[Late phase II clinical study of RP56976 (docetaxel) in patients with non-small cell lung cancer]

A late phase II clinical study of RP56976 (Docetaxel) was conducted in patients with non-small cell lung cancer. Patients with non-small cell lung cancer in Stage IIIB and Stage IV not previously treated were enrolled. Docetaxel was administered at a dose of 60 mg/m2 based on the results of a phase I and an early phase II clinical study, and the efficacy and safety were examined. Of the 77 patients enrolled, 72 patients were evaluated to have completed the scheduled course of treatment by the Evaluation Committee. A partial response (PR) was seen in 18 patients, and the overall response rate was 25.0%. The response rate classified by clinical stage was 28.0% (7/25) in patients with Stage IIIB and 23.4% (11/47) in patients with Stage IV. Hematological adverse reactions included leukopenia of Grade III or more in 53.3% (40/75) and neutropenia of Grade III or more in 86.7% (65/75) as specified in the Adverse Event Reporting Form proposed by the Japan Society for Cancer Therapy. Other major adverse reactions included alopecia, asthenia, and fever, all of which were tolerable. From these results, the efficacy of docetaxel for the treatment of non-small cell lung cancer was confirmed.

Effects of a daily feeding-restriction on the reproductive and development toxicity parameters in female rats

On the assumption of that the oral administration of an acid-unstable test compound into the empty stomach could enhance the systemic exposure to the test compound, the non-pregnant and pregnant rats had free access to the diet only for five hours per day. Female rats under the restricted feeding for a period of 21 days took diet at two thirds of the daily food-intake by the control animals, and lost their weight more than 10%. The vaginal smear test in these animals revealed a prolonged estrous cycle and diestrous period over four days. On the other hand, the restricted feeding from Day 0 to Day 17 of gestation suppressed the weight gain of pregnant animals but did not cause any significant influence upon the litter data, incidence of external anomalies or fetal skeletal development. The restricted feeding from Day 0 of gestation to Day 7 of lactation seriously disturbed the nursing behavior and the growth of offspring. These results suggested that the dosing method under the above-mentioned restricted feeding might be applicable to the teratology study but could not be applied to the fertility study nor to the peri- and post-natal study.

N-hydroxyarylamine O-acetyltransferase of Salmonella typhimurium: proposal for a common catalytic mechanism of arylamine acetyltransferase enzymes

Acetyl-CoA:N-hydroxyarylamine O-acetyltransferase is an enzyme involved in the metabolic activation of N-hydroxyarylamines derived from mutagenic and carcinogenic aromatic amines and nitroarenes. The O-acetyltransferase gene of Salmonella typhimurium has been cloned, and new Ames tester substrains highly sensitive to mutagenic aromatic amines and nitroarenes have been established in our laboratory. The nucleotide sequence of the O-acetyltransferase gene was determined. There was an open reading frame of 843 nucleotides coding for a protein with a calculated molecular weight of 32,177, which was close to the molecular weight of the O-acetyltransferase protein determined by using the maxicell technique. Only the residue of Cys69 in O-acetyltransferase of S. typhimurium and its corresponding residue (Cys68) in N-acetyltransferase of higher organisms were conserved in all acetyltransferase enzymes sequenced so far. The amino acid sequence Arg-Gly-Gly-X-Cys, including the Cys69, was highly conserved. A mutant O-acetyltransferase of S. typhimurium, which contained Ala69 instead of Cys69, no longer showed the activities of O- and N-acetyltransferase. These results suggest that the Cys69 of S. typhimurium and the corresponding cysteine residues of the higher organisms are essential for the enzyme activities as an acetyl-CoA binding site. We propose a new catalytic model of acetyltransferase for S. typhimurium and the higher organisms.

Effect of aminophylline on plasma [K+] and hypoxic ventilatory response during mild exercise in men

To examine the role of endogenous adenosine on the hypoxic ventilatory response (HVR) enhanced during exercise, we measured HVR at rest and during mild exercise (12.5 W) in nine healthy men in a supine position after pretreatment with aminophylline (5 mg/kg), an adenosine receptor blocker, or dipyridamole (0.6 mg/kg), an adenosine uptake blocker, by using a 3-day double-blind placebo-controlled design. Although HVR was enhanced during exercise on all occasions, HVR with aminophylline [0.42 +/- 0.07 (SE) l.min-1.%fall-1 of arterial O2 saturation] was significantly lower than that with placebo (0.64 +/- 0.13 l.min-1.%fall-1) or dipyridamole (0.64 +/- 0.08 l.min-1.%fall-1) during exercise (P < 0.05 for both) at similar end-tidal PCO2 on the 3 days but not at rest. We then examined the changes in plasma K+ concentration ([K+]) and catecholamines, the other possible endogenous potentiators of the carotid body activity. The exercise- and hypoxia-induced increases in plasma [K+] were significantly lower with aminophylline (0.23 +/- 0.09 meq/l) than with the placebo (0.51 +/- 0.10 meq/l) or dypyridamole (0.58 +/- 0.13 meq/l) (P < 0.05 for both). We therefore conclude that aminophylline attenuates the enhancement of HVR during mild exercise and that this might be due to its attenuating effect on exercise- and hypoxia-associated increases in plasma [K+] rather than due to its antagonizing effect on endogenous adenosine.

Serological survey of HIV-1, HIV-2 and human T-cell leukemia virus type 1 for suspected AIDS cases in Ghana

OBJECTIVE

To determine seroprevalence among suspected AIDS patients in Ghana in relation to clinical manifestations.

MATERIALS AND METHODS

Blood samples and medical records were collected from 290 Ghanaian patients with suspected AIDS in 1990 and 1992. Seroprevalence of HIV-1, HIV-2 and human T-cell leukemia virus (HTLV-1) were investigated by the particle agglutination method, indirect immunofluorescence assay, the monoepitope enzyme-linked immunosorbent assay and Western blot.

RESULTS

The specimens were classified into five serologic categories: 78 were HIV-1-positive (26.9%), 25 were HIV-2-positive (8.6%), 17 dual-positive (5.9%), 16 indeterminate (5.5%) and 154 seronegative (53.1%). No significant difference was found between the clinical symptoms of patients with HIV-1 and HIV-2 infection. Of the patients, 14 (4.8%) were HTLV-1-seropositive, of whom 11 were also HIV-positive, indicating a significant correlation between the two groups of viral infections (P < 0.01). However, there was no evidence of an increase in severity of symptoms in cases of dual infection with HTLV-1 and HIV.

CONCLUSIONS

HIV-1 infection is now dominant in Ghana in contrast to our previous survey in 1986 which showed the dominance of HIV-2. The change in seroprevalence suggests that an HIV-1 epidemic has been developing in recent years in this country, where HIV-2 was originally endemic. A relatively high prevalence of dual-reactive specimens implies the existence of highly cross-reactive strains of HIV or frequent coinfection with HIV-1 and HIV-2 in the region. The large number of seronegative patients with clinically diagnosed AIDS raises the question of the inadequacy of AIDS definitions based on clinical manifestations only.

NF-kappa B and Sp1 regulate transcription of the human monocyte chemoattractant protein-1 gene

Expression of the human monocyte chemoattractant protein-1 (hMCP-1) is ubiquitous in various cell types and is increased by a wide variety of stimuli. We initially found that the effects of various stimuli, including IL-1 beta, TNF-alpha, and 2-O-tetradecanoylphorbol 13-acetate, on the expression of hMCP-1 mRNA were quite different among A172 glioblastoma cells, HT1080 fibrosarcoma cells, and SKLMS1 leiomyosarcoma cells. These findings suggested that hMCP-1 expression is regulated both in a stimulus-specific and a tissue-specific manner. To elucidate the mechanism underlying this stimulus-specific and tissue-specific regulation, we isolated a hMCP-1 5'-flanking genomic DNA fragment and sequenced it extensively up to bp 3011 upstream from the transcriptional start site. Among many putative cis-elements, we identified two cis-elements critical for the transcription of the hMCP-1 gene. The first element is a remote kappa B binding site located far upstream between bp -2612 and -2603 that was important for IL-1 beta-, TNF-alpha-, and 2-O-tetradecanoylphorbol 13-acetate-induced enhancer activity. Mutation at the kappa B consensus site resulted in a complete loss of these stimulus-induced enhancer activities. The second element is a GC box located between bp -64 and -59 that was important for the maintenance of basal transcriptional activity. Overexpression of rSp1 resulted in increased hMCP-1 transcriptional activity, possibly suggesting the role of Sp1 in controlling basal hMCP-1 transcription via this GC box. These results together indicate that hMCP-1 expression is controlled by at least two distinct regulatory elements: a kappa B site and a GC box that seem to be associated with stimulus-specific and tissue-specific regulation, respectively.

Cross-reactivity of IgM- and IgG-secreting B cells in murine chronic graft-versus-host reaction

A chamber ELISpot assay was used to measure the frequency with which in vivo activated B cells secreted cross-reactive antibodies during a chronic graft-versus-host reaction in mice. Both normal (C57BL/10 x DBA/2)F1 mice and F1 recipients of syngeneic spleen cells (SynF1) expressed repertoires in which 13-17% of IgM and 3-5% of IgG-secreting cells were cross-reactive. By comparison, 43-55% of IgM and 9-40% of IgG-secreting cells from F1 recipients of parental DBA/2 spleen cells (GVHF1) were cross-reactive (P < 0.01, GVHF1 versus F1 or SynF1). The cross-reactivity of the GVHF1 IgM secreting cells remained elevated for > 2 months following cell transfer. In contrast, the cross-reactivity of IgG-secreting cells, which was significantly high at Week 3 post-transfer, declined to nearly normal levels by Week 9. These findings demonstrate that cross-reactive B cells constitute an abnormally large fraction of the repertoire expressed by mice with chronic GVHR in a period when B cell hyperstimulation was occurring.

Radiation therapy for prostate cancer confined to pelvis

To evaluate the usefulness of external beam radiotherapy for patients with prostate cancer confined to the pelvis, long-term results and prognostic factors were analyzed. During the period 1975-1989, 44 cases were treated with staging pelvic lymphadenectomy followed by monotherapy using external beam irradiation by Linac X-ray and/or fast neutrons and observed without any treatment until relapse was evident. All patients were followed until death or for a mean of 78.6 mo (range: 36-113 mo) for patients still alive. Four cases died of prostate cancer at 26, 28, 54, and 83 mo from the start of radiation. Eleven cases died of other causes (10-72 mo, mean 36.4 mo). Fourteen cases (31.8%) manifested clinical relapse of cancer; 4 had local relapse, 7 developed bone metastases, and 3 relapsed at lymph nodes. After relapse, endocrine therapy was effective in most cases. The five-year disease-free survival rates of pN0 (32 cases) and pN1 (8 cases) patients were 79.8% and 52.5%, respectively, but that of pN2 (4 cases) was worse. Cause-specific survival was similar between patients with pN0 and pN1 disease, the rate at 5 yr being 92.5% in the former and 100% in the latter. Those with high levels of serum prostate specific antigen (PSA) before treatment and advanced local disease (clinical stage C) showed unfavorable prognoses. The number of argyrophilic nucleolar organizer regions (AgNORs) might be a predictive factor in patients treated with irradiation. In conclusion, prostate cancer patients with stage A2-C, diagnosed as pN0-1 by staging pelvic lymphadenectomy, were successfully treated with external beam radiotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

NF-kappa B and Sp1 regulate transcription of the human monocyte chemoattractant protein-1 gene

Expression of the human monocyte chemoattractant protein-1 (hMCP-1) is ubiquitous in various cell types and is increased by a wide variety of stimuli. We initially found that the effects of various stimuli, including IL-1 beta, TNF-alpha, and 2-O-tetradecanoylphorbol 13-acetate, on the expression of hMCP-1 mRNA were quite different among A172 glioblastoma cells, HT1080 fibrosarcoma cells, and SKLMS1 leiomyosarcoma cells. These findings suggested that hMCP-1 expression is regulated both in a stimulus-specific and a tissue-specific manner. To elucidate the mechanism underlying this stimulus-specific and tissue-specific regulation, we isolated a hMCP-1 5'-flanking genomic DNA fragment and sequenced it extensively up to bp 3011 upstream from the transcriptional start site. Among many putative cis-elements, we identified two cis-elements critical for the transcription of the hMCP-1 gene. The first element is a remote kappa B binding site located far upstream between bp -2612 and -2603 that was important for IL-1 beta-, TNF-alpha-, and 2-O-tetradecanoylphorbol 13-acetate-induced enhancer activity. Mutation at the kappa B consensus site resulted in a complete loss of these stimulus-induced enhancer activities. The second element is a GC box located between bp -64 and -59 that was important for the maintenance of basal transcriptional activity. Overexpression of rSp1 resulted in increased hMCP-1 transcriptional activity, possibly suggesting the role of Sp1 in controlling basal hMCP-1 transcription via this GC box. These results together indicate that hMCP-1 expression is controlled by at least two distinct regulatory elements: a kappa B site and a GC box that seem to be associated with stimulus-specific and tissue-specific regulation, respectively.

[A case of Swyer-James syndrome--a morphological study with inflated fixed lung]

Morphological features of Swyer-James syndrome were studied in a specimen obtained during left pneumonectomy. A 67-year-old woman was admitted because her left lung was hyperlucent and contained a solitary nodule. Primary lung adenocarcinoma complicated with Swyer-James syndrome was diagnosed, and left pneumonectomy done. The left upper lobe was inflated and fixed for morphological study. The volume of the specimen was obviously lower than normal but the bronchial branching was normal. Macroscopically, the specimen had irregular bronchial walls, bronchiectatic changes, and dilation of distal air spaces, similar to panlobular emphysema. Microscopically, there was scarring in periarteriolar regions that suggested bronchiolitis obliterans, enlargement of distal airspaces, and an abnormally low number of capillaries. These findings suggest hypoplasia of the lung due to abnormal lung growth after birth.

Immunochemical evidence for the occurrence of Mu class glutathione S-transferase in human fetal livers

Immunoblot analysis showed that alpha-class glutathione S-transferase (GST), which is one of the major forms in adult human liver, was expressed in human fetal liver. Mu-class GST was also expressed in fetal liver. The majority of mu-class GST expressed in adult liver consisted of a subunit with a molecular weight of 27 kDa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), whereas two subunits of 27 and 26 kDa were detected in fetal liver as proteins immunochemically related to mu-class GST. On reverse-phase HPLC, these two subunits cross-reactive with antibodies to rat GST 3-3 in fetal liver were indistinguishable from each other in their retention time; though, they could be separated by chromatofocusing analysis. The molecular weights of GSTs immunochemically related to rat GST 3-3, eluted at pH 7.1, 6.4, and 5.7, were 27, 27 and 26, and 26 kDa, respectively. In addition, the N-terminal amino acid sequence of these subunits suggested that GSTs related to rat GST 3-3 expressed in fetal liver may be homodimeric and heterodimeric proteins. As expected, pi-class GST was found to be a major form of GST in fetal liver but not in adult liver. In contrast, the GST immunochemically related to rat GST Yrs-Yrs, which is classified as theta-class GST, was detected in adult liver but not in fetal liver. These results indicate that several isoenzymes of GST are expressed in human fetal liver, but they are not the same as those in adult liver.

Persistent infection with SIVmac chimeric virus having tat, rev, vpu, env and nef of HIV type 1 in macaque monkeys

A chimeric human and simian immunodeficiency virus carrying the tat, rev, vpu, env, and nef genes of human immunodeficiency virus type 1 was generated. The chimeric virus, NM-3n, grew competently in peripheral blood mononuclear cells from cynomolgus monkeys like the parental SIVmac. Two cynomolgus monkeys and one rhesus monkey inoculated with NM-3n raised antibodies to SIVmac Gag and HIV-1 Env. The antibodies raised in the cynomolgus monkeys persisted for at least 1.7 years. The antibodies contained virus neutralizing activity not only to the original chimeric virus but also to the parental HIV-1. Infectious viruses were isolated from one of the cynomolgus monkeys 37 and 63 weeks after inoculation and from the rhesus monkey continuously from 6 weeks after infection onward. The recovered virus maintained its chimeric structure but included several clones with mutations in the env V3 region. When the recovered virus was inoculated to another rhesus monkey, no difference in the frequency of virus recovery was seen from the originally infected monkeys. These carrier monkeys have so far shown no sign of the disease.

State of adenomatous polyposis coli gene and ras oncogenes in Japanese prostate cancer

Genetic alterations of ras oncogenes (K-, H- and N-ras) and adenomatous polyposis coli (APC) gene in tissues of prostate cancer from Japanese patients were examined using PCR-SSCP (polymerase chain reaction-single strand conformation polymorphism) analysis and direct sequencing. Tissues from 8 cases of untreated stage B prostate cancer surgically removed and from 10 cases of endocrine therapy-resistant metastatic disease obtained at autopsy were used in the present study. In four out of 18 cases (22%), ras point mutations were found, two in either codon 12 or 61 of K-ras and two in either 13 or 61 of H-ras. These point mutations were detected in one of the stage B cases (13%) and in three of the autopsy cases (30%). All these cases were poorly differentiated adenocarcinoma. In autopsy cases showing ras mutation in cancerous prostate, the same alteration was observed in metastatic tissues. No APC gene mutation was detected in any sample, although polymorphism was found in some cases. These results indicate that ras oncogene mutations are related to the progression of prostate cancer, whereas APC gene alteration is not involved in tumorigenesis and development of this cancer.

[The role of repeat transurethral resection in stage A1 carcinoma of the prostate]

In order to evaluate the significance of repeat transurethral resection (TUR) in differentiating stage A1 prostatic adenocarcinoma from those with stage A2, we performed repeat TUR in 34 patients with an initial diagnosis of stage A1 prostatic adenocarcinoma. It was found that residual adenocarcinoma was present in five cases (14.7%), but the diagnosis was changed from stage A1 to stage A2 in only one case (2.9%). In one patient with final diagnosis of stage A1 carcinoma, bone metastases were detected seven months after the repeat TUR. It was concluded that repeat TUR for stage A1 prostatic adenocarcinoma did not yield clinically significant information.

Application of 13C NMR spectroscopy to paratope mapping for larger antigen-Fab complexes

For the purpose of engineering the antibody combining site, mapping residues that are involved in antigen binding provide us with valuable information. By use of 13C NMR spectroscopy with selectively 13C-labeled Fv fragments, we have established a general strategy to identify the residues that are perturbed upon binding of small antigen (hapten) molecules [(1990) Biochemistry 30, 6604-6610]. In the present paper, we demonstrate that this strategy can be extended to molecular structural analyses of the complexes of an Fab fragment and a larger antigen molecule such as Pseudomonas aeruginosa exotoxin A with a molecular mass of 67 kDa.

Central nervous system abnormalities in chromosome deletion at 11q23

Two Japanese pediatric patients with terminal deletion of the long arm of chromosome 11 are described. Both had the morphological abnormalities of the 11q deletion syndrome, such as prominent epicanthal folds, broad flat nasal bridge with short, upturned nose, short philtrum with carp-shaped mouth, cardiac anomalies and nonprogressive moderate psychomotor developmental delay. Patient 1 is the first case to be reported with 11q deletion with serial magnetic resonance (MR) examinations of cerebral white matter. The initial MR imaging studies demonstrated multiple areas of T1 and T2 prolongation in the cerebral white matter in both patients at the ages of 2 5/12 and 2 1/12 years, respectively. A second MR imaging, performed 1 year after the first in Patient 1, demonstrated slight improvement of the lesions. Neither patient showed clinical deterioration. These results suggest that the lesions were caused by delayed myelination, rather than by demyelination. It is suggested that an unknown factor which is important for myelination is located on the long arm of chromosome 11: perhaps the neural cell adhesion molecule (NCAM).

Central nervous system toxicity related to FK506 in patients with Behçet's disease

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[The effects of incentive spirometry on pulmonary functions]

The effects of incentive spirometry on pulmonary functions were studied in 46 normal adults of advanced age ('N' group) and 42 patients with chronic pulmonary emphysema ('E' group). Subjects of the both groups carried out deep breathing exercises by using incentive spirometry, 'Souffle', for five minutes, five times daily for four weeks. Pulmonary functions and arterial blood gases were measured at the start of exercise program, and at two and four weeks after the start. Both groups showed significant increases in VC, FEV1.0, peak expiratory flow, the flow at 75 percent VC (V75), maximal voluntary ventilation and PaO2, and a significant decrease in A-aDO2 at both two and four weeks after the start. In addition, V25 increased significantly in 'E' group. It is concluded that 'Souffle' is one of the useful preoperative respiratory managements for elderly patients and those with chronic pulmonary emphysema.

[A case of primary pulmonary cryptococcosis with increased serum carcinoembryonic antigen]

A case of primary pulmonary cryptococcosis with increased serum carcinoembryonic antigen (CEA) (7.0 ng/ml) is presented. The diagnosis was made by transbronchial lung biopsy (TBLB) and no abnormality was found in either gastrointestinal tract or immunity. Immunohistochemical study of the lung specimen showed that CEA was present on the surfaces of alveoli. The level of CEA fell to 0.8 ng/ml after administration of an antimycotic agent (Fluconazole) with simultaneous improvement of the chest radiographic findings. This case indicates that increased serum CEA depends on pulmonary cryptococcosis. TBLB and administration of antimycotic agents, instead of surgical resection, are useful in the diagnosis and treatment of this disease.

[Laparoscopic pelvic lymphadenectomy for localized prostate cancer]

Between April 1992 and May 1993, 13 patients (age, 66-79) with localized prostate cancer underwent laparoscopic pelvic lymphadenectomy at Asahi General Hospital. Clinical stage comprised A2 for 3 patients, B1 for 1 and C for 9. Lymphadenectomy covered inner half of external iliac nodes and obturator nodes, from pubic bone to proximal end of umbilical ligament. Operating time ranged from 70 minutes to 133 minutes with median of 102 minutes. The number of total lymph nodes dissected ranged from 3 to 17 nodes with median of 7. Lymph nodal involvement was detected in one patient. Two patients needed laparotomy due to bleeding; from abdominal wall caused at insertion of trocar in one, and oozing of blood for 10 hours after procedure in the other. Other serious complications were not observed. In conclusion, laparoscopic pelvic lymphadenectomy was a good staging procedure for localized prostate cancer.

Human monocyte chemoattractant protein-1 expressed in a baculovirus system

Human monocyte chemoattractant protein-1 (hMCP-1) was produced using a baculovirus system. The hMCP-1 cDNA was inserted into the genomic DNA of Autographa californica nuclear polyhedrosis virus (AcNPV) using a transfer vector, pJVP10Z. Spodoptera frugiperda insect cells, which were infected with this recombinant virus, secreted recombinant hMCP-1 (re-hMCP-1) at the level of 10-20 micrograms/ml of culture medium. This product was shown to chemoattract monocytes. Three distinct bands of 11, 11.5 and 12 kDa were revealed by immunoblotting analysis, and this heterogeneity was assigned to differences in carbohydrate processing. N-terminal amino-acid sequence analysis of the purified product revealed identity with hMCP-1. Thus, in this system, re-hMCP-1 was produced in large quantities and modified in a manner similar to native hMCP-1.

[A case of Listeria meningitis associated with systemic lupus erythematosus]

We report a case of Listeria meningitis associated with systemic lupus erythematosus (SLE). The case is a 29-year-old female who was diagnosed as SLE on August, 1982, and had been followed since then. On May 25, 1993, she was admitted to our hospital with complaints of fever, head ache and vomiting which developed 3 days before admission. An examination of the cerebro-spinal fluid (CSF) revealed a cell count of (3664/3/mm3), protein concentration (123 mg/dl), and the quotient of CSF (Q albumin) (27.5) were elevated. A diagnosis of meningitis was made and therapy of antibiotics was begun. A CSF culture on admission was positive for Listeria monocytogenes, but the blood culture was negative. Clinical symptoms disappeared in about a week and abnormal CSF findings returned to normal in about a month with the administration of antibiotics. Listeria infection is a rare disease, but sometimes develops as an opportunistic infection in immunocompromised hosts. As far as we know, only 13 cases have been reported so far (9 cases in foreign countries, 4 cases in Japan). We also discuss Listeria infections associsted with SLE referring to the former reports.

Visualization of sinus venosus-type atrial septal defect by biplane transesophageal echocardiography

In this article we describe three patients in whom biplane transesophageal echocardiography was useful in diagnosing sinus venosus type atrial septal defects. In two patients, diagnosis of anomalous pulmonary venous drainage was made correctly by biplane transesophageal echocardiography.