[Ultra high-dose chemotherapy with peripheral blood stem cell autotransplantation for refractory testicular cancer]

This is a report of 45-year-old man with advanced nonseminomatous germ cell tumor (stage IIIB2: embryonal carcinoma, yolk sac tumor, seminoma), who had relapse after PVB (cisplatin, vinblastine, bleomycin) chemotherapy. Peripheral blood stem cells (PBSCs) were taken by two consecutive apheresis using a CS-3000 blood separator after high-dose chemotherapy of cytarabine and mitoxantrone. In total, 6.4 x 10(5)/kg of granulocytic cells (CFU-GM) was collected. He was treated with ultra high-dose chemotherapy consisting of carboplatin (800 mg/m2), etoposide (1,000 mg/m2) and cyclophosphamide (100 mg/kg) from day 1, followed by peripheral blood stem cell autotransplantation (PBSCT) on day 9. We transfused 2.4 x 10(5)/kg CFU-GM, which was enough number of stem cells for safe PBSCT. No serious side effects or complications were encountered. The patient achieved partial remission for more than two months. However, he died of respiratory dysfunction caused by metastatic lung cancer 5 months later. It was thought that ultra high-dose chemotherapy with PBSCT might be a new therapy for refractory testicular cancer.

Regulation of hepatic level of fatty-acid-binding protein by hormones and clofibric acid in the rat

Regulation of the hepatic level of fatty-acid-binding protein (FABP) by hormones and p-chlorophenoxyisobutyric acid (clofibric acid) was studied. The hepatic level of FABP, measured as the oleic acid-binding capacity of the cytosolic FABP fraction, was decreased in streptozotocin-diabetic rats. The level of FABP was markedly increased in adrenalectomized rats, and the elevation was prevented by the administration of dexamethasone. Hypothyroidism decreased the level of FABP and hyperthyroidism increased it. A high correlation between the incorporation of [14C]oleic acid in vivo into hepatic triacylglycerol and the level of FABP was found for normal, diabetic and adrenalectomized rats. The level of FABP was increased by administration of clofibric acid to rats in any altered hormonal states, as was microsomal 1-acylglycerophosphocholine (1-acyl-GPC) acyltransferase, a peroxisome-proliferator-responsive parameter. These results suggest that the hepatic level of FABP is under regulation by multiple hormones and that clofibric acid induces FABP and 1-acyl-GPC acyltransferase by a mechanism which may be distinct from that by which hormones regulate the level of FABP.

Structure of the L-histidine decarboxylase gene

Two species of L-histidine decarboxylase (HDC) mRNA were found in the KU-812-F basophilic cell line, but only the 2.4-kilobase (kb) one encodes the functional HDC (Mamune-Sato, R., Yamauchi, K., Tanno, Y., Ohkawara, Y., Ohtsu, H., Katayose, D., Maeyama, K., Watanabe, T., Shibahara, S., and Takishima, T. (1992) Eur. J. Biochem. 209, 533-539). The 3.4-kb one encodes a truncated HDC protein and is also found in human leukemia-derived cell lines HEL and KCL-22. To clarify the mechanisms that regulate transcription of the HDC gene and generate the two species of mRNA, we have isolated genomic DNA clones coding for the HDC from human genomic libraries. Structural analysis of the isolated clones revealed that the human HDC gene is composed of 12 exons spanning approximately 24 kb. Genomic DNA blot analysis suggested that HDC is encoded by a single copy gene. The structural analysis also demonstrated that the heterogeneity of the HDC mRNA is caused by an insertion of the seventh intron sequence and alternative use of the splicing acceptor site at the 12th exon. The transcription start site of the HDC gene and the nucleotide sequences of the promoter and first exon regions were determined. We found a TATA-like sequence, a GC box, four CACC boxes, four GATA consensus sequences, and six leader-binding protein-1 binding motifs in the promoter region of the HDC gene.

Chemical modification of natural human tumor necrosis factor-alpha with polyethylene glycol increases its anti-tumor potency

Natural human tumor necrosis factor-alpha (TNF-alpha) was chemically modified with an active ester of monomethoxy polyethylene glycol (PEG). The molecular weight of PEG-modified TNF-alpha depended on the reaction time as well as the initial molar ratio of PEG to TNF-alpha. The specific activity of modified TNF-alpha was gradually reduced with increase in the degree of PEG-modification, but the plasma half-life of TNF-alpha was increased by up to 40-fold. Modified TNF-alpha showed approximately 100 times greater anti-tumor potency than unmodified TNF-alpha. Covalent attachment of PEG to TNF-alpha thus increased the bioavailability of TNF-alpha, and may facilitate its potential therapeutic use.

Roles of neutrophil elastase and superoxide anion in leukotriene B4-induced lung injury in rabbit

The effects of a competitive neutrophil elastase (NE) inhibitor, ONO-5046, and a recombinant human superoxide dismutase on leukotriene B4 (LTB4)-induced polymorphonuclear leukocyte (PMN)-mediated increase in microvascular permeability in isolated non-blood-perfused rabbit lungs were studied. Pulmonary microvascular permeability and lung edema were evaluated by use of the fluid filtration coefficient (Kf) and the wet-to-dry lung weight ratio (W/D), respectively. Pulmonary capillary pressure was estimated by the double occlusion technique. NE activity in the perfusate was determined using a spectrophotometric method. The PMNs (2-3 x 10(8) cells) were added into the perfusate in all groups of lungs. Injection of LTB4 (5 micrograms) increased Kf and W/D without affecting pulmonary arterial or capillary pressure. The LTB4-induced lung injury was closely associated with the increase in NE activity in the perfusate. Infusion of ONO-5046 (1 or 10 mg.kg-1 x h-1) inhibited the LTB4-induced increases in Kf, W/D, and perfusate NE activity in a dose-dependent fashion. Infusion of recombinant human superoxide dismutase (80,000 U.kg-1 x h-1) attenuated the LTB4-induced increases in Kf and W/D, although it did not influence the elevation of perfusate NE activity induced by LTB4. These results suggest that both NE and superoxide anion play important roles in the LTB4-induced PMN-mediated increase in pulmonary microvascular permeability.

Infection by Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans, and antibody responses at different ages in humans

This study examined the serum IgG and IgM responses against Porphyromonas gingivalis and 3 serotypes of Actinobacillus actinomycetemcomitans, and the correlations of these responses with age and homologous infection. A total of 90 individuals were included in this study: 40 subjects with gingivitis, 40 periodontally healthy subjects, and 10 adult periodontitis subjects. The subjects in the gingivitis and periodontally healthy groups were divided into 4 stages based on their physiological age: early childhood, school age, puberty, and adult. In the gingivitis group, there was a positive correlation between increase in age and increase in serum IgG antibody levels against P. gingivalis until puberty. However, no statistically significant difference was found between the puberty stage and the adult stage. The average level of IgG antibodies against A. actinomycetemcomitans in the school age gingivitis group was significantly higher than that in the early childhood gingivitis group for all serotypes (p < 0.01). In serotype c, IgG antibody levels in the school age gingivitis group were significantly higher than in the early childhood gingivitis group or the adult gingivitis group (p < 0.01). With both P. gingivalis and A. actinomycetemcomitans, positive correlations between elevated IgG level and infections by these microorganisms were found in the puberty gingivitis and adult periodontitis groups.

2-(2-furyl)-3-(5-nitro-2-furyl)acrylamide (AF-2) is a weak in vivo clastogen as revealed by the micronucleus assay

The in vivo clastogenicity of 2-(2-furyl)-3-(5-nitro-2-furyl)acrylamide (AF-2) was examined in the micronucleus test using peripheral blood from three mouse strains (ICR, CD-1, and MS/Ae) and bone marrow from one rat strain (Sprague-Dawley). Doses up to the maximum tolerated were tested. The chemical was given once, twice, thrice, or four times via either the i.p. or p.o. route. Under some conditions, ICR and CD-1 mice showed an increased frequency of micronucleated reticulocytes, but definite conclusions were difficult to draw because the increases were very slight. MS/Ae mice showed a markedly elevated micronucleated reticulocyte frequency after the double and triple ip treatments. Rats showed a slightly but statistically significantly increased frequency of micronucleated polychromatic erythrocytes after double i.p. treatments. These results indicate that AF-2 is a weak in vivo clastogen.

Human dihydrolipoamide succinyltransferase: cDNA cloning and localization on chromosome 14q24.2-q24.3

We isolated cDNA for dihydrolipoamide succinyltransferase from a human fibroblast cDNA library in lambda gt11. The cDNA revealed that the human dihydrolipoamide succinyltransferase lacked a sequence motif of an E3 and/or E1 binding site. This suggests that the human dihydrolipoamide succinyltransferase possesses a unique structure consisting of two domains in contrast with the dihydrolipoamide acyltransferases of other alpha-keto acid dehydrogenase complexes. In addition, we found that the human dihydrolipoamide succinyltransferase gene is located on chromosome 14 at q24.2-q24.3 and that a sequence related to the dihydrolipoamide succinyltransferase gene is located on chromosome 1 at p31. Interestingly, the gene for the dihydrolipoamide acyltransferase of the branched chain alpha-keto acid dehydrogenase complex is also located on chromosome 1p31 (Zneimer et al. (1991) Genomics 10, 740-747).

Solitary eosinophilic granuloma of bone occurring in the buccal mucosa: report of a case

Eosinophilic granuloma of bone is not uncommon in the craniofacial region (Anderson and kissane, 1977), and it sometimes occurs in organs such as the lung, stomach and spleen. However there are only few reports on solitary eosinophilic granuloma of bone occurring in oral soft tissue. In this report, we describe a case of eosinophilic granuloma of bone occurring in the soft tissue of a 40-year-old woman.

In vitro activity of a new carbapenem antibiotic, BO-2727, with potent antipseudomonal activity

BO-2727, a new 1-beta-methyl-carbapenem, was active at concentrations of 6.25 micrograms/ml or less against gram-positive and gram-negative bacteria, including some imipenem- and/or meropenem-resistant (MICs, > or = 12.5 micrograms/ml) Pseudomonas aeruginosa strains, against which it proved generally fourfold more active than imipenem and meropenem. BO-2727's antipseudomonal activity and its broad spectrum merit further investigation for clinical use by itself, since it was stable in the presence of renal dehydropeptidase I.

[Immunoglobulin levels and blood parameters in inhabitants of a remote island]

To clarify the alteration of serum immunoglobulin levels with age, serum immunoglobulin and other parameters (age, symptoms, blood biochemical parameters, etc.) of inhabitants (213 persons; 63 men, 150 women) of a remote island in Shimane Prefecture were studied. Their subjective symptoms were collected by means of a questionnaire and various blood parameters were measured. These data were analyzed by t-test and multivariate analysis. The IgM level was decreased with age and each immunoglobulin level correlated with the total-protein level in serum. The IgG level of the subjects feeling fatigue was higher than that of the subjects not feeling fatigue.

Protein synthesis measured in the whole body of chick embryos cultured in vitro

1. Whole body protein synthesis was measured in chick embryos cultured in vitro. On day 7 of incubation chick embryos were cultured for 60 min in synthetic serum-free medium containing 4-[3H]phenylalanine. Specific radioactivities in free and protein-bound phenylalanine in the whole embryo were measured, starting 2 min after commencement of the culture process. 2. The values for fractional synthesis rate (FSR) estimated in vitro at 20, 30, 45 and 60 min during the embryo culture agreed well, ranging from 35 to 40%/d, suggesting that the method would serve as a useful model for studying the effect of growth promoters in chick embryos. 3. Bovine insulin in the synthetic medium did not affect FSR of protein in chick embryos cultured in vitro.

Effects of intracerebroventricular injection of indomethacin on adaptive gastric cytoprotection in the conscious rat

We investigated the role of prostaglandins in the central nervous system for the adaptive gastric cytoprotection in male Wistar rats with chronic intracerebroventricular cannulas. Three, 50, 200, or 500 micrograms of indomethacin or vehicle alone was injected via the intracerebroventricular (central) or intraperitoneal route 1 h before oral administration of 20% ethanol. The animals were then given 1 ml of absolute ethanol 15 min later. One hour later, gastric mucosal damage and plasma indomethacin concentrations were measured. Pretreatment with 50-500 micrograms of indomethacin abolished adaptive gastric cytoprotection induced by 20% ethanol in a dose-dependent fashion, regardless of the route of administration. Central administration of 3 micrograms indomethacin resulted in a more than twofold increase in mucosal damage compared with intraperitoneal administration. Plasma indomethacin concentrations were increased dose-dependently. However, plasma levels were lower in rats administered centrally than those peripherally at a dose of 50 micrograms indomethacin or more. On the other hand, plasma indomethacin concentrations did not differ between central and intraperitoneal administration of 3 micrograms indomethacin. Measurement of gastric mucosal blood flow revealed that central administration of 3 micrograms indomethacin reduced gastric mucosal blood flow, whereas intraperitoneal administration of an identical dose had no effect. These results suggest that central prostaglandins may contribute to adaptive gastric cytoprotection, possibly by altered gastric mucosal blood flow.

[Two cases of acute alcoholic myopathy associated with rhabdomyolysis]

We reported two cases of acute alcoholic myopathy associated with rhabdomyolysis. The first case was 62 year-old man, who had been drinking every day for 40 years. Following diarrhea, he had psychic symptoms, and was admitted to our hospital. He was in a state of delirium. Tremor in extremities, dysarthria and weakness of lower extremities were observed. Neither swelling nor grasping pain were seen in any muscles. Laboratory data showed severe hypokalemia and high levels of serum muscle enzymes and myoglobin. An increase of lactate and pyruvate was not seen in ischemic exercise test performed at the acute or the recovery phase. It was suggested that glycolysis in muscles was suppressed in this case. The second case was 43 year-old man, who had been drinking every day for 27 years. Rapidly progressive weakness of both lower extremities was seen, and he was admitted to our hospital. Grasping pain of both legs and proximal muscle weakness of extremities were observed. Laboratory date showed normokalemia and high levels of serum muscle enzymes and myoglobin. Muscle biopsy showed no abnormal findings in histology and electron microscopy. Although the pathogenesis of acute alcoholic myopathy is unknown, suppression of muscle glycolysis enzyme caused by ethanol may play an important role in the first case.

[A clinical study of 17 cases of penile cancer]

A clinical evaluation of 17 patients with penile cancer treated in our hospital from 1965 to 1991 were surveyed. They were between 34 and 74 years old with a mean age of 63.8 years. The average interval between the onset and the first visit was 22.8 months. Fourteen patients (83%) complained of the manifestation of a tumor and 14 patients (83%) were phimotic. The stage classified according to Jackson was Stage I for 6, Stage II for 6, Stage III for 4 and Stage IV for 1 patient. At the first visit, the inguinal lymph nodes were palpated in 8 patients and metastasis was confirmed in 5 (63%) of them. Surgical treatment was given to 15 patients (88%) (radical or partial penectomy was performed in most cases). Chemotherapy was given to 9 patients (60%) (main chemotherapeutic agent was bleomycin) and irradiation to 5 patients (30%). The overall 3-year survival rate was 71%, and 5-year survival rate was 56%. The 5-year survival rate in the low stage group (Stage I, II) was 75%, while that in the high stage group (Stage III, IV) was 0%, showing a significant difference.

An unspliced cDNA for human dihydrolipoamide succinyltransferase: characterization and mapping of the gene to chromosome 14q24.2-q24.3

Abnormality of the dihydrolipoamide succinyltransferase gene may be a cause of familial Alzheimer's disease linked to chromosome 14q24.3. However, the locus of the dihydrolipoamide succinyltransferase gene on this chromosome was uncertain. An unspliced cDNA of about 2.3 kb for human dihydrolipoamide succinyltransferase was isolated. This cDNA contained three exons and four introns and the nucleotide sequences at the 5' donor and 3' acceptor sites of all introns conformed to the gt-ag rule. The amino acid sequences of the three exons support our previous observation that human dihydrolipoamide succinyltransferase lacks a sequence motif for an E1 and/or E3 binding site. The unspliced cDNA was mapped only on human chromosome 14q24.2-q24.3 by fluorescent in situ hybridization. Thus the dihydrolipoamide succinyltransferase gene is concluded to be located on human chromosome 14q24.2-q24.3.

Human corticotropin-releasing hormone test in patients with hypothalamo-pituitary-adrenocortical disorders

To assess the diagnostic usefulness of a synthetic human corticotropin-releasing hormone (CRH) formulation (Code No. MCI-028), we administered 100 micrograms of the peptide intravenously to 183 patients with hypothalamo-pituitary-adrenocortical (HPA) disorders, and obtained the following findings. Among the 183 patients, data from 125 patients were suitable for analyzing the effects of the test. In patients with Cushing's disease, high plasma adrenocorticotropic hormone (ACTH) and cortisol levels increased further in response to MCI-028, while in patients with adrenal Cushing's syndrome, low ACTH and high cortisol values remained unchanged. In patients with pituitary-type hypopituitarism or isolated ACTH deficiency, low ACTH and cortisol levels responded poorly or insignificantly to MCI-028, whereas those with hypothalamic hypopituitarism showed delayed and considerable degree of responses of plasma ACTH and little increase in plasma cortisol levels. In Addison's disease, high plasma ACTH increased further in response to MCI-028, but low cortisol levels did not change. In patients with Cushing's syndrome soon after successful surgical treatment, plasma ACTH responsiveness was low or different depending on the clinical course of the patient. Patients treated with high doses of glucocorticoids for non-endocrine diseases tended to show impaired ACTH and cortisol responsiveness to MCI-028. Side effects, including the transient flushing which was observed most frequently in this study, did not cause any clinical problems.

[Development of bladder capacity, nocturnal urinary volume and urinary behavior in nonenuretic and enuretic children]

Bladder capacity, nocturnal urinary volume and nocturnal urinary behavior were investigated in 1751 nonenuretic and 282 enuretic children in two primary schools and four kindergartens. The results were as follows: 1. A statistically significant linear correlation was observed between the age and the bladder capacity in the morning and daytime, as well as nocturnal urinary output, in nonenuretic children. 2. The bladder capacity of enuretic children was smaller in the ages below 6 but larger in the ages over 7 than that of noneuretic children. It was not likely from this evidence that an immature bladder capacity was a primary cause of enuresis. 3. For the estimation of the maximum bladder capacity in the study of enuresis, urinary output in the morning immediately after awakening with sufficient urinary sensation was thought to be more reasonable than that in the daytime, because output in the morning was approximately 50% more than that of the daytime. 4. Ten to 15% of nonenuretic children showed nocturnal polyuria with nocturnal urination after complete awakening more than one time every week. It was also not likely from this evidence that polyuria was a primary cause of enuresis. 5. The overall occurrence rate of enuresis was 14%, higher in males up to the ages of 9, and almost equal in males and females after the ages of 10. 6. The average age for the spontaneous disappearance of enuresis was 7.3 y.o., therefore, adequate treatments for enuresis should be instituted after the age of 8.

Human corticotropin-releasing hormone (hCRH) test: sex and age differences in plasma ACTH and cortisol responses and their reproducibility in healthy adults

The effectiveness and safety of MCI-028, a synthetic human corticotropin-releasing hormone (hCRH), as a diagnostic drug were examined in 65 healthy male and 24 healthy female adult volunteers. Mean maximum concentrations of plasma ACTH and cortisol after intravenous administration of 100 micrograms of MCI-028 were 3.0 and 2.0 times their basal concentrations, respectively, and there were no significant age or sex differences in the responses. Good reproducibility was observed in the responses in 59 male subjects who received a second administration after 1 to 2 weeks. Although slight adverse reactions such as mild and transient hot flushing were observed, these were not serious.

Oculomotor parasympathetic pathway to the accessory ciliary ganglion bypassing the main ciliary ganglion by way of the trigeminal nerve

When an HRP or WGA-HRP solution was injected into the rostral midbrain including the oculomotor visceral nuclei, densely distributed HRP/WGA-HRP-positive granules were observed around the ganglion neurons in the accessory ciliary ganglion (ACG) and ectopic neurons in the communicating branch from the long ciliary nerve to the ACG. The same injections labeled fibers within the communicating branch as well as the fibers between the ACG and the main ciliary ganglion (CG). These findings indicate that some oculomotor parasympathetic preganglionic fibers reach the ACG bypassing the CG by way of the trigeminal nerve.

[A case of rheumatoid arthritis with obstructive bronchiolitis appearing after D-penicillamine therapy]

A 56-year-old woman was diagnosed as having rheumatoid arthritis in 1983. She was treated with D-penicillamine in addition to non-steroid anti-inflammatory drugs from April 1990. In August she noticed shortness of breath on exertion. Chest X-ray films showed bilateral interstitial shadows, and chest CT revealed bilateral multiple wedge-shaped shadows extending distally. Blood gas analysis showed severe hypoxemia and pulmonary function tests demonstrated decreased %VC, FEV1.0% and diffusion capacity. Open lung biopsy specimens revealed infiltration of inflammatory cells and fibrotic change in the walls of bronchioles. She was diagnosed as having obstructive bronchiolitis. Corticosteroid therapy and discontinuation of D-penicillamine therapy stopped the progression of her symptoms, and she was discharged on corticosteroid maintenance treatment and home oxygen therapy.

3 cases of anti-Scl-70 (topoisomerase I) antibody associated with central nervous system lupus without renal disorder

We describe 3 cases of systemic lupus erythematosus (SLE) associated with anti-Scl-70 antibody. Common symptoms were central nervous system disorder, discoid rash, lymphadenopathy, and no renal disorder. Two of 3 cases showed some symptoms of scleroderma but could not be diagnosed as such. Although further followup is required to determine if scleroderma develops, these unique symptoms might be a subtype of SLE or a lupus-like syndrome characterized by symptoms and anti-Scl-70 antibody.

Cloning and sequencing of the cDNA encoding a mouse IL-2 receptor gamma

A mouse cDNA encoding an interleukin-2 receptor gamma (mIL-2R gamma) was cloned. The primary amino acid sequence deduced from the nucleotide sequence exhibits 70% overall similarity with human IL-2R gamma and, in particular, the predicted cytoplasmic region shows a higher degree of similarity (about 84.7%).

Sialyl LewisX expression on human Langerhans cells

Recently, it has been demonstrated that the skin-infiltrating T cells express cutaneous lymphocyte-associated antigen, which is the ligand of E-selectin or endothelial-leukocyte adhesion molecule, suggesting that cutaneous lymphocyte-associated antigen functions as the homing receptor of the skin infiltrating T cells. In contrast, the mechanism for the migration of Langerhans cells from the bone marrow to the skin has not been clarified. Sialyl LewisX acts as a ligand for endothelial-leukocyte adhesion molecule and granule membrane protein 140. We examined the expression of sialyl LewisX in epidermal dendritic cells in human skin. Two-color immunofluorescence study on an epidermal sheet revealed that human leukocyte antigen DR+ or CD1a+ epidermal dendritic cells were partially sialyl LewisX+, although all of the sialyl LewisX+ dendritic cells were human leukocyte antigen DR+ and CD1a+. Further analysis of these dendritic cells by flow cytometry demonstrated that most of the human leukocyte antigen DR+ and CD1a+ epidermal cells expressed sialyl LewisX, although the magnitude of its expression was more variable than that of CD1a expression, and that some of human leukocyte antigen DR+ cells were clearly sialyl LewisX-. Immunoperoxidase study of normal skin showed the presence of sialyl LewisX+ dendritic cells not only in the epidermis but also in the upper dermis. These data demonstrating the heterogeneity of the expression of sialyl LewisX by epidermal Langerhans cells suggest their possible relationship to the stage of maturation as well as to the migration of Langerhans cells from the bone marrow to the skin.