All eight possible mono-beta-D-glucosides of validoxylamine A. II. Biological activities

The biological activities of all eight possible mono-beta-D-glucosides of validoxylamine A against Rhizoctonia solani were studied. The attachment of the D-glucosyl residue to validoxylamine A generally diminished the inhibitory activity against trehalase. The introduction of the D-glucosyl residue at the C-3 position did not cause serious loss in activity, while substitution at the C-6' position caused complete loss in trehalase inhibitory activity. Of the eight beta-D-glucosides, 4-O-beta-D-glucopyranosylvalidoxylamine A (4-O-beta-Glc-VA), 3-O-beta-Glc-VA and 5'-O-beta-Glc-VA exhibited very strong activity against R. solani in the "dendroid-test method". The antagonistic activity of sugars (1 mM) against validoxylamine A and 4-O-beta-Glc-VA was examined using the "dendroid-test method". The inhibitory effect of validoxylamine A on hyphal extension was not antagonized by any sugars tested, whereas that of 4-O-beta-Glc-VA was antagonized by beta-1,3- and beta-1,4-glucooligosaccharides. Of 2-O-, 3-O-, 4-O- and 7-O-beta-Glc-VAs, 7-O-beta-Glc-VA exhibiting the lowest activity was not antagonized by any beta-glucooligosaccharides tested. The inhibitory effect of 3-O- and 4-O-beta-Glc-VAs was antagonized by most beta-glucooligosaccharides. The uptake of 4-O-beta-Glc-VA into the mycelia was inhibited by laminaribiose and cellobiose but not by maltose.

All eight possible mono-beta-D-glucosides of validoxylamine A. I. Preparation and structure determination

Validamycin A is the major and most active compound among the validamycin complex. Since the site of beta-glucosidic attachment to validoxylamine A (1) was expected to affect the activity against the pathogenic fungus, Rhizoctonia solani, all eight possible mono-beta-D-glucosides of 1 were prepared. 2-O-, 4-O-, 4'-O-, and 7'-O-beta-D-glucopyranosylvalidoxylamine A (2, 4, 6 and 9, respectively) were prepared by microbial beta-glycosylation of 1 with strains of Rhodotorula sp. 7-O- and 6'-O-beta-D-glucopyranosylvalidoxylamine A (5a and 8a, respectively) were prepared semisynthetically through microbial formation of 7-O-beta-D-glucopyranosylvalidamine (10), oxidation of the primary amine of 10 to a ketone, and coupling of the ketone derivative with valienamine, and through microbial formation of 6-O-beta-D-glucopyranosylvalienamine (11), and coupling of 11 with (2R)-(2,4/3,5)-2,3,4-trihydroxy-5-hydroxymethylcyclohexanone (12), respectively. 3-O- and 5'-O-beta-D-glucopyranosylvalidoxylamine A (3a and 7a, respectively) were chemically synthesized.

Changes in surface charge density of lecithin liposomes by lipid peroxidation. A fluorescence study with 8-anilino-1-naphthalenesulfonate

Treatment of lecithin liposomes with 100 microM ascorbic acid and 10 microM ferrous ion resulted in the formation of fluorescent products exhibiting an emission maximum at 430 nm and a decrease in the fluorescence intensity of 8-anilino-1-naphthalenesulfonate (ANS) bound to the liposomes without change in the emission maximum. The degree of ascorbic acid/Fe(2+)-induced decrease in the ANS fluorescence was dependent on the extent of fluorescent product formation. The results of kinetic studies on ANS-binding to the liposomes showed that treatment of the liposomes with ascorbic acid/Fe2+ causes an increase of the apparent dissociation constant (Kd) of ANS-liposome complex. This indicates that lipid peroxidation of the liposomes by treatment with ascorbic acid/Fe2+ decreases the binding affinity of ANS to the liposomes. In addition, it was also found that there is a good correlation between degrees of the Kd value and the formation of fluorescent products. The fluorescence properties, i.e. emission maximum and response of the fluorescence intensity for borohydride reduction, of the products formed by lipid peroxidation of the liposomes were similar to those derived from modification of the liposomes with monofunctional aldehydes such as acetaldehyde and heptaldehyde. From these results, it is suggested that the decrease of ANS-binding affinity to the liposomes by treatment with ascorbic acid/Fe2+ may be due to changes in the surface charge density of the liposomes relating to the formation of fluorescent products.

1-Hydroxyethylidene-1,1-bisphosphonate decreases the postovariectomy enhanced interleukin 1 secretion from peritoneal macrophages in adult rats

Bisphosphonates are potent inhibitors of bone resorption. In previous studies, we have shown that ovariectomy accelerates bone resorption and 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP) inhibits ovariectomy-accelerated bone resorption in female Wistar adult rats. As interleukin 1 (IL-1) stimulates bone resorption in vitro and in vivo, we have investigated the effects of ovariectomy and HEBP administered in vivo on IL-1 secretion from peritoneal macrophages in adult rats. Ovariectomy or sham surgery were performed in female Wistar rats at 40 weeks of age. Ovariectomized and sham-operated rats were administered with HEBP (10 mg) or saline, 10 times in total, from 43 to 46 weeks of age. Paraffin oil-induced peritoneal macrophages at 46 weeks of age were cultured for 24 hours. Lipopolysaccharide (LPS)-stimulated peritoneal macrophages from ovariectomized rats secreted more IL-1 than sham-operated rats. HEBP decreased LPS-stimulated IL-1 secretion from peritoneal macrophages in ovariectomized rats, but not in sham-operated rats. In vivo administration of HEBP decreased IL-1 secretion only in postovariectomy hyperresorptive states. These results suggest that alterations in LPS-stimulated IL-1 secretion from oil-induced peritoneal macrophages may be responsible, at least in part, for the postovariectomy acceleration in bone resorption and its inhibition by HEBP.

Altered localization of antigen recognized by proteinuria-inducing monoclonal antibody in experimental nephrosis

Change in the localization of the antigen recognized by the proteinuria-inducing monoclonal antibody (MA) 5-1-6 in experimental nephrosis was studied by indirect and biotin-avidin immunofluorescence, and immunoperoxidase at light and electron microscopical levels. The proteinuric state was induced by the administration of the aminonucleoside of puromycin (PAN) or adriamycin. The antigen decreased in quantity and/or its distribution changed with an increase in the amount of protein excreted in both experimental models. Recovery from the alterations observed during the development and proteinuria appeared to occur when PAN-induced proteinuria subsided. This antigenic molecule may thus be essential for maintaining the normal permselectivity of glomerular capillary walls.

The response to epidermal growth factor of human maxillary tumor cells in terms of tumor growth, invasion and expression of proteinase inhibitors

Three cancer cell lines, IMC-2, IMC-3 and IMC-4, were established from a single tumor of a patient with maxillary cancer. We examined responses to epidermal growth factor (EGF) of these 3 cell lines with regard to cell growth and tumor invasion. The growth rate of IMC-2 in nude mice was markedly faster than that of the IMC-3 and IMC-4 cell lines. Assay for invasion through fibrin gels showed significantly enhanced invasive capacity of IMC-2 cells in response to EGF, but no change for IMC-3 and IMC-4 cells. We examined response to EGF of IMC-2 cells with regard to expression of a growth-related oncogene (c-fos), proteinases and their inhibitors. Expression of c-fos was transiently increased in IMC-2 cells at rates comparable to those seen in the 2 other lines in the presence of EGF. There was no apparent effect of EGF on the expression of urokinase-type plasminogen activator and 72-kDa type-IV collagenase in IMC-2 cells. In contrast, EGF specifically enhanced the expression of plasminogen activator inhibitor-I (PAI-I) and tissue inhibitor of metalloproteinases-I (TIMP-I) in IMC-2 cells. Our data suggest that proteinase inhibitors or other related factors may play an important role in tumor growth and invasion in response to EGF.

Preparation of alkyl-substituted pyrrolidone derivatives and their evaluation as transdermal penetration enhancers

The preparation of novel transdermal penetration enhancers derived from 2-pyrrolidone were carried out, and the enhancing activities of drug permeation through the skin were evaluated by means of in vitro experiment. All the enhancers contain a short alkyl group, such as methyl, ethyl, propyl or butyl group, at 1-position and a dodecyl group at 3-position of 2-pyrrolidone ring. The enhancing activities were considerably influenced by the length of the short alkyl group at 1-position. 1-Propyl and 1-butyl-3-dodecyl-2-pyrrolidone showed the effective enhancement of penetration of indomethacin through the skin in 60 wt% ethanolic aqueous solution. Moreover, the similar enhancing activities of these compounds were also observed even in ethanolic vehicle.

Preparations of phosphonate, phosphoramidate and phosphate derivatives and their evaluation as transdermal penetration enhancers

Phosphonate, phosphoramidate and phosphate derivatives containing long alkyl groups were prepared, and their activities enhancing drug penetration through the skin were evaluated by means of in vitro experiments. The effect of chemical structure of these compounds on enhancing activity was investigated. Among the phosphonate and phosphoramidate derivatives, compounds having a hexadecyl group showed the most effective enhancement of transdermal penetration of indomethacin. For the phosphate derivatives, the enhancing activities were almost equal in the compounds containing dodecyl, tetradecyl and hexadecyl group. All the compounds having an octyl group were not effective in penetration enhancement. Diethyl hexadecylphosphonate and diethyl hexadecylphosphoramidate brought about the highest enhancing activities among these compounds, and the permeability coefficient of indomethacin was about 10-fold as much as that without enhancer. The relationship between the enhancing activities and the lipophilicities of these compounds was discussed.

[Endocrine effects of hypotension induced by diltiazem in rabbits]

Endocrine effects of hypotension induced by diltiazem, a calcium antagonist, were studied in 16 male rabbits under the inhalation of 0.7% halothane in oxygen. They were randomly allocated to one of two groups. Group C (n = 8) received no vasodilator therapy and served as control and group D (n = 8) received infusion of diltiazem. Mean arterial pressure was decreased and was maintained at 60 mmHg for 60 minutes in group D. No change was noted in plasma catecholamines measured in group C throughout the experiment but plasma renin activity decreased progressively. During and after induced hypotension in group D plasma epinephrine showed a dramatic rise compared with the control value. The maximum increase occurred 30 minutes after induction of hypotension but this change was not statistically significant. Plasma norepinephrine in group D was significantly higher than the control value. Compared with the control value (0.19 +/- 0.04 ng.ml-1), plasma norepinephrine was activated 30 and 60 minutes after induction of hypotension (0.71 +/- 0.16 ng.ml-1, P less than 0.05, 0.82 +/- 0.20 ng.ml-1, P less than 0.05, respectively). Plasma renin activity in group D was significantly higher than the control value. The highest level of plasma renin activity was three times the control value 30 minutes after induction of hypotension. In conclusion, our data show that induced hypotension by diltiazem activates the renin-angiotensin-sympathetic nervous system.

Organ-specific occurrence and expression of the isoforms of nonspecific lipid transfer protein in castor bean seedlings, and molecular cloning of a full-length cDNA for a cotyledon-specific isoform

Four kinds of nonspecific lipid transfer proteins (nsLTP) were purified from different organs of castor bean (Ricinus communis L.) seedlings. Amino acid compositions and amino-terminal sequences of the four nsLTPs were determined and compared with those of castor bean isoforms, nsLTP-A, -B, and -C, previously reported [Takishima et al. (1986) Biochim. Biophys. Acta 870, 248-255; Takishima et al. (1988) Eur. J. Biochem. 177, 241-249]. Two isoforms from the cotyledons were identified as nsLTP-A and -C, one isoform from the endosperms as nsLTP-B, and the other was a new isoform from the axes. This new isoform was named nsLTP-D and its amino acid sequence was determined. These results demonstrated organ-specific occurrence of the nsLTP isoforms in castor bean seedlings. The isoforms nsLTP-A, -B, -C, and -D showed similar transfer activity not only for phosphatidylcholine and phosphatidylethanolamine but also for monogalactosyldiacylglycerol, although the homology among their amino acid sequences ranged from 70 to 30%. Two cDNA clones (pnsLTP-C and pnsLTP-D) for nsLTPs of castor bean seedlings were isolated and sequenced. pnsLTP-C was the cDNA clone for nsLTP-C expressed in the cotyledons, and pnsLTP-D was that for nsLTP-D in the axis. A coupled in vitro transcription-translation analysis of both cDNA clones revealed that pnsLTP-C encodes the full-length of nsLTP-C precursor (pro-nsLTP-C), while pnsLTP-D encodes a part of nsLTP-D precursor. PronsLTP-C contained a 24-amino acid pre-sequence preceding the mature nsLTP-C (92 amino acids).(ABSTRACT TRUNCATED AT 250 WORDS)

Arteriovenous malformations of the kidneys: diagnosis and follow-up with color Doppler sonography in six patients

We performed color Doppler sonography in six patients with arteriovenous malformations of the kidneys. The diagnosis was established by angiography in all patients. Color Doppler sonograms were obtained at a large Doppler frequency-shift range (55 cm/sec of maximal average flow velocity at zero Doppler angle) to depict high-velocity blood flow in the malformation. In all patients, the malformations were seen as focal areas of flow, portrayed as a mixing of lighter colors. These were reflected by a rapid flow rate and marked tortuosity of the vessels. The sonograms showed a small peripheral malformation that was indistinct on selective renal angiography. However, flow in normal vessels grouped in the hilum obscured lighter-color flow of a small central malformation. In three patients who had total or partial ablation of the malformations with alcohol, follow-up color Doppler sonograms showed that the focal areas of flow, represented as mixing of lighter colors, disappeared or became smaller. This study shows that color Doppler sonography is a useful noninvasive procedure for diagnosing arteriovenous malformations of the kidney.

Small cell carcinoma of the stomach: a clinicopathologic study of 17 cases

Of 17 cases of small cell carcinoma of the stomach, three were early and 14 were advanced. Grossly, the tumors were mostly polypoid at the early stage, and as they advanced, deep ulcerations developed. Histologically, only one tumor was "oat cell type," and the other 16 were "intermediate cell type." With regard to tumor components, five were "pure" tumor, and 12 were "composite" admixing glandular and/or squamous differentiation. Argyrophil cells were seen in eight tumors. Immunohistochemically positive cells for chromogranin, neuron-specific enolase, and keratin were seen in 12, 10, and 7 tumors, respectively. Carcinoembryonic antigen was negative in the small cell component of most tumors as opposed to strong positivity in the glandular component. Electron-dense core granules were evident in seven of nine tumors examined. These findings suggest that histologic variety is quite characteristic of the small cell carcinomas of the stomach, and this type of carcinoma takes an aggressive clinical course like its counterparts in other organs.

A study on peroxidative damage of the porcine intestinal brush-border membranes using a fluorogenic thiol reagent, N-(1-pyrene)maleimide

To examine the effects of lipid peroxidation on the protein conformation in the porcine intestinal brush-border membranes, a fluorogenic thiol reagent, N-(1-pyrene)maleimide (NPM) was employed. By treatment of NPM-labeled membranes with 100 microM ascorbic acid/10 microM Fe2+ in the presence of various concentrations of tert-butyl hydroperoxide (t-BuOOH), the fluorescence intensity of the complex decreased with the formation of conjugated diene, depending on the hydroperoxide concentration. The temperature dependence profile of the fluorescence intensity of NPM-labeled control membranes showed a thermal transition of the NPM fluorescence at 27-28 degrees C. The transition phenomenon of the NPM fluorescence in the membranes around this temperature disappeared by treatment of the labeled membranes with 100 microM ascorbic acid/10 microM Fe2+/0.6 mM t-BuOOH. The difference in response of the fluorescence characteristics of the bound NPM for temperature variation between the control and peroxidized membranes was also observed in the quenching efficiency with acrylamide. Measurement of the fluorescence polarization revealed that the harmonic mean of the rotational relaxation times of the bound NPM molecules to the membrane proteins increased from 1.96 to 4.93 microseconds by lipid peroxidation of the membranes. This indicates that the movement of the region containing NPM-labeled SH groups in the membrane proteins is restricted by lipid peroxidation. Treatment of NPM-labeled peroxidized membranes with sodium dodecyl sulfate (SDS) resulted in a restoration of the intensity of the NPM fluorescence to the level of the control ones. In addition, the temperature dependence profile of the fluorescence intensity of NPM-labeled peroxidized membranes in the presence of SDS also showed an appearance of a transition phenomenon around 30 degrees C. The result of SDS-polyacrylamide gel electrophoresis of the peroxidized membranes revealed that high-molecular-weight aggregates of the membrane proteins were not formed by lipid peroxidation. On the basis of these results, changes in the environmental properties around NPM-labeled SH groups in the membrane proteins by lipid peroxidation are discussed.

Phase I study of weekly intravenous infusions of CPT-11, a new derivative of camptothecin, in the treatment of advanced non-small-cell lung cancer

7-Ethyl-10-[4-(1-piperidino)-1-piperidino]carbonyloxy-camptothecin (CPT-11) is a novel camptothecin derivative that has been selected for clinical evaluation because of its broad spectrum of antitumor activity in animal models and its unique inhibitory effects on mammalian DNA topoisomerase I. Seventeen patients with advanced non-small-cell lung cancer were treated with CPT-11 at weekly dose levels ranging from 50 to 150 mg/m2. At least three weekly doses were given to all patients except four, and a total of 74 weekly doses were given to the 17 patients. The dose-limiting toxic effects were myelosuppression (predominantly leukopenia) and unpredictable diarrhea. Gastrointestinal toxic effects were severe and not well controlled by standard therapy in some patients. Interpatient variability of toxic effects was substantial (including two deaths) and did not correlate with the pharmacokinetic parameters of CPT-11 and 7-ethyl-10-hydroxycamptothecin, its major metabolite. Two previously untreated patients, who received doses of 100 and 125 mg/m2, had partial responses lasting 3.2 and 4.0 months, respectively. The maximum tolerated dose on this schedule was 100 mg/m2, which we also recommend as a starting dose for phase II studies. This schedule appears to allow a CPT-11 dose intensity which is double the dose intensity possible on a once-a-month schedule. However, careful supervision to assess gastrointestinal toxic effects and myelosuppression is indispensable because of wide individual differences in drug tolerance.

Redevelopment of small-cell lung cancer nine years after the start of therapy. A case report and review of the literature

Most patients with small-cell lung cancer usually relapse within 1 to 2 years. Relapses after a 5-year disease-free interval occur extremely rarely. This report describes a patient with limited-stage small-cell lung cancer who had achieved a complete response to combination chemotherapy followed by chest irradiation but developed small-cell lung cancer 9.4 years after the beginning of therapy. Small-cell lung cancer recurred in the same side of the lung, in the mediastinal nodes, and in the liver. The pattern of development of small-cell lung cancer suggests that the patient had a relapse rather than a metachronous lung cancer. To our knowledge, this is the second-latest relapse of small-cell lung cancer in the literature.

A phase I study of chronic daily dosing of oral etoposide in combination with cisplatin for patients with advanced cancer

A dose escalation study of daily oral etoposide and cisplatin was carried out on 22 patients with advanced cancer using starting doses of 20 mg/m2/d of etoposide given orally for 21 days and 80 mg/m2 of cisplatin given intravenously (IV) on day 1. A total of 40 courses were given. Myelosuppression was the major dose-limiting toxicity, with a maximum tolerated dose of 50 mg/m2/d of oral etoposide for 21 days plus 80 mg/m2 of IV cisplatin on day 1. Doses of 40 mg/m2/d of etoposide for 21 days plus 80 mg/m2 of cisplatin for 1 day in four of eight courses (50%) were associated with Grade 3 or worse leukopenia that occurred between days 18 and 26. However, no Grade 3 or worse thrombocytopenia occurred at this dose level. Nausea and vomiting occurred in most patients at each dose level but were mild and could be controlled by antiemetics. Alopecia also occurred frequently. Significant mucositis (Grade 4) occurred in one patient, but no other toxicities were observed. Four partial responses that lasted from 1.3 to 5.8+ months were observed in patients with cervical (one patient), small cell lung (one patient), and squamous cell lung cancer (two patients); one of them had been heavily pretreated with platin analogue-containing regimens. The recommended doses for Phase II studies on this schedule are 40 mg/m2/d of oral etoposide for 21 days plus 80 mg/m2 of IV cisplatin on day 1. A combination regimen on this schedule seems particularly effective in patients with etoposide-sensitive malignancies.

[Permanent cardiac pacing in patients on chronic dialysis]

Four patients on chronic dialysis, who underwent permanent pacemaker implantation, were reviewed. The indication for pacing was sick sinus syndrome in three patients and complete atrioventricular block in one. Physiological pacing modes were chosen in all patients (DDD in three and AAI in one). Sensing and pacing properties in these patients studied at implantation and at follow-up (22-41 months after implantation) were similar as those in non-dialysis patients. However, the study of these properties during hemodialysis showed a significant elevation of atrial pacing threshold associated with marked decrease of serum potassium concentration in two patients. We conclude that dialysis patients with significant bradyarrhythmia should be considered for pacemaker implantation in the same manner as non-dialysis patients. However, special attention should be payed on the elevation of pacing threshold during hemodialysis.

[The significance of CA-50, SLX and ST-439 in lung cancer]

Serum levels of CA-50, SLX and ST-439 were measured in 213 patients with lung cancer (92 adenocarcinomas, 63 squamous cell carcinomas, 37 small cell carcinomas and 21 large cell carcinomas) and 87 patients with benign lung disease. The overall positive rates in patients with lung cancer were 12.8% for CA-50, 29.7% for SLX and 25.3% for ST-439. The positive rates for CA-50, SLX and ST-439 in adenocarcinoma patients were 22.8%, 42.4% and 38.0%, respectively. Of the patients with benign lung disease, 4.8% were false positive for CA-50, 15.3% for SLX and 3.6% for ST-439. In the patients with adenocarcinoma of the lung, the combination assay of CEA and ST-439 had a highly accurate rate (61.9%).

Oxygen-radical-mediated lipid peroxidation and inhibition of ADP-induced platelet aggregation

The effects of lipid peroxidation on ADP-induced aggregation of washed rat platelets were examined using a oxygen-radical-generating system consisting of H2O2 and ferrous ion. Lipid peroxidation was assessed by measurement of thiobarbituric acid-reactive substances (TBARS). Incubation of the platelets with various concentrations of H2O2 (2-10 mM) in the presence of 10 microM Fe2+ resulted in a decrease of the aggregating capacity and an increase of TBARS value, depending on the concentrations of H2O2. Addition of catalase (0.1 mg/ml) to the incubation medium containing 10 microM Fe2+ and 10 mM H2O2 effectively protected the aggregating capacity, but superoxide dismutase (0.1 mg/ml) did not protect H2O2/Fe(2+)-induced inhibition of the platelet aggregation. The results of kinetic studies on the platelet aggregation with varying ADP and Ca2+ concentrations suggested that treatment of the platelets with H2O2/Fe2+ causes decreases in the binding affinities of ADP and Ca2+ for the platelets. On the basis of these results, change in the aggregating capacity of the platelets by treatment with H2O2/Fe2+ is discussed in relation to lipid peroxidation.

Transient massive proteinuria associated with Mycoplasma pneumoniae infection

A 5-year-old girl presented with Mycoplasma pneumoniae infection, which was associated with eyelid edema and massive proteinuria. Her clinical manifestations were similar to those of nephrotic syndrome, except for the absence of hypoproteinemia. Light microscopy of renal biopsy tissue showed minor glomerular abnormalities, with no tubulointerstitial changes. Electron microscopy showed sparse fusion of the foot processes, regular nonthickened glomerular basement membrane, and no electron-dense deposits. Immunofluorescent staining of the glomeruli for immunoglobulins (IgG, IgA, IgM) and complement (C3, C4) was negative. Mycoplasma antigen was not detected by indirect immunofluorescence. These findings suggest a causal relationship between M pneumoniae infection and transient renal injury.

[Mortality patterns of children with epilepsies in a children's medical center]

Two hundred and thirty-seven children have died who were seen in the Division of Neurology, Kanagawa Children's Medical Center from 1975 to 1989. They corresponded to about 11% of the total death in the hospital. A total of 128 cases of 237 deaths (54.0%) were suffering from epilepsies, most of whom were also complicated with other CNS disorders. The causes of death were pneumonia, respiratory failure and suffocation in 60%, whereas status epilepticus or convulsions only in 14%. About 40% of victims died at home or in an emergency room without effective resuscitation. Mortality was considered high in infantile spasms (16 out of 146, 11%) and in severe myoclonic epilepsy in infancy (4 out of 8, 50%). It was note worthy that 3 cases of severe myoclonic epilepsy in infancy died of status epilepticus and 2 died at home. Sixteen cases whose chief problems were partial epilepsies and severe myoclonic epilepsy in infancy, died of status epilepticus in 10 cases, convulsions after tonsillectomy, etc. Causes of death of these 16 cases were related to convulsions except in two cases whose causes were pneumonia in one and unknown in the other. About a half of them (7 cases) died at home. Adequate managements appeared necessary to prevent accidental deaths of children with epilepsies.

[Four cases of Cockayne syndrome]

The evaluation of four patients with Cockayne syndrome (CS) by computed tomography (CT) and magnetic resonance imaging (MRI) is reported. All patients had characteristic clinical manifestations of CS. In a special respect, we found hyperopia in two patients and previous habitual abortions in two maternal histories. Extrapyramidal signs were seen in one patient. Three patients are type 1 CS (case 1, 3, 4) and one patient (case 2) is type 2 CS (congenital form). The cranial CT in two patients (case 1, 2) revealed prominent calcifications in basal ganglia, dentate nucleus and hemispheric white matter. While CT showed vagal calcifications in basal ganglia in other two patients (case 3, 4), T2-weighted MRI revealed obvious low intensity area in putamen and caudate nucleus, and high intensity area in the white matter. Sagittal section revealed atrophic changes of cerebellar vermis and brain stem. Thus it seems that MRI may be useful diagnostic adjunct in CS patients.

Hyperthermic purging in vitro of murine leukemia cells (MK-8057): surviving fractions of normal and leukemic stem cells and the long-term survival of mice injected with the post-hyperthermic leukemia cells

Hyperthermic purging of leukemic cells has been applied in clinical trials, although an accurate evaluation system to compare the effect on leukemia cells with that on normal hemopoietic cells has not been established. We evaluated the heat-sensitivity of murine leukemia cells, MK-8057, and compared differences in heat-sensitivity between surviving fractions of leukemic stem cells (leukemic spleen colony-forming units, L-CFU-S) and normal hemopoietic stem cells (spleen colony-forming units, CFU-S). Using the spleen colony assay, the survival fraction of L-CFU-S was compared with that of CFU-S after various hyperthermic treatments. One of the most efficient conditions, that is, hyperthermia at 42 degrees C for 3 h, allowed only 0.17% of L-CFU-S to survive, whereas 26.5% of normal CFU-S survived. Hyperthermia at 44 degrees C for 45 min further reduced the L-CFU-S (0.13%); however, the relative ratio of L-CFU-S to CFU-S was less than that at 42 degrees C for 3 h, because there was a larger reduction at 44 degrees C in normal CFU-S (5.1%). Recipient mice injected with MK-8057 cells treated with hyperthermia survived longer in proportion to the decreasing number of surviving L-CFU-S injected. This extension of the survival of recipient mice given MK-8057 cells after hyperthermia was also proportional to the estimated survival fraction of L-CFU-S. The survival fraction of MK-8057 cells after hyperthermia that was independently calculated through the extended survival of the recipients showed a good correlation with the surviving fraction of L-CFU-S, seen as the leukemic spleen colonies, at a correlation coefficient of r = 0.985. The number of surviving mice receiving the post-hyperthermic MK-8057 cells and the number of L-CFU-S calculated to have been injected had a relationship based on a Poisson distribution. Thus, the calculated results imply that the hyperthermia proportionally targets L-CFU-S, which are the only cells responsible for killing the recipient mice.

[Hemodynamic effects of endothelin in anesthetized dogs]

The purpose of the present study was to investigate and compare the hemodynamic responses that can be elicited in anesthetized dogs by intravenous administration of endothelin at rates of 300 (group E-I, n = 9) and 600 pmol.kg-1 (group E-II, n = 9) for 15 minutes. In group E-I, no significant pressure response was observed after administration of endothelin and cardiac index remained unchanged throughout the experiment. However, right and left ventricular work indices increased significantly but left ventricular maximum dp/dt and pulmonary vascular resistance decreased significantly. In group E-II, mean arterial pressure increased significantly by elevating systemic vascular resistance with marked decrease in cardiac index. However, right and left ventricular work indices remained unchanged throughout the experiment. On the other hand, each dose of endothelin significantly increased pulmonary capillary wedge pressure and left ventricular end-diastolic pressure but decreased heart rate. The present data revealed that the hemodynamic effects were different according to the doses of endothelin infused. In conclusion, our results show that endothelin (600 pmol.kg-1 BW) produces a long lasting increase in arterial pressure and endothelin-induced pressure responses are caused by an elevation in systemic vascular resistance.

Spindle cell carcinoma of the lung. A clinicopathologic study of three cases

Two cases of monophasic spindle cell carcinomas and one case of adenosquamous carcinoma with the spindle cell component located in the lower respiratory tract are presented. In the biphasic tumor, areas of transition from carcinoma to sarcomatous spindle cells were clearly found. The two monophasic tumors and the spindle cell component of the biphasic tumor were histologically characterized by sheets of spindle cells. However, by electron microscopic and immunohistochemical study, several features of squamous epithelial differentiation were found in the spindle cell areas of all cases. Keratin and vimentin were, in various degrees, coexpressed in all the cases. Therefore, it is supposed that the spindle cell component displays a spectrum of phenotypes originating from squamous cell carcinoma, and monophasic spindle cell carcinoma is considered as a kind of the extreme phenotype of squamous cell carcinoma pretending mesenchymal differentiation.