Comparison of direct negative chronotropic and positive inotropic effects of sematilide to those of E-4031 and MS-551 and the reverse frequency-dependent prolongation of cardiac refractoriness of sematilide

Direct cardiac effects of sematilide, a new class III antiarrhythmic drug, were compared with those of E-4031 and MS-551 in canine isolated blood-perfused heart preparations. Doses of sematilide, E-4031, and MS-551 causing a 10% decrease in the spontaneous sinoatrial beating rate were 58 +/- 15, 9 +/- 5, and 84 +/- 10 micrograms (n = 5); those causing a 10% increase in developed tension of the papillary muscle were 485 +/- 49, 17 +/- 2, and 267 +/- 50 micrograms (n = 6); and those causing a 10% prolongation of effective refractory period (ERP) of the atrioventricular node were 68 +/- 10, 11 +/- 2, and 53 +/- 15 micrograms (n = 5), respectively. There were few effects on atrio-His or His-ventricular intervals. Also, in in situ open-chest dog hearts, the percent increases in ERP of the atrioventricular conduction system caused by 1 mg/kg of sematilide were 21 +/- 3, 16 +/- 2 and 9 +/- 1% at cycle lengths of 800, 600, and 400 ms, respectively (p < 0.01; n = 8). These results indicate that (a) sematilide, as well as E-4031 and MS-551, has direct negative chronotropic and positive inotropic effects and prolongs cardiac refractoriness without affecting conduction velocities; (b) quantitatively, the cardiac effects of sematilide were almost identical to those of MS-551 and five to ten times less potent than those of E-4031; (c) and prolongation of ERP of the atrioventricular conduction system by sematilide occurred in a reverse frequency-dependent manner.

[Preliminary screening for antiviral AIDS drugs. VII. Report for fiscal year 1994]

Preliminary screening of antiviral AIDS drugs has been carried out using three different in vitro assay systems. Among 246 samples of different origin tested, six were shown to inhibit the growth of HIV in vitro. Two of the positive samples have hopeful signs, as the ranges of effective doses are wider than those of most of positive samples which had been found by us.

TCR gamma delta + T cells in peripheral blood of patients with adult Still's disease

OBJECTIVE

Adult Still's disease, a systemic inflammatory disorder of unknown etiology, shows few specific laboratory markers and histological features. We investigated T cell subsets in peripheral blood lymphocytes (PBL) of patients with adult Still's disease to elucidate immunological features of the disease.

METHODS

We studied T cell subsets in PBL of 12 patients with adult Still's disease by flow cytometric analysis. T cell subsets were also investigated for more than 6 months in PBL of 3 patients with adult Still's disease.

RESULTS

Both the percentage and absolute number of T cell receptor gamma delta positive (TCR gamma delta +) T cells in active adult Still's disease (n = 6) were significantly (p < 0.05) higher than those in inactive adult Still's disease (n = 6), inactive rheumatoid arthritis (n = 8), or healthy controls (n = 20). An increase of TCR gamma delta + T cells was observed in 5 of 6 patients with adult Still's disease at the active phase. TCR gamma delta + T cells also increased for a considerable period in all the patients tested. In contrast, there were no significant differences in the other T cell subsets (CD3, CD4, CD8, TCR alpha beta) between all the patients and healthy donors. Levels of TCR gamma delta + T cells in PBL correlated well with those of serum ferritin and C-reactive protein in one of the 3 patients whose PBL could be serially investigated. These increased TCR gamma delta + T cells mostly consisted of a V gamma 9/V delta 2 subset.

CONCLUSION

TCR gamma delta + T cells in PBL are significantly increased in the active phase in patients with adult Still's disease.

A case of nephrotic syndrome developing during postoperative gamma interferon therapy for renal cell carcinoma

A 70-year-old man developed minimal-change nephrotic syndrome and acute interstitial nephritis while undergoing gamma interferon therapy following right nephrectomy for renal cell carcinoma. It appears that gamma interferon as well as renal cell carcinoma may have played a role as etiologic factors in this nephropathy. We report this extremely rare case of renal cell carcinoma complicated by minimal-change nephrotic syndrome and acute interstitial nephritis, and present a review of the literature.

Hyperammonemia in a patient with short bowel syndrome and chronic renal failure

A patient with short bowel syndrome (SBS) and renal failure developed a disturbance of consciousness with hyperammonemia. Abnormally low concentrations of ornithine, citrulline, and arginine were observed on the plasma aminogram. These results suggested that the activities of amino acid synthetase localized in the small intestinal flora were lost. The small intestine is required for arginine synthesis; thus, infusion limited to the essential amino acids to SBS patients will cause a deficiency of the urea cycle intermediates, ornithine, citrulline, and arginine and may lead to hyperammonemia. In addition, the renal insufficiency may have caused decreased excretion of ammonia. In this patient, supplemental arginine improved the symptoms.

Expression of MAGE-1, MAGE-2, MAGE-3/-6 and MAGE-4a/-4b genes in ovarian tumors

MAGE genes encoding tumor-rejection antigens recognized by cytotoxic T lymphocytes are expressed at the mRNA level in various malignant tumors. We have investigated the expression of genes MAGE-1, -2, -3/-6 and -4a/-4b at the mRNA level in malignant and non-malignant ovarian tumors as well as in normal ovaries by reverse transcription-polymerase chain reaction. MAGE-1, -2, -3/-6 and -4a/-4b were expressed in 12, 5, 11 and 4 of 58 malignant tumors, respectively. The majority of these MAGE-mRNA-positive tumors were histologically surface-epithelial-stromal tumors, in particular serous adenocarcinomas. They mostly consisted of either advanced-stage or recurrent tumors. In contrast, neither benign tumors nor normal ovaries expressed any of the MAGE genes investigated. A 46-kDa MAGE-1 protein was identified in MAGE-1-mRNA-positive serous adenocarcinomas by immunoblot analysis with polyclonal anti-MAGE-1 antibody. These results provide important information for specific immunotherapy of ovarian serous adenocarcinomas with MAGE gene products.

Immunohistochemically defined lymphocyte function-associated antigen 1 (LFA-1) on an adenocarcinoma cell line is a distinct molecule from LFA-1 on leukocytes

We previously reported that the immunohistochemically defined LFA-1 antigen (LFA-1-like antigen) was expressed on various exocrine tissues uninvolved with tumors in patients with malignant diseases using LFA-1 alpha-specific monoclonal antibodies (mAb) 2F12 and HVS6B6. In this study we investigated differences at the molecular level between LFA-1 on leukocytes and LFA-1-like antigen on MKN45.16, a subline derived from an adenocarcinoma line MKN45 that expresses a high amount of LFA-1-like antigen. LFA-1-like antigen was reactive to mAb 2F12 or HVS6B6, but not to any of the other five different LFA-1 alpha (CD11a)-specific or four LFA-1 beta (CD18)-specific mAb. mAb 2F12 immunoprecipitated a 200-kDa membrane protein (LFA-1-like antigen) from MKN45.16 cells, whereas it precipitated 180-kDa (LFA-1 alpha) and 95-kDa (LFA-1 beta) proteins from a monocytic cell line (THP-1) under both nonreducing and reducing conditions. The molecular difference was confirmed further by N-glycanase treatment of the immunoprecipitates. The isoelectric point of LFA-1-like antigen was 6.0, whereas those of LFA-1 alpha and LFA-1 beta were 6.0 and 4.7, respectively, by two-dimensional gel electrophoresis. Expression of LFA-1 alpha gene on MKN45.16 cells was not detected at the mRNA level by six different sets of LFA-1 alpha-specific oligonucleotides and reverse transcription-polymerase chain reaction. These results indicated that LFA-1-like antigen on an adenocarcinoma cell line was a distinct molecule from LFA-1 on leukocytes.

Comparative analysis of anti-human immunodeficiency virus type 1 activities of dideoxynucleoside analogs in resting and activated peripheral blood mononuclear cells

We determined the anti-human immunodeficiency virus type 1 (anti-HIV-1) activities of various dideoxy-nucleoside analogs by using phytohemagglutinin-activated peripheral blood mononuclear cells (PHA-PBMs) and resting PBMs (R-PBMs) as target cells. The comparative order of anti-HIV-1 activity in PHA-PBMs was azidothymidine (AZT) > dideoxycytidine (ddC) > dideoxythymidinene (d4T) > dideoxyinosine (ddI) and 9-(2-phosphonylmethoxyethyl)adenine (PMEA) > 2'-beta-fluoro-dideoxyadenosine (F-ara-ddA), while that in R-PBMs was ddC > ddI, PMEA, and F-ara-ddA, >> AZT and d4T. A pronucleotide, bis-(S-acetylthioethanol)phosphotriester-ddAMP, which bypasses the anabolic monophosphorylation step for the intracellular delivery of ddAMP, was highly active both in PHA-PBMs and R-PBMs. These data may have basic and clinical relevance in the design of anti-HIV chemotherapy, particularly combination chemotherapy with dideoxynucleosides, and in the development of active pronucleotides.

Creation of a controlled venoarterial shunt. A surgical intervention for right-side circulatory failure

BACKGROUND

Right-side circulatory failure (RSCF), a common complication of heart transplant and left ventricular assist device recipients, results in decreased cardiac output because of diminished flow across the pulmonary circuit. We hypothesized that creation of a controlled venoarterial shunt would result in decompression of the right ventricle and improved systemic cardiac output at tolerable oxygen saturations.

METHODS AND RESULTS

A venoarterial shunt was created in a large-animal model (calf, n = 6). RSCF was induced by banding the pulmonary artery. Hemodynamic measures and blood gas determinations were obtained during nonshunted and shunted states. Pulmonary artery banding increased mean right ventricular systolic pressure from 44.9 +/- 2.1 mm Hg (mean +/- SEM) to 85.9 +/- 6.9 mm Hg (P < .05, paired t test) and decreased mean aortic flow from 7.8 +/- 1.0 to 4.2 +/- 1.1 L/min (P < .05). Flow through a venoarterial shunt at approximately 40% of cardiac output resulted in a decrease in right ventricular end-systolic pressure from 85.9 +/- 6.9 to 72.1 +/- 5.6 mm Hg (P < .01, ANOVA), a decrease in mean pulmonary artery pressure from 42.9 +/- 5.0 to 37.2 +/- 3.8 mm Hg (P < .01), and an increase in aortic flow from 4.2 +/- .05 to 5.1 L/min (P < .01). Left ventricular stroke work decreased from 2.22 +/- 0.28 to 1.55 +/- 0.88 (P < .05). Carotid artery oxygen saturation did not change significantly (99.9 +/- .02 to 97.6 +/- 1.7) during shunting.

CONCLUSIONS

A controlled venoarterial shunt improved hemodynamics and cardiac output in a large animal model with RSCF. This strategy may be useful in the management of transplant and left ventricular assist device recipients with perioperative RSCF.

Approaching the zygoma with an endoscope

A hemicoronal or coronal incision is required in combination with a buccal incision to expose the zygoma, including zygomatic process of the temporal bone, and lateral orbital rim under direct visualization. An endoscope was used to expose zygoma in selected cases to reduce the length of the incision. The zygomatic bone and arch were exposed and corrected using an endoscope in eight cases of zygomatic fracture and one case of zygomatic reduction through a small incision just behind the temporal hairline together with a buccal incision. The results obtained were satisfactory with no complications. Clear, magnified endoscopic visualization made it possible to correct some deformities located in this area without using a coronal incision. Endoscopic procedures result not only in dramatically less postoperative scarring because of the small access incisions, but they also cause less damage to vascular and lymphatic circulation and, therefore, are associated with less postoperative edema. However, the fixation of the zygomatic arch using the percutaneous method with an endoscope is a complicated procedure that requires more time than conventional procedures.

Spontaneous production of various cytokines except IL-4 from CD4+ T cells in the affected organs of sarcoidosis patients

We investigated surface antigens and spontaneous cytokine production of T cells from bronchoalveolar lavage fluid (BALF) and aqueous humor (AH) from pulmonary sarcoidosis patients for a better understanding of the role of T cells in granuloma formation. The levels of CD3, CD11b, and CD28 antigen expression on freshly isolated T cells in the BALF of patients were significantly lower than those in peripheral blood lymphocytes (PBL) of either sarcoidosis patients or healthy donors (HD). In contrast, the levels of CD80 (B7/B7-1) and CD86 (B70/B7-2) antigen expression were significantly higher on these T cells and alveolar macrophages in the BALF of patients. Fifty-three T cell clones (TCC) established from the BALF and AH of the three sarcoidosis patients displayed primarily either CD4+ CD11b+ CD28+ or CD4+ CD11b- CD28- phenotypes. Most (61-90%) of these TCC spontaneously produced greater amounts of IL-1 alpha, IL-10, tumour necrosis factor (TNF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) than did TCC from the PBL from sarcoidosis patients or HD (P < 0.05). Interferon-gamma (IFN-gamma), IL-6, and IL-2, but not IL-4, were also produced by 40-48% of these TCC. These results suggest that CD4+ T cells of the affected organs of sarcoidosis patients are activated and involved in the immunopathogenesis of sarcoidosis through production of various cytokines.

Induction of cytochrome P450-dependent monooxygenase in serum-free cultured Hep G2 cells

We examined the induction of cytochrome P450-dependent mixed-function monooxygenase (MFO) in the human hepatoma cell line Hep G2 by means of several factors. The MFO activities induced in the cells cultured in medium containing five commercial sera varied significantly, and the activity in the cells cultured in the absence of serum was about twice as high as that in cells supplemented with serum. The activity of ethoxycoumarin O-deethylase was highest 12 hr after adding 3-methylcholanthrene, and it was induced by several polycyclic aromatic hydrocarbons such as benzo(a)anthracene and benzo(a)pyrene, which are usually found in urban air as environmental contaminants. Furthermore, an extract from the total suspended particles collected using a high volume air sampler, which was mutagenic in the Ames assay using Salmonella typhimurium TA98, induced the same enzyme activities in Hep G2 cells. These findings suggest that serum-free culture allows the stable and highly sensitive measurement of induced MFO activity, and that studies of MFO induction by environmental samples using human hepatoma Hep G2 cells should provide helpful information regarding the risk associated with environmental contaminants.

Nucleotide sequencing of phenylalanine dehydrogenase gene from Bacillus badius IAM 11059

The nucleotide sequence of the pdh gene coding for PheDH from Bacillus badius IAM 11059 was analyzed. The gene consists of an ORF of 1140 nucleotides which specifies a protein of 380 codons. The primary structure of PheDH is similar to PheDH from B. sphaericus, PheDH from Themoactinomyces intermedius, and leucine dehydrogenase from B. stearothemophilus, etc.

Rabbit anti-chromatin antibodies recognize similar epitopes on a histone H1 molecule as lupus autoantibodies

Autoantibodies in systemic lupus erythematosus (SLE) are believed to be produced through an antigen-driven mechanism, i.e., autosensitization with autoantigens. If this is the case, it is conceivable that antigenic determinants reactive with SLE autoantibodies and induced antibodies raised by immunization are quite similar. To examine this issue, rabbits were immunized with purified histone H1 or chromatin. Although immunization with purified histone H1 did not produce detectable amounts of anti-histone H1 antibodies, immunization with chromatin mounted relatively good antibody responses against not only all histone subunits but also ssDNA. Epitopes on a histone H1 molecule reactive with SLE autoantibodies and rabbit antisera were determined using deletion mutants of a histone H1 molecule. At least two epitopes reactive with induced antibodies were found on a histone H1 and these were closely related to or the same as major autoepitopes in SLE. These data might indicate that B cells producing anti-histone H1 autoantibodies are quite similar to those induced by immunization and provide additional evidence that autosensitization with an autoantigen might be operative and a particulate antigen chromatin could be one of the immunogens for the production of anti-nuclear antibodies of various kinds in SLE.

The secular trend in the incidence of subarachnoid hemorrhage in Miyagi, Japan: 1979-1990

Since 1978, a stroke registry has been carried out in Miyagi Prefecture (2.2 million in population), Japan. Approximately 2,000 cases of stroke were annually registered through 16 hospitals which have cerebrovascular disease units. The incidence of subarachnoid hemorrhage was 17.4 per 100,000 population in 1990. The incidence increased gradually during early 1980's and reached plateau during late 1980's. Further, the trend in the incidence of subarachnoid hemorrhage is compared with those in other communities in other countries as well as Japan.

Mutation in aspartic acid residues modifies catalytic and haemolytic activities of Bacillus cereus sphingomyelinase

Four aspartic acid residues (Asp126, Asp156, Asp233 and Asp295) of Bacillus cereus sphingomyelinase (SMase) in the conservative regions were changed to glycine by in vitro mutagenesis, and the mutant SMases [D126G (Asp126-->Gly etc.), D156G, D233G and D295G] were produced in Bacillus brevis 47, a protein-producing strain. The sphingomyelin (SM)-hydrolysing activity of D295G was completely abolished and those of D126G and D156G were reduced by more than 80%, whereas that of D233G was not so profoundly affected. Two mutant enzymes (D126G and D156G) were purified and characterized further. The hydrolytic activities of D126G and D156G toward four phosphocholine-containing substrates with different hydrophobicities, SM, 2-hexadecanoylamino-4-nitrophenylphosphocholine(HNP), lysophosphatidylcholine (lysoPC) and p-nitro-phenylphosphocholine (p-NPPC), were compared with those of the wild-type. The activity of D126G toward water-soluble p-NPPC was comparable with that of the wild-type. On the other hand, D156G catalysed the hydrolysis of hydrophilic substrates such as HNP and p-NPPC more efficiently (> 4-fold) than the wild-type. These results suggested that Asp126 and Asp156, located in the highly conserved region, may well be involved in a substrate recognition process rather than catalytic action. Haemolytic activities of the mutant enzymes were found to be parallel with their SM-hydrolysing activities. Two regions, including the C-terminal region containing Asp295, were found to show considerable sequence identity with the corresponding regions of bovine pancreatic DNase I. Structural predictions indicated structural similarity between SMase and DNase I. An evolutionary relationship based on the catalytic function was suggested between the structures of these two phosphodiesterases.

Augmentation of coronary responsiveness to serotonin at the site of X-ray-induced intimal thickening in miniature pigs

OBJECTIVE

X-irradiation is known to enhance atherosclerotic change. We tested whether coronary vasoconstrictor responses are augmented at the sites of X-ray-induced intimal thickening in Göttingen miniature pigs.

METHODS

In 17 pigs, a major branch of the left coronary artery was denuded with a balloon catheter. In 10 pigs, the denuded portion of the left coronary artery was selectively irradiated with 15 Gy of X-rays twice at 3 and 4 months after denudation (group 1). The remaining 7 pigs were not irradiated (group 2). The effects of intracoronary administration of serotonin, histamine and phenylephrine on the coronary diameter were studied 3 (3M) and 5 months (5M) after denudation. After the angiographical study at 5M, the vessels were isolated and isometric tension was measured in an organ chamber.

RESULTS

The percent reduction in coronary diameter evoked with 10 micrograms.kg-1 of serotonin increased from 39(s.e.m. 4)% before X-irradiation (3M) to 75(6)% after X-irradiation (5M) in group 1 (P < 0.01), while it did not differ in group 2 [39(6)% at 3M vs. 33(8)% at 5M[ [39(6)% at 3M vs. 33(8)% at 5M]. In group 1, serotonin-induced coronary constriction was frequently accompanied by ischemic ECG changes. Histamine (10 micrograms.kg-1)-induced vasoconstriction was also augmented but to a smaller degree [47(6)% at 3M vs. 62(4)% at 5M; P < 0.05] in group 1, while it remained unchanged in group 2[52(5)% at 3M vs. 44(7)% at 5M]. Phenylephrine did not cause detectable contraction in either group at 3M or 5M. Methysergide and ketanserin attenuated serotonin-induced hypercontraction in a dose-dependent fashion. In the in vitro studies, endothelium-dependent relaxation to serotonin was impaired at the denuded site with (group 1) and without (group 2) X-irradiation to a similar extent. Isometric tension of medial smooth muscle developed by serotonin was significantly greater at the denuded site with X-irradiation (group 1) than the control site and the denuded site without X-irradiation (group 2) (P < 0.05). Intimal thickening was significantly greater at the denuded sites with X-irradiation [group 1, 238(45) microns] than at the denuded sites without X-irradiation [group 2, 58(5) microns] (P < 0.05).

CONCLUSIONS

These results indicate that X-irradiation augments the coronary vasoconstrictor responses to autacoids, predominantly to serotonin, and that this augmentation is accompanied by enhanced intimal thickening. Serotonin-induced hypercontraction after X-irradiation resulted mainly from the hyperreactivity of medial smooth muscle.

[Tubulointerstitial nephropathy secondary to collagen-vascular diseases]

Although collagen-vascular diseases mainly affect glomeruli and vessels, tubulointerstitial (TI) involvements as well, are frequently demonstrated histologically. In renal biopsy specimens from patients with lupus erythematosus, tubular atrophy, mononuclear (MN) cell infiltration into the interstitium and interstitial fibrosis are demonstrated in nearly 50% of cases. Immunoglobulins and complement components are sometimes deposited along tubular basement membrane, suggesting an immune-complex mediated mechanism. Infiltrating cells are mainly T cells, but the surface marker studies are not conclusive as to the subset of T cells responsible for the inflammation. As for Sjögren syndrome, TI changes and renal tubular acidosis are the prominent features of the disease. MN cell infiltration in the renal interstitium is also reported in patients with systemic vasculitis.

Sequence analysis of the MAGE gene family encoding human tumor-rejection antigens

The MAGE multigene family, which includes the MAGE-1 and -3 genes that encode tumor-rejection antigens on HLA-A1 recognized by cytotoxic T-lymphocytes (CTL), is preferentially expressed at the mRNA level on human malignant cells, but not on normal cells. However, little is known about the MAGE-4, -41 and -6 genes. In this study, we have amplified 1040 bp (MAGE-1), 1061 bp (MAGE-3 and -6) and 1064 bp (MAGE-4 and -41) cDNA fragments, including the entire coding sequences (927-951 bp), using the reverse transcription-polymerase chain reaction (RT-PCR) method followed by nucleotide (nt) sequencing. One member had greater than 80 or 66% homology with the other members at the nt or deduced amino acid (aa) levels, respectively. Higher homology was found between MAGE-3 and -6 (98% at the nt level) and also between MAGE-4 and -41 (98%). The results of this investigation demonstrated high homology, as well as the clear differences between the members of the MAGE family at the coding sequence level.