S100-positive histiocytes in T-cell-dependent area in human lymph nodes express P-glycoprotein

In the present study, we examined P-glycoprotein (P-gp)-expressing cells in human lymph nodes (LN) from patients with reactive lymph adenitis and various malignant lymphomas (ML). MDR1 mRNA was detected in all reactive LN and in 8 of 10 ML samples examined by reverse transcription polymerase chain reaction (RT-PCR). The signal intensity of the bands was stronger in samples from T-cell ML LN than in those from LN of reactive lymph adenitis and B-cell ML. Immunohistochemistry also showed positive reactivity with cellular components in the LN. The P-gp-positive cells, detected by UIC2, in reactive lymph adenitis and ML samples were large in size in the T-cell-dependent paracortical area in LN. Further, morphological characteristics were similar in UIC2-positive cells between reactive and ML LN. Double staining with UIC2 and a hematopoietic cell lineage-specific monoclonal antibody showed that UIC2-positive cell co-expressed S-100, but not other lymphocyte- and ML cell-specific antigens, indicating that these cells correspond to histiocytes in the T-cell-dependent paracortical area. Our results show that P-gp was expressed in histiocytes but not ML cells in LN, and suggest that this molecule may play an important role in the biological function of histiocytes and/or for maintenance of homeostatic levels in T-cell ML LN.

Gene therapy for vascular smooth muscle cell proliferation after arterial injury

Accumulation of vascular smooth muscle cells as a consequence of arterial injury is a major feature of vascular proliferative disorders. Molecular approaches to the inhibition of smooth muscle cell proliferation in these settings could potentially limit intimal expansion. This problem was approached by introducing adenoviral vectors encoding the herpesvirus thymidine kinase (tk) into porcine arteries that had been injured by a balloon on a catheter. These smooth muscle cells were shown to be infectable with adenoviral vectors, and introduction of the tk gene rendered them sensitive to the nucleoside analog ganciclovir. When this vector was introduced into porcine arteries immediately after a balloon injury, intimal hyperplasia decreased after a course of ganciclovir treatment. No major local or systemic toxicities were observed. These data suggest that transient expression of an enzyme that catalyzes the formation of a cytotoxic drug locally may limit smooth muscle cell proliferation in response to balloon injury.

Identification of unlawful food dyes by thin-layer chromatography-fast atom bombardment mass spectrometry

A thin-layer chromatographic-fast atom bombardment mass spectrometric (TLC-FAB-MS) method incorporating an analyte condensation technique was established for the identification of the 27 food dyes consisting the twelve dyes permitted for use in foods and the fifteen unlawful dyes in Japan. The use of magic bullet [1,4-dithiothreitol-1,4-dithioerythritol (3:1)] as a matrix allowed the measurement of the FAB mass spectra of the food dyes except for Food Blue No. 2 (Indigo Carmine). The separation was performed on a C18-modified silica gel TLC plate using the following two solvent systems: methanol-acetonitrile-5% aqueous sodium sulphate solution (3:3:10) and methyl ethyl ketone-methanol-5% aqueous sodium sulphate solution (1:1:1). The condensation technique for concentration of a diffuse sample spot on the TLC plate improved the detection limit 4-20-fold with good reproducibility. The method was successfully applied to the identification of unlawful dyes in imported foods.

Detection of bacteria in phagocyte-smears from septicemia-suspected blood by in situ hybridization using biotinylated probes

We report herein the detection of intracellular bacteria in phagocyte-smears obtained from septicemia-suspected blood samples by in situ hybridization. This was obtained by using nick-translated biotin-11-dUTP-labeled DNA probes and streptavidin-alkaline phosphatase conjugates for visualization of the hybridized signals. The probes were made from random genomic DNA clones of bacteria which are frequently the causative agents of bacteremia, such as Staphylococcus spp., Pseudomonas aeruginosa, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Enterobacter spp. When our in situ hybridization method was compared with conventional culture protocols for the ability to detect bacteria from the blood of patients suspected of having septicemia, 30 positive results were obtained in 50 specimens by in situ hybridization methods. In contrast, only 7 positive results were obtained by blood cultures. Thus, even if bacteria cannot be detected by conventional blood cultures and histology, our in situ hybridization method allows for direct observation of bacterial foci in circulating phagocytes and identification of the bacteria. Our investigations suggest that in septicemia, circulating polymorphonuclear neutrophils carry some surviving bacteria as well as metabolized bacterial DNA and RNA for a considerable period of time. Thus, our in situ hybridization method using the phagocyte-smears have diagnostic value for detecting most bacteria which cause septicemia.

[Successful pregnancy after allogeneic bone marrow transplantation: two case reports]

A case of successful pregnancy after allogeneic bone marrow transplantation (BMT) in a woman with severe aplastic anemia conditioned with 200 mg/kg cyclophosphamide and 4.5 Gy total lymphoid irradiation (TLI) at the age of 15 years is reported. She delivered a normal child 92 months after BMT. A male with paroxysmal nocturnal hemoglobinuria received allogeneic BMT at the age of 22 years is described as a second case. He was conditioned with 200 mg/kg CY and 7.5 Gy TLI and parented a normal child 32 months after BMT. These observations demonstrate that normal pregnancy can follow high dose chemotherapy and TLI.

MR angiography of renal vascular malformations

OBJECTIVE

We wanted to determine whether three-dimensional phase contrast (3DPC) MR angiography is clinically useful in the diagnosis of renal vascular malformations.

MATERIALS AND METHODS

Three-dimensional PC MR angiography was performed in 22 patients with gross hematuria and in 8 healthy volunteers. Small flip angles and 60 cm/s velocity encoding best demonstrated the normal intrarenal arteries with arteriovenous differentiation in the eight healthy volunteers. In the 22 patients with gross hematuria, intraarterial digital subtraction angiography demonstrated cirsoid-type malformations in 6 patients, aneurysmal-type malformations in 3 patients, and normal vascular anatomy in 13 patients.

RESULTS

Magnetic resonance angiography detected all three aneurysmal-type malformations and four of the cirsoid-type malformations. Small cirsoid-type malformations were not detected in two patients. The moderate or large malformations were demonstrated as dilated and tortuous feeding arteries and high intensity renal veins with high flow velocity. We found no correlation between signal intensity in the suprarenal inferior vena cava and the presence of arteriovenous shunts. There were no false-positive cases.

CONCLUSION

Sensitivity, specificity, and accuracy in this series were 78, 100, and 91%, respectively.

[A progress in the diagnosis of malignant lymphoma]

Malignant lymphoma is usually divided into Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) according to the biological characteristics. Although the exact nature of HD is still unclear, NHL is well known to be a neoplasm of monoclonal and malignant B- or T-lymphocytes. Nowadays, the classification of pathologic type in HD seems to be settled in the Rye classification. On the other hand, in NHL the LSG classification has been fixed routinely in Japan and the Working Formulation originating in the USA has been used internationally after some historical confusion. As a recent trend in lymphoma diagnosis, the introduction of immunological and molecular biological techniques has had an impact on the previous concept and classification of malignant lymphoma based mainly on morphological criteria. In this article, recent progress in the diagnosis of malignant lymphoma, mainly NHL, including the analysis of immunophenotype and immunogenotype (intragenic and intergenic gene rearrangement) is briefly described.

[Successful surgical treatment in a case of complete rupture of the posterior papillary muscle of the mitral valve caused by infective endocarditis]

Forty three year-old male who had cough and easy fatigability since three weeks prior to admission was diagnosed to have acute pulmonary edema with severe mitral regurgitation caused by active infective endocarditis. Transesophageal echocardiograms under the endotracheal intubation for controlled respiration suggested rupture of the posterior papillary muscle of the mitral valve and the emergency surgical treatment was performed. Intraoperatively the total rupture of the posterior papillary muscle was confirmed and mitral valve replacement was carried out with a SJM prosthetic valve. Histological examination of the ruptured papillary muscle revealed hemorrhage, muscle necrosis and small cell infiltration suggesting the presence of active inflammation with bacteria on it. Staphylococcus epidermidis was demonstrated by the bacteriological studies of the ruptured papillary muscle.

Pharmacological characteristics of hyperambulation induced by the sigma ligand (+)-3-PPP in rats

(+)-3-(3-Hydroxyphenyl)-N-(1-propyl)piperidine ((+)-3-PPP), a sigma ligand, at doses above 3 mg/kg (s.c.) increased the ambulatory activity of rats, while the (-) isomer of 3-PPP with low affinity for sigma receptors, did not significantly modify the ambulatory activity at 10 and 30 mg/kg (s.c.). The ambulation-increasing effect of (+)-3-PPP was prevented by the sigma receptor antagonists BMY 14802 and rimcazole or the sigma/dopamine D2 antagonist haloperidol. The (+)-3-PPP effect was also attenuated by pretreatment with the monoamine depletor reserpine or the tyrosine hydroxylase inhibitor alpha-methyltyrosine, but was not affected by the tryptophan hydroxylase inhibitor p-chlorophenylalanine. Moreover, the (+)-3-PPP effect was antagonized by the dopamine D2 antagonist sulpiride, whereas pretreatment with the 5-HT1A agonist 8-OH-DPAT and the alpha-adrenoceptor antagonist phenoxybenzamine did not exert any significant effect. These results indicate that sigma receptors are involved in the neuronal mechanism(s) of hyperambulation induced by (+)-3-PPP, and the sigma system may exert both a presynaptic action and a dopamine D2 receptor-mediated action to increase the central dopaminergic function.

Myocardial beta-receptor and cardiac angiotensin alterations during the acute and chronic phases of viral myocarditis

Recovery from viral myocarditis is usually excellent and complete although it occasionally results in sudden death during its acute stage. While neurohormonal mechanisms play an important role in the adaptation to heart diseases, little is known about the alteration of the neurohormonal system in viral myocarditis. Therefore, we examined the myocardial beta-adrenergic receptor and cardiac angiotensin I and II concentrations in a murine model of viral myocarditis induced by an encephalomyocarditis virus. The down-regulation of the beta 1-adrenergic receptor subtype was observed on day 10. The heart weight, heart weight/body weight ratio and myocardial necrosis were significantly increased at this stage. On day 30, the beta 2-adrenergic receptor subtype was up-regulated without up-regulation of the total beta-adrenergic receptor. Both angiotensin I and II concentrations were significantly increased with myocardial hypertrophy in the left ventricle on day 30. The up-regulation of the total beta-adrenergic receptor and beta 2-subtype was observed on day 120, but neither the angiotensin I nor II concentration was increased. Therefore, the up-regulation of the beta 2-adrenergic receptor density and the temporal increase of the angiotensin I and II concentrations in the murine ventricle during viral myocarditis may play an important role in the pathophysiology of post-viral myocarditis.

[Observation of the rat gastric mucosal microcirculation by vital-microscopy]

The greater curvature of the stomach of fasted rats was cut under urethane anesthesia (1.25 g/kg, i.p.). The dorsal side of the glandular stomach was fixed in a plastic chamber by facing the mucosal side to the chamber and perfused with warm Tyrode solution at 37 degrees C. A window made by partial removal of the serosa, the muscularis externa and the submucosa allowed us to observe the basal part of the mucosal microcirculation through the muscularis mucosae. Images of the microcirculation were transmitted through a TV camera to a TV monitor screen and recorded on videotapes by a videotape-recorder. The diameters of the arterioles, collecting venules and venules were measured by an image analyzer. Arterioles, running along the muscularis mucosae, responded to acetylcholine and epinephrine applied on the window, by dilatation and constriction, respectively, but the collecting venules and venules showed no changes in diameter. Application of 50% ethanol on the mucosal side caused dilatation of the arterioles and constriction of the collecting venules and venules. This method may be useful for analyzing the mechanisms of gastric mucosal injury and those of the effects of vasoactive agents on the gastric mucosal microcirculation.

Smooth tubular aggregates associated with plasmalemmal invagination in alveolar soft part sarcoma

The ultrastructure of four alveolar soft part sarcomas was examined to search for ultrastructural signs of myogenic or neural origin. A new ultrastructural structure, an unusual tubular structure, was found in two of four cases. The structure appeared as a large, smooth, tubular aggregate in the cytoplasm of some tumor cells but did not show a honeycomb arrangement of tubules. The aggregate was composed of long, serpentine, branching, smooth, irregularly arranged tubules without ribosomes that ran in various directions. The aggregates intermingled with small amounts of cytoplasmic organelles. Because the aggregated tubules were at times continuous with cell membranes, it was shown that they were the complex extensions or invaginations of cell membranes. Neither myelin-axon complexes nor myofilaments, including Z band material, were seen in any case. There was a possibility that the smooth tubular aggregate was a T-tubule-like structure, suggesting that the tumors were derived from skeletal muscle cells.

RES-701-1, a novel, potent, endothelin type B receptor-selective antagonist of microbial origin

The unique cyclic peptide designated RES-701-1 blocked the binding of 125I-labeled endothelin (ET)-1 to bovine cerebellar membranes. ETB receptors are predominant in bovine cerebellum. However, in bovine lung membranes, where both ETA and ETB receptors are expressed, RES-701-1 inhibited 125I-ET-1 binding by up to 70%; RES-701-1, in the presence of the ETA-selective antagonist BQ-123 at 1 microM, displaced 125I-ET-1 binding completely. With membranes from transfected Chinese hamster ovary cells expressing the human ETA or ETB receptors, RES-701-1 inhibited 125I-ET-1 binding to the ETB receptor with an IC50 value of 10 nM but had no effect on 125I-ET-1 binding to the ETA receptor. Thus, RES-701-1 is highly specific for the ETB receptor; it has no effect on a number of other receptors. RES-701-1 selectively inhibited the ET-1-induced increase in intracellular Ca2+ concentration in COS-7 cells expressing the ETB receptor but did not inhibit the Ca2+ transient in ETA-expressing cells. When injected intravenously (250 nmol/kg) into anesthetized rats, RES-701-1 abolished the initial depressor response to ET-1 but enhanced the subsequent pressor response. These results suggest that RES-701-1 is a potent and specific antagonist for the ETB receptor and that RES-701-1 will be a powerful tool for understanding the physiological roles of this receptor.

[Aggressive transformation of an indolent myeloma with abdominal extramedullary plasmacytoma after 6-year period of observation]

62-year-old female, who had been under observation for an indolent myeloma for six years without therapy, was admitted because of left flank pain. Various imaging modalities disclosed left pleural effusion, and a huge abdominal tumor involving the left crus of the diaphragm, spleen, stomach, pancreatic tail, left adrenal gland, left kidney and left posterior abdominal wall. Morphological and immunological examinations revealed extensive proliferation of more anaplastic myeloma cells within the tumor and in the pleural effusion than those in bone marrow on admission or at the beginning of the period of observation. Chemotherapy reduced serum M-protein, but LDH, the volume of the pleural effusion, and the size of the tumor increased. She died of pancreatitis associated with massive bleeding from the gastric tumor. Renal function was well preserved until her terminal phase. The clinical course showed the progression of indolent myeloma into an aggressive one without chemotherapeutic intervention, implying a rare subtype in terms of the natural history of multiple myeloma.

Compressed air injury of the colon complicated by rhabdomyolysis: case report

We present a case of traumatic injury of the colon by compressed air. Elevated levels of urinary myoglobin, creatinine phosphokinase, lactate dehydrogenase, and glutamic oxaloacetic transaminase indicating rhabdomyolysis were noted. In this type of injury, rhabdomyolysis related to acute peripheral circulatory failure may occur because of obstruction of venous return to the heart following a great increase in intraperitoneal pressure.

[Injury of the coronary artery following non-penetrating chest trauma--a case report]

A previously healthy 71-year-old man sustained a non-penetrating chest trauma. The chest CT scan revealed cardiac tamponade and then emergent operation was performed. We opened the pericardium through median sternotomy and found a laceration of the distal left anterior descending coronary artery (seg. 8). We ligated the artery and he showed signs of a limited myocardial infarction on the postoperative ECGs, but echocardiography revealed symmetric contraction and normal ejection fraction. His postoperative course was uneventful. We think that injuries of distal coronary arteries could be successfully ligated.

PRAD1 gene over-expression in mantle-cell lymphoma but not in other low-grade B-cell lymphomas, including extranodal lymphoma

Employing Northern blot analysis and the polymerase chain reaction, we investigated PRAD1 gene overexpression in the tumour tissues of 58 patients with B-cell lymphoma. These findings were then examined in relation to the patients' clinical and immunohistological characteristics. The over-expression of this gene was detected in 6/8 patients with mantle cell lymphoma (MCL) and in only 1/50 other lymphomas, indicating its close association with MCL. The patients with MCL had common clinical findings of advanced disease with generalized lymphadenopathy on admission, and they had a CD5+CD10-IgD+ phenotype. The patients with chronic lymphocytic leukaemia (CLL) also showed findings indicating a distinctive disease entity: a CD5+CD10-IgD+ phenotype and lack of PRAD1 over-expression. In contrast, most patients with diffuse low-grade lymphoma other than MCL and CLL had localized extranodal disease, expressed a CD5-CD10-IgD- phenotype, and lacked PRAD1 over-expression. These findings suggest that extranodal low-grade lymphomas differ from nodal MCL and are not part of the spectrum of CLL.

New genotype of hepatitis C virus in South Africa

Partial nucleotide sequences in the core region of the hepatitis C viral genome were determined by reverse transcription followed by polymerase chain reaction, in a patient with chronic hepatitis from South Africa. These nucleotide sequences showed a low degree of homology with known types of HCV: the degree of homology between the nucleotide sequences of these clones with HC-J1, J4, J6, J7, Tr, and Eb-1 were 86.1-87.3%, 87.3-87.9%, 83.0-83.9%, 81.1-82.0%, 81.0-82.2%, and 82.8-83.4%, respectively, and that the deduced amino acid sequence homologies between these clones and HC-J1, J4, H6, J7, Tr, and Eb-1 were 90.7-91.6%, 89.7-91.6%, 91.6-93.5%, 90.7-91.6%, 81.5-82.4%, and 89.2-90.2%, respectively. The nucleotide sequence homologies of these clones with HC-J1, J4, J6, J7, Tr, and Eb-1 were very low, compared to those between the same genotype. Further comparison using molecular evolutionary methods suggested that this sequences should be classified in a new genotype.

Malignant histiocytosis associated with autoimmune thrombocytopenia

We describe a patient with malignant histiocytosis whose serum contained an autoantibody against platelet protein. The patient was admitted because of nasal bleeding and high-grade fever. The clinical course was fulminantly progressive and terminated with cerebral hemorrhage. Bone marrow aspirate showed the proliferation of large atypical cells, some of which exhibited phagocytic activity. At postmortem examination, there was diffuse infiltration of these atypical cells in the liver, spleen, kidney, and bone marrow. Morphological, cytochemical, immunohistochemical, and genotypic characteristics suggested that the proliferating cells were derived from the monocyte-macrophage system. Western blot analysis revealed the presence of autoantibody against an approximately 88 kd molecule of platelet proteins. Although the relationship of cause and effect remains to be clarified, this autoantibody appeared to have stimulated thrombophagocytosis of the neoplastic cells.