of NM394 is 3 mg/kg for 4-week repeated dose toxicity in rats.

Adverse events associated with MMR vaccines in Japan

The largest nationwide active surveillance of four Measles-Mumps-Rubella (MMR) vaccines was conducted in Japan. A total of 1255 pediatricians actively participated in the study, which comprised 8.6% of all members of the Japanese Pediatric Society. The total number of registered recipients of MMR vaccines was 38 203. They were arbitrarily given one of the MMR vaccines produced by three makers (Takeda, Osaka city, Kitasato Minato-ku. Tokyo and Biken Suita city, Japan) or the standard MMR vaccine made of designated strains (Kitasato's measles-AIK-C, Biken's mumps-Urabe Am9 and Takeda's rubella-To336) produced by Takeda, Kitasato and Biken and were observed for 35 days. The rates of virologically confirmed aseptic meningitis per 10,000 recipients were 16.6, 11.6, 3.2 and 0 for the standard MMR, Takeda MMR, Kitasato MMR and Biken MMR vaccines, respectively. The incidence of convulsions between 15 and 35 days was the highest with the standard MMR vaccine and the incidence of fever associated with vomiting occurring between 15 and 35 days (symptoms relevant to aseptic meningitis) were also the highest with the standard MMR vaccine. The incidence of parotid swelling was the lowest with Takeda MMR vaccine. This surveillance revealed that incidences of aseptic meningitis after administration of the standard MMR vaccine and of Biken MMR vaccine were different. This posed questions about the manufacturing consistency of the Urabe Am9 mumps virus vaccines. On the other hand, the National Institute of Health found that the biological characteristics of the Urabe Am9 mumps virus contained in the standard MMR vaccine and in the Biken MMR vaccine were different. The Biken Company reported that the mumps vaccine in the standard MMR vaccine was a mixture of two Urabe Am9 mumps vaccine bulks; one identical to that contained in the Biken MMR vaccine and the other produced by a different manufacturing process.

[A 4-week oral toxicity study of prulifloxacin (NM441) in rats followed by a 4-week recovery test]

A repeated dose toxicity study of prulifloxacin, a new antibacterial agent, was conducted in Sprague-Dawley rats. Male and female rats were given the test material orally for 4 weeks at doses of 0 (control), 30, 300 and 3000 mg/kg. After discontinuation of the treatment, a 4-week recovery test was also conducted. There was one case of death in the 3000 mg/kg group. Grayish green and soft feces, unkempt fur, transient deep respiration and decreased body weight gain were observed in the 3000 mg/kg group. Decreased food consumption and increased water intake were seen in the 300 and 3000 mg/kg groups. Ophthalmoscopic examination failed to show any abnormalities related to the treatment. In urinalysis, crystalline substance in the urinary sediments, cloudy urine and decreased Na+ excretion were observed in the 300 and 3000 mg/kg groups. Increased urine volume, lowered urine specific gravity and decreased K+ and Cl- excretions were seen in the 3000 mg/kg group. Hematologic examination showed decreased Hb, Ht, MCV and MCH and increased WBC in the 3000 mg/kg group. Blood chemical examination revealed increased BUN and decreased K+ and Cl- in the 3000 mg/kg group, and decreased K+ and gamma-globulin in the 300 mg/kg group. Pathological changes caused by the treatment were as follows. Cecal weight was increased in all dose groups. Cecal distention and swelling of its absorptive cells were seen in the 300 and 3000 mg/kg groups. In kidney, tubular nephrosis with crystalline substance was observed in the 300 and 3000 mg/kg groups, and its organ weight was increased in the 3000 mg/kg group. The above-mentioned changes were reversible except for decreased gamma-globulin, increased BUN and urine volume, and lowered urine specific gravity. Ulcer and small cavities associated with proliferation of fibrous tissue in the femoral articular cartilage were observed in the 3000 mg/kg group at the end of recovery period of 4 weeks. Plasma levels and urinary concentrations of active metabolite of the test material were increased in all dose groups with dose-related manner, whereby no sex difference was observed. No effects caused by the repeated dosing were seen in the plasma concentrations. Increased cecal weight in the 30 mg/kg group was considered to be attributable to the pharmacological effect of the test material. The results show that the NOAEL of prulifloxacin is 30 mg/kg for 4-week repeated dose toxicity in rats.

Intrahepatic cholangiocarcinoma presenting intrabile duct tumor growth: report of a case

A case of intrahepatic cholangiocarcinoma with intrabile duct tumor growth is presented. A 70-year-old female with prolonged obstructive jaundice and cholangitis was diagnosed with a mass lesion in the left lobe of the liver accompanied by an intrabile duct component which caused hilar bile duct obstruction. Percutaneous transhepatic biliary drainage (PTBD) was performed via three routes with intensive care of the drainage catheters over a 2-month period to alleviate jaundice and cholangitis. Extended left hepatic lobectomy with combined resection of extrahepatic bile duct and regional lymph nodes were carried out curatively. Macroscopically, a tumor formed a 8 x 6 cm mass with a scalloped margin in the left lobe and had an intraductal component with a round smooth surface protruding from the lumen of the left hepatic duct into the common bile duct. The histologic type of the tumor was well differentiated tubular adenocarcinoma. The intraluminal tumor grew expansively without invasion to the bile duct wall. The postoperative course was uneventful and the patient has remained in good health without recurrence for 1 year and 3 months since surgery. This case report discusses a rare extension pattern in ICC and the management of malignant hilar obstruction during radical surgery.

Isolation and characterization of mumps virus strains in a mumps outbreak with a high incidence of aseptic meningitis

In 1993, mumps with a high incidence of aseptic meningitis became prevalent in Akita prefecture, Japan. Three mumps virus isolates obtained from the nonvaccine-associated cases lacked the BamHI restriction cleavage site of the P gene, like the Urabe strain (Yamada, A. et al, Vaccine 8: 553-557). However, four additional nucleotide substitutions were found in the determined region of 157 bp. Fourteen of 19 cases from which mumps virus showing the Urabe-like RFLP profile was detected were complicated with symptomatic meningitis, whereas there were only four cases of meningitis among 23 individuals infected with the wild type showing no Urabe-like RFLP profile (non-"Urabe-like" wild-type). The incidence of meningitis was over 70% among patients infected with the "Urabe-like" wild-type virus. The "Urabe-like" wild-type. disappeared after February 1994 in the epidemic area and was replaced by the non-"Urabe-like" wild-type. Patients infected with the "Urabe-like" wild-type lived in a closed colony, in which there were two instances of transmission between siblings. Thus this outbreak was transient and narrowly localized.

Adenomyoepithelioma of the Breast: A Case Reprot and a Review of Literature

A 74-year-old woman complained of a small nodule in the outer lower quadrant of her left breast. On physical examination, a 0.9 x 0.8 cm, round-shaped and firmly elastic nodule was palpated. Excisional biopsy was performed. Histologically, the tumor was separated into, with a bicellular pattern, containing both numerous glandular structures and numerous spindle-shaped cells. Immunohistochemical staining for EMA and cytokeratin showed strongly positive immunoreactivity for epithelial cells. Staining for &aipha;-SMA showed strongly positive immunoreactivity for myoepithelial components. Staining for keratin and S-100 protein showed weakly positive immunoreactivity for myoepithelial cells. Microscopically, the tumor was diagnosed as adenomyoepithelioma of the breast. Immunohistochemical examination is needed to distinguish epithelial cell proliferation from myoepithelial cell proliferation. Immunohistochemical examination using antibodies against EMA, alpha-SMA, Keratin, cytokeratin and S-100 protein, is indispensable.

Cutaneous myiasis due to Dermatobia hominis in Japan

A 29-year-old man with a furuncle-like lesion brought in a maggot on the next day after his first visit to our clinic. He said it moved out from the eruption spontaneously. He had previously visited Parana and Sao Paulo in Brazil before he noticed the symptom. The maggot was confirmed to be a third instar larva of Dermatobia hominis. Japanese cases of cutaneous myiasis are reviewed.

Derivation of T-cell receptor alpha-chain double expresser lines from normal murine mature T cells

Because the T-cell receptor (TCR) alpha-chain locus is known to lack allelic exclusion of rearrangements, and as a recent report revealed the existence of alpha-chain double expressers among normal human peripheral blood lymphocytes (PBL), the possible existence of TCR alpha-chain double expressers among mature murine T cells was examined. Although two-colour staining analysis of normal T-cell populations did not immediately reveal recognizable clusters of V alpha double expressers, alternative in vitro stimulations of normal murine T cells with antibodies to two different TCR V alpha chains reproducibly induced TCR alpha-chain double-expresser lines. TCR complexes with different alpha-chains on such T cells were both shown to be functional. The cell lines were heterogeneous with respect to V beta usage and the ratio of the expressed amounts of the two alpha-chains on the surface. The ratio of the two expressed alpha-chains was found to be very stable over a long period of time. These results are consistent with the earlier report on alpha-chain double expressers among human T cells and also show normal occurrence of TCR alpha-chain double expressers in murine T-cell populations.

Reverse transcription-polymerase chain reaction detection and sequence analysis of small round-structured viruses in Japan

Between 1985 and 1995, mass outbreaks of acute gastroenteritis caused by small round-structured virus (SRSV), occurred in eight prefectures in Japan. Fecal samples from 59 patients ill during these outbreaks were recently examined in our laboratory by electron microscopy (EM) and by reverse transcription-polymerase chain reaction (RT-PCR). For RT-PCR, we prepared two sets of primers, a set corresponding to the polymerase region of open reading frame 1 (ORF-1) and a set corresponding to the capsid region of ORF-2 of Norwalk virus (NV). The SRSV nucleic acid detection rate with these primers was more than double that achieved with EM. Most samples found by EM to contain virus particles were also positive by PCR. When the two sets of primers were used separately, the virus detection rate differed depending on the primer used, suggesting that the viral strains examined were not genetically not homogeneous. We then selected nine strains of the virus, cloned their PCR products and analyzed their base sequences. The base sequences of these strains were compared with those of reference strains including prototype NV and Snow Mountain agent (SMA). This comparison yielded the following findings: (1) SRSVs that cause mass outbreaks of gastroenteritis in Japan are genetically variable; (2) SRSV strains that are genetically similar to SMA and SRSV-OTH 25/89/J(OTH25) are dominant in Japan, but strains similar to NV are also present in this country; and (3) a strain (MI1/94) which is genetically identical to Southampton virus (SHV) was detected. Detection of SRSV using sensitive RT-PCR and analysis of the sequences of the amplification products seems to provide a useful means of studying the molecular epidemiology of SRSV.

Human T-lymphotropic virus type II in Japan

Serum specimens were assayed for human T-lymphotropic virus type II(HTLV-II) infection in 1,500 individuals known to be seropositive for HTLV-I and 30,000 blood donors in Japan. All HTLV-I-positive individuals were negative for HTLV-II. However, one of the blood donors was clearly seropositive for HTLV-II. Further, the donor was shown to be positive for HTLV-IIb. Here we report at least one case with HTLV-II in Japan and discuss the origin of the infection.

Production of chemotactic factor(s) of Langerhans cells by lymph node cells in contact sensitivity

Langerhans cells (LCs) have to leave the epidermis to migrate into the regional lymph node (LN) after receiving immunogenic signals in contact sensitivity. There should be some molecules responsible for migration of LC in this process. In order to determine whether LN cells can generate such regulatory molecules, we made a search of such molecules in the culture supernatant of LN cells obtained from hapten-painted mice by using a modified Boyden chamber method. The molecule of LC chemotaxis appeared in the culture supernatant at 24 h after hapten painting and its production declined with time thereafter. Antibodies against both ICAM-1 and LFA-1 partially inhibited the chemotactic activity, but this was not the case with anti-TNF-alpha antibody, anti-GM-CSF antibody, fibronectin RGDS. RGES peptide or laminin. The molecule was heat labile and appeared as a molecule of 45-68 kDa on high performance liquid chromatography. Our results suggest that LN cells generate one of the chemotactic molecules of LCs, by which LC can migrate to the regional LN in contact sensitivity.

[Seroepidemiology of human parvovirus B19 using recombinant VP1 + VP2 particle antigen]

Antibody prevalence to B19 virus in Japan was previously reported with 1973 and 1984 serum collections. Since then we have had two big epidemics of erythema infectiosum in Japan: 1986-87 and 1991-92. In an attempt to estimate how much those epidemics have affected seroprevalence to B19 virus infection, we studied seroepidemiology in three separate areas using a newly developed ELISA system consisting of recombinant VP1 + VP2 particle antigen. Total of 900 sera obtained in 1993 from healthy individuals living in northern, central and southwest parts of Japan were assayed for the presence of anti B19 IgG antibody. In the first, the new assay system was compared with our conventional assay system in which native B19 virus particles were used as antigen. Of 220 serum samples tested, 212 (96.4%) gave same results in both assays. Remaining 8 samples which gave variable results were those of near cut off values. We concluded that this new ELISA system can be recommended for seroepidemiological use. Antibody prevalence rates were 10% (0-4 y), 54% (5-9 y), 59% (10-14 y), 46% (15-19 Y), 38% (20-29 y), 48% (30-39 y), 64% (40-49y) and 76% (50 y-). No gender difference was observed. Comparison of antibody prevalences in 1973, 1984 and 1993 suggested that approximately 10% (about 8 million people) of the total population under 40 years of age acquired immunity to B19 virus during one epidemic period.

Protective immune responses induced by secretion of a chimeric soluble protein from a recombinant Mycobacterium bovis bacillus Calmette-Guérin vector candidate vaccine for human immunodeficiency virus type 1 in small animals

A recombinant Mycobacterium bovis bacillus Calmette-Guérin (BCG) vector-based vaccine that secretes the V3 principal neutralizing epitope of human immunodeficiency virus (HIV) could induce immune response to the epitope and prevent the viral infection. By using the Japanese consensus sequence of HIV-1, we successfully constructed chimeric protein secretion vectors by selecting an appropriate insertion site of a carrier protein and established the principal neutralizing determinant (PND)-peptide secretion system in BCG. The recombinant BCG (rBCG)-inoculated guinea pigs were initially screened by delayed-type hypersensitivity (DTH) skin reactions to the PND peptide, followed by passive transfer of the DTH by the systemic route. Further, immunization of mice with the rBCG resulted in induction of cytotoxic T lymphocytes. The guinea pig immune antisera showed elevated titers to the PND peptide and neutralized HIVMN, and administration of serum IgG from the vaccinated guinea pigs was effective in completely blocking the HIV infection in thymus/liver transplanted severe combined immunodeficiency (SCID)/hu or SCID/PBL mice. In addition, the immune serum IgG was shown to neutralize primary field isolates of HIV that match the neutralizing sequence motif by a peripheral blood mononuclear cell-based virus neutralization assay. The data support the idea that the antigen-secreting rBCG system can be used as a tool for development of HIV vaccines.

[A case of Addison's disease complicated by lung carcinoma treated with surgical resection--a case report]

Surgery was successful in a 72-year-old man with Addison's disease complicated by right lower lobe carcinoma of the lung. The patient had been diagnosed Addison's disease 25 years earlier and had been treated with cortisone acetate 25 mg every morning. A tumor shadow was found in the right lower lobe of the lung on chest X-ray. Squamous cell carcinoma was diagnosed by cytological examination. Right lower lobectomy with partial resection of the right diaphragma and lymph-node dissection were performed. The bronchial stump was closed using Sweet's method and covered with a pericardial fat pad. The intra- and post-operative course was uneventful with intravenous administration of adequate doses of hydrocortisone. The patient has been free from the carcinoma for two years.

[Serological diagnosis for human parvovirus B19 infection by an enzyme immunoassay kit with recombinant antigens synthesized in a baculovirus expression system]

Propagation of human parvovirus B19 (B19) in cell cultures are not applicable to the source of viral antigens for serological assays at present. Enzyme immunoassay (EIA) kits with recombinant B19 capsids by E. coli or baculovirus expression system have been developed. We tested serum samples from the patients with erythema infectiosum and aplastic crisis by EIA kit with recombinant antigens synthesized in a baculovirus expression system (Denka Seiken Co., Tokyo, Japan). The antigens used in the kit are self-assembled recombinants containing both VP-1 and VP-2 with the same proportion as found in native B19 capsids. B19 IgM is detected by antibody capture methods and IgG by indirect methods. All of the samples were positive for B19 DNA by nested PCR. Thirty-six (97%) of the 37 patients with erythema infectiosum and all (100%) of the 4 patients with aplastic crisis were positive for B19 IgM. The EIA kit with recombinant antigens synthesized in a baculovirus expression system has proved to be reliable and useful for the diagnosis of B19 infection.