Myeloperoxidase gene expression and regulation by myeloid cell growth factors in normal and leukemic cells

Myeloperoxidase (MPO) is present in azurophilic granules which appear in the promyelocyte stage of differentiation, and is the most common functional protein of myeloid cells. With progress in molecular biology, the expression and regulation of MPO have been clarified in normal myeloid and leukemic cells, not only by enzymatical activity but at the gene level MPO expression is affected by the differentiation of myeloid cells, and has been suggested to be regulated by myeloid cell growth factors, such as granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor and interleukin-3. In the past decade the signal transduction from their receptors has been clarified. This review describes the expression and regulation of the MPO gene in myeloid cells including myeloid disorders, such as myeloid leukemia or myelodysplastic syndromes, The effects on MPO by myeloid growth factors and signal transduction from their receptors are also presented.

Alkaline phosphatase, defensin gene expression and effect of myeloid cell growth factors in normal and leukemic cells

In neutrophils, four different granules are defined, i.e. azurophil, specific, gelatinase and secretary vesicles. In these granules many neutrophil-specific constituents are identified. Some of these constituents have already been cloned and their gene expressions studied. In such constituents, alkaline phosphatase (ALP) and defensin are well known, although their functions are not yet fully clarified. ALP is present in secretary vesicles and has important roles in the diagnosis of some myeloid disorders. On the other hand, defensin is the most abundant functional peptide of neutrophils and is present in azurophillic granules. Which are subdivided into defensin-rich and defensin-poor granules. This review describes the expression of ALP and the defensin gene in normal and leukemic cells and the effect on these genes of myeloid growth factors, such as granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor and interleukin 3.

Functional outcome of anterior transposition of the vascularized ulnar nerve for cubital tunnel syndrome

Anterior transposition of the ulnar nerve is a widely used treatment for cubital tunnel syndrome, but neurolysis performed at the time of surgery may impair the blood supply to the ulnar nerve. This study compared the results of intramuscular anterior transposition of the ulnar nerve with or without preserving the extrinsic vessels of the ulnar nerve in 35 patients. The postoperative nerve conduction velocity and the clinical results were better in the group in which the extrinsic vessels were presented.

Effects of glycerol on intracellular ice formation and dehydration of onion epidermis

Microscopic observations of freezing processes of onion epidermis have been carried out using a directional solidification stage. Effects of cryoprotectant on the intracellular ice formation and the dehydration were examined for several kinds of concentrations of glycerol in a wide range of cooling rate. With an increase of the glycerol concentration the ice formation due to the surface-catalyzed nucleation (SCN) at the plasma membrane was suppressed and the freezing temperature decreased. Especially, under a rapid cooling condition, a large supercooling should be achieved and we observed a different type of freezing in the lower temperature conditions. At the slower cooling rate, on the other hand, the use of glycerol can not prevent the cell shrinkage caused by the dehydration. It is also found that the intracellular ice formation and the dehydration under the ordinary cooling condition can be estimated based on the SCN theory by Toner et al. and Mazuar's dehydration model.

Minimized platelet interaction with poly(2-hydroxyethyl methacrylate-block-4-bis(trimethylsilyl)methylstyrene) hydrogel showing anomalously high free water content

Novel hydrophilic-hydrophobic block copolymers - poly(2-hydroxyethyl methacrylate-block-4-bis(trimethylsilyl)methylstyrene) (poly(HEMA-block-BSMS) or BH polymer) - were prepared as materials potentially useful for blood-contacting devices. Among the BH(X) series including poly(HEMA) itself, platelet adhesion and activation are minimum on the surface of BH(10), the block copolymer composed of 10 mol% of the hydrophobic segment. The unique physicochemical characteristics of BH(10) such as the high free water content and the increased mobility of PHEMA segments seem to play an important role in the prevention of platelet adhesion and activation. The water content of BH(10) was twice that of poly(HEMA) itself, even in the presence of 10 mol% of the hydrophobic moiety [poly(BSMS)]. Further, an anomalous increase in free water content was observed for the BH(10) sample measured by DSC. The glass transition temperature of BH(10) in the dry state was determined to be c. 10 degrees C, which was much lower than that observed for each of the homopolymers (c.f.: Tg [poly(HEMA)] = 70 degrees C; Tg [poly(BSMS)] = 160 degrees C), suggesting an increased mobility of tethered PHEMA segments in the BH(10) film.

[Crescentic glomerulonephritis in a patient with rheumatoid arthritis]

A 56-year-old female with rheumatoid arthritis was admitted because of bilateral hip pain. In a few months of her hospitalization, a relatively abrupt renal dysfunction was emerged besides complement breakdown, and renal biopsy revealed crescentic glomerulonephritis. Immunofluorescence study showed peripheral granular deposits of IgG, IgM, and C3 in the glomeruli. Cresents were predominantly composed of macrophages and glomerular epithelial cells. Amyloid nephropathy, renal vasuculitis, and association of other collagen vascular diseases were negligible for the causative factor. It was suggested that immune complexes were formed in the glomeruli, in which both humoral and cellular immune responses were to be induced, that brought cescents formation in the lesions. Crescentic glomerulonephritis in patients with rheumatoid arthritis is rare and a possible pathogenetic mechanisms involved in the development of renal dysfunction are discussed with the special reference to immune complex-induced inflammation.

Liposome encapsulated doxorubicin transfer to the pelvic lymph nodes by endoscopic administration into the bladder wall: a preliminary report

PURPOSE

Liposome encapsulated doxorubicin administered to the pelvic lymph nodes might be effective against pelvic node metastasis. We determined whether the drug can be delivered to the nodes via the bladder wall.

MATERIALS AND METHODS

Ten patients underwent endoscopic administration of 10 mg. liposomal doxorubicin into the bladder wall 3 days before cystectomy. The concentration of doxorubicin in the pelvic lymph nodes obtained at operation was measured.

RESULTS

No complication developed after drug administration. Almost all lymph nodes examined contained more than 100 ng./gm. doxorubicin (median 1,860).

CONCLUSIONS

Endoscopic administration of liposomal doxorubicin into the bladder wall may be an alternative method to deliver doxorubicin to the pelvic lymph nodes.

CA19-9: a possible serum marker for embryonal carcinoma

We determined whether a carbohydrate antigen in serum, CA19-9, serves as a marker for embryonal carcinoma. Serum CA19-9 was serially measured in 18 male patients with a germ cell tumor. Five of 8 patients with an embryonal carcinoma had an elevated serum CA19-9. The elevated serum CA19-9 returned to normal in parallel to the clinical response to the treatment. Patients with a seminoma had a normal serum CA19-9 irrespective of their tumor size. Paraffin-embedded specimens of germ cell tumors from 9 of the 18 patients and 10 other patients were stained with the monoclonal antibody against CA19-9. These immunohistochemical stainings showed that embryonal carcinomas and mature teratomas were consistently positive and seminomas were often faintly positive for CA19-9, whereas choriocarcinomas, yolk sac tumors and immature teratomas were negative for CA19-9. These results indicate that serum CA19-9 may be a useful serum marker for embryonal carcinomas.

Adsorbed serum protein mediated adhesion and growth behavior of bovine aortic endothelial cells on polyamine graft copolymer surfaces

Polyamine-brushed substrata for cell culture were designed by solvent casting of polystyrene-graft-polyamine copolymer (SA) on hydrophobically modified glass surface, and adhesion, spreading, and proliferation of bovine aortic endothelial cells (BAEC) on these substrata were evaluated. Adhesion and spreading of BAEC increased with increasing polyamine content in the copolymer. Close correlation was found between cellular spreading and subsequent cell growth; the surface inducing better spreading of adhered cells showed higher endothelial cell growth. Adhesion and spreading of BAEC were significantly influenced by fetal calf serum (FCS)-pretreatment of the SA copolymer surfaces, being increased with increasing polyamine content, whereas on bovine serum albumin (BSA)-preabsorbed surfaces, BAEC adhesion was considerably prevented and eventually no cell spreading was observed. Then, adsorption of cell-adhesion proteins, fibronectin (FN), and vitronectin (VN), out of FCS onto SA copolymer surfaces were evaluated using enzyme immunoassay. Both FN and VN adsorption on SA copolymer surfaces were increased with increasing polyamine content in the copolymer, suggesting a crucial role of these cell-adhesion proteins in BAEC adhesion and subsequent growth behavior on SA copolymer surfaces.

[Clinical analysis of 169 patients with prostate cancer]

At Matsumoto National Hospital, 169 patients with prostate cancer were diagnosed between April 1986 and May 1994. The prostate cancer incidence was the highest in the latter half of the seventies, with an average age of 74.3 years. The clinical stage was defined as A1, A2, B, C, and D2 in 24 (14.2%), 38 (22.5%), 39 (23.1%), 23 (13.6%) and 45 (26.6%) patients, respectively. The clinical stage was not correlated with the patient's age. Incidental carcinoma was discovered in 5.8% of the patients who underwent prostatectomy for benign prostatic hypertrophy (BPH). At initial diagnosis, the tumor was well, moderately, and poorly differentiated adenocarcinoma in 71 (42.0%), 64 (37.9%), and 34 (20.1%) patients, respectively. The median follow-up period was 38.7 months. The over all five-year crude survival rate was 54.8%, while the cause-specific five-year survival rate was 80.0%. The five-year crude survival rate was 58.4, 82.0, 55.2, 42.5 and 37.4%, for patients with cancer at stage A1, A2, B, C, and D. The survival rate was higher for patients with cancer at clinical stage A and shorter for those with cancer at clinical stage D than in other stages. Prognosis was also worse in patients with moderately or poorly differentiated adenocarcinoma than in those with well-differentiated adenocarcinoma. The clinical stage and the pathological grade are important as prognostic factors, although the high incidence of death from other diseases shows that the patients' age should be considered to choose the modality of therapy. These findings indicate that intensive treatment of the patients in clinical stage A2, B and C prostate cancer in combination with screening for the men between 50 and 75 years old for early cancer detection is required.

[A clinical and pathological study of radical prostatectomy for prostate cancer]

BACKGROUND

Thirty-one patients with prostate cancer underwent radical prostatectomy and simultaneous pelvic lymphadenectomy at Matsumoto National Hospital between 1988 and 1994. Prognostic factors are discussed from their clincopathological findings.

METHODS

The patients ranged from 54 to 80-year-old, with an average age of 69.9 years. The median follow-up period was 44 months. The diagnosis was confirmed by needle biopsy or transurethral resection of the prostate. All the patients received short-term endocrine therapy preoperatively, and only noncuratively resected patients underwent adjuvant therapy postoperatively. At initial diagnosis, the tumor grades were well, moderately, and poorly differentiated adenocarcinoma in 9, 12, and 10 patients, respectively. The clinical stage was defined as A2, B, C, D1, and D2 in 12, 4, 6, 3, and 6 patients, respectively.

RESULTS

A difference of tumor grade was found between the initial diagnosis and the final diagnosis based on the resected prostate in 8 patients (26%), with 7 of them (88%) showing an increase in grade in the final diagnosis. Also revealed was that 11 of the 25 patients (44%) in stage A2, B, C, or D1 had been understaged preoperatively. The five-year actuarial survival rates were 100%, 92%, and 51% for patients with well, moderately, and poorly differentiated adenocarcinoma, respectively, with a significant difference noted between well and poorly differentiated adenocarcinoma (p = 0.03). Recurrence only developed in patients with pathological stage D tumors. However, the presence or absence of lymph node metastasis did not affect the crude 5-year survival rate. Several stage D patients were successfully treated by radical prostatectomy and adjuvant therapy, achieving long survival.

CONCLUSION

These results indicate that patients in clinical stage C have tumors which exhibit differing biological behavior. These patients should be analyzed and classified more precisely so that the most appropriate therapy can be chosen.

Effects of myeloid cell growth factors on alkaline phosphatase, myeloperoxidase, defensin and granulocyte colony-stimulating factor receptor mRNA expression in haemopoietic cells of normal individuals and myeloid disorders

The mRNA expression of alkaline phosphatase (ALP), myeloperoxidase (MPO), defensin and G-CSF receptor (G-CSFR) in bone marrow cells of normal individuals and myeloid disorders, with or without in vitro stimulation by myeloid cell growth factors, i.e. G-CSF, GM-CSF and IL-3, were examined as markers for myeloid cell differentiation in both mononuclear cell (MNC) and polymorphonuclear cell (PMN) fractions. Without any stimulation, ALP mRNA was expressed only in PMNs, G-CSFR mRNA in PMNs were expressed stronger than in MNCs; both MPO and defensin mRNA were expressed to the same degree in both fractions. With stimulation, the ALP mRNA expression in both fractions was strongly enhanced by G-CSF, but the expression was inhibited by GM-CSF and/or IL-3. MPO mRNA expression was stimulated by G-CSF and/or GM-CSF in MNCs. G-CSFR mRNA expression was enhanced by G-CSF in both fractions. Defensin mRNA expression was inhibited by G-CSF. In cases of myelodysplastic syndrome and chronic myelogenous leukaemia which display a suppressed maturation of myeloid cells, our results demonstrated an almost normal response to these growth factors. Our results suggest that studies on these myeloid marker mRNA expressions would provide more knowledge about the differentiation state and cytokine reactivity of myeloid cells in normal individuals as well as various disorders.

Effect of lithium on serum calcium level and parathyroid function in manic-depressive patients

The purpose of this study is to find out whether hypercalcemia and hyperparathyroidism are rare or not in manic-depressive patients taking lithium carbonate. The subjects were 13 patients receiving lithium and 19 healthy subjects not receiving it as normal controls. Serum ionized calcium (Ca++), serum parathyroid hormone (PTH), urinary calcium and cyclic AMP(cAMP) were measured. Cervical ultrasonographic examination was also performed. The mean serum Ca++ level in the lithium administered group was significantly higher than that in the control group (P < 0.02). There was no significant difference between the serum PTH levels in the two groups. The mean urinary calcium level in the lithium administered group was below the normal range, but the mean urinary of cAMP level was within the normal range. Although a parathyroid cyst was found in one lithium administered patient on ultrasonographic examination, no swelling of the parathyroid gland was observed in the other patients in the lithium administered group or in any of the control subjects. In the present study, no distinct hyperparathyroidism was found in the patients in the lithium administered group. Lithium administration affects calcium metabolism in manic-depressive patients and hypercalcemia seems to be one of the complications needing attention at the time of lithium administration.

A new technique for endoscopic carpal tunnel decompression

A new one-portal technique for endoscopic carpal tunnel release (ECTR) is introduced with its clinical results. The incision is made at the palmar aspect of the hand. A custom-made glass tube with a groove is inserted, and under endoscope observation, a meniscus knife is pushed forward along the groove to release the flexor retinaculum. This new technique has been studied in ten fresh cadaver hands and used in 123 patients' hands. Results of the cadaver study showed that the flexor retinaculum was released completely in all ten hands. No injuries to tendons, nerves, or arteries were noted. In one case the cotton tip was lost from the stick. All clinical releases were performed uneventfully except for three cases of neuropraxia of the digital nerve of the radial side of the ring finger, one laceration of the motor branch of the median nerve, one mild infection, one loss of cotton tip from the cotton swab stick, and one case of chipping of the glass tube. The case with the laceration of the motor branch of the median nerve occurred early in the series and required the conventional open incision to repair the nerve. The cases with loss of cotton from the stick and chipping of the tube also required a conventional incision to remove the cotton and glass chip. Advantages of this one-portal technique with the glass tube include less scar tenderness than with two-portal techniques, decreased risk of injury to the superficial palmar arch and ulnar nerve because of the distal approach, a view of pathology in the carpal tunnel through the glass tube, and confirmation of release of the flexor retinaculum.

Clinical and ultrastructural comparison of immunohistochemically inactive and gonadotropin-producing pituitary adenomas

A clinicoendocrinological and ultrastructural comparison of immunohistochemically inactive pituitary adenomas from 14 patients and gonadotropin-positive pituitary adenomas from 26 patients was carried out. Clinicoendocrinological characteristics were similar except the male to female ratios. The immunohistochemically unstable antigenicity of gonadotropin prevents clear immunohistochemical characterization, but the difference between the two types is not absolute and may be an indication of a cell line relationship.

Vascularization and innervation of the canine wrist joint synovial membrane

The correlation between vascular distribution and synovial structures was investigated using corrosion cast of the synovial fold of the dog antebrachiocarpal joint (wrist joint) under scanning electron microscopy. Arterial branches arose from a main artery deep in the subsynovial layer, ascended toward the free margin of the fold, dividing into several branches, and finally formed a dense capillary network beneath the lining layer. Immunohistochemical study and a retrograde axonal tracing experiment revealed that almost all nerve fibers were associated with the arterial tree and that: (1) proximal parts of the arterial tree were innervated with neuropeptide Y (NPY)-containing noradrenergic sympathetic fibers, vasoactive intestinal peptide-containing non-catecholaminergic sympathetic fibers from the stellate ganglion and substance P (SP)- and calcitonin gene-related peptide (CGRP)-containing sensory fibers from the C7-T1 segments of the dorsal root ganglia; (2) more distal parts of the arterial branches were associated with NPY-immunoreactive sympathetic fibers and SP- and CGRP-immunoreactive sensory fibers; and (3) the most peripheral precapillary arterioles were accompanied by only SP- and CGRP-containing sensory fibers. These results indicate that synovial blood flow is regulated by at least three different nerve systems which possess regional differences.

A new operative technique: cubital tunnel decompression with endoscopic assistance

The final outcome of a surgical decompression of the ulnar nerve depends on the precise release of all potential entrapment points. Careful attention must be given to all anatomic structures around the ulnar nerve and elbow area to ensure adequate dissection and surgical accuracy. In the authors' new endoscopic technique, glass tubes have been specially designed to house an endoscope and guide a meniscus knife, allowing for the release of all involved structures up to 10 cm both proximally and distally through a 3-cm skin incision. The authors present their experience in a cadaver trial and with 26 patients with follow-up of at least 6 months.

Comparison of proximal and distal one portal entry techniques for endoscopic carpal tunnel release. A cadaver study

Reported complications of endoscopic carpal tunnel release have increased as more surgeons use this technique to release the flexor retinaculum. We used a cadaver model to compare the results of endoscopic carpal tunnel release through a one-portal distal (Group A, 15 specimens) and a one-portal proximal (Group B, 15 specimens) entry site with a new endoscopic technique. Our custom-made glass tube of three different sizes (5, 7, and 9 mm in diameter) is designed to house an endoscope and accommodate a meniscus knife for releasing the flexor retinaculum. Complete release of the flexor retinaculum was obtained in all limbs in both groups. In Group A the one complication (7%) was loss of the cotton tip from the cotton swab stick within the carpal tunnel. In Group B, there was a single case of injury to the superficial palmar arch in one hand and breakage of a glass tube in another hand, for a total complication rate of 13%. No other damage to anatomical structures was noted.

Bladder peptic ulcer after gastrocystoplasty for radiation cystitis

We report on a woman who underwent gastrocystoplasty for radiation cystitis and in whom a peptic ulcer developed in the native portion of an augmented bladder despite hydrogen blockade medication. The ulcer resolved after the administration of a hydrogen secretion inhibitor. Peptic ulcer may be a potential hazard to patients who undergo gastrocystoplasty after pelvic radiation therapy.

[Gastrocystoplasty in adults and postoperative aciduria]

We performed augmentation gastrocystoplasty in five adult female patients with radiation cystitis after excising the injured bladder wall. The gastric segment was isolated from the body of the stomach with the right gastroepiploic vessels. The ureters were reimplanted into the gastric segment in 3 patients. Postoperatively, all patients were able to urinate from the urethra, although 1 patient needed reoperation for postoperative fistula. Since strongly acid urine developed after meal in all patients, they were placed on oral famotidine 40 mg/day. With this medication the urine pH was kept above 5. Follow-up ranged from 6 months to 3 years 2 months. In 3 patients the dosage of famotidine was gradually reduced without any symptoms. In the other 2 patients strongly acid urine caused symptoms despite the medication of famotidine. Of the 2 patients, one developed a small ulcer at the native bladder with occasional urethral pains and hematuria 7 months postoperatively. The ulcer and symptoms were improved by administration of omeprazole for 6 weeks. The other patient who consistently had mild stress incontinence complained of mild urethral and suprapubic pain. These results indicate that gastrocystoplasty is useful for radiation cystitis and postoperative complication secondary to strongly acid urine are controllable by administration of an acid secretion inhibitor.

Colocalization of growth hormone (GH) and glycoprotein subunit alpha in GH-producing pituitary adenomas in acromegalic patients

Thirty-one consecutive cases of pituitary adenoma in acromegalic patients were studied by immunohistochemistry. All adenomas contained cells immunoreactive with the anti-alpha-subunit of gonadotropic hormones (alpha; 0.6-53% of tumor cells) as well as with anti-growth hormone (GH; 4-74% of tumor cells). In serial section study, most cells immunoreactive with anti-alpha were identical to cells immunoreactive with anti-GH. There was a positive correlation between the percentages of cells immunoreactive for alpha in GH cells [alpha (%)/GH(%)] and those for prolactin (PRL) in immunoreactive tumor cells (PRL(%)/[PRL(%) + GH(%)]) in mixed GH cell-PRL cell adenomas, suggesting that the alpha-subunit may play a role in emergence of PRL cells.

Recombinant human glycosylated granulocyte colony-stimulating factor (rhG-CSF)-combined regimen for allogeneic bone marrow transplantation in refractory acute myeloid leukemia

Recombinant human glycosylated G-CSF (rhG-CSF) may stimulate proliferation of myeloid leukemia cells and thereby increase their susceptibility to anti-cancer agents. By in vitro colony assay, the rhG-CSF-responsive NFS-60 leukemic cell clones are more effectively killed by Ara C in the presence of rhG-CSF than in the absence of rhG-CSF, while the killing of the rhG-CSF-unresponsive HL-60 cell clones is unaffected by rhG-CSF. Leukemia cell colony forming units (L-CFU) derived from most AML patients demonstrate similar results to those of the NFS-60 cell clone when treated in vitro. Encouraged by these in vitro results, we used rhG-CSF as a component of a conditioning regimen for 15 relapsed AML patients who were receiving allogeneic BMT. The patients were conditioned with total body irradiation (TBI) and high-dose Ara C. rhG-CSF was infused continuously at a dose of 5 micrograms/kg/day from 24 h before the beginning of TBI to the end of Ara C therapy. Proliferation of the leukemia cells in vivo in response to rhG-CSF was confirmed in 7 of 14 patients tested and the combined use of rhG-CSF had no additional adverse effects. After BMT, four patients died of non-leukemic causes and three patients had leukemic relapse: the other eight patients have remained disease-free for 200-1600 (median 417) days. The actuarial probabilities of relapse and disease-free survival (DFS) at 4.4 years after BMT were 43.2% and 41.7%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of environmental parameters and composition of poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymers on the retention of rat lymphocyte subpopulations (B- and T-cells)

Retention behavior of rat lymphocyte subpopulations (B- and T-cells) was investigated on poly(2-hydroxyethyl methacrylate)-graft-polyamine (HA) copolymers with various copolymer compositions. Separation mechanism of B- and T-cells was then evaluated by focusing on several parameters, such as pH, temperature, and ionic strength. The interaction of lymphocytes with HA surfaces was mainly through the electrostatic force from their retention profile at varying ionic strengths of the medium. Temperature also has a crucial effect on the response of lymphocytes toward pH-induced phase transition of polyamine grafts at the polymer interface with aqueous milieu. At 4 degrees C, both B- and T-cells showed minimal retention on HA surfaces at pH 8. At this pH, polyamine grafts existed in a compact conformation with a low degree of protonation. However, at pHs below 8, at which polyamine grafts existed in extended conformation, the resolution of B- and T-cells was achieved. In contrast, at 23 degrees C, the phase transition of polyamine grafts significantly influenced T-cell retention, resulting in a decrease in the retention of T-cells on HA with polyamine in a compact conformation. Consequently, preferential retention of B-cells was achieved under this condition. The polyamine content was found to be another important factor affecting the retention behavior of lymphocyte subpopulations. On HA copolymers with low polyamine content (HA7, HA10), conformational transition of polyamine grafts showed a significant influence for B-cell retention, although the influence decreased with increasing polyamine content. From the study estimating the effect of neuraminidase treatment of lymphocytes on their retention to HA surfaces, sialic acid residues on the plasma membrane surface of lymphocytes are suggested as feasible anionic sites showing electrostatic interaction with polyamine grafts.

Novel function of C4a anaphylatoxin. Release from monocytes of protein which inhibits monocyte chemotaxis

The complement C4-derived anaphylatoxin, C4a, possesses a strong chemotaxis inhibitory capacity to blood monocytes at concentrations as low as 10(-16) mol/L. In our study, treatment with carboxypeptidase B to convert it to C4a des Arg77 decreased the inhibitory activity to less than 1/1,000. The extraordinary inhibitory capacity of C4a suggests the presence of an amplification mechanism in this inhibition. Indeed, we found that the conditioned media of peripheral blood mononuclear cells or monocyte/macrophage lineage cell lines (U937 and THP-1 cells) preincubated with 10(-16) mol/L C4a for 5 minutes or more at 37 C possessed the inhibitory capacity 100,000-fold stronger than the original activity of C4a. The monocyte-derived chemotaxis inhibitory factor seemed monocyte-specific. This cell-derived factor was sensitive to treatment with trypsin and chymotrypsin and immunologically distinct from C4a. The apparent molecular size of the monocyte factor was estimated to be approximately 20 kd by gel filtration. These results indicate that C4a anaphylatoxin induces the release from monocytes of a protein with inhibitory activity for monocyte chemotaxis.

[Optimal way of administration of granulocyte colony stimulating factor in the treatment of urological cancer]

Granulocyte-Colony Stimulating Factor (G-CSF) was administered to patients with bladder cancer, ureteral cancer and testicular cancer following chemotherapy. Chemotherapy included 23 courses of M-VAC (Methotrexate, Vinblastine, Adriamycin, Cisplatin) therapy to patients with bladder cancer or ureteral cancer and 10 courses of EP (Etoposide, Cisplatin) therapy to patients with testicular cancer. During M-VAC chemotherapy, about a half of the patients experienced leukopenia below 3000/mm3 until the 11th day. Leukopenia failed to improve promptly when G-CSF was started after leukocytes decreased below 3000/mm3. On the other hand, 5-days of prophylactic administrations of G-CSF from the 9th day of M-VAC therapy were able to increase leukocytes promptly. In EP chemotherapy against testicular tumor, G-CSF was started on the 9th day and continued for 5 days. Leukocytes increased immediately and the average duration of leukopenia below 3000/mm3 was only 1.2 day. These results indicate that a short term of prophylactic administration of G-CSF following these chemotherapies is able to accelerate a recovery from leukopenia and decrease a risk of bacterial infection. G-CSF is proposed to be enrolled in the treatment of urological cancer for the improvement of safety and the outcome of therapy.

The production of granulocyte colony-stimulating factor and interleukin 6 by human bone marrow stromal cells in aplastic anemia

Stromal cells are known to produce granulocyte colony-stimulating factor (G-CSF) and interleukin 6 (IL-6). To assess the function of bone marrow stromal cells in the pathological state, we studied their in vitro ability to produce G-CSF and IL-6 in 9 patients with aplastic anemia and 5 normal volunteers, using an enzyme immunoassay method. Constitutive production of IL-6, but not G-CSF, was detected in almost all cases. Interestingly, the inducible production of G-CSF and IL-6 by stromal cells after stimulation with interleukin-1 and/or lipopolysaccharides was severely depressed in 3 patients with aplastic anemia. Our results may reflect poor hematopoietic activity in the bone marrow in some cases of aplastic anemia.

[Fertility after treatment for testicular tumor]

Thirty-four patients with stage 1 or stage 2A testicular tumor all survived 5 years after the treatment, whereas eighteen patients with stage 2B or 3 testicular tumor, including only nonseminomatous tumor, had a 5-year survival rate of less than 50%. Spermatogenesis returned to normal in 3 patients surviving 22 months after chemotherapy. Five patients who had undergone retroperitoneal lymph node dissection with division of the inferior mesenteric artery developed impaired ejaculation, whereas 3 patients who had undergone the operation without division of the inferior mesenteric artery had normal ejaculation. In 17 patients with right testicular tumor metastases were found in the para-aortic, paracaval and interaortocaval lymph nodes. On the other hand, in 4 patients with left testicular tumor metastases were limited to the para-aortic nodes. These results indicate that impaired spermatogenesis by conventional chemotherapy is reversible in patients with stage 1 or 2 testicular tumor, and patients with stage 1 tumor or stage 2 tumor with localized para-aortic metastases, not involving the inferior mesenteric artery, should undergo retroperitoneal lymph node dissection without division of the inferior mesenteric artery to preserve postoperative fertility.

[A case of flexion myelopathy with thoracic outlet syndrome]

A 26-year-old woman had the right shoulder pain, weakness in her right arm, and noticed coldness in her right arm when it is down. On examination, she had droopy shoulder dominantly in right side, weakness and paresthesia in her right upper limb in the distribution of C8-Th1. The thoracic outlet compression tests were positive in her right side. Angiography of the right subclavian artery and brachial plexography under Allen's position revealed compression at the thoracic outlet. A cervical MRI revealed localized atrophy of the spinal cord (right side dominant) at the level of C5-6 vertebral body. Her spinal cord and dural sac moved anteriorly in cervical flexion. Droopy shoulder may be a risk factor of thoracic outlet syndrome and also flexion myelopathy. Double crush nerve compression of lower motor neuron at anterior horn of the cord and at the thoracic outlet may have accelerated the symptoms.

Immunohistochemical study of the sympathetic and sensory innervation to the blood vessels of the dog forepaw

Immunohistochemical staining of arteries supplying the dog forepaw showed a dense distribution of nerve fibers which were immunoreactive to tyrosine hydroxylase (TH), neuropeptide Y (NPY), vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP) around the vascular walls. The density of each immunoreactive fiber tended to increase in the peripheral branch of the vascular tree. Retrograde axonal tracing with Fast Blue from the artery revealed that these immunoreactive fibers originated from NPY-containing catecholaminergic as well as VIP/SP/CGRP-containing non-catecholaminergic neurons in the stellate ganglion and SP/CGRP-containing neurons in the dorsal root ganglia of segments C7 to Th1. After stellate ganglionectomy, TH-, NPY-, and, VIP-immunoreactive fibers disappeared completely from the arterial walls while approximately 40% of SP- and CGRP-immunoreactive fibers remained. The present results indicate that the artery of the dog forepaw receive triple innervation of adrenergic sympathetic, non-adrenergic sympathetic, and sensory fibers, and suggest that about 40% of SP- and CGRP-immunoreactive fibers are of sensory origin.

Mixed growth hormone cell- prolactin cell pituitary adenoma with acromegaly: α-subunit most growth hormone cells

A 51 -year-old woman with mixed growth hormone (GH) cell-prolactin (PRL) cell pituitary adenoma is presented. She had clinical signs due to hypersecretion of GH and PRL. Resected tissue was studied immunohistochemically and morphologically. The serial sections revealed that GH and α-subunit were co-localized in most cells, while GH and PRL were localized in different cells.

Adult T-cell leukemia developing during immunosuppressive treatment in a renal transplant recipient

We report a case of a 32-year-old male, an asymptomatic carrier of human T-cell leukemia virus type 1 (HTLV-1), who underwent a renal transplantation and developed adult T-cell leukemia (ATL) during the course of posttransplant immunosuppressive treatment. He was treated with combination chemotherapies consisting of cyclophosphamide, vincristine, doxorubicin, prednisolone, cisplatin, cytosine arabinoside, etoposide, and methyl-prednisolone, without any improvement. Bestrabucil (KM2210), a conjugate of chlorambucil and estradiol, was administered as an alternative therapy; this therapy successfully suppressed his leukemic cell growth, and partial remission was achieved. Posttransplant immunosuppressive therapy with prednisolone, mizoribine, and cyclosporin A might have been the predominant cause of the transition from an asymptomatic HTLV-1 infection to overt ATL. A careful approach is required with HTLV-1 asymptomatic carriers who need organ transplantation followed by immunosuppressive treatment.

The role of protonation and conformational transition of polyamine grafts in platelet retention to polyamine-graft-PHEMA copolymer surfaces

Blood platelet retention on polyamine-graft-poly(2-hydroxyethyl methacrylate) (PHEMA) copolymer (HA) surface was investigated, focusing on pH and ionic strength of the surrounding medium to elucidate the nature of ionic interaction between platelets and HA copolymer surfaces. The conformational transition of polyamine graft chain in response to the protonation degree of amino groups was demonstrated to be an important factor influencing platelet retention on HA surfaces. When the polyamine graft chain exists in an extended conformation, protonated amino groups distribute from the matrix interface into the aqueous interior, resulting in the effective ionic interaction with platelets to increase their retention on HA copolymer surfaces. The number of protonated amino groups in polyamine portions crucially affected platelet retention. Worth noticing is that an introduction of a small but definite amount of cationic sites on the polymer surface led to significantly minimized platelet retention. It is considered that the surface property of PHEMA was drastically changed to a non-adhesive surface by introducing a small amount of protonated amino groups.

Adhesion and proliferation of bovine aortic endothelial cells on monoamine- and diamine-containing polystyrene derivatives

Adhesion and proliferation of bovine aortic endothelial cells on polystyrene derivatives having monoamine or diamine side chain was investigated focusing on the chemical structure of amino groups. Copolymers, SE8.5, is composed of polystyrene with 8.5 mol% of monoamine side chains, and SED8, which is with 8 mol% of diamine side chains, were estimated to contain almost the same amount of protonated amino groups in bulk composition at physiological pH (pH 7.4). There observed significant difference in cellular spreading of attached endothelial cells between these two types of copolymer surfaces. Spreading-% of attached cells on SED8 surfaces was approximately 1.6 times greater than that on SE8.5 6 h after seeding. This difference in cellular spreading influenced to subsequent cell growth. Cellular growth on each polymer surface was featured by parameter k, which corresponds to the 'rate constant' of cellular proliferation. While the k-value for SE8.5 decreased with decreasing seeding density as well as the case for polystyrene, SED8 maintained a high k-value even at low seeding density as 2 x 10(3) cells/cm2. These results suggest that cells may recognize the difference in the chemical structure of amine side chains of SE and SED copolymers.

Complement C4-derived monocyte-directed chemotaxis-inhibitory factor. A molecular mechanism to cause polymorphonuclear leukocyte-predominant infiltration in rheumatoid arthritis synovial cavities

To reveal the mechanism of the lesser infiltration of monocytes in synovial cavities with rheumatoid arthritis despite the presence of chronic inflammation, the synovial fluid from 15 rheumatoid arthritis patients was analyzed with respect to leukocyte chemotaxis. The synovial fluid possessed strong chemotactic activity to polymorphonuclear leukocytes but rather suppressed one to monocytes. The synovial fluid contained two different inhibitory activities in monocyte chemotaxis. One, which also suppressed polymorphonuclear leukocyte chemotaxis, was identified as alpha 1 protease inhibitor. The other, with molecular weight of 8 kd, possessed the specificity to monocytes and shared the antigenicity with complement C4 but not with C3 or C5. A similar inhibitor was generated in normal human plasma when the classical pathway of the complement system was initiated with aggregated human IgG, while it was not when alternative pathway was initiated with zymosan. The small size factor in the synovial fluid, apparently derived from C4, seemed to be a cyto-directed factor that might block an early part of signal transduction system of monocytes in the chemotaxis. After removal of the small-size inhibitor, the synovial fluid exhibited chemotactic ability to monocytes. Therefore the apparent C4-derived factor might play a key role in the polymorphonuclear leukocyte-predominant infiltration in the synovial fluid of rheumatoid arthritis.

Target cell of leukemic transformation in acute megakaryoblastic leukemia

Acute megakaryoblastic leukemia (AMkL) is a newly defined acute leukemia in which the differentiation of proliferating blasts is arrested at the megakaryocytic precursor stage. In order to clarify whether a target cell of leukemic transformation in AMkL is a cell committed to megakaryocytic lineage, or a multipotential stem cell, we examined AMkL patients with regard to: a) the presence of myelodyplastic features in residual erythroid and granulocytic cells, b) coexistence of myeloperoxidase (MPO)-positive blasts with megakaryoblasts, and c) the presence of the same chromosomal abnormality in erythroid and granuloid colony-forming cells as seen in megakaryoblasts. Regarding the former two items, results were compared with those from megakaryoblastic crisis of chronic myelocytic leukemia (CML-MkBC) and transient myeloproliferative disorder in Down syndrome (DS-TMD), which are thought to be multipotential stem cell disorders. Among 18 patients with AMkL, three, all complicating myelofibrosis, had marked myelodysplastic changes of erythroid series and/or granulocytic series. In 4 out of 7 patients with CML-MkBC, 5 out of 8 patients with DS-TMD, and 7 out of 18 patients with AMkL, MPO-positive blasts, even though rare, were observed in addition to PPO-positive blasts. All except one of these patients with AMkL also showed complicating myelofibrosis. In one case of AMkL with myelofibrosis, chromosomal analysis of cultured cells of individual colonies revealed that all the analysable metaphases from both CFU-GM and BFU-E had the same chromosomal abnormality as megakaryoblasts. This study has clarified that a considerable proportion of AMkL cases, particularly those with complicating myelofibrosis or showing acute myelofibrosis, arise against the background of a multipotential stem cell disorder, even if blasts are exclusively megakaryocytic in phenotype.

Expression of granulocyte and granulocyte-macrophage colony-stimulating factors by human non-hematopoietic tumor cells

The expression of granulocyte colony-stimulating factor (G-CSF) mRNA was studied in human non-hematopoietic tumors, including 18 cases of lung cancers 10 cases of stomach cancers, three cases of glioblastomas, and one case each of breast phyllode sarcoma, thyroid cancer, and hepatocellular carcinoma. Northern blot analysis detected G-CSF mRNA in two of the lung cancer cases, in one of the glioblastoma cases, and in both the breast phyllode sarcoma and hepatocellular carcinoma cases. Since G-CSF receptors were not detected on the tumor cells by 125I-G-CSF binding assay, G-CSF autocrine loop are probably not involved in the growth of these G-CSF-producing tumors. Interestingly, granulocyte-macrophage colony-stimulating factor (GM-CSF) mRNA was concomitantly expressed in most of these G-CSF-producing tumors. No major gene deletions or rearrangements of G-CSF and GM-CSF genes were demonstrated by Southern blot analysis in the tumors expressing G-CSF and GM-CSF mRNAs except for one of the glioblastomas (G3) in which one chromosome 17 allele was deleted. Although the mechanism of the concomitant expression of G-CSF and GM-CSF mRNA is unknown, relatively high frequency of this phenomenon suggests the presence of common transcriptional factors acting on regulatory regions of G-CSF and GM-CSF genomes.

Separation of B and T lymphocytes by cellular adsorption chromatography with polyamine graft copolymers as column matrices. II. Recovery of adsorbed B cell enriched populations from the column

Poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymers were developed for column adsorbents for separating lymphocyte subpopulations collected from rat mesenteric lymph nodes. Bead-shaped adsorbents were prepared by coating poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymer on glass beads. Separation features of the column packed with poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymer-coated glass beads were evaluated under various operating conditions. Separation efficacy, AB/AT, was significantly affected by the infusion rate of lymphocyte suspension into the column, increasing with decreasing infusion rate. T cell purity in the column effluent was almost 95% at the infusion rate of 0.1 ml/min. The infusion rate was also found to affect the detachment of adsorbed lymphocytes from the poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymer surface by mechanical pipetting; lymphocytes adsorbed at a low infusion rate were able to be detached quantitatively by suspending the lymphocyte-adsorbed beads with gentle pipetting. The detached lymphocytes thus obtained were confirmed to be enriched in B cells 1.4 times the initial mixture of B and T cells. The addition of albumin in the medium was found to affect the processes of adsorption and recovery of lymphocyte.

Elimination of cellular active adhesion on microdomain-structured surface of graft-polyamine copolymers

To investigate the mechanisms involved in lymphocyte adsorption on poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymer, which is utilized as an adsorbent for cell separation, the role of cellular metabolism in lymphocyte adsorption on these copolymers was evaluated. We examined the effect of lowering environmental temperature and of the drug cytochalasin B that inhibits reorganization of microfilaments in cellular cytoskeletons on lymphocyte adsorption. Although the adsorption of lymphocytes on poly(2-hydroxyethyl methacrylate) was considerably reduced in the presence of cytochalasin B or by lowering temperature, no marked influence of these factors was observed for lymphocyte adsorption on poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymers. These results suggest that, in contrast to common plastics surfaces including poly(2-hydroxyethyl methacrylate), the surface of poly(2-hydroxyethyl methacrylate)-graft-polyamine copolymers does not stimulate or activate adsorbed lymphocytes.

In vivo release of cholecystokinin-like immunoreactivity in rat frontal cortex under freely moving conditions

Release of cholecystokinin-like immunoreactivity (CCK-LI) was measured in rat medial prefrontal cortex in vivo by brain dialysis and enzyme immunoassay under freely moving condition. Perfusion of 50 mM K+ resulted in the increase of CCK-LI in the dialysate. The data on high-performance liquid chromatography (HPLC) of the dialysate showed that the increase of the CCK-LI was mainly due to the increase of CCK octapeptide sulfate itself. In the preliminary experiments, we applied this brain dialysis method for determination of CCK-LI release with drug treatment. After treatment with sulpiride (i.p.), a D2 dopamine receptor antagonist, a significant increase of CCK-LI was observed, indicating that this brain dialysis technique is applicable to detect change in the level of CCK-LI release after a certain drug treatment.

Lethal form of fibuloulnar A/hypoplasia with renal abnormalities

The present report describes two sibs with lethal acrorenal developmental complex who were products of a nonconsanguinous marriage. Clinical and roentgenologic characteristics did not match any of the known types of fibuloulnar dysostosis. Distinct abnormalities included lethality at birth, facial anomalies, ear anomalies, symmetrical mesomelic shortness of long bones, fibular agenesis, normal vertebrae, oligosyndactyly of phalanges, congenital heart defect, and cystic or hypoplastic kidney. These cases suggest a new lethal form of recessively inherited fibuloulnar dysostosis with renal anomalies.

Separation of B and T lymphocytes by a hybrid field-flow fractionation/adhesion chromatography technique

A hybrid of the techniques of cellular adhesion chromatography and field-flow fractionation has been used for the effective separation of rat mesenteric B and T lymphocytes with nearly complete recovery of both cell species. Use of this hybrid technique also allows the relative binding strengths of cells to biomaterials and other surfaces to be rapidly and simply estimated. For the copolymer surface used here, B cells appear to bind with a force five times greater than T cells.

Quantitative evaluation of rat lymphocyte adsorption on microdomain structured surfaces of poly(2-hydroxyethyl methacrylate)/polyamine

The adsorption behaviour of rat lymphocytes on poly(2-hydroxyethyl methacrylate)-graft-polyamine (HA) copolymers was evaluated using a newly developed chromatographic method. The quantity of lymphocyte adsorption can be varied by regulating the polyamine content in the HA copolymer. A remarkable depression in lymphocyte adsorption was observed on the surface of HA copolymer, consisting of 7 wt% of polyamine graft and 93 wt% of poly(2-hydroxyethyl methacrylate) (pHEMA) backbone. Further introduction of a polyamine graft on pHEMA resulted in the increase of lymphocyte retention on the copolymer surfaces. Lymphocytes adsorbed on HA copolymer surface retained their original round shape. Detailed analysis of the chromatogram showed that interaction of lymphocytes with HA copolymer was very much weaker than that with homopolymer of pHEMA or polyamine.

Separation of B- and T-lymphocytes by cellular adsorption chromatography using poly(2-hydroxyethyl methacrylate)/polyamine graft copolymer as column adsorbent

A series of poly(2-hydroxyethyl methacrylate)/polyamine graft copolymers (HA copolymers) were examined as an adsorbent for cellular adsorption chromatography in order to separate cell populations with high efficacy. The capability of each copolymer sample to selectively adsorb rat lymphocyte subpopulations (B-cells and T-cells) was evaluated by applying a lymphocyte suspension to a copolymer-coated glass bead column. A separation factor (AB/AT) greater than 5.0 was achieved for the HA copolymer, compared to 1.9 and 1.1 for homopolymers of poly(2-hydroxyethyl methacrylate) and of a polyamine (poly(N,N-diethylaminoethylstyrene], respectively. By loading a rat lymphocyte suspension containing B-cells (28%) and T-cells (72%) through the HA copolymer column, more than 60% of T-cells in 90% purity or more were recovered in the effluent.

Immunoaffinity chromatography of lymphocyte subpopulations using tert-amine derived matrices with adsorbed antibodies

New polymeric solid-phase matrices for cell affinity chromatography were prepared and their advantageous characteristics compared with conventional matrices were highlighted. These new matrices are derivatives of poly(2-hydroxyethyl methacrylate) (PHEMA) containing a slight quantity of amino compounds as a co-monomer. They were applied to immunoaffinity selection between IgG+ and IgG- lymphocytes of the rat mesenteric lymph node. Simple physical adsorption was sufficient for anti-rat IgG antibodies to be immobilized on these matrices, allowing us to omit the laborious procedure of covalent-linking of antibodies on a matrix. As these matrices themselves showed extremely low non-specific adsorption of lymphocytes, a very dilute solution of antibody (0.02-0.08 mg/ml) was enough for column conditioning. This separation method gave IgG- lymphocytes of more than 90% purity and almost 95% yield within as short a time as 7 min. Further, IgG+ lymphocytes were obtained in good yield (80-90% of loaded number) by recovering the adsorbing cell fraction from the column by gentle pipetting of the matrix.

A new type of achondrogenesis

A new type of neonatal death dwarfism, resembling the achondrogenesis syndromes on clinical examination but presenting distinctive radiographic and microscopic features has been described. It presents another, new form of achondrogenesis.

Osteogenic sarcoma of the fourth thoracic vertebra. Long-term survival by chemotherapy only

A unique case of a 15-year-old boy with complete paraplegia due to the compression of osteogenic sarcoma at the fourth thoracic vertebra is presented. Because of the difficulty of surgical treatment, he was treated merely by the arterial infusion of Adriamycin (doxorubicin) and systemic chemotherapy in conformity with the cyclophosphamide, Oncovin (vincristine), methotrexate, phenylalanine mustard, Adriamycin (doxorubicin) ( COMPADRI )-III regimen. The patient regained normal function, and has been disease-free without any neurologic deficit for 6 years. There appears to be some hope for cure using chemotherapy only in otherwise unpromising patients.