Lymphocytic hypophysitis presenting with diabetes insipidus: case report and literature review

Lymphocytic adenohypophysitis is an autoimmune disorder of the anterior pituitary gland which usually occurs in a women in the postpartum period. It has been considered that lymphocytic hypophysitis is confined to the adenohypophysis sparing the neurohypophysis, and that diabetes insipidus is not a clinical feature of the disorder. Here we report the case of a 50-year-old woman with lymphocytic hypophysitis which presented with diabetes insipidus. MRI indicated homogeneous swelling of the whole pituitary gland, loss of the normal high intensity of the posterior pituitary, and thickening of the pituitary stalk. A biopsied specimen of the pituitary revealed diffuse lymphocytic infiltration. The diabetes insipidus was controlled by the administration of DDAVP. The anterior pituitary function was not greatly damaged, and no hormonal replacement therapy was necessary. We suggest that this case represents a variant of lymphocytic adenohypophysitis and/or lymphocytic infundibuloneurohypophysitis, in which the chronic inflammatory process involves the infundibulum, adenohypophysis and neurohypophysis.

Distinctive developmental origins and specificities of murine CD5+ B cells

CD5+ B cells constitute a small fraction of cells in the spleen of adult mice that exhibit numerous features serving to distinguish them from the bulk of IgD++CD5- "conventional" B cells. In this review we focus on two major questions relating to this population: 1) the relationship of CD5+ B cells to other B cells; and 2) the distinctive enrichment of particular autoreactive specificities in this subset. The nature of their origins is clarified by a thorough analysis of intermediate stages of early B-cell development in both fetal and adult tissues. The reactivity to bromelain-treated mouse red blood cells serves as a prototype system for the investigation of biased specificities in CD5+ B cells. These lines of investigation lead us to propose that CD5+ B cells in the adult are the remnant of a distinct fetal B-cell differentiation pathway wherein selection of cells from this fetal/neonatal population into the adult long-lived pool results in the over-expression of certain germline-encoded autoreactivities.

Crystallization of canine cardiac calsequestrin

Calsequestrin is the major Ca2+ binding protein in the lumen of the sarcoplasmic reticulum membranes. Two X-ray quality crystal forms of canine cardiac calsequestrin were obtained by the hanging drop method using KCl as a precipitant. One form is monoclinic (space group P2(1), a = 73.4 A, b = 104.4 A, c = 60.2 A, beta = 120.4 degrees) with two molecules in the asymmetric unit and a solvent content of approximately 40%. The second form is trigonal (P3(1)21 or P3(2)21, a = b = 99.3 A, c = 89.8 A) with a single molecule in the asymmetric unit and 55% solvent content. Cross rotation function calculations show that despite the different space groups the packing of the molecules in both crystals is likely to be similar suggesting the existence of a stable dimer. The monoclinic crystals diffract beyond 3 A using a laboratory rotating anode source, while under the same conditions the trigonal crystals diffract only to approximately 4.5 A. This is the first report of successful preparation of X-ray quality crystals of a high capacity Ca2+ binding protein.

Nerve growth factor prevents neurotoxic effects of cisplatin, vincristine and taxol, on adult rat sympathetic ganglion explants in vitro

Anti-cancer drugs, cisplatin, vincristine and taxol clinically induce toxic sensory as well as autonomic neuropathy. Administration of nerve growth factor (NGF) has been found to prevent experimental sensory neuropathies induced by these anti-cancer drugs, but the information about autonomic neuropathy is lacking. We developed an adult rat superior cervical ganglion (SCG) explant culture, which we treated with cisplatin, vincristine and taxol either in the presence or absence of NGF. The maximum length of regenerated neurites was shortened by cisplatin, vincristine and taxol in a dose-dependent manner. However cotreatment with NGF significantly promoted the regeneration of neurites in all drug-treated explants. The effect of NGF was clearly blocked by the anti-NGF antibody. These findings suggest that cotreatment of NGF prevents and reverses the toxic effects of the anti-cancer drugs on the sympathetic neurons.

Effect of iodinated contrast media on ionic calcium

This study was conducted to characterize the alterations in serum ionized calcium induced by contrast media (CM) and to determine the cause of the change. Fresh human blood samples as well as an electrolyte solution (ES) containing 1.2 mM calcium ions were diluted with CM and alterations in ionized calcium were measured using an electrometer. The CM tested were diatrizoate, iopamidol, iohexol, ioxaglate, isotonic saline, Na2-Ca-EDTA and pure meglumine. When CM were mixed with blood, ionic CM produced a greater decrease in ionized calcium than nonionic CM or saline. When mixed with ES, a significant reduction of ionized calcium was induced by ioxaglate and diatrizoate in comparison with saline. Na2-Ca-EDTA and meglumine caused no reduction in ionized calcium. Ioxaglate and diatrizoate caused calcium binding due to anions; binding induced by the latter was more prominent than that by the former. These observations suggest that a nonionic CM is more desirable for coronary arteriography of high-risk patients.

Therapy of Graves' ophthalmopathy with intravenous high-dose steroid followed by orbital irradiation

We investigated the effects of intravenous high-dose steroid therapy followed by orbital irradiation for Graves' ophthalmopathy in eight patients. All patients presented with diplopia or fixed globes. Extraocular muscle dysfunction showed excellent improvement after the combined therapy; diplopia disappeared completely in five of them, and one patient with fixed globes showed normal eye movement. Two other patients also exhibited great improvement, although their diplopia persisted. Their ophthalmopathy index was decreased from (mean +/- SD) 4.25 +/- 0.82 to 0.75 +/- 1.48. Extraocular muscle enlargement, assessed by magnetic resonance imaging study after the radiotherapy, was also reduced after the combined therapy, although two patients did not show remarkable enlarged extraocular muscles. There was no change in extraocular muscle thickness 6-9 months after the therapy, and the ophthalmopathy index did not show change in a long follow-up (maximum 37 months after the therapy). These results suggest that high-dose methylprednisolone followed by orbital radiotherapy is a good therapeutic design for Graves' ophthalmopathy and justify a prospective randomized trial.

An autopsy case of pulmonary adenocarcinoma of fetal type treated with radiation therapy

A 68-year-old female patient with well-differentiated adenocarcinoma simulating fetal lung tubulus in pseudoglandular stage (pulmonary adenocarcinoma of fetal type) is reported. This type of tumor was first described by Kradin et al. in 1982, and reported by Kodama et al. in 1984. This tumor has characteristics consistent with those of pulmonary endodermal tumor but not with typical pulmonary blastoma. This patient with clinical stage IIIA disease was treated with definitive radiation therapy alone and had shown a good course for two years, but died from malignant pleural effusion and extensive distant metastases. At autopsy, the tumor showed pathological features consistent with those of previously reported cases.

Second lung cancer following radiation therapy of locally advanced pulmonary cancer

Three cases of second primary lung cancer following radiation therapy to the first pulmonary cancer were reported. In all cases, the first cancers located in the upper lobe and were unresectable diseases, their histologic type being epidermoid carcinoma. Radiation therapy was given with total doses of 60-70 Gy. Ten years later the second cancers arose in the contralateral lung and were treated with radiation therapy again.

The effects of biotin deficiency on organic acid metabolism: increase in propionyl coenzyme A-related organic acids in biotin-deficient rats

Volatile organic acid levels in plasma and tissues and nonvolatile organic acid levels in urine of biotin-deficient (BD) rats were measured and compared with other factors of biotin deficiency. Biotin levels and the activities of propionyl coenzyme A (CoA) carboxylase (PCC) in the livers of these rats were decreased, respectively, to 22% +/- 3% and 3.6% +/- 0.3% of the average values of pair-fed controls. Plasma concentrations of propionate were higher (15 to 223 micrograms/mL) than those of controls (5 to 7 micrograms/mL), whereas plasma levels of 3-methylcrotonate were only minimally increased as compared with those of controls. Concentrations of these volatile acids in the tissues were similarly increased, although those in brain showed less remarkable increases as compared with levels in other tissues. In the urine of BD rats, large amounts of organic acids derived from propionyl CoA, as well as those from 3-methylcrotonyl CoA, were excreted. Plasma propionate levels were not apparently related to the severity of clinical symptoms, biotin levels, or carboxylase activities, but were related to the amounts of urinary ketone bodies, lactate, and some of the organic acids derived from branched-chain amino acids, including those from propionyl CoA.

Increase in the ability of human cancer cells to induce cytotoxic T lymphocytes by ultraviolet irradiation

The roles of ultraviolet-B (UV) radiation in the immunogenicity of human cancer cells have not been fully studied. We have investigated the effects of UV radiation on metastatic melanoma and renal cell carcinoma cells with regard to MHC antigen expression and the ability to induce cytotoxic T lymphocyte (CTL) activity in peripheral blood mononuclear cells (PBMC) or tumor-infiltrating lymphocytes (TIL) against untreated autologous tumor cells. UV radiation respectively decreased or increased MHC class I expression of freshly isolated tumor cells or cultured tumor cells, and also decreased MHC class I expression of starved cultured tumor cells. It increased the ability of both freshly isolated and cultured tumor cells to induce CTL activity from PBMC against untreated autologous tumor cells. UV-irradiated subclones that were more susceptible to CTL lysis were more potent for CTL induction from TIL than either an untreated parental clone or a UV-irradiated subclone that was resistant to CTL lysis. In summary, UV radiation increased the ability of tumor cells to induce CTL activity without a corresponding effect on MHC antigen expression.

An autopsy case: limited small cell lung cancer controlled with radiation therapy alone

We report a patient with limited small cell lung cancer treated with radiation therapy alone, who survived more than two years. At autopsy no residual tumor or metastasis was found. This case can be of help in estimating the value of thoracic irradiation for local control of tumor, which is still a subject of controversy.

Determination of free N-acetylneuraminic acid in human body fluids by high-performance liquid chromatography with fluorimetric detection

Determinations of both the free and bound form of N-acetyl-neuraminic acid (NANA) in several human body fluids, such as serum, cerebrospinal fluid (CSF), saliva, urine, amniotic fluid, and milk were carried out by HPLC with fluorimetric detection. The method utilized 1,2-diamino-4,5-methylenedioxybenzene dihydrochloride (DMB) as a fluorimetric derivatizing reagent. Free-form NANA was obtained from the body fluids after ultrafiltration with Microcon 10 (YM-10 cellulose membrane, filtration limit M(r) = 10,000, Amicon). The DMB derivative of NANA was separated isocratically by a Nucleosil 5C18 column with a mixture of 0.1 M sodium phosphate buffer (pH 2.0)-methanol (75:25, v/v). A gradient elution system was used for urine analysis. Analysis times were 10-30 min. Recoveries of free NANA by ultrafiltration were satisfactory: 95.66 +/- 1.80% for serum and 97.27 +/- 1.55% for CSF, respectively. The high sensitivity and specificity render this method applicable to all the body fluids tested. Although a physiological role for free NANA has not yet been elucidated, the method presented promises to contribute to the basic understanding of the NANA metabolism.

Increased expression of cofilin in dystrophic chicken and mouse skeletal muscles

A monoclonal antibody (McAb) specific for actin depolymerizing factor (ADF) was prepared. With this and previously prepared anti-cofilin McAb (MAB-22) and other antibodies, the expression of cofilin and ADF in the muscles of dystrophic (NH-413) chicken and dystrophic (C57BL/6J dy/dy) mice was compared with that in normal control animals by immunoblotting and immunocytochemical methods. Since cofilin expression is down-regulated during normal postnatal development of skeletal muscles [Abe et al. (1989) J. Biochem. 106, 696-702], cofilin was detected in the breast (pectoralis) muscle of normal adult chicken and the leg (femoris and tibialis anterior) muscles of normal mice only at a low level. ADF was not detectable in adult skeletal muscles. However, a significant increase of cofilin amount, but not of ADF amount, was observed in these muscles of the dystrophic animals, when the symptom of muscular dystrophy became evident. In order to localize cofilin in individual muscle fibers, serial cryosections of the dystrophic chicken muscle were examined with anti-cofilin antibody (MAB-22). The antibody stained cells of different size in the dystrophic muscle, indicating that cofilin expression was induced in the regenerating muscle cells as well as in the pre-existing myofibers. We suggest that cofilin is involved in disassembly or reorganization of actin in the dystrophic muscle.

[Anterior chamber dimensions in normal subjects on Kume Island, Okinawa]

The anterior chamber dimension and axial length were studied by photogrammetry and ultrasonography in 365 normal subjects over 21 years of age on Kume island, Okinawa. There was no difference between right and left eyes in the anterior chamber dimensions, corneal curvature, or axial length. Male subjects had a larger anterior chamber and longer axial length than female subjects. The volume, depth, and diameter of the anterior chamber diminished with age and degree of hyperopia. The axial length was related to the anterior chamber dimensions, corneal curvature, and degree of ametropia. The anterior chamber dimensions and axial length in subjects over 60 years of age on Kume island were significantly smaller than in normal subjects over 60 years in Tokyo.

Purification and characterization of an enzyme releasing lacto-N-biose from oligosaccharides with type 1 chain

An enzyme specific for oligosaccharides with type 1 chain was purified 7,000-fold from the culture broth of Streptomyces sp. 142. The enzyme, lacto-N-biosidase, was induced and secreted into culture medium when the strain was cultured in the presence of porcine stomach mucin. The enzyme was purified by anion-exchange chromatography on Q Sepharose, cation-exchange chromatography on S Sepharose, fast protein liquid chromatography on a Mono S column, and gel filtration chromatography on TSK gel HW55S. To remove contaminating alpha-1,3/4-fucosidase and beta-N-acetylglucosaminidase, final purification was done by fast protein liquid chromatography on a Mono S column and affinity chromatography on N-acetylglucosamine agarose. The purified enzyme gave only one major protein band with an apparent M(r) of 60,000 on sodium dodesyl sulfate-polyacrylamide gel electrophoresis. The enzyme had maximum activity at pH 5.5 and was stable at the pH range of 4.0-10.0. Substrate specificity studies with oligosaccharides labeled with 2-aminopyridine showed that the enzyme specifically hydrolyzed lacto-N-tetraose and the N-acetyllactosamine type of triantennary sugar chain with the type 1 chain, but did not hydrolyze type 2 chain oligosaccharides or the type 1 chain oligosaccharides with fucose or sialic acid including lacto-N-fucopentaose I and II and alpha-2,3-sialyl lacto-N-tetraose. The enzyme released lacto-N-biose from asialofetuin, and almost all oligosaccharides in asialofetuin were found to have only type 2 chains. Sequential digestion of extended type 1 chain oligosaccharides with alpha-1,3/4-fucosidase and lacto-N-biosidase was possible.

Developmental features of the brain in preterm and fullterm infants on MR imaging

Normal development and maturation in pre- and postnatal periods were studied using MR imaging. For this purpose, we performed MR imaging at a postmenstrual age of 37-44 weeks in both low-risk preterm and fullterm infants and assessed the myelination pattern and the dimension of the pituitary gland, corpus callosum, pons and cerebellar vermis. There were no differences in stages of myelination and the size of these structures in both groups. MR imaging was also performed in infants with various cerebral injuries. Focal or diffuse areas of hyperintensity on T2-weighted images and delayed myelination were the commonly observed abnormal findings in these infants.

The regulated expression of B lineage associated genes during B cell differentiation in bone marrow and fetal liver

The expression of B lineage associated genes during early B cell differentiation stages is not firmly established. Using cell surface markers and multiparameter flow cytometry, bone marrow (BM) cells can be resolved into six fractions, representing sequential stages of development; i.e., pre-Pro-B, early Pro-B, late Pro-B/large Pre-B, small Pre-B, immature B, and mature B cells. Here we quantitate the levels of several B lineage associated genes in each of these fractions by RT-PCR, demonstrating different patterns of expression. We find that expression of terminal deoxynucleotidyl transferase (TdT), lambda 5, and VpreB is predominantly restricted to the Pro-B stages. Rag-1 and Rag-2 expression is also tightly regulated, and is found largely in the Pro-B through small Pre-B stages. Mb-1 is present from Pro-B throughout the pathway at high levels. Finally, Bcl-2 is expressed at high levels only at the pre-Pro-B and mature B stages, whereas it is low during all the intermediate stages. We also correlate this expression data with an analysis of the onset of Ig gene rearrangement as assessed by amplifying D-JH, VH-DJH, and VK-JK. Finally, we report differences in gene expression during B lymphopoiesis at two distinct ontogenic timings, in fetal liver and adult BM: both TdT and the precursor lymphocyte regulated myosin-like light chain are expressed at high levels in the Pro-B cell stage in bone marrow, but are absent from the corresponding fraction in fetal liver. In contrast, lambda 5, VpreB, Rag-1, and Rag-2 are expressed at comparable levels.

Chromatographic determination method for 1-nitropyrene and its metabolites in biological samples with fluorescence detection after on-line reduction

A high performance liquid chromatographic (HPLC) method with fluorescence detection after on-line reduction for the determination of 1-nitropyrene (NP), 1-nitrosopyrene (NSP), 1-aminopyrene (AP) and N-acetylaminopyrene (AAP) has been developed. The reduction efficiency of NP and NSP on a zinc column was found to be higher than that of an electrochemical reducer. Using a HPLC system equipped with a zinc column (4.0 mm i.d. x 10 mm) and an imidazole/HClO4 (pH 6.8): acetonitrile mobile phase, detection limits (S/N = 3) of 20-30 fmol for NP, NSP and AP and 350 fmol for AAP were obtained. NP, NSP and AP were determined in the incubation mixture of NP and Salmonella typhimurium, YG1021, by this method. Time course studies showed that a large ratio of NP was metabolized in the pre-incubation step of the Ames test.

Immunohistochemical analysis of ras oncogene product p21 in human endometrial carcinoma

Monoclonal antibody rp-28 directed against the ras gene product p21 has been used to evaluate ras p21 expression in endometrial lesions. Endometrial cancer showed a variable reactivity according to histological type: in well differentiated adenocarcinoma 63% were positive (12/19); in moderately differentiated adenocarcinoma 53% were positive (8/15); in poorly differentiated adenocarcinoma 40% were positive (2/5). The staining intensity of ras p21 seemed to be stronger in the more differentiated types of endometrial carcinoma. In endometrial carcinoma with premenopausal women, 27% were positive (3/11), and with postmenopausal women 71% were positive (20/28). The difference between premenopausal and postmenopausal groups was statistically significant (Mantel-Haenszel procedure, M-H chi 2 = 6.765, P < 0.01). The results suggest the existence of different carcinogenetic mechanisms in these two groups of endometrial cancer.

Simultaneous determination of methamphetamine and its metabolites in the urine samples of abusers by high performance liquid chromatography with chemiluminescence detection

A HPLC determination method for methamphetamine (MA) and its metabolites in the urine samples of abusers has been developed. MA, amphetamine (AP), norephedrine (NE), p-hydroxymethamphetamine (pOHMA), p-hydroxyamphetamine (pOHAP) and an internal standard, namely beta-phenylethylamine (PEA) were derivatized with dansyl chloride. They were separated on a reversed phase column with gradient elution using an acetonitrile/tetrahydrofuran/imidazole buffer mobile phase and chemilumigenically determined using bis(2,4,6-trichlorophenyl)-oxalate/hydrogen peroxide as post column reagents. The lower determination limits were as low as 1 x 10(-14)-3 x 10(-14) mol. AP, NE, pOHAP and PEA were derivatized with naphthalene-2,3-dicarboxaldehyde, and were separated on a reversed phase column using an acetonitrile/imidazole buffer mobile phase and chemilumigenically determined. The lower determination limits were 3 x 10(-16)-1.5 x 10(-15) mol. Enzymatic hydrolysis of glucuronides of pOHMA (pOHMAG) and pOHAP (pOHAPG) allowed them to be determined as pOHMA and pOHAP, respectively. After adjusting the pH of the urine samples to 10.5 and adding PEA, all metabolites except glucuronides were extracted quantitatively into chloroform-isopropanol (3:1). Utilizing the two methods, MA and all metabolites were determined in urine samples of MA abusers. The tendency, in order of decreasing concentration was: [MA] > [A] > [pOHMAG] > [pOHMA] > [NE] > [pOHAPG] > [pOHAP]. Although ephedrine (EP) was was detected in several samples, it was not considered to be a metabolite of MA but rather a component derived from cough medicine.