[Detection of chlamydial antibodies by immunoblotting technique--in comparison of three commercially available test kits and micro-IF]

We reexamined the assay conditions of immunoblotting (W-B) technique to detect antibodies (IgG and IgA) to C. trachomatis serovar L2. Partially purified Chlamydia (35% urografin) was used as the antigen. The marker bands of W-B for positive and/or negative are major outer membrane protein (MOMP) band and either one or more bands staining in 40-62 KDa area. We then compared the sensitivity and specificity of three commercially available test kits and micro-IF by using W-B as a standard. The kits compared were sero-IPALISA-IgG-IgA, IP-Azyme-IgG-IgA and HITAZYME-IgG-IgA, and micro-IF. Serum samples were collected from the outpatient departments of gynecology, urology, and internal medicine and pediatrics. The results of agreement between W-B and test kits in IgG detection were as follows: in sero-IPALISA, total agreement was 85.7%, positive agreement 83.3%, negative agreement 90.9% and in IPAzyme: 85.7%, 83.3%, 90.9%, respectively and in HITAZYME: 82.9%, 75%, 100%, respectively. These results are almost the same as micro-IF: 85.7%, 79.2%, 100%, respectively. These kits may have relatively high sensitivity and specificity in IgG antibody detection. In IgA detection, the total agreement between W-B and sero-IPALISA was 82.9%, positive agreement 100%, negative agreement 66.7%, in IPAzyme: 77.1%, 58.8%, 94.4%, respectively and in HITAZYME: 65.7%, 64.7%, 66.7%, respectively and in micro-IF: 82.9%, 70.6%, 94.9%, respectively. Although these agreements are not so high in IgA detection, the W-B technique gives fairly consistent results as well as those kits. This indicates that W-B technique with MOMP and other protein bands (40-62 KDa) as marker for positive reaction is a useful method for detection of chlamydial antibodies.

Physical and functional association of the cbl protooncogen product with an src-family protein tyrosine kinase, p53/56lyn, in the B cell antigen receptor-mediated signaling

To identify novel signal transducers involved in signaling mediated by the Src-family protein tyrosine kinases (PTKs), we used a yeast two-hybrid system with a probe corresponding to the regulatory region of p56lyn, a member of Src-family PTKs. One of the isolated clones contained the COOH-terminal 470 amino acid residues of p120c-cbl, the product of the cellular homologue of the v-cbl retroviral oncogene. p120c-cbl is a cytoplasmic protein with nuclear protein-like motifs. Here we show in vivo association of p120c-cbl with p53/56lyn. After stimulation of the B cell antigen receptor (BCR), p120c-cbl was rapidly tyrosine phosphorylated. Studies with lyn- or syk-negative chicken B cells demonstrated that p53/56lyn, but not p72syk, was crucial for tyrosine phosphorylation of p120c-cbl upon stimulation of the BCR. We also show the importance of p59fyn in tyrosine phosphorylation of p120c-cbl in the T-cell receptor-mediated signaling using fyn-overexpressing T cell hybridomas and splenic T cells from fyn-deficient mice. These results suggest that p120c-cbl is an important substrate of Src-family PTKs in the intracellular signaling mediated by the antigen receptors

Elevated plasma RANTES levels in patients with atopic dermatitis

Eosinophils and T cells are involved in the pathologic process of atopic dermatitis. To further understand the role of these cells, and the possible involvement of RANTES, in the pathogenesis of atopic dermatitis, we measured the plasma level of RANTES using the sandwich ELISA. The mean plasma level of RANTES in 11 patients with atopic dermatitis was significantly higher than that of 15 normal control subjects. RANTES levels were higher in patients with severe form of atopic dermatitis than that of patients with mild disease. These findings suggest that RANTES may play a role in the recruitment and activation of eosinophils and T cells in atopic dermatitis.

RANTES mRNA expression in skin and colon of patients with atopic dermatitis

The expression of RANTES mRNA in dermal and colonic tissue was examined in patients with atopic dermatitis by the reverse transcription polymerase chain reaction method. RANTES mRNA was detected in the colon in 8 of 10 patients and in 1 of 5 control patients. It was present in rashes in 9 of 10 patients and at non-eruptive sites in 5 of 7 patients. These findings suggest that RANTES is involved in eosinophil infiltration and T cell infiltration in atopic dermatitis.

Detection of varicella-zoster virus DNA in maternal breast milk from a mother with herpes zoster

BACKGROUND

We previously reported that varicella-zoster virus (VZV) DNA was detected by polymerase chain reaction (PCR) from maternal breast milk of a post-partum mother with chickenpox.

OBJECTIVES

We tried to decide the route of VZV contamination to maternal milk.

CASE REPORT

A 22-year-old woman developed herpes zoster on her right Th3-4 dermatome.

RESULTS AND CONCLUSIONS

VZV DNA was detected by PCR from peripheral blood and the maternal milk of the right breast, but not from the maternal milk of the left breast. These results suggest that VZV in maternal milk may not derive from VZV-infected mononuclear cells in peripheral blood, but from the VZV-infected epitheliums of the lacteal gland.

Exanthem subitum (roseola infantum) with vesicular lesions

We report a 7-month-old boy who developed vesicular lesions during the course of exanthem subitum. Human herpesvirus-6 (HHV-6) DNA was detected both in the skin lesions and in the throat, by polymerase chain reaction. IgG and IgM antibodies against HHV-6 were 1:10 and < 1:10, respectively on the tenth day of the illness, and > 1:640 and 1:10 on the twenty-second day, respectively. These results suggest that this was primary HHV-6 infection.

Expression of granulocyte colony-stimulating factor receptor on CD10-positive human B-cell precursors

We examined the expression of CD10 and G-CSF receptor (G-CSFR) on the lymphoid population of mononuclear cells obtained from bone marrow (BM) using two-colour analysis. In the BM of children with ALL in remission, the CD10+ population was significantly increased (20.6 +/- 5.1% compared with that of controls (2.5 +/- 0.5%). More than half (61.3 +/- 2.9%) of the CD10+ cells co-expressed G-CSFR, but not CD13. These results indicate G-CSFR+ B-cell precursors are markedly increased in BM of ALL in remission, suggesting the probable involvement of G-CSF in the human early B-cell ontogeny.

[Bacteriological, pharmacokinetic and clinical studies of SY5555 dry syrup in the pediatric field]

Bacteriological, pharmacokinetic and clinical studies on SY5555 dry syrup (powder which is dissolved before use), a new penem antibiotic for oral use, were performed. The following results were obtained. 1. Antibacterial activities. MICs of SY5555, clavulanic acid/amoxicillin (CVA/AMPC), cefotiam (CTM), cefpodoxime (CPDX), cefaclor (CCL) and cefdinir (CFDN) were determined against clinically isolated Staphylococcus aureus, coagulase negative staphylococci, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Moraxella catarrhalis, Escherichia coli and Enterobacter cloacae at a dose of 10(6) CFU/ml. MICs of SY5555 against S. aureus, CNS, S. pneumoniae, S. pyogenes, H. influenzae, M. catarrhalis, E. coli and E. cloacae were 0.2, 0.2, 0.2, < or = 0.025, 0.78, 0.2, 0.78 and 3.13 micrograms/ml, respectively, showing excellent antibacterial effects on these pathogens. Although the effects of SY 5555 against H. influenzae and E. coli were slightly inferior to those of CPDX and CFDN, the drug showed the most excellent antibacterial effect on other strains as compared with the control drugs. 2. Absorption and excretion In this study, plasma concentrations and urinary recovery rates were examined after administration of SY5555 at doses of 5 and 10 mg/kg (potency) after meals. With both 5 and 10 mg/kg doses, peak plasma concentrations were reached 1 hour after administration, at 0.25-2.61 micrograms/ml (mean 1.47 micrograms/ml) and 1.08-2.17 micrograms/ml (mean 1.74 micrograms/ml), respectively. The plasma levels rapidly decreased to 0.06-0.19 micrograms/ml (0.12 micrograms/ml) and 0.0503-0.0637 micrograms/ml) after 6 hours. The half-lives 1.12 hours in the 5 mg/kg group and 1.0 hour in the 10 mg/kg group. The urinary recovery rates were determined in the first 8 hours after administration in the 5 mg/kg and 6 hours in the 10 mg/kg group, and the values were as low as 1.05-12.3% and 1.6-4.33%, respectively. 3. Clinical results The clinical responses were examined in a total of 73 cases including 4 acute pneumonia, 13 acute bronchitis, 11 tonsillitis, 3 pharyngitis, 12 scarlet fever, 2 pertussis, 6 urinary tract infection, 6 otitis media, 7 lymphadenitis, 2 staphylococcal scalded skin syndrome, 2 phlegmon, 4 impetigo and 1 purulent parotitis. The treatment was effective or better in 66 of 70 cases with an efficacy rate of 94.3% (3 undeterminable cases were excluded). Bacteriological effects were examined during the clinical course for detected or suspected pathogens found before administration of SY5555. The effects were determined in 50 cases including 7 cases of polymicrobacterial infections, 57 strains in total. Eight strains, however, persisted, hence the overall eradication rate was 86.0%.(ABSTRACT TRUNCATED AT 400 WORDS)

Inhibition of growth and cysteine proteinase activity of Staphylococcus aureus V8 by phosphorylated cystatin alpha in skin cornified envelope

The activity of a cysteine proteinase purified from Staphylococcus aureus V8 (SAV8) was inhibited by phosphorylated cystatin alpha (P-cystatin alpha) and by purified cornified envelope protein of newborn rat, a conjugated form of P-cystatin alpha. Immunohistochemical analysis demonstrated a marked decrease in P-cystatin alpha content in cornified envelope treated with sphingosine. The inhibition of papain activity by proteins from sphingosine-treated skin was much weaker than that exerted by proteins from the untreated skin. The suppression of SAV8 colony formation inoculated on the sphingosine-treated skin was examined. Colony formation on the sphingosine-treated skin was enhanced compared to that on normal skin. These findings suggest that P-cystatin alpha in the cornified envelope may have a bacteriostatic barrier function against bacterial infection, such as that with SAV8.

[Pharmacokinetic and clinical studies on biapenem (L-627) in the pediatric field]

Pharmacokinetic and clinical studies on biapenem (L-627), a newly developed carbapenem, were performed and the following results were obtained. 1. Absorption/excretion: Pharmacokinetics of biapenem was studied in 14 children at doses of 6 mg/kg and 12 mg/kg administered through 30 minutes-drip infusion. Peak plasma levels and plasma half-lives of the 2 doses were 22.5, 29.9 micrograms/ml, and 0.84, 0.85 hours, respectively. Their urinary recovery rates were 54.5 to 76.1% and 37.3 to 59.5%, respectively. Cerebrospinal fluid levels of biapenem in two patients with purulent meningitis were 0.88 and 2.72 micrograms/ml, and the penetration rates were 3.7 to 8.3%. 2. Clinical study: Forty-nine patients were treated with biapenem at doses exceeding 90 to 100 mg/kg/day for purulent meningitis and at doses between 15.0 and 36.0 mg/kg/day for other infections. Biapenem gave "Excellent" or "Good" responses in 48 cases, hence an efficacy rate of 98.0% was obtained. Only one patient with pneumonia showed a fair response. No adverse reactions were observed. Abnormal laboratory test results were noted in 7 patients including elevation of GOT, GPT, and eosinophils. In no cases the treatment had to be discontinued.

Lymphocutaneous nocardiosis with multiple subcutaneous nodules distributed over the extensor aspect of the forearm. Report of a case

We report a case of lymphocutaneous nocardiosis due to Nocardia brasiliensis, marked by multiple subcutaneous nodules and abscesses on the extensor aspect of the left forearm in a 53-year-old woman with systemic lupus erythematosus. Nine months before she was first examined, she had fallen on a concrete surface. A nodule had appeared 2 months later at the same site and had expanded and been followed by others, which finally covered most of the extensor aspect of the forearm. We speculated that the bacteria may have been conveyed retrogradely via the lymph vessels in a distal direction, perhaps as a result of the trauma and the subsequent development of an intradermal lesion.

Rapid purification of yeast cytoplasmic fumarate reductase by affinity chromatography on blue sepharose CL-6B

The rapid and effective purification of soluble fumarate reductase from baker's yeast achieved by Blue Sepharose CL-6B chromatography. Cibacron Blue F3GA, the chromophore of Blue Sepharose, inhibited the activity of fumarate reductase. The enzyme bound to the column was selectively eluted by flavin adenine dinucleotide (FAD), flavin mononucleotide (FMN) or riboflavin. The purified enzyme was essentially homogeneous as indicated by polyacrylamide gel electrophoresis under nondenaturing conditions and under denaturing conditions in sodium dodecylsulfate. By this procedure, the enzyme could be rapidly purified with high yield from yeast cells.

A novel monoclonal antibody to the outer root sheath cells

A novel monoclonal antibody to hair keratins (TYHF-1) which recognized a doublet of 43/44-kDa hair keratins in the immunoblot analysis was developed. TYHF-1 strongly reacted with the outer root sheath cells at the region of prekeratinization, the keratogeneous zone and the lower part of the isthmus portion in the indirect immunofluorescent examination. The cells of the inner root sheath and cuticle in the upper bulbar portion were also stained with this antibody. In addition, the tongue and nail matrix were also reacted with TYHF-1. However, TYHF-1 reacted with no epidermal keratins either in the indirect immunofluorescent examination or by immunoblot analysis using plantar epidermis. In addition, the cells of the eccrine and apocrine sweat glands, the epithelia of the buccal mucosa, larynx, tonsil, oesophagus, liver, intestine, gallbladder and urinary bladder demonstrated no positive reaction.

Male genital herpes complicated with urethral infection

A 26-year-old man had a primary infection or reinfection of genital herpes due to herpes simplex virus (HSV) type 2 complicated with herpetic urethritis. By analysis of the restriction endonuclease digestion pattern of the viral DNA, two isolates, one from the penile lesion and one from the urethra, were identified as the same strain.

A case of sporotrichosis treated successfully with oral fluconazole 200 mg once weekly

A case of fixed cutaneous sporotrichosis that developed on the extensor aspect of the left wrist of an 83-year-old woman was treated once a week with 200 mg of oral fluconazole. This dermatological lesion healed within 4 months, leaving a scar. No side-effects were seen. At the time of writing, 7 months after the end of treatment, there has been no recurrence. Reports on the efficacy of once-weekly fluconazole administration in cases of sporotrichosis have appeared, but it would be valuable to study more such cases.

Identification and structural determination of the KDN-containing N-linked glycan chains consisting of bi- and triantennary complex-type units of KDN-glycoprotein previously isolated from rainbow trout vitelline envelopes

KDN-gp, which is the unique glycoprotein of the rainbow trout egg envelope, was shown to have a small amount of N-linked oligosaccharide units in addition to a large number of O-linked glycan units. Structural analysis based on chemical analysis in combination with 400 MHz 1H NMR spectroscopy revealed the presence of fully KDNosylated bi- and triantennary complex-type oligosaccharide chains, mostly fucosylated at the innermost GlcNAc residue and bisected by the GlcNAc residue linked beta 1-->4 to the beta-Man residue. The structures thus determined represent the first demonstration of N-linked glycan unit containing the KDN residues in the KDN-containing glycoproteins (see Chart 1). The KDN-gp of the rainbow trout egg envelope is a molecule that is present in the second layer of the vitelline envelope but is exposed to the outer surface around the micropyle through which sperm can get in at fertilization. Like human hematopoietic cell surface glycoproteins such as glycophorin A and leukosialin, KDN-gp, which is now characterized to contain N-linked complex-type glycan chains as minor components, is heavily O-glycosylated with alpha 2-->8-linked oligo/polyKDN-containing glycan units attached O-glycosidically to Ser/Thr residues. Although little is known about the functional roles of these glycan chains, KDN-gp appears to form a model for further study on the function of cell surface receptor for sperm in fertilization.

Linkage between phosphorylated cystatin alpha and filaggrin by epidermal transglutaminase as a model of cornified envelope and inhibition of cathepsin L activity by cornified envelope and the conjugated cystatin alpha

Lysine-rich phosphorylated cystatin alpha (P-cystatin alpha) from newborn rat epidermis is a good substrate for epidermal transglutaminase (TGase) and also one of the component proteins of cornified envelope in the stratum corneum. Since the filaggrin linker segment peptide was efficiently conjugated with P-cystatin alpha and was mediated by epidermal TGase in the presence of Ca2+ ions, filaggrin is a candidate for the glutamine-rich linkage protein to conjugate with lysine-rich P-cystatin alpha. A conjugated protein was found by epidermal TGase in the activated condition with Ca2+ ions and dithiothreitol. In contrast, the conjugated protein was not formed under chelated conditions with EDTA. The conjugated protein reacted positively with anti-P-cystatin alpha polyclonal antibody (PoAb). The conjugated protein and purified cornified envelope showed an inhibitory effect against papain and cathepsin L, but cathepsin B and H were not inhibited by these P-cystatin alpha conjugates. Although the component protein, P-cystatin alpha itself, inhibited cathepsin H strongly, these conjugated proteins inhibited specifically the cathepsin L family. The amino acid composition of cornified envelope protein and the conjugated protein of P-cystatin alpha and filaggrin linker segment peptide was not completely the same. The conjugated protein of P-cystatin alpha and filaggrin linker segment peptide showed the same inhibitory properties against cysteine proteinases as the cornified envelope. These findings suggest that the linkage protein between P-cystatin alpha and filaggrin linker segment peptide may be considered a model of cornified envelope, although skin cornified envelope may be conjugated with some additional proteins.

Conjunctivitis caused by human parvovirus B19 infection

A 26-year-old woman with erythema infectiosum is reported. She had small faint erythemas on her extremities and congestion of palpebral and bulbar conjunctiva of both eyes. Human parvovirus B19 (B19) DNA was detected in the specimen of the conjunctiva by the polymerase chain reaction. This result suggests that conjunctivitis in erythema infectiosum may cause the B19 infection.

Terminal differentiation of facial epidermis of the aged: immunohistochemical studies

In old age, the epidermis tends to become dry and flaky, especially on the lower legs. However, this does not occur on the face, although long-term ultraviolet light irradiation has important effects on the differentiation of facial keratinocytes. Therefore, the differentiation of the epidermal cells of the facial skin in the young and the aged was immunohistochemically examined using antibodies against four differentiation products: filaggrin, involucrin, cystatin A (CTA) and carbonic anhydrase-like protein. The results showed that there was no difference in the amounts of the above three proteins in facial skin between the young and the aged with the exception of CTA. The amount of CTA was much greater in the facial skin of the aged. However, there was a striking decrease of filaggrin content in the skin of the lower leg in the aged. One of the reasons why no scaly skin is found on the face in the aged may be the fact that especially filaggrin does not decrease with aging.

Detection of varicella-zoster virus DNA in conjunctivas of patients with herpes zoster

Detection of varicella-zoster virus (VZV) DNA was carried out in the conjunctivas of 18 patients with herpes zoster by polymerase chain reaction. The rate of VZV DNA detection in conjunctivas was 3/4 in herpes zoster ophthalmicus associated with eruption on the dorsum nasi, 2/5 in herpes zoster ophthalmicus without eruption on the dorsum nasi, 1/2 in herpes zoster with eruption on the cheek and lower jaw, 1/2 in generalized herpes zoster and 0/5 in herpes zoster associated with eruption on the trunk or extremities, respectively. The reason for the detection of VZV DNA in conjunctivas is discussed.

A novel 203 kD aberrant BCR-ABL product in a girl with Philadelphia chromosome positive acute lymphoblastic leukaemia

We report a girl with Ph1-positive ALL with the aberrant BCR-ABL product. In this case, bcr exon 3 jointed not to ordinal abl exon 2 but to exon 3 resulting in the production of a 203 kD BCR-ABL fusion protein with marked tyrosine kinase activity. To our knowledge, this is the first report of an aberrant BCR-ABL product in childhood. This case was characterized with younger age and low leucocyte count at the onset, but relapsed early like the typical Ph1-positive ALL, suggesting the diversity in the clinicopathogenesis of Ph1-positive ALL.

[Pharmacokinetic and clinical studies of S-1108 in the pediatric field]

Pharmacokinetic and clinical studies on S-1108, a new oral cephem antibiotic, were performed in the field pediatrics. The following results were obtained. 1) Antibacterial activities Antibacterial activities of S-1006, the active form of S-1108, were studied against clinically isolated strains of (Staphylococcus aureus (n = 5), Streptococcus pneumoniae (n = 6), Streptococcus pyogenes (n = 3), Haemophilus influenzae (n = 8), Branhamella catarrhalis (n = 5) and Haemophilus parainfluenzae (n = 2). MIC values ranged < or = 0.025-1.56 for GPC and < or = 0.025-0.78 microgram/ml for GNR. 2) Absorption and excretion Blood concentrations and urinary excretion rates of S-1108 were measured upon administration of S-1108 after meal at dose of 3 mg/kg (n = 4), 4 mg/kg (n = 1) and 6 mg/kg (n = 1). The peak blood concentrations of S-1006 at a dose of 3 mg/kg (n = 4), ranged from 0.57 to 1.82 micrograms/ml at 1, 2 and 4 hours after dosing. Mean pharmacokinetic parameters T1/2 and AUC were 1.29 +/- 0.69 hours and 4.47 +/- 2.25 micrograms.hr/ml, respectively. At a dose of 4 mg/kg and 6 mg/kg, peak concentrations were 1.79 and 1.27 micrograms/ml at 2 and 3 hours after treatment. T1/2 and AUC were 1.34 and 1.11 hours, and 8.19 and 5.65 micrograms.hr/ml, respectively. Urinary recovery rates ranged from 13.0 to 37.2% for the first 8 hours after administration. 3) Clinical studies Clinical efficacies were examined in 32 cases of various pediatric infections including 5 cases of acute pneumonia, 11 cases of bronchitis, 2 cases of scarlet fever, 8 cases of tonsillitis, 1 case of pharyngitis, 2 cases of otitis media and 3 cases of UTI. Clinical efficacy rate was 96.9% (31/32) and bacteriological eradication rate was 87.1% (27/31). There were no side effects and abnormal laboratory test values except 1 case (Eosino. 2-->10%) in the 32 cases.

[Bacteriological, pharmacokinetic and clinical studies of cefditoren pivoxil in the pediatric field]

Bacteriological, pharmacokinetic and clinical studies on cefditoren pivoxil (CDTR-PI, ME 1207) in granules, a new oral cephalosporin, were performed in the field of pediatrics. The results are summarized below. 1. Antibacterial activities: Antibacterial activities of CDTR were studied against Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Haemophilus influenzae, Haemophilus parainfluenzae and Branhamella catarrhalis in comparison with those of cefteram (CFTM), cefixime (CFIX), cefaclor (CCL), cefpodoxime (CPDX) and cefotiam (CTM). MIC80's of CDTR against S. aureus, S. pneumoniae, S. pyogenes, H. influenzae, H. parainfluenzae and B. catarrhalis were 1.56, 0.39, < or = 0.025, < or = 0.025, 0.05 and 0.20 micrograms/ml, respectively. These results showed that CDTR has high antibacterial activities against these organisms. 2. Absorption and excretion: Serum concentrations and urinary recovery rates of CDTR-PI (administered in granules) were determined. Upon single oral doses of 3 mg/kg and 6 mg/kg, the peak serum concentrations were 0.5-2.45 micrograms/ml at 2 to 4 hours and 1.79-4.05 micrograms/ml at 1 to 4 hours, respectively, and T 1/2 was 1.07-9.67 hours and 0.99-3.00 hours, respectively. At 8 hours after dosing, serum concentrations were 0-0.87 micrograms/ml with a dose of 3 mg/kg and 0.27-0.73 micrograms/ml with 6 mg/kg. These values indicated that the drug has a dose-dependent pharmacokinetic behavior. Urinary recovery rates in the first 8 hours were 12.9-34.2% with a dose of 3 mg/kg and 11.8-26.9% with 6 mg/kg. 3. Clinical study: Clinical efficacies were examined in a total of 81 cases consisting of 20 cases of acute bronchitis, 13 of acute pneumonia, 21 of tonsillitis, 5 of pharyngitis, 7 of scarlet fever, 2 each of impetigo, otitis media and purulent cervical lymphadenitis, 1 of pertussis and 8 of UTI. The clinical efficacy rate was 97.5% (79/81), and bacteriological eradication rate was 100% (76/76). As for side effects, 2 cases of watery stools and 1 case of minor elevation of GPT were observed.

The influence of volatile anesthetics on portwine stain

To examine the relationship between volatile inhalation anesthetics and the fading of portwine stain (PWS), the study retrospectively investigated the incidence of termination of pulsed dye laser treatment vis-à-vis PWS fade during use of a general inhalation anesthetic in 107 infants and children with facial PWS. The fading of PWS is disadvantageous to the pulsed dye laser treatment. All patients received pulsed dye laser treatment under general anesthesia using one of four kinds of volatile inhalation anesthetics (halothane, enflurane, isoflurane, and sevoflurane). Two hours before the induction of anesthesia, all patients were rectally irrigated. Treatment was discontinued in none of the 44 patients in the halothane group or the 7 patients in the enflurane group; in one of the 29 in the isoflurane group; and in 10 of the 27 patients in the sevoflurane group. The sevoflurane group showed a significantly (P < 0.01) higher incidence of PWS fading. Thus, when using a volatile inhalation anesthetic in combination with pulsed dye laser treatment for PWS, caution should be exercised if sevoflurane is selected, as PWS fading is harmful to the pulsed dye laser.

[Effect of storage conditions on the infectivity of Chlamydia pneumonia]

In order to facilitate the isolation of C. pneumoniae, strain similar TWAR, with high frequency, we investigated the effect of various factors on the infectivity of Chlamydia using two laboratory strains, C. pneumoniae TWAR and C. trachomatis serovar D. The factors tested were the effects of different temperatures for storage conditions, saliva from healthy person, storage media for Chlamydia, and the frequency of freezing and thawing. Chlamydial suspension was prepared in the two media, SPG (sucrose-phosphate-glutamate buffer pH 7.5), and CT-GM (culture medium for Chlamydia which contains 1 micrograms/ml cycloheximide and 0.04% glucose). Chlamydial suspension was allowed to stand in each of four different thermal conditions: 37 degrees C, room temperature (25 degrees C), 4 degrees C, 0 degrees C and -75 degrees C for 1, 3, 6, 24, 48, 72, 96, 120 and 144 hours. For storage at -75 degrees C, one of three groups of glass vial tubes containing Chlamydia was covered with an "airmat" to prevent the rapid freezing of Chlamydia. The effect of various factors on the infectivity was assayed by inoculation of the suspension on HeLa 229 cell monolayers. Results showed that the infectivity rapidly decreased at 37 degrees C and room temperature, while at 4 degrees C, 0 degrees C and -75 degrees C, relatively high infectivity was maintained and contained until days 4 to 6. This decreasing pattern was similar to among the media used. We were not able to find any differences in the infectivity among the samples with or without the "airmat".(ABSTRACT TRUNCATED AT 250 WORDS)

Epithelial cell membrane specific, novel monoclonal antibody KA-1

In order to develop a novel monoclonal antibody reacting with the cell membrane protein which could be a receptor for cell growth, differentiation or an adhesion molecule, keratinocytes from psoriatic epidermis and A-431 cell line were used to immunize BALB/c mice. A monoclonal antibody, KA-1 was developed. KA-1 reacts with the cell membranes of the whole epidermis with the exception of the stratum corneum cells and the basal cell membrane in contact with the basement membrane. In electron microscopy, the antigenic site was located on the surface of the microvilli of the cultured keratinocytes, especially at the contact area with another villi, the cell membrane or collagen. The antigenic protein was a 44-kDa protein which was different from E-cadherin in both molecular weight and cross-reactivity.

The location of Ted-R-1 antigen on the cell membrane of the stratum corneum: immunoelectron microscopic study

As the Ted-R-1 monoclonal antibody yields fluorescence on the keratohyalin granules, in the cytoplasm of the lower stratum corneum cells and on the cell membrane region of the stratum corneum in indirect immunofluorescent examination, the location of the antigen of this Ted-R-1 monoclonal antibody was examined by the post-embedding, immunoelectron microscopic technique using gold labelled antibody. The number of gold particles located on the keratohyalin granules was 184.00 +/- 28.69 per micron2. In contrast, there were only a few gold particles in the nucleus and the cytoplasm of the stratum granulosum (3.85 +/- 1.34) and none were found in the intercellular spaces of these cells (< 1.00). On the other hand, they were diffusely located in the lower two to three cell layers of the stratum corneum (319.75 +/- 44.41) and on the inner surface of the marginal band of the upper cell layers of the stratum corneum, but only a few were located in the cytoplasm of the upper stratum corneum cells (12 +/- 7.00). These observations indicate that the Ted-R-1 antigen locates on both keratohyalin granules and the inner surface of the marginal band of the upper part of the stratum corneum cell layers.

[Postoperative arrhythmia after operation of esophageal cancer]

The postoperative arrhythmias (exclusive of sinus tachycardia) was reviewed in 77 patients (male: 69, female: 8, mean age: 63.9 years) who underwent esophagectomy for esophageal carcinoma. The results were as follows: 1. The incidence of postoperative arrhythmias in all patients but seven who had preoperative chronic atrial fibrillation (af) or pacemaker rhythm was 47.1%, and af was observed most frequently (45.5%). Postoperative arrhythmias occurred in patients with abnormal preoperative electrocardiographic findings more often than in those with normal preoperative electrocardiographic findings (53% vs 41%). The incidence of postoperative arrhythmias in aged patients (> or = 66 years old) was significantly higher than that in younger patients (< or = 65 years old) (64% vs 35%, p < 0.05). Other risk factors for postoperative arrhythmias were sex and history of hypertension. 2. Postoperative arrhythmias occurred more often in patients who underwent blunt dissection of the thoracic esophagus and reconstruction using the whole stomach via the posterior mediastinal route than in those who underwent esophagectomy with right thoracotomy and reconstruction using the gastric tube via the poststernal route (60.0% vs 45.0%). 3. Most supraventricular premature contractions and ventricular premature contractions occurred immediately after surgery or on the first postoperative day, and af often occurred during the first postoperative night or the second postoperative day. 4. For treatment, various antiarrhythmic agents were administered according to the patient's condition. Glucose-insulin-kalium therapy was especially effective (63%). None of the arrhythmias was fatal.

[A case of cat scratch disease: from the clinical pathological point of view]

We described a forty-four-year-old female who was scratched by her cat, and developed lymphadenopathy. Cat scratch disease skin-test was positive. Cat scratch disease is well known, but there are not many reports in Japan. Reports of cat scratch disease will increase as the pathogen was recently detected. Attention must be drawn to zoonosis containing cat scratch disease.

Case report: detection of varicella-zoster virus DNA in maternal breast milk

A 27-year-old woman developed chickenpox postpartum. Her 2-month-old son who was breast fed also acquired chickenpox 16 days after the onset of the mother's illness. Varicella-zoster virus (VZV) DNA was detected in maternal breast milk by the polymerase chain reaction. These results suggest that transmission of VZV may occur via maternal breast milk.

[A case of complete response of locally advanced breast cancer to arterial infusion chemotherapy: cannulation through the right femoral artery and combined use of G-CSF]

We reported a case of locally advanced breast cancer who was cannulated into the right internal thoracic artery through the right femoral artery by Seldinger's method for intra-arterial chemotherapy and obtained good results. In general, aggressive chemotherapy is often accompanied by bone marrow suppression necessitating discontinuation of chemotherapy. However, this patient recovered from this complication by G-CSF. It was suggested that Seldinger's method is suitable for locally advanced breast cancer and that G-CSF has an immediate effect of bone marrow suppression caused by aggressive chemotherapy.

[Intra-arterial infusion chemotherapy with side-hole catheter for primary and metastatic liver, bile duct, and pancreas cancers]

Dislodgement and obstruction of catheter inserted into the artery are great hazards for the hepatic artery infusion chemotherapy. To prevent dislodgement, a new Anthron-coated catheter with a side hole was applied for the treatment of 32 patients with primary and metastatic liver cancer, bile duct cancer and pancreas cancer. The tip of the catheter was advanced deep into the gastroduodenal artery, proper or right hepatic artery, or splenic artery. Anti-cancer drugs were administered through the proximal side hole for targeting cancer. If necessary, the gastroduodenal artery was occluded with a metal coil. No dislodgement or obstruction of the catheter was noticed in the 32 patients thus treated. The new Anthron-coated catheter with a side hole proved to be useful for prevention of catheter dislodgement and accomplishment of long-term intra-arterial infusion chemotherapy.

Mild adrenal 3 beta-hydroxysteroid dehydrogenase deficiency in children with accelerated growth, premature pubarche and/or hirsutism

We studied eight children (seven girls and one boy, of whom three are siblings) with accelerated growth, premature pubarche and/or hirsutism between the ages of 7 and 9.5 years. These patients were studied for the presence of adrenal steroidogenic defect by adrenocortico tropic hormone (ACTH) stimulation testing (Cortrosyn, 0.25 mg iv bolus dose). Baseline and stimulated 17-hydroxypregnenolone (delta 5-17P), 17-hydroxyprogesterone (17-OHP), dehydroepiandrosterone (DHEA), androstenedione (delta 4-A), testosterone, and cortisol levels were measured. Six children, including three siblings, were diagnosed with a mild form of 3 beta-hydroxysteroid dehydrogenase deficiency based upon the elevated response of serum delta 5-17P and the elevated ratio of delta 5-17P/17-OHP and of DHEA/delta 4-A to ACTH stimulation. Thus, a mild form of 3 beta-hydroxysteroid dehydrogenase deficiency may not be uncommon in children with accelerated growth, premature pubarche and/or hirsutism and routine assay of delta 5-steroid metabolites should be generally available.

[A case of neuroleptic malignant syndrome developed in liver cirrhosis patient addicted to alcohol]

A 55-year-old man with addiction of alcohol was admitted to our hospital with hematoemesis. After admission, the rupture of esophageal varices was observed and it was treated with endoscopic injection sclerotherapy. On the 3rd hospital day, the patient showed alcohol withdrawal syndrome and therefore haloperidol was administered intramuscularly and intravenously. After a half day of this treatment, high fever, diaphoresis, hypotension, tachycardia, muscular rigidity and tremor developed. With the laboratory data including high serum levels of CK, LDH, GOT and GPT, neuroleptic malignant syndrome (NMS) was suspected. Regardless of intensive care, hepatic failure, DIC and acute renal failure promptly developed, and he died on the 11th hospital day. Neuroleptics may cause serious side effects, such as NMS, when the physical status of patients was deteriorated. Especially in exhausted patient such as our case, even the small dose of neuroleptics caused NMS within short term. Thus, it seemed to be important for clinicians to pay attention to choice of neuroleptics.

Identification of hematoxylin-stainable protein in epidermal keratohyalin granules as phosphorylated cystatin alpha by protein kinase C

The hematoxylin-stainable protein (HSP) in keratohyalin granules of the newborn rat epidermis was found to have the same amino acid composition and the same inhibitory and immunological properties as cystatin alpha. However, only its pI value (4.7) differed from that of cystatin alpha (5.3). Alkaline phosphatase treatment of HSP changed its pI value from 4.7 to 5.3. This pI change was inhibited by EDTA, an inhibitor of alkaline phosphatase. Furthermore, 32P from [gamma-32P]ATP was incorporated into recombinant cystatin alpha by a protein kinase C (PKC) preparation in the presence of phosphatidyl serine and Ca2+ ions as co-factors. The incorporation increased dose-dependently with the added cystatin alpha and was inhibited significantly by H-7, a specific inhibitor of PKC. SDS-PAGE autoradiography of the 32P-labeled proteins showed that 32P was incorporated into the cystatin alpha. This incorporation was not observed by the action of cAMP-dependent protein kinase. Therefore, it is highly possible that the HSP is a phosphorylated cystatin alpha and that the phosphorylation is catalyzed specifically by PKC.

Properties and nature of a cysteine proteinase inhibitor located in keratohyalin granules of rat epidermis

The pI 4.7, 14.5 kDa hematoxylin-stainable protein (HSP) from rat epidermis inhibited the activities of the cysteine proteinases papain, ficin, cathepsins B, H and L with similar inhibitory characteristics as recombinant cystatin-alpha. Proteinases of other classes were not inhibited. The inhibitory activity of HSP was heat stable in the wide pH range of 3.0-10.0. Polyclonal antibodies against HSP cross-reacted with cystatin-alpha and the molecular mass of HSP was similar to that of cystatin-alpha, though its isoelectric point was different. The in vivo location of both HSP and cystatin-alpha is on keratohyalin granules in epidermis as detected by indirect immunofluorescence technique using individual antibodies. Therefore it is highly probable that HSP is a cystatin-alpha derivative or a very similar proteinase inhibitor belonging to a family of cystatins.

Simple monochromatic refractometer for trans-epidermal water loss (TEWL)

We have developed a novel, portable refractometer (Noevir-Eva) for measuring transepidermal water loss (TEWL) which consists of a light emitting diode and a phototransistor. Cobalt chloride is used as an indicator of the amount of water. Filter paper, previously soaked with cobalt chloride solution and then dried, is attached to the skin with tape (3M Blenderm). Then, the monochromatic light (670 nm) which is yielded from the light-emitting diode is irradiated, reflecting on the above-mentioned filter paper, and the intensity of the reflected light is detected by a phototransistor. The amount of water evaporation from the surface of the skin is determined by the unit of reflected light intensity. The measured values by this new apparatus show a linear relationship with those of the commercially available apparatus (Evaporimeter EP-1). Accordingly, this new refractometer for the TWEL proved to be sensitive, dependable and also inexpensive.

Recurrent male herpes genitalis with two different strains of herpes simplex virus type 2

A case of a 50-year-old man with recurrent herpes genitalis with two different isolated strains of herpes simplex virus (HSV) type 2 is reported. Morphologically, two types of cytopathic effects (CPE) induced by viruses were observed in the Vero cell cultures, one being a syncytial giant cell formation and the other a rounded cell formation without cell adhesion resembling the CPE induced by ordinary HSV type 2. In this case, it is clinically interesting that the patient complained of persistent pain on the glans and urethra without recurrence of herpetic lesions even after the involution of enanthema. The correlation between the persistent pain and neurovirulence of the two different HSV strains is discussed.

Change in sphingomyelinase activity in human epidermis during aging

We have investigated the change in activity of sphingomyelinase in human whole epidermis during aging. The sphingomyelinase activity gradually decreased with the aging process; that of people aged eighty decreased to one fourth of that of people aged twenty in same area. This result indicates that the lipid metabolism may be altered in the epidermis during aging.