Marked potentiation of activity of beta-lactams against methicillin-resistant Staphylococcus aureus by corilagin

We found that an extract of Arctostaphylos uva-ursi markedly reduced the MICs of beta-lactam antibiotics, such as oxacillin and cefmetazole, against methicillin-resistant Staphylococcus aureus. We isolated the effective compound and identified it as corilagin. Corilagin reduced the MICs of various beta-lactams by 100- to 2,000-fold but not the MICs of other antimicrobial agents tested. The effect of corilagin and oxacillin was synergistic. Corilagin showed a bactericidal action when added to the growth medium in combination with oxacillin.

A 10-kda fragment of fibronectin type III domain is a neutrophil chemoattractant purified from conditioned medium of rat granulation tissue

A neutrophil chemoattractant has been purified from the conditioned medium of granulation tissue obtained from carrageenan-induced inflammation in rats. The purified chemoattractant was a basic protein with a molecular mass of 10 kDa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) under reducing and non-reducing conditions. NH2-terminal amino acid sequence of the purified 10-kDa protein was identical with the sequence of rat fibronectin starting from the residue Thr585, indicating that the purified 10-kDa chemoattractant is a fragment derived from the NH2-terminal type III domain of rat fibronectin.

NorM of vibrio parahaemolyticus is an Na(+)-driven multidrug efflux pump

NorM of Vibrio parahaemolyticus apparently is a new type of multidrug efflux protein, with no significant sequence similarity to any known transport proteins. Based on the following experimental results, we conclude that NorM is an Na(+)-driven Na(+)/drug antiporter. (i) Energy-dependent ethidium efflux from cells possessing NorM was observed in the presence of Na(+) but not of K(+). (ii) An artificially imposed, inwardly directed Na(+) gradient elicited ethidium efflux from cells. (iii) The addition of ethidium to cells loaded with Na(+) elicited Na(+) efflux. Thus, NorM is an Na(+)/drug antiporting multidrug efflux pump, the first to be found in the biological world. Judging from the similarity of the NorM sequence to those of putative proteins in sequence databases, it seems that Na(+)/drug antiporters are present not only in V. parahaemolyticus but also in a wide range of other organisms.

A novel peroxiredoxin of the plant Sedum lineare is a homologue of Escherichia coli bacterioferritin co-migratory protein (Bcp)

We cloned a gene encoding a 17-kDa protein from a cDNA library of the plant Sedum lineare and found that its deduced amino acid sequence showed similarities to those of Escherichia coli bacterioferritin co-migratory protein (Bcp) and its homologues, which comprise a discrete group associated with the peroxiredoxin (Prx) family. Studies of the recombinant 17-kDa protein produced in E. coli cells revealed that it actually had a thioredoxin-dependent peroxidase activity, the hallmark of the Prx family. PrxQ, as we now designate the 17-kDa protein, had two cysteine residues (Cys-44 and Cys-49) well conserved among proteins of the Bcp group. These two cysteines were demonstrated to be essential for the thioredoxin-dependent peroxidase activity by analysis of mutant proteins, suggesting that these residues are involved in the formation of an intramolecular disulphide bond as an intermediate in the reaction cycle. Expression of PrxQ suppressed the hypersensitivity of an E. coli bcp mutant to peroxides, indicating that it might exert an antioxidant activity in vivo.

Phenolic constituents of licorice. VIII. Structures of glicophenone and glicoisoflavanone, and effects of licorice phenolics on methicillin-resistant Staphylococcus aureus

Two new phenolic compounds, glicophenone (1) and glicoisoflavanone (2), were isolated from commercial licorice, and their structures were elucidated on the basis of spectroscopic data. Antibacterial assays of licorice phenolics for Staphylococcus aureus, including four strains of methicillin-resistant S. aureus (MRSA), and also for Escherichia coli K12 and Pseudomonas aeruginosa PAO1, were then examined. Two compounds among them, 8-(gamma,gamma-dimethylallyl)-wighteone (21) and 3'-(gamma,gamma-dimethylallyl)-kievitone (28), showed remarkable antibacterial effects [minimum inhibitory concentrations (MICs), 8 microg/ml on the MRSA strains and methicillin-sensitive S. aureus. Licochalcone A (14), gancaonin G (20), isoangustone A (24), glyasperins C (30) and D (31), glabridin, (32), licoricidin (33), glycycoumarin (34) and licocoumarone (40) showed antibacterial effects on the MRSA strains with MIC values of 16 microg/ml. Effects on the beta-lactam resistance of the MRSA strains were also examined, and licoricidin (33) noticeably decreased the resistance of the MRSA strains against oxacillin, as shown by the reduction in the MICs of oxacillin (lower than 1/128-1/1000 in the presence of 8 microg/ml of 33, and 1/8-1/32 in the presence of 4 microg/ml of 33). Mechanistic study suggested that 33 does not inhibit the formation of penicillin-binding protein 2' (PBP2'), but affects the enzymatic function of PBP2'.

Restoration of effectiveness of beta-lactams on methicillin-resistant Staphylococcus aureus by tellimagrandin I from rose red

We found that extract from petals of Rosa canina L. (rose red) strikingly reduced the minimum inhibitory concentration of beta-lactams in methicillin-resistant Staphylococcus aureus. We isolated two compounds that reduced the minimum inhibitory concentrations of beta-lactams from the extract, tellimagrandin I and rugosin B. Tellimagrandin I was very effective regarding the reduction of the minimum inhibitory concentration, and rugosin B showed some effect. Tellimagrandin I showed a weak bactericidal action when added together with oxacillin. Judging from the fractional inhibitory concentration index, the effect of tellimagrandin I and oxacillin was synergistic. Tellimagrandin I also significantly reduced the minimum inhibitory concentration of tetracycline in some strains of methicillin-resistant Staphylococcus aureus.

Susceptibilities of oral and nasal isolates of Streptococcus mitis and Streptococcus oralis to macrolides and PCR detection of resistance genes

The susceptibility of viridans group streptococci to macrolides was determined. Thirteen isolates (17%) were resistant to erythromycin. Five strains carried an erm gene that was highly homologous to that in Tn917. Four strains had mefE genes that coded erythromycin efflux ability.

Interactions of cyclodextrins with dipalmitoyl, distearoyl, and dimyristoyl phosphatidyl choline liposomes. A study by leakage of carboxyfluorescein in inner aqueous phase of unilamellar liposomes

The interaction of cyclodextrins (CDs) with L-alpha-dipalmitoyl phopsatidyl choline (DPPC), L-alpha-distearoyl phosphatidyl choline (DSPC), and L-alpha-dimyristoyl phosphatidyl choline (DMPC) unilamellar liposomes was investigated by the leakage of carboxylfluorescein (CF) entrapped in the inner aqueous phase of liposomes, at 25 degrees C (DPPC and DSPC liposomes) and at 5 degrees C (DMPC liposomes). The efficiency of CDs for CF leakage was remarkable in the order of heptakis (2,6-di-O-methyl)-beta-CD (DOM-beta-CD) > alpha-CD > heptakis (2,3,6-tri-O-methy)-beta-CD (TOM-beta-CD) from DPPC liposomes, in the order of DOM-beta-CD > TOM-beta-CD > alpha-CD from DSPC liposomes and in the order of alpha-CD > DOM-beta-CD > TOM-beta-CD from DMPC liposomes. The other CDs used in the present studies, beta-CD, 2-hydroxylpropyl beta-CD, and gamma-CD scarcely induced the CF leakage from above the three liposomes. From the profiles of % CF leakage, together with measurements of differential scanning calorimetry, it was found that hydrophobic DOM-beta-CD penetrates the matrix of the liposomes to interact with them as well as TOM-beta-CD, and that less hydrophobic alpha-CD exists at the surface of the membrane to interact with the liposomes. Further, it was found that the interaction of CDs with liposomes changes depending not only on the length of fatty acid chain of phospholipid (condensation force and hydrophobicity) but also the hydrophobicity and the cavity size of CD.

Marked reduction in the minimum inhibitory concentration (MIC) of beta-lactams in methicillin-resistant Staphylococcus aureus produced by epicatechin gallate, an ingredient of green tea (Camellia sinensis)

We found that epicatechin gallate, a constituent of an extract of tea leaves (green tea) markedly lowered the minimum inhibitory concentration (MIC) of oxacillin and other beta-lactams, but not of other antibacterial agents tested, in strains of methicillin-resistant Staphylococcus aureus. The antibacterial action of epicatechin gallate plus oxacillin was a bactericidal one.

Spontaneous hemothorax secondary to immature teratoma of the mediastinum

Spontaneous hemothorax in a 20-year-old boy was caused by rupture of an immature teratoma of the mediastinum. The tumor bled spontaneously into the right pleural space. This life-threatening complication necessitated emergency surgery. The unusual cause and the interesting clinical course of spontaneous hemothorax are described.

Phenolic constituents of Cassia seeds and antibacterial effect of some naphthalenes and anthraquinones on methicillin-resistant Staphylococcus aureus

Thirteen phenolic glycosides including six new compounds were isolated from seeds of Cassia tora (Leguminosae). The structures of the new compounds, rubrofusarin triglucoside (7), nor-rubrofusarin gentiobioside (9), demethylflavasperone gentiobioside (10), torachrysone gentiobioside (11), torachrysone tetraglucoside (12) and torachrysone apioglucoside (13), were elucidated on the basis of spectroscopic and chemical evidence. The effects of the phenolic glycosides, their aglycones and several other compounds structurally related to them on Escherichia coli K12, Pseudomonas aeruginosa PAO1 and some strains of Staphylococcus aureus were then examined. Among them, torachrysone (15), toralactone (16), aloe-emodin (18), rhein (19) and emodin (20) showed noticeable antibacterial effects on four strains of methicillin-resistant Staphylococcus aureus with a minimum inhibitory concentration of 2-64 micrograms/ml. On the other hand, the phenolic compounds tested did not show strong antibacterial effects on E. coli and P. aeruginosa.

[Seven cases of marked pulmonary fibrosis in the upper lobe]

We report on 7 patients with marked idiopathic pulmonary fibrosis in the upper lung lobes. The patients were generally characterized by the following pathological and clinical features: (1) marked subpleural pulmonary opacities and reticular shadows mainly in the upper lobes, with a progressive reduction in lung volume; (2) nonspecific fibrosis (subpleural, zonal, rather well-defined fibrosis with small cysts and honeycomb lesions) in 5 patients and interstitial pneumonia in 2, mainly in the upper lobes; and (3) a slender build, and a family history of recurrent spontaneous pneumothorax. Clinically, all 7 cases resembled idiopathic upper-lobe fibrosis as described by Amitani in 1992. Further clinical and experimental research will be required to delineate the characteristics of idiopathic fibrosis affecting primarily the upper lobes.

NorM, a putative multidrug efflux protein, of Vibrio parahaemolyticus and its homolog in Escherichia coli

We found that cells of Vibrio parahaemolyticus possess an energy-dependent efflux system for norfloxacin. We cloned a gene for a putative norfloxacin efflux protein from the chromosomal DNA of V. parahaemolyticus by using an Escherichia coli mutant lacking the major multidrug efflux system AcrAB as the host and sequenced the gene (norM). Cells of E. coli transformed with a plasmid carrying the norM gene showed elevated energy-dependent efflux of norfloxacin. The transformants showed elevated resistance not only to norfloxacin and ciprofloxacin but also to the structurally unrelated compounds ethidium, kanamycin, and streptomycin. These results suggest that this is a multidrug efflux system. The hydropathy pattern of the deduced amino acid sequence of NorM suggested the presence of 12 transmembrane domains. The deduced primary structure of NorM showed 57% identity and 88% similarity with that of a hypothetical E. coli membrane protein, YdhE. No reported drug efflux protein in the sequence databases showed significant sequence similarity with NorM. Thus, NorM seems to be a novel type of multidrug efflux protein. We cloned the ydhE gene from E. coli. Cells of E. coli transformed with the cloned ydhE gene showed elevated resistance to norfloxacin, ciprofloxacin, acriflavine, and tetraphenylphosphonium ion, but not to ethidium, when MICs were measured. Thus, it seems that NorM and YdhE differ somehow in substrate specificity.

[Significance of full-thickness chest wall resection as a local treatment for sternum metastasis of breast cancer]

Bone metastasis of breast cancer generally tends to be multiple. However, breast cancer frequently metastasizes to the sternum as solitary metastasis. Resection of the sternum was reported to be an effective surgical technique for sternum metastasis which could not be remarkably improved by chemo-endocrine therapy and locoregional recurrent breast cancer invading the skin. A first patient was diagnosed with sternum metastasis invading the skin 44 months after radical mastectomy for breast cancer of stage II. A second patient had breast cancer of stage IV simultaneously with metastases to the sternum and the lung. Only the lung metastasis was successfully controlled by chemo-endocrine therapy, but the sternum metastasis was progressive, following radical mastectomy. Both patients manifested solitary bone metastases and underwent full-thickness chest wall resection. The defect of the chest wall was reconstructed with the mucocutaneous flap using the dorsal latissimus muscle in case 1 and with the abdominal rectus muscle in case 2. Twenty months after the resection of the sternum, the first patient suffered from supraclavicular lymph node metastasis, and the multidisciplinary treatment including radiation therapy was indicated. This therapeutic procedure was effective, and the patient survived for 63 months after resection of the sternum. The second patient has made good progress for six months in maintaining complete remission with chemo-endocrine therapy. These findings suggested that surgical resection was a useful local treatment for solitary sternum metastasis.

Double infection with Giardia lamblia and Salmonella paratyphi A associated with acute renal failure

While traveling in India, a previously healthy twenty-year-old man had febrile diarrhea. The patient was prescribed medical therapy, and all symptoms were resolved. Fourteen days later, however, similar symptoms recurred. The patient was admitted to a local hospital, but was transferred to our department because of oliguria. Salmonella paratyphi A was isolated from blood and stool specimens, and Giardia lamblia was identified in his stool. The patient's condition was complicated by acute renal failure. The patient received tosufloxacin and metronidazole. Renal function recovered completely without hemodialysis. Paratyphoid fever and giardiasis were resolved. It is suggested that giardiasis exacerbated the paratyphoid fever.

[A case of humidifier lung characterized by histopathologic feature]

A 61-year-old man was discharged from our hospital after recovering from bilateral fractures in the neck of each femur. However, a productive cough, dyspnea, and a high grade fever occurred eight hours after returning home. He was thus admitted once more. At rehospitalization, there was radiographic evidence of bilateral infiltrates and hypoxemia. Hypersensitivity pneumonitis was strongly suggested by radiographic evidence, by the fact that no new drugs had been administered, and by a positive result after an environmental provocation test. A diagnosis of humidifier lung was confirmed by a positive precipitins test for humidifier water. Several microorganisms were isolated from humidifier water, and precipitins tests for the isolated microorganisms were mostly positive. Microscopic examination revealed focal alveolitis, bronchiolitis, and perivasculitis. Perivascular leucocytic infiltrations around venules suggested that inhaled antigens might have also caused humidifier lung via a vascular route. Humidifier lung may be due in part to soluble factors, such as endotoxin, present in humidifier water.

[Bufferin-induced lung injury manifesting as acute eosinophilic pneumonia]

A 26-year-old woman was admitted to our hospital because of dyspnea and fever one day after taking medicines for the common cold. A chest roentgenogram and a computed tomogram revealed diffuse patchy infiltrates in both lung fields. Examination of a specimen obtained by transbronchial lung biopsy showed thickening of alveolar walls and infiltration of eosinophils. Bronchoalveolar lavage fluid had many eosinophils. DLST was positive for Bufferin, which the patient took one day before the dyspnea and fever began. We believe that this patient's pulmonary disease was caused by Bufferin. We should realize that this widely used analgesic can cause acute eosinophilic lung disease. The patient was not given corticosteroids, and her condition improved soon after she stopped taking Bufferin.

[Intraoperative interstitial microwave therapy for recurrent hepatocellular carcinoma of the caudate lobe: a case report]

Microwave tissue coagulation (MTC) therapy was given patients with recurrent hepatocellular carcinoma (HCC) of the caudate lobe of the liver, in which radical surgery for deteriorated liver function was impossible. A total of 40 MTC sessions was applied to two tumors under laparotomy. MTC was administered for 20 seconds in each session. Microwave energy output was 70 watts for 15 mm needle-electrodes and 100 watts for 30 mm electrodes. Alpha-fetoprotein levels in serum had decreased after surgery. Abdominal computed tomography showed no blood flow whatsoever in tumors undergoing MTC. There are fewer limits to the sites and angles for insertion of electrodes under laparotomy. Thus, the surgical approach provides access to all parts of the liver for treatment. We conclude that intraoperative MTC is highly effective in tumor necrosis, and can be a useful local treatment for nonresectable HCC.

[An autopsy case of severe tuberculosis associated with anal fistula and intestinal perforation]

A 55 year-old man was admitted to the department of the gastroenterology of the hospital because of severe weakness and appetite loss for the past one month. In the last two months, he has been suffering from recurrent fistula of the anus. He left his symptoms without therapy. A gastric ulcer was found out with gastric endoscopy. At the same time, chest X-ray film showed bilateral abnormal shadows, which were suspected of severe pulmonary tuberculosis by a chest physician. After the admission, the patient immediately developed respiratory failure. Both sputa and discharge from anal fistula were positive for acid fast bacillus. Despite of anti-tuberculosis therapy and mechanical ventilation, he died of respiratory failure. At the autopsy, severe pulmonary tuberculosis, tuberculous fistula of the anus, intestinal tuberculosis with perforation, miliary tuberculosis and peptic ulcer of the stomach were defined. We suspected that the extensive disease caused by hematogeneous spread and the late diagnosis of tuberculosis was owing to patient's delay.

Amplification of the DNA repair gene O6-methylguanine-DNA methyltransferase associated with resistance to alkylating drugs in a mammalian cell line

The cytotoxic action of such alkylating chemotherapeutic drugs as 2-chloroethyl-N-nitrosourea (CNU) derivatives is countered by the repair protein O6-methylguanine-DNA methyltransferase (MGMT), which removes O6-alkylguanine induced in the DNA by these agents. Resistance to these drugs is often correlated with the MGMT levels in normal and tumor cells of human and rodent origin. Exposure of mouse 3T3 cells to increasing concentrations of CNU, and subsequent selection of resistant cells, led to the isolation of clones with 5-10 times higher levels of MGMT activity than in the control. The increased MGMT expression at both mRNA and protein levels resulted from 5- to 10-fold amplification of the Mgmt gene. Amplification of this gene was not associated with concomitant amplification of another alkylation damage repair gene, N-methylpurine-DNA glycosylase. No amplification of at least three other genes on chromosome 7 (which contains the Mgmt gene) was observed in the drug-resistant cells. Furthermore, the amplified Mgmt sequence was not associated with a homogeneously staining region, or double minute chromosomes, nor present as episomal DNA. In situ hybridization of metaphase chromosomes of the drug-resistant cells indicated both translocation and localized amplification of the Mgmt gene.

UV endonuclease of Micrococcus luteus, a cyclobutane pyrimidine dimer-DNA glycosylase/abasic lyase: cloning and characterization of the gene

The gene of Micrococcus luteus UV endonuclease (cyclobutane pyrimidine dimer-DNA glycosylase/ abasic lyase) was cloned and characterized. The cloned gene, whose product had a predicted molecular mass of 17,120 Da, was found to be capable of complementing the Escherichia coli uvrA6 mutation in vivo with respect to resistance to acetonemediated molecular photosensitization, a treatment producing exclusively cyclobutane pyrimidine dimers in DNA. It also generated a nicking activity specific for photosensitization-treated DNA by in vitro transcription/translation. When expressed in E. coli cells, the gene produced a protein structurally identical with UV endonuclease and possessing an activity consistent with cyclobutane pyrimidine dimer-DNA glycosylase/abasic lyase with respect to the effect of inhibitors and the site of the DNA backbone scission. Furthermore, the UV endonuclease-deficient mutant DB7 was shown to regain the enzyme through transformation with the cloned gene. The deduced amino acid sequence of the gene product was at best 27% identical with that of endonuclease V of phage T4, an enzyme strikingly similar to UV endonuclease in molecular and catalytic properties. Despite this marginal overall similarity in amino acid sequence, four of the seven amino acid residues reported to be functionally important in the T4 enzyme were found to be conserved in the M. luteus enzyme. We propose that the gene be called uveA.

Cytological evaluation of the effects of chemotherapy on metastatic liver cancer

We present a method for the cytological evaluation of the therapeutic effects of various treatments on unresectable metastasis in the liver from colorectal cancer. A degeneration index (DI) for cancer cells obtained by aspiration was determined in 17 patients before and after treatment. The relationships of the rate of tumor reduction and of the post-treatment survival period to the treatment-induced changes in DI were studied. The treatment-induced change in DI was represented by the difference between the pretreatment DI and the posttreatment DI. The treatment-induced change in DI was significantly correlated with the rate of tumor reduction (r = 0.794, P < 0.001). The survival rate was significantly higher in patients with higher changes in DI than in patients with lower changes (P < 0.05). The change in the DI of cancer cells seems to be a useful parameter for evaluating the effects of chemotherapy on unresectable liver metastases from colorectal cancer.

The T-C(8356) mitochondrial DNA mutation in a Japanese family

A rare point mutation at nucleotide position 8356 in the transfer RNA gene in mitochondrial DNA was found in a Japanese family. Our proband had migraine and dementia associated with lactic acidosis in addition to myoclonic epilepsy with ataxia and ragged-red fibres in a muscle biopsy specimen consistent with the clinical characteristics of myoclonic epilepsy with ragged-red fibres (MERRF). His mother, who had the same point mutation, also had migraine but without myoclonus or ataxia. His aunt, who had the same point mutation and migraine, developed diabetes mellitus, encephalomyopathy and several stroke-like episodes associated with lactic acidosis (MELAS). This is the third family with the rare mutation seen in American and Italian families. The mutation may not be specific to Caucasians, and is probably closely related to the MERRF/MELAS overlap syndrome.

Cytokine-induced neutrophil chemoattractant (CINC)-2 alpha, a novel member of rat GRO/CINCs, is a predominant chemokine produced by lipopolysaccharide-stimulated rat macrophages in culture

Neutrophil chemotactic factors (chemokines) have been purified from conditioned medium of lipopolysaccharide (LPS)-stimulated rat macrophages in culture. The LPS-stimulated macrophages produced one acidic chemokine, rat macrophage inflammatory protein (MIP)-1alpha, and four basic chemokines, cytokine-induced neutrophil chemoattractant (CINC)-1. CINC-2alpha, CINC-2beta and CINC-3/rat MIP-2. CINC-2alpha, a novel chemokine recently isolated from conditioned medium of rat granulation-tissue culture, was the major chemoattractant among these four basic chemokines. The results suggest that CINC-2alpha is produced by activated macrophages in vivo and plays an important role in the infiltration of neutrophils into inflammatory sites in rats