[Simple determination methods for blood grouping from biological stains. 1. Immunologic gold colloid aspiration test and dot ELISA test by membrane aspiration method for determining ABO blood groups from saliva specimens]

Two immunologic tests using nitrocellulose membrane and an aspiration device were applied to determine the ABO blood groups and secretor status from saliva specimens. First, immunologic gold colloid membrane aspiration test (IMAT) was performed with orange-red colloidal gold particles (GP) sensitized with anti-A or anti-B antibody or anti-H lectin (A chicken antiserum to O secretor saliva was also used as an anti-H reagent in some experiments). The boiled saliva specimens were serially diluted and dotted to the nitrocellulose membrane, which was equipped to a disposable aspiration kit, and the antibody- or lectin-coated GP was aspirated through the membrane. The stained saliva changed red by the immunologic binding of the GP. Test results could be obtained within some minutes. Detection limits of IMAT shown by saliva dilution were 1:100 to 1:10,000 for secretor salivas, whereas those for non-secretor salivas were 1:10 or lower. Second, a revised dot ELISA was performed by using the membrane aspiration device. The requisite time for this test (Dot ELISA-A) was 40 to 45 minutes, whereas that for conventional dot ELISA was 3 to 4 hours. The detection limits of the dot ELISA-A shown by the saliva dilutions were 1:1,000 to 1:100,000 for secretor salivas, whereas those for non-secretor salivas were 1:1,000 or below.

Comparison of ultrastructure of germinating pea leaves prepared by high-pressure freezing-freeze substitution and conventional chemical fixation

High-pressure freezing-freeze substitution (HPF-FS) methods were applied to germinating pea leaves. Good ultrastructural preservation without visible freezing damage was obtained up to 200 microns in thickness. Compared to conventional chemical fixation (CF), cellular membranes were smoother without undulation, and organelles appeared more turgid. The matrices of cytoplasm and organelles were denser and more homogeneous. The features imply that HPF-FS samples retain more substances and ultrastructure closer to the living state. There were differences in membrane stainability among organelles in HPF-FS specimens, which were not seen after CF. Bundles of microfilaments were observed frequently after HPF-FS.

Presence of alternative 5' untranslated sequences and identification of cells expressing ctk transcripts in the brain and testis

From a mouse brain cDNA library, two species of the Csk-type tyrosine kinase (ctk) gene containing different 5' untranslated sequences were cloned. Using the common as well as specific nucleotide sequences of the two clones as probes, we examined the expression of ctk in various mouse tissues by Northern blot analysis. The results indicated that both species of ctk were expressed in the brain, testis and bone marrow. By in situ histochemistry of the brain, ctk transcript was detected in neurons throughout the entire brain, especially those of the cortex, the hippocampus and the cerebellum. This distribution pattern is similar to that of the Src family kinases including Yes, Src, Fyn and Lyn. In the testis, the major transcript (0.7 kb) was shorter than that expressed in the brain and the bone marrow (2.0 kb). A subsequent Northern blot analysis of fractionated germ cell populations and in situ histochemistry revealed that the short and long transcripts were expressed in germ cells and somatic cells, respectively, and that the expression level was quantitatively regulated during germ cell development. These results suggest that Ctk is involved in the regulation of neural function and differentiation of male germ cells through interactions with member(s) of the Src family kinases.

[The left-sided atrioventricular replacement of corrected transposition of the great arteries through a left thoracotomy]

In a 17-year-old female with dextrocardia and corrected transposition of the great arteries, whose VSD and PFO had been surgically closed through median sternotomy two years previously, the left-sided atrioventricular valve replacement was performed for its severe insufficiency. The left anterolateral thoracotomy was chosen to have good visual field and to prevent unnecessary dissection of the adhesion. The postoperative course was uneventful.

[Comparison of MICs of new quinolones obtained using agar-dilution and broth-microdilution procedures]

Minimum inhibitory concentrations (MIC) of new quinolones against both Gram-positive and Gram-negative bacteria obtained using agar-dilution and broth-microdilution procedures were compared. A primary regression curve and a correlation coefficient (r) between 2 MICs for each of ofloxacin, ciprofloxacin, tosufloxacin, sparfloxacin or balofloxacin were calculated. For the 5 quinolones, average correlation coefficients were 0.891 for the Gram-positive bacteria tested, and 0.865 for the Gram-negative bacteria. The range of, correlation coefficients for the Gram-positive bacteria for these drugs was from 0.835 to 0.919, and that for the Gram-negative bacteria was from 0.815 to 0.865. From these data, it is clear that there is a good correlation between the 2 MICs of the new quinolones obtained using the agar-dilution and the broth-microdilution procedures. It was also shown that the value of the slope of the regression curves were nearly the same for the 5 quinolones tested. However, some particular strains of Morganella morganii, Pseudomonas cepacia, Xanthomonas maltophilia, Pseudomonas aeruginosa and Streptococcus pneumoniae exhibited different correlation coefficients from other strains.

Inhibitory effect of dexamethasone and progesterone in vitro on proliferation of human renal cell carcinomas and effects on expression of interleukin-6 or interleukin-6 receptor

Interleukin-6 (IL-6) has been suggested as an autocrine growth factor of human renal cell carcinomas. Since steroids are known to inhibit IL-6 gene expression, we investigated their effects on the growth of renal cell carcinoma. Dexamethasone inhibited proliferation of 2 of 4 renal cell carcinoma cell lines in a dose-dependent manner. In one of these 2 cell lines, IL-6 gene expression was also inhibited, but not in the other. The inhibitory effect of dexamethasone on cell proliferation was not reversed by the exogenous IL-6. In 1 of the 2 remaining cell lines, the inhibition of IL-6 gene expression was observed, although there was no inhibition of cell proliferation. Thus, inhibition of growth by dexamethasone did not correlate with an inhibitory action of dexamethasone on IL-6 mRNA expression. Progesterone inhibited the growth of 1 cell line without concomitant inhibition of IL-6 gene expression. Expression of IL-6 receptor mRNA was not altered. A dose-dependent increase in mRNA expression of gp130, the transducer of IL-6 signal, was induced by dexamethasone and progesterone in 2 and 1 of the 4 cell lines, respectively. These data suggest that, in some renal cell carcinomas, steroids may inhibit cell proliferation by a mechanism independent of their effects on mRNA expression of IL-6 and IL-6 receptors. Dexamethasone may be useful, not only for palliation of paraneoplastic syndrome caused by overproduction of IL-6, but also for inhibition of growth of renal cell carcinomas.

Severe hyponatremia and hyperkalemia induced by trimethoprim-sulfamethoxazole in patients with Pneumocystis carinii pneumonia

An antimicrobial agent trimethoprim-sulfamethoxazole (Tmp-Smx) does not usually cause electrolyte disturbances at regular doses, and few cases of Tmp-Smx-induced electrolyte imbalance have been reported in the English-language literature to date. Recently, however, we treated two patients with Pneumocystis carinii pneumonia who developed severe hyponatremia and hyperkalemia on administration of high-dose Tmp-Smx. These electrolyte disturbances were attributable to the direct effect of Tmp-Smx on the renal distal tubules, were reversible, and corrected by infusion of a sodium-enriched and potassium-free liquid. Therefore, it is suggested that even after electrolyte disturbances have occurred, high-dose Tmp-Smx therapy may be continued for severe infectious diseases under appropriate electrolyte correction.

Cutaneous ciliated cyst: a case report and histochemical, immunohistochemical, and ultrastructural study

A 19-year-old woman with a cutaneous ciliated cyst on her buttock is reported. Histological, histochemical, and electron microscopic studies revealed ciliated cells, mucinous cells showing merocrine secretion, and areas of squamous metaplasia in the cyst wall. This is the first case of cutaneous ciliated cyst that contained non-ciliated mucinous cells as a component.

Enhanced expression of multiple protein tyrosine phosphatases in the regenerating mouse liver: isolation of PTP-RL10, a novel cytoplasmic-type phosphatase with sequence homology to cytoskeletal protein 4.1

To elucidate the role that protein tyrosine phosphatase (PTPs) may play in liver regeneration, PTPs expressed in the mouse liver after partial hepatectomy (PH) were investigated by a PCR-based cloning method. Sequencing of 115 cDNA clones identified 10 different sequences including MPTP (T cell PTP), PTP-1B, PTP-P19, mR-PTP mu, R-PTP alpha, PTP NE-3 (PTP-P1), R-PTP-kappa and the murine homologue of human LAR. The remaining two sequences, PTP-RL9 and PTP-RL10, encoded novel PTPs. PTP-RL10 cDNA contained an open reading frame of 1176 amino acids with no apparent membrane-spanning region. The amino-terminal region had sequence homology to those of human erythrocyte protein 4.1 and ezrin, cytoskeletal proteins. In the regenerating liver, the levels of five PTP gene mRNAs (MPTP, PTP-P19, R-PTP alpha, LAR homologue, and PTP-RL9) increased within 6 h, decreased to the normal level by 24 h, and increased again at 48 to 72 h after PH. The levels of PTP-1B and R-PTP-kappa mRNAs peaked within 6 h, decreased gradually, and returned to the normal level by 168 h after PH. In contrast, the levels of two PTP mRNAs (mR-PTP mu and PTP-RL10) peaked at 48 to 72 h, and returned to the normal level by 168 h after PH. No expression of PTP NE-3 was detected in the liver by Northern blotting. The differential expression of multiple PTPs during the pre-replicative and post-replicative stages of liver regeneration suggests that PTPs are involved in the regulation of growth and differentiation of liver cells.

The maize brittle 1 gene encodes amyloplast membrane polypeptides

A chimeric protein, formed of 56 amino acids from the carboxy terminus of the maize (Zea mays L.) wild-type Brittle1 (Bt1) protein fused to the glutathione-S-transferase gene, was synthesized in Escherichia coli, and used to raise antibodies. Following affinity purification, the antibodies recognized a set of 38- to 42-kDa proteins in endosperm from wild-type Bt1 plants, as well as from brittle2, shrunken2 and sugary1 plants, but not in mutant bt1 endosperm. Bt1 proteins were not detected with the preimmune antibodies. A low level of Bt1-specific proteins was detected at 10 d after pollination (DAP) and increased to a plateau at 16 DAP. At the same time, the ratio of slow- to fast-migrating forms of the protein decreased. During endosperm fractionation by differential centrifugation and membrane sedimentation in sucrose gradients, the Bt1 proteins co-purified with the carotenoid-containing plastid membranes. They were localized to amyloplasts by electron-microscopic immunocytochemistry; most of the signal was detected at the plastid periphery. These results are consistent with predictions made from the deduced amino-acid sequence and previous in-vitro experiments that the bt1 locus encodes amyloplast membrane proteins.

Clinical perspectives on capnography during sedation and general anesthesia in dentistry

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Study of the regenerating newt retina by electrophysiology and immunohistochemistry (bipolar- and cone-specific antigen localization)

Immunohistochemical and electrophysiological examinations were carried out to investigate the sequence of appearance of the retinal neurons during regeneration after a complete surgical removal of the original retina of the newt. We produced a monoclonal antibody, RB-1, specific for cone photoreceptors and a subtype of bipolar cells in adult newt retina. This antibody was used as a major tool for this analysis. Appearance of spiking activity as a possible marker of ganglion cell differentiation was examined with whole-cell patch-clamp techniques. Spiking cells, which possessed voltage-dependent Na+, K+, and Ca2+ channels similar to those of mature ganglion cells, appeared in the regenerating retina by 24 days before cone photoreceptors had been labeled by the RB-1 antibody. Cones and ganglion cells differentiated before the retina had been segregated into distinct synaptic layers. The RB-1-labeled bipolar cells as well as PKC-immunoreactive bipolar cells appeared in the regenerating retina after the segregation of the synaptic layers. Their appearance seemed to coincide with the appearance of immunoreactive amacrine cells described previously (Negishi et al. [1992] Dev. Brain Res. 68:255-264). During embryonic development of the newt retina, cone photoreceptors appeared prior to bipolar cells. Thus the process of reformation of a functional retina seems to follow the same steps as differentiation of retina during development.

Kinetic study of quenching reactions of singlet oxygen and scavenging reactions of free radicals by alpha-, beta-, gamma- and delta- tocopheramines in ethanol solution and micellar dispersion

Quenching reactions of singlet oxygen and scavenging reactions of free radicals by alpha-, beta-, gamma- and delta-tocopheramines (Toc-amines) were investigated spectrophotometrically in ethanol and Triton X-100 micellar dispersions. The rate constants of quenching of singlet oxygen (kQ) by alpha-, beta-, gamma- and delta-Toc-amines increased as the total electron donating capacity of the methyl groups at the aromatic ring increased. A plot of logkQ vs. peak oxidation potential (Ep) was found to be linear and the slope was negative. Similar results were obtained for scavenging of a phenoxyl radical (PhO.). The results suggest that charge transfer plays an important role in these reactions. The kQ values were found to be 1.30-2.57 times as large as kQ for alpha-tocopherol (alpha-Toc). Although alpha-Toc has the highest antioxidant activity among natural tocopherols and related phenols, Toc-amines also can serve as antioxidants.

[Surgical treatment of acute Stanford Type-A aortic dissection]

Twelve cases of Stanford Type-A aortic dissection were operated in an acute phase. The male vs female ratio was 3:9, and their ages ranged from 47 to 79 (mean 61.3) years old. Most of them complained of chest and/or back pain, and four of them complained of syncope. Eight patients had the history of hypertension. As to the complications of aortic dissection, cardiac tamponade was seen in two cases, myocardial infarction in one, and transient hemiplegia and paraplegia in one case each. In five cases, moderate to severe aortic regurgitation was also noted. All but one case were operated within twenty-four hours after admission. The replacement of the ascending aorta with a tube graft was performed in all cases including the two cases whose entries were located in the aortic arch. CABG was done concomitantly in three cases, and aortic valve replacement and CABG in one case. The open distal anastomosis was carried out under the systemic circulatory arrest combined with the retrograde cerebral perfusion. The systemic perfusion was reinstituted after the distal anastomosis was completed. In cases whose dissecting pseudo-lumen of the distal aorta was not thrombosed, the arterial cannulation site was shifted from the femoral artery to the tube graft. All but two cases were discharged from the hospital in good condition. One case, who had been transferred to the operating room under cardiac massage due to myocardial infarction, was lost by severe LOS three weeks postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical significance of chromosome abnormalities in childhood acute lymphoblastic leukemia in Japan

Of 240 Japanese children with acute lymphoblastic leukemia (ALL) treated between 1983 and 1990, 75 (31%) had normal diploidy, 47 (20%) hyperdiploidy with more than 50 chromosomes, 18 (8%) hyperdiploidy with 47-50 chromosomes, 77 (32%) pseudodiploidy, 22 (9%) hypodiploidy and one hypotetraploidy in the leukemic cells. Event-free survival (EFS) +/- standard error (SE) at 4 years was 74 +/- 7% in patients with hyperdiploidy > 50, 68 +/- 6% in those with normal diploidy, 55 +/- 13% in those with hyperdiploidy 47-50, 54 +/- 11% in those with hypodiploidy, and 22 +/- 5% in those with pseudodiploidy (log-rank, p < 0.0001). Seventy-four patients with translocation and 166 patients without translocation had EFS +/- SE of 26 +/- 6% and 64 +/- 4%, respectively, at 4 years (p < 0.0001). The overall prognosis of our patients was comparable to that of the patients mainly treated in the late 1970s and reported by the Sixth International Workshop on Chromosomes in Leukemia, but was much poorer than that of the patients more recently treated and reported from some American institutions. These findings may possibly reflect less appropriate chemotherapy having been applied to Japanese children with ALL.

[Clinical studies of renal trauma]

A total of 70 patients with renal trauma were treated at the Department of Urology, Nara Medical University and Nara Prefectural Hospital, including Life-Saving Emergency center, from January 1982 to June 1993. They were between 3 and 79 years old (mean 30.0) and preponded to the younger generation. The main cause of injury was traffic accident in 46 cases (65.7%). According to the Classification of Renal Injury by the Japanese Association for the Surgery of Trauma in Japan, there were 31 cases (44.3%) of type I (subcapsular injury), 18 cases (25.7%) of type II (superficial injury), 15 cases (21.4%) of type III (deep injury), and 6 cases (8.6%) of type IV (pedicle injury). Surgical treatment was performed in 17 cases (24.2%). The major associated injuries were bone fracture in 32 cases (45.7%), lung injury in 17 cases (24.2%), and liver injury in 15 cases (21.4%). Furthermore, hydronephrosis and ureteral tumors were incidentally found in 4 and 1 patient during the course of treatment for renal trauma. Post-traumatic plasma renin activities (PRA) in types III and IV were significantly higher than those in types I and II. Hypertension developed in 1 case of types I and II and 4 cases of types III and IV. The mean level of PRA was significantly decreased 2 years after renal injury in both groups. We should bear in mind that renal trauma may be associated with other urological diseases such as hydronephrosis and urological malignancies, and post-traumatic PRA should be followed carefully.

Hypometabolism and dipole localization in hemimegalencephaly: a case report

A case of hemimegalencephaly was studied by means of neuroimaging (CT, MRI and PET) and magnetoencephalography (MEG). Hemimegalencephaly (HM) is a neuronal migration disorder. This is the first report of evaluation of HM with the use of PET and MEG from not only the morphological but also the functional point of view. PET with 11C-glucose showed a low radioactive concentration in the affected hemisphere, which suggested a metabolic deficit. MEG proved the epileptic foci existed mainly in the affected hemisphere, especially around a heterotopia and the pachygyric cortex, which was disclosed on MRI.

Spontaneous perforation of pyometra: a case report

Spontaneous perforation is a rare complication of pyometra and is usually associated with uterine cervical occlusion. We report a very rare case of spontaneously perforated pyometra without cervical occlusion. A 56-year-old woman with severe abdominal pain was admitted to our hospital. Exploratory laparotomy was performed because of suspicion of gastro-intestinal perforation with generalized peritonitis. There was no perforation of the stomach, gallbladder, or bowels, but examination of the uterus revealed a perforation of the uterine fundus. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, the condition must be born in mind with regard to elderly women with acute abdominal pain.

[To establish confidential relationship between physician and patient: as a patient undergone an operation]

In October 1990, I was diagnosed as malignant gastric lymphoma and was admitted into Hokkaido University Hospital and underwent surgery. Among many memories of my stay in the hospital, the most reassuring moment was that my doctor expressed his sincere thoughts to work with me as a partner in fighting the illness. The surgeon in charge of my surgery visited my room every day and explained all the details, so I was able to undergo the operation without fear. Needless to say, the cheerful talk and care of the nurses throughout my stay in the hospital supported me. It has been about four years after the operation and I am currently healthy and working. The following points are my requests for better medical practice. 1) A reduction in the amount of waiting time for outpatients. 2) Improvement of amenities for admitted patients. 3) An increase in efficiency of examination for the treatment. 4) Work harder and become a good doctor, and improvement of younger doctors.