Natural killer cell leukemia. An autopsy case

We describe an autopsy case of natural killer cell leukemia. Leukemic cells appeared morphologically as large granular lymphocytes and expressed a restricted natural killer cell phenotype (CD2, CD38, CD56, HLA-DR). Immunogenotypic analysis revealed germline configurations of TCR-beta, TCR-gamma, and JH genes, indicating a non-T-cell or non-B-cell lineage. These features are consistent with natural killer cell leukemia, a recently proposed clinicopathologic entity. Autopsy findings were characterized by an extremely dense infiltration of leukemic cells in most organs, along with destruction of the normal architecture, corresponding to an aggressive clinical course. Hemophagocytic histiocytosis and an absence of chronic inflammatory reactions caused by recurrent infection in our case are different from morphologic features of CD3+ large granular lymphocytic leukemia. No relationship between Epstein-Barr virus and natural killer cell leukemia was observed.

[Thrombotic thrombocytopenic purpura (TTP) observed in a patient with primary antiphospholipid antibody syndrome]

Thrombotic thrombocytopenic purpura (TTP) is a rare syndrome of unknown etiology and has a high mortality rate. TTP is characterized by a pentad of clinical findings, including microangiopathic hemolytic anemia, thrombocytopenia, renal abnormalities, neurologic signs and fever. The pathological feature of TTP consists of disseminated microvascular platelet thrombi. We describe a case of TTP with primary anti-phospholipid syndrome. A 27-year-old woman developed TTP in her second trimester of pregnancy. She presented with classical symptoms of TTP with compatible renal biopsy findings. Although four articles of SLE criteria (1982 ARA) were fulfilled, three of them were considered to be derived from multiple thrombosis except for a positive antinuclear antibody. Positive antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibody) with SLE-like findings suggested the diagnosis of antiphospholipid antibody syndrome rather than SLE. Although TTP has been described in patients with SLE and they can share common clinical and pathological features, the relationship between these two diseases is controversial. Many theories have been proposed to explain the nature and cause of intravascular platelet aggregation in TTP. But the pathogenesis of TTP is still unclear. This case suggests an important causal relationship between antiphospholipid antibodies and TTP during pregnancy. In TTP patients who also have SLE or SLE-like features, the antiphospholipid antibodies may have a role in the development of multiple microthrombosis.

Antiepileptic effects of inhibitors of nitric oxide synthase examined in pentylenetetrazol-induced seizures in rats

The effects of intraperitoneal NG-methyl-L-arginine and N omega-nitro-L-arginine methyl ester, specific inhibitors of nitric oxide (NO) synthase, were examined on the pentylenetetrazol (PTZ)-induced seizures in rats. The incidence and latency for the onset of myoclonic jerks, clonic seizures, and tonic generalized extension were observed as specific parameters among PTZ-induced seizures. Both drugs preferentially suppressed the tonic generalized extension and prolonged the latency for the onset of each parameter, suggesting NO has a significant effect on the PTZ-induced seizure.

Transcriptional regulation of the human interleukin-6 gene promoter in human T-cell leukemia virus type I-infected T-cell lines: evidence for the involvement of NF-kappa B

Freshly isolated leukemic cells from patients with adult T-cell leukemia (ATL) and human T-cell leukemia virus type I (HTLV-I)-infected T-cell lines constitutively produce high levels of interleukin-6 (IL-6) protein and mRNA. To clarify the mechanisms that lead to the activation of IL-6 gene in HTLV-I-infected cells, we first studied the regulatory regions in the IL-6 gene transcription by transfection of chloramphenicol acetyltransferase (CAT) reporter plasmids containing the IL-6 promoter. When transfected into HTLV-I-infected T-cell lines MT-2 and HUT-102, IL-6 promoter/CAT plasmids were strongly activated without any stimulation. By deletion analysis of 5' upstream region of IL-6 promoter, the DNA region between -73 and -59 bp from the transcription start site of IL-6 gene was important in the expression of IL-6/CAT activities in HTLV-I-infected cells. This region contains nuclear factor (NF)-kappa B binding site. The site-directed mutation of the kappa B motif in IL-6/CAT plasmid resulted in the complete abrogation of IL-6 promoter activity in these cells. Furthermore, when IL-6 promoter/CAT plasmid was introduced into an HTLV-I-uninfected T-cell line, Jurkat, IL-6 promoter activity was silent in the basal level, but strongly increased by the cotransfection with an HTLV-I tax expression plasmid. However, tax expression plasmid showed no transactivation activity, when kappa B site was mutated in IL-6 promoter/CAT plasmid. We found that the IL-6 kappa B site specifically formed a complex with NF-kappa B-containing nuclear extracts from MT-2 and HUT-102 cells. Finally, transfection of HTLV-I tax into Jurkat cells resulted in induction of specific binding of nuclear extracts to the NF-kappa B sequence. These results strongly suggest that HTLV-I tax gene may transactivate IL-6 gene through kappa B site in HTLV-I-positive T-cell lines and activation of NF-kappa B may be crucial in HTLV-I-induced IL-6 gene activation in ATL.

Effects of 3'-angeloyloxy-4'-acetoxy-3',4'-dihydroseselin on cardiohemodynamics in anesthetized dogs

Cardiohemodynamic effects of 3'-angeloyloxy-4'-acetoxy-3',4'-dihydroseselin (Pd-Ia) isolated from the Chinese medicinal plant Peucedanum praeruptorum Dunn were compared with those of diltiazem (Dil) in anesthetized open-chest dogs. Pd-Ia 3 mg.kg-1 increased coronary blood flow from 25 +/- 11 to 58 +/- 16 ml.min-1 (n = 7, P < 0.01) and decreased mean aortic pressure (MAP) from 13 +/- 2 to 8 +/- 1 kPa (P < 0.01), rate pressure product (RPP) from 1.9 +/- 0.5 to 1.3 +/- 0.3 MPa.bpm (P < 0.05), +dp/dtmax from 246 +/- 56 to 160 +/- 36 kPa.s-1 (P < 0.01) and systemic vascular resistance from 19 +/- 4 to 12 +/- 7 Pa.ml-1.min-1 (P < 0.05), together with an increase in HR. Dil showed effects similar to those of Pd-Ia except for a marked decrease in HR. The effects of Pd-Ia on MAP and RPP were approximately one-tenth as potent as those of Dil. The results demonstrated that Pd-Ia was a Ca2+ channel blocker.

The effect of adenosine on cochlear potentials in the guinea pig

The effect of adenosine on cochlear potentials was examined in the guinea pig. Perilymphatic perfusion with 10(-4) M adenosine produced a significant decrease in the amplitudes of cochlear microphonics, negative summating potential (-SP) and compound action potential (CAP) and significant prolongation of N1 latency with no change in the endocochlear potential. The decreases in the amplitudes of -SP and CAP caused by adenosine were dose-dependent. Perilymphatic perfusion with an inactive analogue, 8-bromoadenosine, produced no changes in the cochlear potentials. The A1-receptor agonist, 2-chloro-adenosine, produced a similar change in cochlear potentials to adenosine, while no changes were produced by the A2-receptor agonist, 5'-(N-ethylcarboxamido)-adenosine. These results suggest that adenosine may have a modulatory function through an A1 receptor in the cochlea.

CD30-positive lymphoma in human T-cell leukaemia virus type 1 carrier without monoclonal integration of HTLV-1

CD30, Ki-1 antigen, an activated T-cell antigen, is a member of the nerve growth factor receptor family. This antigen is expressed on the lymphoma cells of some adult T-cell leukaemia/lymphoma (ATL/L) patients and some patients with Epstein-Barr virus infection. CD30-positive large cell cutaneous T-cell lymphomas occasionally integrate a defective HTLV-1 provirus. We describe here an HTLV-1 carrier who developed Ki-1 lymphoma with no evidence of monoclonal integration of the HTLV-1 proviral sequence.

Hormone-dependent human tumors express the fms gene-product

Human mammary and thyroid tumors as well as peripheral blood cells of the same patients were examined for the amplification of oncogene fins and the expression of its product. Of the 7 mammary tumors analyzed, amplification of fms was observed in 6 (86%) mammary tumor DNAs, while no amplification was seen in 5 thyroid tumors and 7 peripheral blood cell DNAs tested. None of the mammary and thyroid tumors showed any rearrangement of the fms gene. Investigations of the expression of the product of fms in various human tumors were carried out following the method of immunohistochemical staining in which polyclonal antibody to the fms gene product was used. The incidence of the expression of fms gene product in the tumors of mammary and thyroid glands, prostate and ovary, the hormone-dependent organs, was 38-97%, whereas fms protein was found to be present only in 20 and 42% of the tumors from hormone-independent organs, the brain and the bladder. Expression of the fms gene product was not detectable in normal tissue surrounding the tumor tissue in any of the cases examined. These results suggest that the expression of the product of fms may be associated with the development of some tumors of hormone responsive organs, especially the breast and thus the fms gene product may be a valuable marker for human mammary tumors.

Effects of a novel, selective and potent phosphodiesterase type V inhibitor, E4021, on myocardial ischemia in guinea pigs

The anti-ischemic effects of a new, selective and potent cyclic 3',5'-guanosine monophosphate-specific phosphodiesterase (phosphodiesterase type V) inhibitor, sodium 1-[6-chloro-4-(3,4-methylenedioxybenzyl)aminoquinazolin-2-yl ]piperidine-4- carboxylate (E4021), in a vasopressin-induced guinea pig anginal model were examined and compared with those of coronary vasodilators with a guanylate cyclase-activating action. An intravenous injection of vasopressin (0.2 IU/kg) into anesthetized guinea pigs produced ST segment elevation on the electrocardiogram (an index of myocardial ischemia) of 0.28 +/- 0.02 mV (n = 10) from the baseline within 30 s. E4021 administered intravenously at doses of 0.03 and 0.1 mg/kg, 5 min before the injection of vasopressin, significantly inhibited the ST segment elevation to 0.15 +/- 0.03 mV (n = 6, P < 0.01) and 0.17 +/- 0.02 mV (n = 6, P < 0.01), respectively. Three guanylate cyclase activators, isosorbide dinitrate (0.1 mg/kg), nicorandil (0.1 mg/kg), and FK409 (0.3 mg/kg), also significantly reduced the ST segment elevation to 0.18 +/- 0.03, 0.11 +/- 0.02 and 0.17 +/- 0.02 mV, respectively. In a second experiment, E4021 was administered intraduodenally 30 min before the injection of vasopressin to examine its oral effectiveness. Intraduodenal E4021, at doses of 1.0 and 3.0 mg/kg, also significantly inhibited the ST segment elevation to 0.16 +/- 0.02 mV (n = 6, P < 0.01) and 0.13 +/- 0.02 mV (n = 6, P < 0.01), respectively. It is concluded that the potent phosphodiesterase type V inhibitor, E4021, administered intravenously or intraduodenally, ameliorated myocardial ischemia similarly to guanylate cyclase activators. Thus, E4021 may be an orally effective drug in the treatment of angina pectoris.

Emergency cardiopulmonary bypass support in patients with cardiac arrest caused by myocardial infarction

Emergency percutaneous cardiopulmonary bypass support (PCPS) was instituted in 3 patients with acute myocardial infarction in cardiac arrest refractory to conventional resuscitation measures. All had severe double or triple vessel disease. Percutaneous transluminal coronary angioplasty (PTCA) was performed in 1 patient and PTCA and directional coronary atherectomy (DCA) were performed in the other 2 patients on combined intraaortic balloon pumping (IABP) and PCPS. Flow rates of 2 to 5 L/min were achieved, with restoration of mean arterial pressure to more than 60 mm Hg during PCPS. The status of all patients was improved hemodynamically with PCPS. One patient died of hemorrhage during PCPS. DCA was successfully performed in the other 2 patients, and PCPS and IABP was discontinued. Time on PCPS ranged from 10 h to 8 days. Time on IABP ranged from 10 days to 2 weeks. These 2 patients died of pneumonia or multiorgan failure after 1.5 months. In conclusion, emergency PCPS is a powerful resuscitative tool that may stabilize the condition of patients in cardiac arrest to allow for definitive intervention.

Establishment of enzyme-linked immunosorbent assays for lipoprotein lipase with newly developed antibodies

We developed eight new antibodies against lipoprotein lipase (LPL), which included polyclonal antibodies raised against recombinant human LPL produced by transformant cells and two synthetic peptides corresponding to either amino (N)- or carboxy (C)-terminus of human LPL. With these antibodies, we established three effective sandwich enzyme-linked immunosorbent assays (ELISAs) for LPL, which enabled us to examine LPL mass not only in the postheparin plasma from human, rat, mouse, and guinea pig but also in the media and lysates of cultured cells. All of the developed antibodies showed high affinities for LPL, but their binding to LPL did not always influence the lipolytic activity of the enzyme. Interestingly, although the anti-C-terminus antibody should bind to a common epitope of human and mouse LPL, its binding selectively suppressed only human LPL activity. Because amino acid sequence surrounding the epitope is common to both LPLs, difference in the sequence outside the epitope will contribute to the selective suppression of LPL activity by the antibody. Our results also suggested that both termini of LPL would be exposed on the surface of the molecule because they were fully accessible to antibodies and that the N-terminus of LPL would be functionally less important because binding of the anti-N-terminus antibody did not affect human LPL activity. The ELISAs were further utilized to demonstrate the presence of C-terminus truncated LPL protein in the postheparin plasma of an LPL-deficient patient, to map an epitope of the anti-C-terminus antibody within residues 433-436, and to gain insight into the structure-function relationship of the LPL molecule.(ABSTRACT TRUNCATED AT 250 WORDS)

Rapid free radical reduction in the perfused rat liver

The reduction of nitroxide free radicals was investigated in detail by Electron Paramagnetic Resonance (EPR) spectroscopy in perfused liver. The nitroxide free radical was rapidly reduced to the corresponding hydroxylamine more efficiently at the lower flow rate of 8 [ml/min], while at higher flow rates, the amount of reduced nitroxide showed a significant decrease. Oxidation of hydroxylamine using hydrogen peroxide provided dynamic information concerning the reduction of the free radical within the liver. In addition, liver homogenates were also investigated to determine the level of nitroxide uptake. The results suggested that a portion of the infused nitroxide was taken up by the liver and cleared from the circulation.

Genetic control of the radiosensitivity of lymphoid cells for antibody formation ability in mice

To analyze the genetic basis of the relationship between the radiosensitivity of the immune response and radiation lymphomagenesis, we examined the radiosensitivity of lymphoid cells for antibody formation in BALB/cHeA, STS/A, F1 hybrids, and their recombinant inbred mouse strains. The decrease in the number of plaque-forming spleen cells in BALB/cHeA mice exposed to 3 Gy X-irradiation was more than tenfold that in STS/A mice. The phenotype of radioresistance was dominant over sensitivity. The coincidence between the strain distribution patterns of the genetic markers and radiosensitivities of antibody formation in the various recombinant inbred strains was in the region with the Igh locus on chromosome 12. There was obvious difference between the patterns in the region containing the Ifa locus on chromosome 4 which has been shown to be related to the incidence of radiation-induced lymphomas. These results indicate that the region on chromosome 12 may contain major gene(s) related to radiosensitivity for antibody formation.

[Five cases of tsutsugamushi disease]

We experienced 5 cases of tsutusgamushi disease from October to November 1993 at Hokusyo Central Hospital. All patients showed high fever, skin rash and eschar and four patients showed lymph node swelling. All cases were diagnosed serologically by indirect-immunofluorescence technique and treated with minocycline. In a survey of anti-Karp, Kato, Gilliam, Kawasaki, Kuroki antibodies, all patients showed the highest antibody titers against the Kawasaki strain and they were considered Kawasaki type. In Nagasaki Prefecture, the number of patients with tsutsugamushi disease has been increasing since 1982. We carried out immunologic and epidemiologic studies about this disease in Nagasaki Prefecture.

Identification of mutation sites of a temperature-sensitive mutant of HCMV DNA polymerase activity

The human cytomegalovirus (strain Towne) temperature-sensitive mutant ts 256 exhibits a virus specific DNA polymerase-negative phenotype. The position of the mutation of ts 256 was determined by three step marker-rescue assays to be within a 5.1 kb XbaI-BamHI fragment between map unit 0.33 and 0.35 in a HindIII-D fragment located in a long unique region. Nucleotide sequencing showed that the 5.1 kb fragment contained three open reading frames corresponding to those of the genes for UL52, UL53 and UL54 (DNA polymerase gene), respectively, of strain AD169. The functions of UL52 and UL53 are unknown. Comparison of the DNA sequences of the 5.1 kb fragments of the wild-type and ts 256 mutant revealed two base changes within UL53 and UL54, respectively, which result in amino acid substitutions. The mutation in the UL54 gene was located within a distinct conserved region VI common to alpha-like DNA polymerases, suggesting that this base change would be responsible for DNA negative phenotype.

SCG10 mRNA localization in the hippocampus: comparison with other mRNAs encoding neuronal growth-associated proteins (nGAPs)

SCG10 is a nerve growth factor (NGF)-inducible, neuron-specific protein whose expression is tightly correlated with axonal and/or dendritic growth. We have recently shown that the mRNA encoding SCG10 is expressed at significant levels in certain subsets of neurons in the adult rat brain, while its expression is undetectable or negligible in other non-neuronal tissues. Here we show that regional SCG10 mRNA expression in the adult mouse brain is comparable to that in the rat, however, in the hippocampus its expression profile is distinct. In the mouse, SCG10 mRNA is expressed at high levels in pyramidal cells of CA3-CA4 sub-fields of Ammon's horn and at low levels in the CA1-CA2 sub-fields, while it is found rather uniformly throughout the pyramidal cell layer of the rat hippocampus. SCG10 mRNA is not detectable in the dentate gyrus of the mouse hippocampus, although it is expressed in the rat dentate gyrus. Comparison with other mRNAs encoding neuronal growth-associated proteins (nGAPs) such as GAP-43, MAP2, alpha 1-tubulin and stathmin suggests that dentate granule cells express a different repertoire of neuronal growth-associated genes in mouse and rat.

[A case of HTLV-1 carrier associated with pulmonary cryptococcosis and thymoma]

A 46-year-old female was admitted to our hospital on December 1991 for further examination of an abnormal shadow on chest X-ray. A huge mass in the upper mediastinum and a thin-walled cavitary lesion in the right upper lobe were found by chest radiography and computed tomography. On March 2, 1992, surgical resection was performed with pathological diagnosis of thymoma for the mediastinal mass and pulmonary cryptococcosis for the cavitary lesion. Although ATL cells were not found in the peripheral blood, anti-HTLV-1 antibody was found to be positive. Natural killer cell activity was lower than normal control and other tests of humoral and cell-mediated immunity were normal. Histological examination of the specimens obtained from the thymoma revealed lymphocytic predominance without atypical cells such as ATL cells, but with integration of HTLV-1 proviral DNA. There seemed to be a causal relationship between HTLV-1 carrier state and thymoma. Since there are no reported cases of HTLV-1 carrier associated with pulmonary cryptococcosis and thymoma, we report the first case with a review of the literature.

Mineralocorticoid type I receptor in the rat cochlea: mRNA identification by polymerase chain reaction (PCR) and in situ hybridization

Expression of mineralocorticoid type I receptor (MR) gene in the rat cochlea was determined using molecular biological techniques. We synthesized complementary DNA (cDNA) from rat cochlear total RNA and then amplified MR cDNA fragments by polymerase chain reaction (PCR). The amplified cDNA fragments were subcloned into an expression vector and the nucleotide sequence was analyzed to confirm the expression of mRNA encoding MR in the cochlea. We then synthesized digoxigenin-labeled riboprobes with this cloned DNA template and examined the localization of MR mRNA in the cochlea by in situ hybridization. The amino acid sequence of MR cDNA expressed in the cochlea was identical to that of the MR first cloned in the rat hippocampus. In situ hybridization showed the expression of MR mRNA in marginal cells of the stria vascularis, suggesting that aldosterone may regulate microhomeostasis of the endolymph, presumably by modulating Na, K-ATPase activity. Intense MR signal was also identified in spiral ganglion cells, the function of which remains to be determined.

Mouse Mammary Tumor Virus Proviral Integration in the DD/Tbr Mice

The patterns of mouse mammary tumor virus (MMTV) integration in the DNA of spontaneous-mammary tumors, salivary glands and livers of DD/Tbr mice were examined using MMTV env, int -1c and int-2c probes. The MMTV env probe revealed 1 to 7 new proviral insertions in all mammary tumors. MMTV integration into int-1 was observed in 10 of 18 mammary tumors, whereas that into int-2 was seen in only 2 of 18 tumors. Of the 13 salivary glands examined, only 3 showed new MMTV proviral integrations, but rearrangement in int-1 or int-2 loci by MMTV was not observed. Immuno-collidal gold electron microscopy revealed the presence of MMTV particles both in mammary tumors and in salivary glands, but no tumors were found to be developed in salivary glands. Taken together these results suggest that salivary glands support MMTV replication, but the virions thus produced may not lead to salivary gland tumorigenesis. It is suggested that the salivary gland is the source of horizontally transmitted MMTV in DD/Tbr mice.

The effect of thyrotropin-releasing hormone (TRH) on limbic status epilepticus in rats

We produced limbic status epilepticus in rats by injecting a combination of dibutyryl-cAMP (db-cAMP) and ethylenediaminetetraacetic acid (EDTA) into the amygdala (AM). Thirty minutes after intra-AM db-cAMP/EDTA injection, thyrotropin-releasing hormone (TRH) was administered intravenously or intracerebroventricularly. Intravenous TRH (3, 25, 50 mg/kg) produced immediate activation of electroclinical seizures, lasting for 25-45 min. In some animals which showed this seizure activation, complete seizure suppression occurred 55-70 min after the TRH treatment. Similar activation of ictal seizures with delayed seizure suppression was obtained after intracerebroventricular TRH (25, 50 micrograms). The findings suggest that the effects of intravenous TRH are due to its central action and that the use of intravenous TRH is not a promising approach for the treatment of status epilepticus.