Roles of dopamine and serotonin in larval attachment of the barnacle, Balanus amphitrite

In order to clarify the roles of neurotransmitters including serotonin and dopamine in larval settlement (attachment) and metamorphosis of the barnacle Balanus amphitrite, the effects of lisuride, which acts as both a serotonin agonist/antagonist and a dopamine agonist, were examined. Lisuride did not induce larval attachment and metamorphosis; however, it promoted only larval behavior of searching for attachment sites without actual attachment to substrata which lasted for 5 to 6 days in a dose-dependent manner. Further evidence was obtained with a range of agonists/antagonists; serotonin agonists promoted the attachment, while serotonin antagonists inhibited it. Similarly, dopamine agonists inhibited the attachment. Furthermore, mixtures of serotonin and dopamine showed similar effects to those of lisuride. These results suggested that the promotion effect on larval searching behavior was derived from a combination of activities of serotonin and dopamine. Moreover, both serotonin and dopamine were detected in cyprids by HPLC. Thus, larval attachment process is regulated by both serotonin and dopamine neurons in this species. J. Exp. Zool. 284:746-758, 1999. Copyright 1999 Wiley-Liss, Inc.

Intracellular signaling pathways in human eosinophil activation: role of a beta2 integrin, alphaMbeta2

Cellular adhesion is crucial roles for eosinophil effector functions such as degranulation. Here, we focused on the role of a beta2 integrin, alphaMbeta2, in intracellular signaling pathways of human eosinophil activation. We found that the ligation of alphaMbeta2 triggers the activation of an intracellular signaling cascade, including protein tyrosine phosphorylation and phosphoinositide turnover, and subsequent cellular degranulation in human eosinophils. These signaling events may play important roles in adhesion-dependent cellular functions of eosinophils.

Coordinated regulation of radioadaptive response by protein kinase C and p38 mitogen-activated protein kinase

Eukaryotic cells are known to have an inducible or adaptive response that enhances radioresistance after a low priming dose of radiation. This radioadaptive response seems to present a novel cellular defense mechanism. However, its molecular processing and signaling mechanisms are largely unknown. Here, we studied the role of protein kinase C (PKC) and mitogen-activated protein kinase (MAPK) in the expression of radioadaptive response in cultured mouse cells. Protein immunoblot analysis using isoform-specific antibodies showed an immediate activation of PKC-alpha upon X-irradiation as indicated by a translocation from cytosol to membrane. A low priming dose caused a prolonged translocation, while a nonadaptive high dose dramatically downregulated the total PKC level. Low-dose X-rays also activated the p38 MAPK. The activation of p38 MAPK and resistance to chromosome aberration formation were blocked by SB203580, an inhibitor of p38 MAPK, and Calphostin C, an inhibitor of PKC. Furthermore, it was demonstrated that p38 MAPK was physically associated with delta1 isoform of phospholipase C (PLC-delta1), which hydrolyzed phosphatidylinositol bisphosphate into diacylglycerol, an activator of PKC, and that SB203580 also blocked the activation of PKC-alpha. These results indicate the presence of a novel mechanism for coordinated regulation of adaptive response to low-dose X-rays by a nexus of PKC-alpha/p38 MAPK/PLC-delta1 circuitry feedback signaling pathway with its breakage operated by downregulation of labile PKC-alpha at high doses or excess stimuli.

Treatment of neonatal infection caused by coxsackievirus B3

Four male infants with early neonatal infection caused by coxsackievirus B3 (presumed in one case) exhibited severe thrombocytopenia and liver dysfunction at presentation. The three infants who were administered human normal immunoglobulin within 3 days of disease onset survived, while the fourth infant, who received the preparation 6 days after disease onset, died.

Cell-cycle-dependent and ATM-independent expression of human Chk1 kinase

Checkpoint genes cause cell cycle arrest when DNA is damaged or DNA replication is blocked. Although a human homolog of Chk1 (hChk1) has recently been reported to be involved in the DNA damage checkpoint through phosphorylation of Cdc25A, B, and C, it is not known at which phase(s) of the cell cycle hChk1 functions and how hChk1 causes cell cycle arrest in response to DNA damage. In the present study, we demonstrate that in normal human fibroblasts (MJ90), hChk1 is expressed specifically at the S to M phase of the cell cycle at both the RNA and protein levels and that it is localized to the nucleus at this time. hChk1 activity, as determined by phosphorylation of Cdc25C, is readily detected at the S to M phase of the cell cycle, and DNA damage induced by UV or ionizing radiation does not enhance the expression of hChk1 or its activity. Furthermore, hChk1 exists in an active form at the S to M phase in fibroblasts derived from patients with ataxia telangiectasia (AT) which lack the functional AT mutated (ATM) gene product, suggesting that hChk1 expression is independent of functional ATM. Taken together with the findings that phosphorylation of Cdc25C on serine 216 is increased at the S to M phase, it is suggested that at this particular phase of the cell cycle, even in the absence of DNA damage, hChk1 phosphorylates Cdc25C on serine 216, which is considered to be a prerequisite for the G2/M checkpoint. Thus, hChk1 may play an important role in keeping Cdc25C prepared for responding to DNA damage by phosphorylating its serine residue at 216 during the S to M phase.

Copper increases in both plasma and red blood cells at the onset of acute hepatitis in LEC rats

Ceruloplasmin is excreted mostly in the apo-form in Wilson's disease patients and Long-Evans rats with a cinnamon-like coat color (LEC rats), an animal model for Wilson's disease, and hence the concentration of Cu in the plasma is low. However, it increases toward and at the onset of acute hepatitis in LEC rats, the increased Cu in the plasma being bound to ceruloplasmin, metallothionein and albumin. Changes in the concentration of Cu in red blood cells (RBCs) were monitored with age for the first time together with that in the plasma in LEC rats. Cu in the RBCs was found to increase to a 5-7 times higher level than that in the plasma toward the onset and peaked at the onset, the pattern being similar to that in the plasma. The source of the Cu increase in the RBCs was discussed, and it was assumed that the so-called free Cu ions that leak from the damaged hepatocytes are bound to albumin and/or taken up by the RBCs.

Specificity of mutations in the PMS2-deficient human tumor cell line HEC-1-A

The spectrum of mutations was determined at the hypoxanthine-guanine phosphoribosyltransferase (hprt) locus in the human uterine tumor cell line HEC-1-A which is defective in the mismatch repair gene hPMS2. The mutation frequency at the hprt locus in HEC-1-A was about two orders higher than that in wild type repair-proficient cells. The fifty-eight mutations detected were exclusively point mutations, with frameshifts of one base deletion/addition predominating (66%) the remaining were base substitutions. All the frameshift mutations occurred at sites of monotonous repeating sequences, including six consecutive guanine bases site which was the hot spot for the addition of one G that contributed 60% of the total mutations. Although the observed specificity of mutations in HEC-1-A apparently resembled that of the hMLH1-deficient cell line HCT116 [Ohzeki, S., Tachibana, A., Tatsumi, T., Kato, T., 1997. Spectra of spontaneous mutations at the hprt locus in colorectal carcinoma cell lines defective in mismatch repair. Carcinogenesis, 18, 1127-1133.], the pronounced increase of +/-1 bp frameshifts and the reduced incidence of C-->T transitions at the CpG site suggest that the hPMS2 gene product may have an additional function in the mismatch repair process independent of it's role in the hMutLalpha heterodimer.

Improved hatching for in vitro quail embryo culture using surrogate eggshell and artificial vessel

The establishment of avian embryonic culture is important both for the analysis of the developmental process and the establishment of transgenic chickens that produce useful biological materials in eggs. However, the hatchability of cultured embryos has been approximately 50%. We identified that the low rate of hatchability of cultured embryos was caused by limited oxygen and calcium availability. In quail embryo culture using chicken eggshell as a culture vessel, viability in the middle stage of culture was improved and 30% of embryos were hatched by oxygen enrichment. Furthermore, hatchability increased to 80% by supplementation with calcium lactate in addition to oxygen aeration. In the present study, a fully artificial vessel for quail embryo culture was designed using a gas-permeable Teflon membrane. By the addition of fine eggshell powder and calcium lactate, quail embryos grew and developed normally, and 43% of embryos hatched. Although the hatchability was lower than that of cultures using a surrogate eggshell, we achieved in hatching an avian embryo using a fully artificial vessel.

Effects of calmodulin inhibitors on cyprid larvae of the barnacle, Balanus amphitrite

During our study on signal transduction systems involved in larval settlement and metamorphosis of the barnacle Balanus amphitrite, we could detect calmodulin, a major intracellular calcium-binding protein, in both cyprids and adult barnacles using immunoblot technique. In order to examine roles of calmodulin in larval settlement and metamorphosis, we examined the effects of calmodulin inhibitors involved in phosphodiesterase (PDE), myosin light chain kinase (MLCK), calmodulin kinase II (CaM-II) on cyprids. Calcium-calmodulin-dependent PDE inhibitors inhibited larval attachment and metamorphosis in a dose-dependent manner. In contrast, cyclic AMP (cAMP)-dependent PDE inhibitors promoted larval attachment and metamorphosis, while cyclic GMP (cGMP)-dependent PDE inhibitors did not show such effect. Thus, PDE activity may depend on cAMP rather than calmodulin or cGMP in promotion of larval attachment and metamorphosis. Moreover, calmodium inhibitors involved in MLCK or CaM-II inhibited larval behaviors for attachment and metamorphosis. These results suggest that calmodulin, which is present in both adult barnacles and cyprids, may be involved in enzyme reactions such as MLCK or CaM-II rather than PDE in B. amphitrite cyprids.

A high prevalence of functional inactivation by methylation modification of p16INK4A/CDKN2/MTS1 gene in primary urothelial cancers

We analyzed the genetic and epigenetic alterations of p16INK4A/CDKN2/MTS1 gene (MTS1 gene) in 38 primary urothelial cancers. Genetic alterations of the MTS1 gene consisted of one base substitution mutation in exon 2 (2.6%) and 6 homozygous deletions (16.2%). Hypermethylation of the 5' CpG island in exon 1 of the MTS1 gene was observed in 12 tumors (37.5%). Consequently, 19 of 38 tumors (50%) showed genetic alterations or epigenetic hypermethylation of the MTS1 gene. Retention of hypermethylated MTS1 gene(s) in 36% of the tumors showing loss of heterozygosity at the critical region indicates that the methylation modification could be an initial event followed by genomic rearrangements associated with total loss of MTS1 gene function. Immunohistochemical analysis of MTS1 expression revealed that all the tumors with genetic alterations of the MTS1 gene and 9 of 12 highly methylated tumors displayed an absence of MTS1 nuclear antigen. Genetic and epigenetic changes of the MTS1 gene were not correlated with the grade and stage of tumors, indicating that these alterations are early events in urothelial carcinogenesis, in which functional inactivation by hypermethylation is a predominant mechanism.

Increased pain threshold following electroacupuncture: analgesia is induced mainly in meridian acupuncture points

Pain thresholds were determined before and after electroacupuncture of the dorsal aspect acupuncture points (AP) of the hand and non acupuncture points (NAP) located 15 mm from the traditional acupuncture points to assess changes in pain threshold thus provoked.

METHODS

In eight volunteers the pain threshold of specific points was determined before and after acupuncture in the Hegu point (L.I. 4), at the back of the hand. A pressure dolorimeter was used to evaluate pain threshold at the Yangxi (L.I. 5) and Quchi (L.I. 11) points and at sites 15 mm from them. The effects on pain threshold were also measured at Yingxiang (L.I. 20) on both sides.

RESULTS

Before electrostimulation there were no significant differences among the pain thresholds in both AP and NAP. After electrostimulation of the Yangxi point, pain threshold raised from 5.20 kg/sq.cm to 9.20 kg/sq.cm (p < 0.01); acupuncture at Quchi caused the threshold to increase from 5.36 kg/sq.cm to 9.20 kg/sq.cm (p < 0.01) and Yingxiang stimulation changed threshold from 2.63 kg/sq.cm to 3.83 kg/sq.cm (p < 0.051) at the point on the same side and from 2.26 kg/sq.cm to 3.90 kg/sq.cm (p < 0.05) in the opposite side. Before electroacupuncture the pain thresholds at all the tested sites were not statistically different (p > 0.1). After electrostimulation the pain threshold increased 77% at L.I. 5 but went up just 9% and 6% 15 mm from L.I. 5 (p < 0.01); threshold increased by 70% at L.I. 11 but only by 6% and 7% (p < 0.01) 15 mm from L.I. 11.

CONCLUSIONS

The pain threshold increased significantly in all tested sites after electroacupuncture but the analgesic effect was predominant in those points lying along the acupuncture meridians.

Spectra of spontaneous mutations at the hprt locus in colorectal carcinoma cell lines defective in mismatch repair

Spectra of spontaneous mutations at the hypoxanthine-guanine phosphoribosyltransferase (hprt) locus in colon carcinoma cell lines HCT116 and HCT-15 deficient in mismatch repair and displaying mutator phenotypes were determined. HCT116 and HCT-15 cells, respectively, harbour a mutation in the mismatch repair gene hMLH1 and GTBP. The mutation frequency at the hprt locus in both cell lines was elevated by about two orders, but the microsatellite instability in HCT116 cells was one order higher than in HCT-15 cells. Except for one mutant of HCT-15, all the mutations (114/115) were point mutations; base substitutions of various types and frameshifts (deletions/insertions of less than a few bases, predominantly of +/-1 bp). Base substitutions (57%) and frameshifts (43%) occurred at a comparable rate in HCT116, whereas base substitutions (92%) were the major mutational events in HCT-15. Most frameshifts in HCT116 occurred at sites of monotonous or short tandem repeating sequences, and two of these sites, where there was a run of six Gs and four As, were hot spots. Three hot spot sites of base substitutions were found in HCT-15; two of them at splice acceptor sites, the other at the CpG site shared with HCT116. The distinct mutation spectra of the HCT116 and HCT-15 cell lines may reflect functional differences in the hMLH1 and GTBP gene products in mismatch repair. The gene product GTBP may be involved in the preferential repair of base mismatches, and MLH1 in the repair of both base mismatches and deletions/insertions of less than a few bases. These results suggest that mismatch repair deficiency affects the microsatellite stability as widely reported in colorectal tumour cells, but that it may not severely affect chromosome integrity as the karyotypes of these tumour cells are, unlike other tumour cells, relatively stable.

[Five cases of pneumonitis induced by sho-saiko-to]

We report five cases of pneumonitis induced by sho-saiko-to. The patients complained of coughing (4/5), dyspnea (4/5), and pyrexia (3/5). The duration of sho-saiko-to treatment ranged from 4 to 1155 days. Abnormal laboratory findings included high levels of C-reactive protein (4/5), leucocytosis (4/5), severe hypoxemia (4/5), low vital capacity (3/5), and low diffusing capacity (5/5). Chest X-ray and CT films revealed diffuse reticulonodular or ground-glass shadows in both lung fields (4/5). Bronchoalveolar lavage was done in three cases, and revealed lymphocytosis in two cases and abnormally low CD4/8 ratios in three cases. The results of lymphocyte stimulation tests against sho-saiko-to and its component were positive in 3 of 5 cases. After discontinuation of sho-saiko-to, corticosteroids were given in all cases. Symptoms were relieved, and laboratory data and chest X-ray findings returned forward normal. Sho-saiko-to toxicity should be included in the differential diagnosis of pneumonitis. If drug-induced pneumonitis is suspected, administration of sho-saiko-to should be stopped and corticosteroid therapy should be given immediately.

Spectrum of spontaneous mutations in the cyclic AMP receptor protein gene on chromosomal DNA of Escherichia coli

We determined 46 spontaneous mutations occurring in the cyclic AMP receptor protein gene (crp) on the chromosomal DNA of Escherichia coli by the use of PCR cloning. Of 24 base substitutions, 17 were transversions and 7 transitions including all types of base substitutions. The frequency of the changes of A:T base pairs was similar to that of G:C pairs, suggesting that A:T pair is also a target for base substitution. Frameshifts including seven-1 and four +1 frameshifts occurred at the sites of a run of identical bases. Deletions extending 18 and 172 bases occurred at the sites where the deleted sequences were flanked by short repeated sequences at the junction. The insertions of IS2 element or its inverted sequence were detected in two and six mutations, respectively. The assay system of the mutation used here is available for the determination of the mutational spectrum of base substitutions.

[Mycoplasma pneumoniae pneumonia with diffuse nodular shadows and right hilar lymphadenopathy]

A 51-year-old man was admitted to our hospital because of fever, a productive cough, and dyspnea. His chest X-ray film revealed diffuse reticulonodular shadows and right hilar lymphadenopathy. A chest CT scan revealed thickened bronchial walls and diffuse centriacinar or centrilobular nodular shadows. Serologic testing provided conclusive evidence of Mycoplasma pneumoniae infection. The diffuse pattern and hilar lymphadenopathy on chest X-ray films are uncommon in this disease, and they caused some uncertainty regarding the correct diagnosis. M. pneumoniae attaches to cells of the respiratory tract and produces a locally acting cytotoxin. Immunologic mechanisms have been shown to play an important role in the pathogenesis of pneumonia. This case suggests that immunologic mechanisms are an important factor in diffuse lung lesions.

[Etoposide-induced pneumonitis]

A 70-year-old man was given a diagnosis of small cell lung cancer because of the findings of examination of a specimen obtained by transbronchial lung biopsy from the rS4 a. He was treated with 2 courses of neoadjuvant chemotherapy (CBDCA, Etoposide) and underwent right middle lobectomy. He was then given 3 courses of adjuvant chemotherapy (CBDCA, Etoposide) as an inpatient and received oral etoposide (50 mg/day) as an outpatient. He was then admitted to our hospital because of dyspnea and fever. A chest-X-ray film showed reticulonodular shadows in both lung fields and blood gas analysis showed marked hypoxemia. A differential cell count of bronchoalveolar lavage fluid showed a high level of lymphocytes; and examination of a specimen obtained by transbronchial lung biopsy revealed edema of the alveolar walls, lymphocyte infiltration, and marked proliferation of type II alveolar epithelial cells. Administration of etoposide was stopped and steroid therapy was given. The symptoms, hypoxemia, and bilateral reticulonodular shadows resolved. The clinical course along with the findings from examination of bronchoalveolar lavage fluid and of the biopsy specimen, suggest that this patient had drug pneumonitis caused by oral etoposide.

[Massive hemoptysis in a patient with a tuberculous thoracic aneurysm]

A 91-year-old man with a history of pulmonary tuberculosis 20 years earlier came to our hospital because of hemoptysis in May 1993. A chest X-ray film showed infiltrative shadows in the left first arch of the cardiac silhouette, and sputum cultures were positive for Mycobacterium tuberculosis. Despite treatment with antituberculosis drugs, chest X-ray films revealed gradual progression, and he had occasional hemoptysis. He was admitted because of massive hemoptysis in December 1993 and a computed tomogram of the chest revealed an aneurysm of the descending aorta. Sudden and massive hemoptysis occurred in January 1994. At autopsy, the wall of the aneurysm and the surrounding tissue were found to have histological changes characteristic of tuberculosis. Tuberculous thoracic aneurysms are quite rare, but may develop in patients with tuberculosis in other areas.

Large deletions at the HPRT locus associated with the mutator phenotype in a Bloom's syndrome lymphoblastoid cell line

Bloom's syndrome (BS) is an autosomal recessive disorder with a high cancer incidence. BS cells exhibit increased chromosomal instability and sister-chromatid exchange. The rate of spontaneous mutation at the locus encoding hypoxanthine phosphoribosyltransferase (HPRT) in a lymphoblastoid cell line derived from a BS patient, GM3403, was 1.39 x 10(-6) mutations/cell/generation, whereas that in TK6, a lymphoblastoid cell line derived from an individual who is not suffering from BS, was 1.75 x 10(-8) mutations/cell/generation. Molecular analysis of the HPRT gene in mutant clones by multiplex polymerase chain reaction revealed that 83.3% of the spontaneous mutants from GM3403 cells contained deletions at the HPRT locus, whereas 30.8% of mutants from TK6 cells had deletions. Approximately half of the BS mutants had lost the entire gene. Some mutant clones of GM3403 had also lost markers near the HPRT locus, although no mutant clones from TK6 cells had lost these markers. These results indicate that the mutator phenotype of BS cells is mainly due to an increase in large DNA alterations, reflecting the remarkable genomic instability that could be responsible for cancer proneness in this disease.

Quantitative and qualitative effect of gamma-ray dose-rate on mutagenesis in human lymphoblastoid cells

Induction of mutations to 6-thioguanine resistance (TGr) by gamma-rays at three different dose-rates and molecular changes in the HPRT gene were studied in human lymphoblastoid WIL2-NS cells. Mutant induction showed a curvilinear dose-response for acute irradiation (30 Gy/h). The total mutant frequency was lower after irradiation at 0.17 or 0.006 Gy/h compared with acute irradiation. An apparent linear relationship between total dose and mutant frequency was found for the chronic irradiations. Spontaneous mutant frequency increased linearly with the exposure time of protracted irradiation at 0.006 Gy/h. After the spontaneous mutant frequency was subtracted from the total mutant frequency for irradiation at 0.006 Gy/h, no significant difference was found in the mutant frequency as a function of dose between the cultures irradiated at 0.17 Gy/h and those at 0.006 Gy/h. The inverse dose-rate effect, which has been observed in proliferating mouse L5178Y leukemia cells was not evident in WIL2-NS cells at the dose-rates employed. Structural alterations at the HPRT locus in TGr mutants were examined with the multiplex PCR method and compared among cultures irradiated at different dose-rates. Assuming that the mutants isolated were primarily independent, approximately 17% of spontaneous mutants were deletion mutants. When the fraction of spontaneous mutants in the irradiated cultures was subtracted from the total fraction of each type of mutant, it is clear that low dose-rate gamma-rays induced deletion mutations at the HPRT locus just as efficiently (79%) as high dose-rate gamma-rays (74%).

Evidence for farnesol-mediated isoprenoid synthesis regulation in a halophilic archaeon, Haloferax volcanii

Farnesol strongly inhibited growth of a halophilic archaeon, Haloferax volcanii, with an IC50 value of only 2 microM (0.4 microgram/ml) in rich medium and 50 nM (0.01 microgram/ml) in minimal medium without lysis. Other isoprenoid alcohols such as isopentenol, dimethylallyl alcohol, geraniol, and geranylgeraniol at 500 microM did not affect its growth. Mevalonate, which is the precursor of all isoprenoid membrane lipids in archaea, led to recovery of the growth inhibition of H. volcanii, but acetate had no such effect. Farnesol inhibited incorporation of acetate, but not mevalonate, into the lipid fraction. These results suggest that farnesol inhibited the biosynthetic pathway from acetate (acetyl-CoA) to mevalonate. Farnesol is known to be derived from the important intermediate of isoprenoids, farnesyl diphosphate (FPP), and found in neutral lipid fraction from this archaeon. Moreover, the cell-free extracts from H. volcanii could phosphorylate farnesol with ATP to generate farnesyl monophosphate and FPP. We conclude that farnesol-mediated isoprenoid synthesis regulation system by controlling farnesol concentration is present in H. volcanii.

[A case of pulmonary tuberculosis associated with triple cancer]

A 76-year-old man came to our hospital complaining of bloody sputum and anterior chest pain. He had undergone operations for rectal cancer six years previously and for gastric cancer nine months previously. His chest X-ray film showed a mass shadow in the left lower field and a small nodular shadow in the right middle field. After treatment with antibiotics and antituberculosis drugs, symptoms and laboratory findings improved and left mass shadow on the chest X-ray film began to resolve. Adenocarcinoma of the lung was diagnosed after a transbronchial lung biopsy from the right S3a. An operation was scheduled for two months later, but a new mass shadow appeared in the right lower field. Right upper lobectomy with mediastinal lymph node dissection and partial resection of the right S9 was done. The surgical specimens revealed well-differentiated adenocarcinoma from the right S3a and tuberculosis from the right S1, S2, and S9. A recent increase in multiple cancers has been noticeable, but cases of triple cancer concurrent with tuberculosis are rare. When chest-radiographic abnormalities unrelated to the original tumor occur in lung cancer patients, a second primary cancer should be considered. It is also important to determine if they are caused by intra-lung metastases or by some other condition, such as exacerbation of pulmonary tuberculosis.

[A case of cilostazol-induced pneumonitis]

A 73-year-old man had been treated with cilostazol for antithrombotic therapy after a myocardial infarction. Seventy days after the start of cilostazol therapy, he developed dyspnea, dry cough, and fever. He was admitted to our hospital on April 13, 1923. Chest radiography and CT revealed a ground glass appearance. All drugs except isosorbide dinitrate were discontinued and he was treated with steroids under the presumptive diagnosis of drug-induced pneumonitis. Steroid therapy was effective. The result of a lymphocyte stimulation test was positive for cilostazol. Based on the above findings, cilostazol-induced pneumonitis was diagnosed. To our knowledge, there have been no previous reports of cilostazol-induced pneumonitis.

[Treatment of aspiration pneumonia with low-dose methylprednisolone and antibiotics]

Low-dose methylprednisolone and antibiotics were used to treat 30 patients with aspiration pneumonia, in a prospective, randomized, double-blind trial with placebo control. All patients received clindamycin phosphate 1200 mg per day. In addition, 15 patients received methylprednisolone 20 mg per day for three days and the other 15 patients received placebo according to the same schedule. In the methyl prednisolone group, CRP had decreased (p < 0.05) from 12.7 +/- 9.8 to 6.4 +/- 5.4 mg/dl day 4, neutrophil elastase had decreased (p < 0.05) from 402 +/- 304 to 231 +/- 64 micrograms/dl by day 4 and to 184 +/- 59 micrograms/dl by day 7, maximum body temperature had decreased (p < 0.01) from 37.9 +/- 1.1 to 36.8 +/- 0.6 degrees C by day 7, and the pneumonia score had improved (p < 0.01) from 11.8 +/- 3.0 to 8.6 +/- 2.4 by day 4. In the placebo group, there were no significant improvements by those days. We conclude that low-dose methylprednisolone therapy with antibiotics is effective against aspiration pneumonia.

[A case of pulmonary blastoma coexisting with well-differentiated adenocarcinoma]

A 66-year-old man came to our hospital because of hemoptysis and fever. Chest radiograph and CT scan showed a large circumscribed shadow in the posterior segment of the right upper lobe. Bronchoscopy revealed bronchial compression and stenosis. The histopathological specimen obtained by transbronchial biopsy showed total necrosis, but cytological examination of the bronchial lavage specimen showed class 5 adenocarcinoma. Right upper lobectomy was done, and regional lymph nodes were removed. The resected tumor was found to be a pulmonary blastoma by histopathological examination. The main tumor was composed of malignant epithelial and mesenchymal elements with rhabdoid differentiation and chondroid tissue, the former of which looked like fetal lung tissue. This case is interesting, because the fact that the adenocarcinoma and pulmonary blastoma were close together may be related to the histogenesis of pulmonary blastoma.