[Effect of recognition of head and neck malignancies on patients' psychosomatic condition and personality]

In order to elucidate the effect of recognition of head and neck malignancies on patients' psychosomatic condition and personality, we applied the Cornell Medical Index Health Questionnaire (CMI) and the Maudsley Personality Inventory (MPI) and collected medical and psychological data from 35 male (42-78 years of age; average 62.5) and 15 female (20-76 years of age; average 54.7) patients with malignant head and neck tumors (10 nose and paranasal, 8 oral, 8 pharyngeal, 14 laryngeal, 6 thyroid gland and 4 others). The two tests were done twice for each patients; at first immediately before hospitalization for treatment of the tumors at Mie University Hospital and secondly just before discharge from the hospital. The period of hospitalization ranged 1 to 13 months, average 3.3 months. At the end of hospitalization doctors and nurses who had mainly taken care of the patients estimated the patients' recognition of their malignancy by analyzing behavior and information mainly from their family and classified patients into three groups; Group R (Patients who recognized that they were patients with head and neck malignancies) comprised 22 patients, Group N (who did not recognize the condition) comprised 15 and Group U (who could not be classified into Groups R or N) comprised 13. Comparison among the three groups revealed the followings. 1) Patients in Group R were relatively young (average 56.3 years) and extrovert (estimated by MPI) and their somatic and psychological complaints registered on the CMI were less than those in other 2 groups. Psychosomatic condition after recognition that they had been patients with malignant tumors was better than before.(ABSTRACT TRUNCATED AT 250 WORDS)

[A case of lobar cerebral hemorrhage with low concentration of CSF cystatin C]

A 49-year-old male was admitted to our hospital because of severe headache and dizziness which had occurred suddenly one day before admission. There was no past history contributory to cerebral hemorrhage but was family history of cerebrovascular accidents in his father and brother. Neurological examination revealed left homonymous hemianopsia, mild left hemiparesis, and left side hemi-neglect in simultaneous stimuli on bilateral extremities. Laboratory data including peripheral blood cells, coagulation tests, and serum chemistry were unremarkable. Brain CT and MRI demonstrated large lobar hematoma in the right parieto-occipito-temporal region. Cystatin C level in the CSF samples taken on the 39th and 59 th days (38 and 27 ng/ml respectively) were low, compared with the normal value (greater than 100 ng/ml). These findings suggest that the lobar cerebral hemorrhage of the present case might have been caused by cerebral amyloid angiopathy with cystatin C deposits.

Propagation of transient Ca2+ increase in sea urchin eggs upon fertilization and its regulation by microinjecting EGTA solution

Upon fertilization, the concentration of intracellular Ca2+ (Cai) in sea urchin eggs increased up to 3 microM when measured with fura-2, a fluorescent Ca indicator and the increase in Cai traversed from the sperm entry point as a wave over the entire egg at the mean propagation velocities of 5.0 microns/sec in C. japonicus egg and 5.3 microns/sec in H. pulcherrimus egg. However, the velocity was not uniform; i.e., it was rapid in the vicinity of the sperm entry point and the opposite point, but slow in the central region of the egg. Microinjecting a Ca-EGTA buffer and an IP3 solution into the C. japonicus egg induced the transient Cai increase more rapidly than that upon fertilization, due perhaps to the diffusion of the injectates. In order to investigate Ca2+ release during Cai increase upon fertilization, EGTA solutions were microinjected into unfertilized or fertilizing eggs. Microinjecting 100 mM EGTA (final concentration of 1 mM) not only suppressed the transient Cai increase, but also reduced the increased Cai rapidly, and never induced egg activation after insemination, whereas 10 mM EGTA (final concentration of 0.1 mM) did not significantly affect the Cai increase or the activation. Ca2+ released upon fertilization was estimated to be 150-170 microM in the egg cytoplasm from the amount of microinjected EGTA and fura-2. It was concluded that although more than 150 microM of Ca2+ was released intracellularly upon fertilization, Cai increased to only a few microM because most of the released Ca2+ was sequestered by intracellular Ca2+ binding substances.

Change in the heterogeneous distribution of tubulin isotypes in mitotic microtubules of the sea urchin egg by treatment with microtubule depolymerizing or stabilizing drugs

In the mitotic sea urchin egg, the spindle microtubules were composed of different tubulin isotypes from those of astral microtubules using monoclonal antibodies [Oka et al. (1990) Cell Motil. Cytoskeleton, 16, 239-250]. Three of the antibodies, D2D6, DM1B, and YL1/2, were specific for spindle microtubules, astral microtubules and reactive with both microtubules, respectively. The mitotic sea urchin egg was treated with microtubule depolymerizing (colcemid and nocodazole) and stabilizing (hexylene glycol) drugs and change in the heterogeneous distribution of the tubulin isotypes was investigated by the immunofluorescence procedure using these three monoclonal anti-tubulin antibodies. We observed that: (1) the microtubule depolymerizing drugs caused quick depolymerization of most mitotic microtubules, and a small number of spindle microtubules remaining were stained with all three antibodies; (2) hexylene glycol induced many microtubules in the mitotic apparatus, which was stained with D2D6 but was not stained with DM1B; (3) hexylene glycol also induced a great number of miniasters in the cytoplasm, and they were stained with three antibodies. These results suggest that these drugs altered the distribution of tubulin isotypes in the mitotic microtubules during depolymerization or polymerization within a short time.

Chromosomal behavior in starfish (Asterina pectinifera) zygotes under the effect of aphidicolin, an inhibitor of DNA polymerase

When calf thymus histones were labeled fluorescently and microinjected into oocytes of the starfish, Asterina pectinifera, the labeled histones visualized chromosomes during maturation division and cleavage. In doing so, we confirmed the previously reported phenomenon that chromosomes became incompetent at the first cleavage in the aphidicolin-treated egg, although cleavage itself took place. Moreover, we found that chromosomes were aligned at the equator of the metaphase spindle of the first cleavage and that they did not separate into two groups at all, but made a lump in the middle of the spindle. Chromosomes finally entered one blastomere, although they did not participate in the following karyokinesis. DNA and microtubules were examined by cytochemistry and immunofluorescence in order to investigate the relation between chromosome movement and the microtubular cytoskeleton. The mitotic apparatus developed and grew in the aphidicolin-treated cells in the same manner as those in normal cells without normal chromatin condensation or chromosome movement during the first cleavage. However, the mitotic apparatus consisted of two asters without the spindle formed at subsequent cleavages. Electron microscopic study revealed that chromosomes did not condense normally and kinetochores were not detected during the first cleavage. These results indicate that the dynamic changes in microtubular structures during mitosis have poor relation with the chromosome behavior such as prophase chromosome condensation and anaphase chromosome movement.

Cloning and characterization of a protein binding to the J kappa recombination signal sequence of immunoglobulin genes

A protein with molecular weight of 60,000 that binds to the recombination signal sequence (RS) of the immunoglobulin J kappa segment was purified from the nuclear extract of a murine pre B cell line 38B9. This binding protein was found in lymphoid cell lines but not in non-lymphoid cell lines. The Kd value of the J kappa RS binding protein to the J kappa RS was 1 nM. The cDNA clone (RBP-2) was isolated based on partial amino-acid sequence of this protein. This cDNA encodes 526 amino-acid residues, and its sequence does not show extensive overall homology with any known proteins, but displays an interesting homology to a 40-residue region that is conserved among a subset of site specific recombinase (integrase family).

Effects of endotoxin and neutrophil lysate on experimental otitis media with effusion in cats

Middle ear effusion (MEE) from otitis media with effusion (OME) contains large amounts of chemical mediators and substances from bacteria, which may act on the mucosa itself and cause further changes in the inflamed mucosa and MEE. To clarify the effects of such substances in MEE, we instilled endotoxin (LPS) or allogeneic neutrophil lysate (NL) into the middle ear cavity of OME induced by Eustachian tube obstruction (ETO). ETO + LPS and ETO + NL groups showed retention of a large amount of MEE as a characteristic difference between ETO alone group and these groups. The instillation of LPS into the middle ear cavity of the ETO model significantly increased the number of total cells and the ratio of the concentrations of albumin to total protein in MEEs. The instillation of NL significantly increased the number of goblet cells in the middle ear. These facts indicate that the pathology of OME may change in response to various factors added to MEE. Hence, we propose that a vicious circle of self-mediated inflammation is a possible causative factor for chronic OME.

ELISA to determine immunoreactive Pseudomonas aeruginosa elastase in chronic suppurative otitis media

A sensitive sandwich ELISA has been developed to measure the levels of Pseudomonas aeruginosa elastase (PE) in ear discharges from chronic suppurative otitis media (CSOM) patients. Preincubation of the sample with EDTA-2Na before ELISA was employed to inhibit PE activity which hydrolyzes the anti-PE IgG antibody into a smaller molecular form. The PE levels of 10 middle ear effusions (MEE) from chronic otitis media with effusion were also measured. In CSOM, 9 of 10 samples had significant PE levels, ranging from 6.8 to 62.1 micrograms/ml, which were significantly higher than those in MEE (p less than 0.01), the majority of which was below the detection limit. Two samples of CSOM with the P. aeruginosa infection showed high PE levels. This sandwich ELISA for the measurement of PE is a very sensitive method requiring only a small sample amount.

Neutrophil elastase and its complex with alpha 1-antitrypsin in soluble and insoluble fractions of nasal secretions of chronic sinusitis

Immunoreactive neutrophil elastase (NE) and its complex with alpha 1-antitrypsin (AT) was measured by double antibody enzyme linked immunosorbent assay (ELISA) in nasal secretions of chronic sinusitis (CS). Nasal secretions were separated into two fractions: PBS-soluble and insoluble fractions. Elastolytic activity was also examined. Mean value of total NE level was 31.0 micrograms/ml in the soluble fraction, which was significantly lower than that in the insoluble fraction (71.9 micrograms/ml, p less than 0.01). On the other hand, the percentage of complexed NE in total NE in the soluble fraction (33.7%) was significantly higher than that in the insoluble fraction (12.1%, p less than 0.01). Elastolytic activity in the soluble fraction (23.4 RFU) was significantly lower than that in the insoluble fraction (170.5 RFU, p less than 0.01). NE with elastolytic activity exists in nasal secretions of CS, and active-free NE in the insoluble fraction could be a major source of enhancement and continuation of mucosal inflammation.

Quantitative histochemical study of secretory cells after short term tubal obstruction in the cat

Quantitative histochemistry of goblet cells producing different types of glycoproteins was examined in cat middle ears with and without Euatachian tube obstruction (ETO). The goblet cell population significantly increased at 1 week after ETO and showed a tendency to decrease down to the normal level at 4 weeks after ETO. In the normal ears, approximately 85% of glycoprotein in the secretory cells were sulphated and 15% were neutral. ETO significantly increased goblet cell population containing sulphated glycoprotein at the expense of neutral glycoprotein. The results indicate that goblet cells can easily and within a short period be modified both in number and in intracellular glycoproteins by a tubal obstruction.

Rheological properties of middle ear mucus in relation to goblet cell population in cat

Seventeen mucoid middle ear effusions were collected from the tympanic cavity of 15 cats 1 or 2 weeks after tubal obstruction. Middle ear mucosa was also taken both from the tympanic cavity and bulla, and the number of goblet cells was counted. Both elasticity (G') viscosity (eta') of the mucoid effusion were determined with an oscillating sphere magnetic rheometer and compared with goblet cell count. There was a significant correlation between G' and goblet cell population in the tympanic cavity. A similar significant correlation was observed between eta' and goblet cells. The G' and eta' values of the mucoid mucus were much higher than the optimal viscoelasticity for mucociliary transport. Results indicate that the mucus obtained in this study mainly originated from the goblet cells, and that its viscoelasticity was beyond ideal values for mucociliary transport.

The relationship between proteases activity and glycoprotein levels in middle ear effusions from experimental otitis media in cats

The relationship between lysosomal proteases activity (elastase and cathepsin B) and levels of mucous glycoproteins in middle ear effusions (MEEs) was studied using a cat model of otitis media with effusion (OME) induced by Eustachian tube obstruction (ETO). The ratio of cathepsin B activity to total protein concentration (TPC) in MEE was 25.6 +/- 19.4 RFU/g x dl-1 at 1 week after ETO, and increased with the duration of OME. The ratio of elastase activity to TPC had a significant correlation to total leukocyte count. The ratio of fucose levels to TPC, which is one of the parameters reflecting levels of mucous glycoprotein, at 1 week after ETO was significantly higher than that at both 2 and 4 weeks after ETO. The percentage of glycoprotein levels absorbed to wheat germ lectin was highest at 1 week after ETO, and decreased with the duration of OME. In conclusion, mucous glycoproteins in cat occupy a larger portion of glycoproteins in MEE at the early stage of OME, and elastase and other lysosomal proteases may play a role in both stimulation of mucin release from goblet cells and mucin degradation. The balance of these processes seems to be a key factor determining mucin levels in MEEs.

A quantitative study of the ciliary area of experimental otitis media with effusion in cats

A quantitative electron microscopic study was performed to determine the extent of the ciliary surface area of the middle ear epithelium in cats. In normal cats, 97.8% of the middle ear mucosa in the hypotympanum and 45.9% in the upper part of the bulla were covered by cilia. Eustachian tube obstruction (ETO) significantly reduced the ciliary area to 73.1% in the hypotympanum and to 16.2% in the upper part of bulla at 1 week after ETO. Instillation of Escherichia coli lipopolysaccharide (LPS) or cat polymorphonuclear leukocyte (PMN) lysate into the middle ear cavity followed by ETO did not reduce the ciliary area, compared with ETO induced alone. Our results indicate that ETO reduces the ciliary area of the middle ear mucosa and that LPS or neutrophils do not enhance reduction of the ciliary area compared to ETO induced alone in this experimental condition.

ELISA for determination of immunoreactive free elastase and elastase in complex with alpha 1-antitrypsin in nasal secretions with sinusitis

Sensitive double antibody sandwich ELISA methods was developed in order to quantify immunoreactive neutrophil elastase (NE) levels in nasal secretions with chronic sinusitis (CS). Microwell plate as a solid phase was coated with anti-NE antibody. Two different horseradish peroxidase (HRP) labelled antibodies used as the second antibody were anti-NE-HRP for measuring total (free + complexed) NE level and anti-alpha 1-antitrypsin (AT)-HRP for complexed NE level. Mean value of total NE was 31.0 +/- 20.7 micrograms/ml in nasal secretions from adult patients with CS, and the percentage of complexed NE in total NE was 33.7 +/- 21.4%. This sandwich ELISA is a useful method for measuring both total and complexed NE levels in nasal secretions.

Rheological and biochemical properties of middle ear effusions from experimental otitis media in cats

Both rheological and biochemical analyses were performed on middle ear effusions (MEEs) from cats with experimental otitis media with effusions (OME) induced by obstruction of the Eustachian tube. This study was undertaken in order to clarify the factors determining rheological properties (elasticity and viscosity) of MEEs. The viscoelasticity of the effusions had a positive significant correlation to fucose/total protein concentration (TPC), and a negative correlation to cathepsin B level/TPC. No correlation was observed between albumin level/TPC and viscoelasticity. These results indicate that in cats the rheological properties of MEEs depend on the level of secretory glycoproteins in MEEs and on the severity of inflammation in the early stage after tubal obstruction.

Microinjection of the monoclonal anti-tubulin antibody YL1/2 inhibits cleavage of sand dollar eggs

Two monoclonal antibodies against alpha-tubulin (YL1/2 and D2D6) were microinjected into the egg of the sand dollar Clypeaster japonicus, and their effects on cleavage of the egg were investigated. They had already been shown by immunoblotting to react specifically with egg tubulin and by immunofluorescence to stain the mitotic apparatus [OKA et al., (1990). Cell Motil. Cytoskel. 16:239-250]. Injection of YL1/2 prevented chromosome movement and cleavage, although the cleavage furrow developed in some cases. In all eggs injected at prometaphase, metaphase, or anaphase, the birefringence of the mitotic apparatus disappeared immediately after injection. Injection of D2D6 had no significant effect on mitosis or cleavage of whole eggs injected after nuclear disappearance, although it prevented the disappearance of the nuclear envelope in 54% of the eggs injected before the disappearance. FITC-conjugated D2D6 did not accumulate in the spindle when injected into the dividing sand dollar egg. These results indicate that YL1/2 disassembled microtubules, whereas D2D6 did not bind to microtubules in the living cell.

Quantitative analysis of the process and propagation of cortical granule breakdown in sea urchin eggs

Cortical granule breakdown in sea urchin eggs has been investigated with a video microscope system using Nomarski differential interference contrast optics, when induced by fertilization, microinjecting inositol 1,4,5-trisphosphate (IP3) or Ca-EGTA buffer solution into the egg, or perfusing a medium containing 1 mM Ca2+ to isolated cortices. The cortical granule increased up to 1.2 times in diameter and broke down within 40 msec. These values were almost constant among the three methods used to induce cortical granule breakdown. Upon fertilization, the cortical granule breakdown propagated over the egg surface at a speed of 3.3 microns/sec in Clypeaster japonicus eggs, which indicates that cortical granule breakdown propagated through the 3.3-microns-wide egg surface within 1 sec. In such a small area of the egg surface, however, it took much more than 1 sec for all cortical granules to break down because the maximal rate of breakdown was 7.6%/sec; that is, it took 9 sec and 18 sec for 50% and 90% respectively, of cortical granules to break down. Moreover, the rate did not simply decrease with time, and a shoulder was found during the reducing phase, which suggests that cortical granules are divided into fast and slow breakdown groups according to the responsiveness to the breakdown stimulus. The cortical granule breakdown induced by microinjecting the Ca-EGTA buffer and IP3 solutions propagated at 68 microns/sec and 35 microns/sec, respectively. The stimulus for cortical granule breakdown is discussed concerning the transient intracellular Ca2+ increase.

Simultaneous investigation of intracellular Ca2+ increase and morphological events upon fertilization in the sand dollar egg

An increase in intracellular Ca2+ concentration ([Ca2+]) and morphological were simultaneously observed by epifluorescence and differential interference contrast (DIC) microscopy during fertilization of the sand dollar, Clypeaster japonicus. [Ca2+], which was detected by a Ca2+ indicator, Fluo-3, initially increased just beneath the sperm-attached site on the egg surface 8.6 sec after attachment. The increase spread into the egg as a concentric sphere to the egg center and, thereafter, propagated in the egg cytoplasm as a planar wave rather than a spherical wave. It reached the site opposite the initiation site across the egg 24.2 sec after initiation. The fertilization envelope (FE) began to elevate 10.3 sec after the initiation of the increase in [Ca2+] and 21.2 sec after sperm attachment.

Endotoxin and lysosomal protease activity in acute and chronic otitis media with effusion

Endotoxin levels and lysosomal protease (collagenase, cathepsin B, and lysozyme) activity were measured in 104 middle ear effusions (MEEs) from patients with otitis media with effusion (OME). The MEE samples were classified into four groups: pediatric serous, mucoid, and acute, and adult serous. Endotoxin levels and lysosomal protease activity in MEEs were significantly different in the following order: adult less than serous less than mucoid less than acute groups, indicating that both endotoxin and lysosomal proteases are more closely related to the pathogenesis of pediatric chronic OME than to adult OME. In pediatric serous and mucoid effusions, endotoxin level had a significant correlation with activity of the lysosomal proteases. In conclusion, endotoxin enhances leukocyte infiltration into the middle ear, and lysosomal proteases released from leukocytes damage the middle ear mucosa and thereby prolong mucosal inflammation, which may be responsible for delayed recovery from acute OME.

[An autopsy case of Alzheimer's disease associated with Parkinson's disease, compared to 2 autopsy cases of diffuse Lewy body disease]

A 68 year old male, diagnosed as Alzheimer's disease clinically, pathologically showed both findings of Alzheimer's disease and Parkinson's disease. The brain weight was 940 g. Macroscopically, severe cortical brain atrophy and depigmentation of the substantia nigra was noted. Microscopic examination showed marked appearance of senile plaque and a large number of neurofibrillary tangle with sever neuronal loss of the cerebral cortex. Additionally, the loss of neuron with many Lewy bodies was found in the substantia nigra. Lewy bodies were also found in the locus ceruleus and the dorsal vagal nucleus, but few in the cerebral cortical neurons. We compared this case neuropathologically with two autopsy cases of diffuse Lewy body disease (DLBD). There was no distinction concerning the lesions of the brain stem between this case and the cases of DLBD. In all three cases, the nucleus of basalis of Meynert showed marked neuronal loss. However, the brain was lighter than those of the cases of DLBD. Senile changes such as senile plaque and neurofibrillary tangles were more marked in this cases than in the cases of DLBD. Furthermore a large number of cortical Lewy bodies were found in the cases of DLBD, but few in this case. The distribution and number of Lewy bodies did not correspond with those of senile changes in the cases of DLBD. Also the cerebral cortical structure was better preserved in the cases of DLBD than in this case. In conclusion, from the clinicopathological findings, we considered that this case is Alzheimer's disease associated with Parkinson's disease. According to Kosaka's study, this case seemed to correspond with a transitional type of the Lewy body disease.

Lysosomal proteases and protease inhibitors in nasal allergy and non-atopic sinusitis

Patterns of protease activity and levels of protease inhibitors were analyzed in both nasal secretions and tissue extracts from patients with nasal allergy and non-atopic sinusitis to investigate the role of proteases in the inflammatory reaction. Protease activity was measured using specific methyl-coumaryl-7-amide substrates. The pattern of protease activity in the nasal secretions of chronic sinusitis patients was similar to that in neutrophil lysate and quite different from that in plasma. Both gluthatione activation testing and inhibition testing using synthetic inhibitors revealed that the majority of proteases in both secretions and tissues are lysosomal thiol proteases such as cathepsins B and L. Neutrophilic elastase is also a major protease in nasal secretions. In acute sinusitis, both protease activity and inhibitor levels were very high, suggesting an interaction between proteases and inhibitors. Cathepsin B and B-like thiol proteases appear to play a key role in prolonging chronic inflammation against the healing process, due to their resistance to plasma inhibitors and the shortage of thiol protease inhibitors. Protease activity in the secretions of nasal allergy patients was very weak, and the reaction between proteases and inhibitors appeared to be weak.

A protein binding to the J kappa recombination sequence of immunoglobulin genes contains a sequence related to the integrase motif

Site-specific recombination requires conserved DNA sequences specific to each system, and system-specific proteins that recognize specific DNA sequences. The site-specific recombinases seem to fall into at least two families, based on their protein structure and chemistry of strand breakage. One of these is the resolvase-invertase family, members of which seem to form a serine-phosphate linkage with DNA. Members of the other family, called the integrase family, contain a conserved tyrosine residue that forms a covalent linkage with the 3'-phosphate of DNA at the site of recombination. Structural comparison of integrases shows that these proteins share a highly conserved 40-residue motif. V-(D)-J recombination of the immunoglobulin gene requires conserved recombination signal sequences (RS) of a heptamer CACTGTG and a T-rich nonamer GGTTTTTGT, which are separated by a spacer sequence of either 12 or 23 bases We have recently purified, almost to homogeneity, a protein that specifically binds to the immunoglobulin J kappa RS containing the 23-base-pair spacer sequence. By synthesizing probes on the basis of partial amino-acid sequences of the purified protein, we have now isolated and characterized the complementary DNA of this protein. The amino-acid sequence deduced from the cDNA sequence reveals that the J kappa RS-binding protein has a sequence similar to the 40-residue motif of integrases of phages, bacteria and yeast, indicating that this protein could be involved in V-(D)-J recombination as a recombinase.

Purification and characterization of a protein that binds to the recombination signal sequence of the immunoglobulin J kappa segment

A protein that binds to the recombination signal sequence (RS) of the immunoglobulin J kappa segment was purified almost to homogeneity from the nuclear extract of a murine pre-B cell line 38B9. A similar binding protein was found in lymphoid cell lines but not in non-lymphoid cell lines. The binding activity was associated with a polypeptide with a molecular weight of 60,000. DNase I footprinting analysis demonstrated that this binding protein interacted with the heptamer and several 3' bases close to the heptamer. The Kd value of the J kappa RS binding protein to the J kappa RS was 1 nM. One base substitution in the heptamer of the J kappa RS greatly reduced the affinity of the J kappa RS binding protein. The high specificity of the binding site of the J kappa RS binding protein suggests that this protein may be involved in V-J recombination.

Proteases and protease inhibitors in immune complex otitis media in chinchillas

Using an immune complex-induced (IC) otitis media model in chinchillas sensitized with human serum albumin (HSA), we measured the levels of protease activity, protease inhibitors, and HSA in the middle ear fluid (MEF). The effect of a corticosteroid agent (triamcinolone) on the degree of IC otitis media also was studied. The levels of protease inhibitors alpha 1-antitrypsin and alpha 2-macroglobulin in the MEF were significantly higher than in nonsensitized animals. Fibrinolytic (plasminogen activator [PA]) activity was detected in the MEF; however, only a small level of activity of nonspecific proteases was detected because of the significant level of antitryptic activity in the MEF. The levels of protease inhibitors and PA activity were significantly reduced by the steroid treatment. It is concluded that protease inhibitors play an important role in the protection of the middle ear mucosa and that corticosteroid treatment can reduce the severity of IC otitis media.

Biochemical study of protease inhibitors in normal chinchilla middle ear

Protein concentration and inhibitory capacity of both alpha 1-antitrypsin (alpha 1-AT) and alpha 2-macroglobulin (alpha 2-M) were measured in plasma and middle ear bulla (MEB) washings of chinchillas by use of specific antisera against chinchilla alpha 1-AT and alpha 2-M. Low molecular weight (LMW) trypsin inhibitor also was analyzed in MEB washings. Chinchilla alpha 2-M showed a common antigenicity with human alpha 2-M. The mean value of alpha 1-AT in chinchilla plasma was 412.0 +/- 87.8 and that of alpha 2-M was 435.0 +/- 117.1 mg/dL. There was a significant relationship between alpha 1-AT level and antitryptic activity, and between alpha 2-M level and trypsin binding activity in plasma. The majority of alpha 1-AT and alpha 2-M in plasma is present as free inhibitors unsaturated with proteases. The MEB washings had significant antitryptic activity, which is attributed to both alpha 1-AT and LMW trypsin inhibitors. Inhibitory functions of alpha 1-AT and LMW trypsin inhibitors appear to play an important role in the defense of the normal middle ear mucosa.

A comparative study of the distribution of fluorescently labeled calmodulin and tubulin in the meiotic apparatus of the mouse oocyte

The localizations of tubulin and calmodulin were investigated in the mouse oocyte during the second meiosis by fluorescently labeling and microinjecting these proteins prepared from porcine brain tissue. When injected, both tubulin and calmodulin were quickly incorporated into the preformed meiotic apparatus of the oocyte at metaphase. The localization of labeled tubulin was coincident with that of birefringence. However, the localization of labeled calmodulin was somewhat different: the fluorescence of calmodulin was intense in the polar regions of the spindle. After the chromosomes began to move, followed by parthenogenetic activation upon microinjection of a calcium buffer, these two fluorescent proteins, localized in the meiotic apparatus, moved to the interzonal region of the spindle during anaphase. At late anaphase and throughout telophase, calmodulin was excluded from the mid-bodylike structures in the interzonal region, whereas tubulin did accumulate in these structures.

Protease inhibitors in middle ear effusions from experimental otitis media with effusion: kinetics of alpha 1-antitrypsin and alpha 2-macroglobulin levels

Alpha 1-antitrypsin (alpha 1-AT) and alpha 2-macroglobulin (alpha 2-M) were measured by both immunochemical and functional assays in paired plasma and middle ear effusions (MEEs) from experimental otitis media models (serous otitis media [SOM], purulent otitis media [POM], and SOM + POM). The MEE/plasma ratio of alpha 1-AT in SOM was significantly higher than that in POM (p less than .01) because of the high alpha 1-AT level in POM plasma. The ratio of both antitryptic activity and trypsin-binding activity in POM was significantly higher than that in SOM + POM (p less than .01, less than .05), and significantly lower than that in SOM (p less than .01). The majority of both inhibitors in SOM exists as the free state, and the reaction between proteases and inhibitors in POM and SOM + POM is more active than that in SOM. It is concluded that both alpha 1-AT and alpha 2-M appear to play an important role in the protection of middle ear mucosa by forming protease-inhibitor complexes to reduce proteolytic damage in POM and SOM + POM models.

Effects of middle ear effusion on neutrophil function

The neutrophil chemotactic activity of middle ear effusions (MEE) was measured in patients with pediatric chronic, adult chronic, and acute otitis media with effusion (OME). Chemotactic activity differed significantly among the three groups of otitis media in the following order: adult chronic less than pediatric chronic less than acute. Culture-positive effusions had higher chemotactic activity than did those that tested culture negative, suggesting that bacterial infection is related to neutrophil chemotactic activity. The chemotactic function of normal peripheral neutrophils was not enhanced by preincubation with MEE, but their bactericidal function was enhanced. In conclusion, bacterial infection in the middle ear is one of the major determining factors of neutrophil infiltration during OME, and MEE enhances the bactericidal function of neutrophils.

Plasma cell leukaemia of non-producer type with missing light chain gene rearrangement

A case of plasma cell leukaemia of non-producer type is described. The patient presented with typical clinical features of plasma cell myeloma, including multiple osteolytic lesions, hypercalcaemia, renal failure and reduced polyclonal immunoglobulins, except that M-component was not detected in either the serum or urine. Morphological examinations showed a plasmacytoid appearance of the neoplastic cells, while immunological studies failed to detect cytoplasmic immunoglobulin or secretory capacity. The surface phenotype of CD38+, PCA-1+, DR-, CD20-, CD24-, CD9-, CD10- and surface immunoglobulin- was compatible with mature plasma cells. Chromosomal analysis showed the 14q+ marker due to translocation (6;14) and deletion of the short arm of chromosome 1. Analysis of immunoglobulin genes revealed the presence of heavy chain gene rearrangement, but the light chain genes, both kappa and lambda, remained in germline configuration. Such defective immunoglobulin gene rearrangement may be responsible for the failure of immunoglobulin biosynthesis and secretion by the neoplastic plasma cells. Furthermore, it is suggested that the morphological and phenotypic development of B cells may not necessarily depend on immunoglobulin light chain gene rearrangement, and that the oncogenic event in myeloma may occur at an earlier stage of B cell differentiation.

Recurrence of antigen-induced otitis media by thiol compound

Reduced glutathione (GSH), a potential factor in the chronicity of human otitis media, was tested to determine its potency in the recurrence of antigen-induced otitis media in chinchillas sensitized with human serum albumin (HSA). GSH instillation into the healing middle ear bulla reproduced a level of otitis media similar to the original antigen-induced otitis media with cellular involvement occurring earlier, according to cytologic analyses. This study indicates that GSH is probably a factor in recurrent antigen-induced otitis media, controlling the balance between thiol proteases and thiol protease inhibitors during middle ear inflammation.

Hearing impairment in relation to viscoelasticity of middle ear effusions in children

Both dynamic viscosity (eta') and elasticity (G') of middle ear effusion were measured with an oscillating sphere magnetic rheometer and compared with the degree of conductive hearing loss in 65 ears of 40 children. There was a significant correlation between eta' and the magnitude of the air-bone gap at 500 and 1,000 Hz, but there was no significant correlation between eta' and the magnitude of the air-bone gap at 2,000 or 4,000 Hz. No significant correlation was noted between G' and the magnitude of the air-bone gap at 500, 1,000, 2,000, or 4,000 Hz. These results indicate that the eta' of middle ear effusion has an effect on the amount of hearing impairment at frequencies below 1,000 Hz.

Antiinflammatory effects of a corticosteroid and protease inhibitor agents on antigen-induced otitis media in chinchillas

Using an antigen-induced otitis media (OM) model in chinchillas sensitized with human serum albumin (HSA), we studied the antiinflammatory effect of a corticosteroid (triamcinolone) and a protease (kallikrein) inhibitor (aprotinin) by conducting both biochemical and cytologic analyses of middle ear fluid (MEF). The levels of HSA, alpha 1-antitrypsin, alpha 2-macroglobulin, and total protein concentration were measured in the MEF to evaluate the degree of OM. Both vascular leakage and leukocyte infiltration were significantly reduced by corticosteroid and inhibitor treatments. HSA levels in the MEF were markedly reduced after HSA challenge, and both treatments reduced the drop in HSA levels. In conclusion, the kallikrein-kinin system is related to the early stage of antigen-induced OM. Both corticosteroid and inhibitor treatments effectively reduce the degree of antigen-induced OM in chinchillas, suggesting that both may be useful local therapeutic agents in the treatment of human OM.

The relationship between antigen levels and middle ear inflammation in antigen-induced otitis media in the chinchilla

The relationship between antigen levels in middle ear effusions (MEE) and the degree of middle ear inflammation was studied in an antigen-induced otitis media model, using chinchillas sensitized with human serum albumin (HSA). The degree of middle ear inflammation was evaluated by both tympanometric analysis, and cytological and biochemical analyses of the MEE. Middle ear inflammation develops after HSA challenge with a remarkable decrease in HSA levels in the MEE. This inflammation persists even when HSA levels are no longer detectable in the MEE. These findings show that local challenges with an antigen induce a certain degree of middle ear inflammation, which continues even after complete elimination of the antigen from the middle ear through an immunological defense mechanism.

[Infarct size related to the distribution and site of coronary artery lesions studied by the unfolded map technique using single photon emission computed tomography]

To assess the relative importance of the anatomical characteristics of the coronary artery distribution and the sites of the arterial stenoses in relation to infarct size, 21 patients with old myocardial infarction and angiographically-proven 90% or greater stenoses (AHA classification) of one of the major coronary arteries were studied. The infarct size was evaluated by a new quantitative method, the unfolded map, derived from single photon emission computed tomography (SPECT). Eleven patients had right coronary artery disease (Group RCA: segment 1; five patients and segment 2; six patients). Seven patients who had the large left anterior descending artery (LAD) which was distributed to the inferior portion of the apical area were defined as Small R, and four patients with large RCA as Large R. Ten patients each had a significant stenosis in the LAD (Group LAD: segment 6; six patients and segment 7; four patients). Four patients with significant stenosis proximal to segment 9 were defined as Pre-9, and seven patients with stenosis distal to the segment, as Post-9. Stress T1-201 scintigraphy with SPECT was performed and the unfolded map was obtained with data of the maximal count circumferential profiles in the redistribution image. Infarction was defined as a defect below 55% of the standard value. The necrotic area ratio expressed as percentage of the defect area to the entire map area was calculated and used as the indicator of infarct size. Although there was no significant difference in the necrotic area ratio between segment 1 and 2 lesions. Large R had the significantly larger necrotic area ratios (24.9 +- 4.6%) than did Small R (9.7 +- 4.4%; p less than 0.01). In the Group LAD, there was no significant difference in the necrotic area ratio between segment 6 and 7 lesions, but Pre-9 had the larger ratio (30.4 +- 3.3%) than did Post-9 (15.4 +- 7.7%; p less than 0.01). These data suggest that the factors related to infarct size are either the distribution of the coronary arteries in the apical area in the Group RCA or the sites of the stenotic lesions relative to the branching portion of the first diagonal branch in the Group LAD.

Micromanipulation studies of the asymmetric positioning of the maturation spindle in Chaetopterus sp. oocytes: I. Anchorage of the spindle to the cortex and migration of a displaced spindle

We investigated the nature of the asymmetric positioning and attachment of Chaetopterus oocyte meiotic spindles to the animal pole cortex by micromanipulation. The manipulated spindle's behavior was analyzed in clarified oocyte fragments using video-enhanced polarized light microscopy. As the spindle was drawn towards the cell interior with a microneedle, the cell surface dimpled inwards adjacent to the outer spindle pole. As the spindle was pulled further inwards, the dimple suddenly receded indicating a rupture of a mechanical link between the cell cortex and outer spindle pole. The spindle paused briefly when released from the microneedle; then it spontaneously migrated back to the original attachment site and reassociated with the cell cortex. Positive birefringent astral fibers were seen running between the outer spindle pole and the cortex during the migration. The velocity of the spindle during its migration tended to increase as it came closer to the cortex. Velocities as high as 1.25 micron/sec. were measured. If removed too far from the attachment site cortex (greater than 35 micron), the spindle remained stationary until pushed closer to the original attachment site. Spindles, inverted by micromanipulation, migrated and reattached to the cortical site by their former inner pole; thus either spindle pole can seek out and migrate to the original attachment site. However, spindle poles pushed against other cortical regions did not attach demonstrating that there is only one unique, localized attachment site for spindle attachment.

Relationship between antigen levels in middle ear and antigen passage through round window membrane in antigen-induced otitis media

By using an antigen-induced (Arthus) otitis media (OM) model in chinchillas sensitized with human serum albumin (HSA), we investigated the passage of HSA through the round window membrane (RWM) by measuring HSA levels in both the middle ear fluid (MEF) and the perilymph (PL). The effect of corticosteroid treatment on HSA passage was also studied. Mean HSA levels in both the MEF and the PL were proportional to the HSA dose administered (0.5, 5, 50 mg/ml). The proportion of HSA-positive PL samples was significantly lower in the sensitized group than that of the control (p less than 0.01). HSA levels in the PL appear to depend on HSA levels in the MEF, which were significantly depressed in the sensitized animals. These results suggest that an immunological reaction may be involved in the reduction of antigen (HSA) passage through the RWM by reducing antigen concentrations in the MEF. Corticosteroid treatment reduces the passage of HSA into the PL in non-sensitized animals.

Round window membrane permeability to human serum albumin in antigen-induced otitis media

The round window membrane (RWM) permeability to human serum albumin (HSA) was investigated in both normal chinchillas and chinchillas sensitized with HSA. The effect of a corticosteroid agent (triamcinolone) on the RWM permeability was also analyzed. It was found that HSA could not be detected in either the perilymph or the cerebrospinal fluid of normal chinchillas within 1 hour after instillation into the middle ear bulla. Perilymph levels of HSA peaked 24 hours after instillation. In antigen-induced otitis media, the HSA level in the perilymph at 12 hours after challenge was significantly higher than that in normal chinchillas (P less than .01), but it did not increase with the development of otitis media. A significant difference of HSA level in the perilymph of animals with and without steroid treatment was noted (P less than .025 at 24 hours and P less than .05 at 48 hours). It is concluded that little HSA passes through the normal RWM in a short time and that the RWM permeability to HSA increases in the early stage (about 12 hours) of antigen-induced otitis media. Corticosteroids can affect the RWM permeability to HSA by reducing the level of antigen-induced otitis media.

Introduction and expression of the interleukin 2 receptor (Tac) gene in hematopoietic stem cells with retrovirus vectors

Retrovirus vectors provide an efficient carrier for introducing a gene into hematopoietic stem cells although expression of the inserted gene is not always successful. We constructed and compared three retrovirus vectors which carried cDNA encoding the light chain (Tac) of the interleukin 2 receptor under the control of different promoters; long terminal repeat (LTR) of murine retroviruses, the early promoter of simian virus 40 (SV40) and the promoter of the class I antigen gene of the major histocompatibility complex. We made three constructs containing these promoters. A first construct did not contain any additional promoter but LTR. A second and a third constructs contained the SV40 and the class I antigen gene promoters, respectively, in addition to LTR. The LTR of retrovirus vectors is derived from MoMuLV except that the U3 region of the 3'LTR of the third construct is derived from myeloproliferative sarcoma virus (MPSV). The second and third constructs were used for infection of bone marrow stem cells as the first construct was less efficient in expression of the interleukin 2 receptor in fibroblasts. Hematopoietic stem cells infected with the recombinant viruses were transplanted into lethally irradiated mice, and the expression of the transduced gene in hematopoietic progenitor cells was analyzed. Analysis of RNA isolated from spleen colonies showed that substantial amounts of interleukin 2 receptor mRNA were made by the construct containing the class I gene promoter and MPSV LTR. However, we could not detect any transcripts from the constructs containing MoMuLV LTR and SV40 early region promoter.

Accumulation of fluorescently labeled actin in the cortical layer in sea urchin eggs after fertilization

Actin from sea urchin eggs was fluorescently labeled with fluorescein isothiocyanate (FITC), N-(7-dimethylamino-4-methylcoumarinyl)-maleimide (DACM), or 5-iodoacetamidofluorescein (IAF) and microinjected into sea urchin eggs and oocytes. It distributed evenly in the cytoplasm of unfertilized eggs. Upon fertilization, actin accumulated first around the sperm binding site and, soon afterwards, in the fertilization cone. The accumulation propagated all over the cortex after a latent period of 10-20 sec. In the case of Clypeaster japonicus eggs, propagation of the accumulation coincided with a shape change in the egg, suggesting that the accumulated actin in the cortex generates forces. FITC-actin was incorporated into microvilli and retained in the cortex after cleavage. On the other hand, DACM- or IAF-actin was not incorporated into microvilli and was dispersed from the cortex by cleavage. These differences may be attributable to differences in the properties of the actins labeled at different sites. After photobleaching by laser light irradiation, FITC- or IAF-actin redistributed in the cortex of fertilized egg as quickly as it did before fertilization. When an unfertilized egg was injected with both actin and a calcium buffer (intracellular free Ca2+ concentration 9 microM), the actin accumulation was similar to that during fertilization but without the latent period. This suggests that the accumulation depended on the increase in the intracellular free Ca2+ concentration. When the unfertilized egg was injected with 0.2 M EGTA after injection of labeled actin and then inseminated, it accumulated only in the protrusion of cytoplasm where the sperm had entered, and fertilization was not completed. In immature oocytes, the accumulation was observed in the cortical region, including the huge protrusion of the cytoplasm where the sperm had entered. These results suggest that actin accumulation in the sperm binding site plays an important role in the sperm reception mechanism of the egg.

Sensorineural hearing loss in antigen-induced otitis media

Chinchillas were sensitized with human serum albumin (HSA). When circulating antibody-titers were sufficiently elevated as to induce local inflammation, 1 ml of HSA (50, 5, 0.5 mg/ml) was instilled into the left middle ear cavity from the superior bulla. HSA containing a steroid agent was instilled into the right ear. Non-sensitized animals were used as control. In the sensitized animals, a significant hearing loss occurred at higher frequencies. The loss was dose-related. Less severe hearing loss was found following steroid treatment. We conclude that sensorineural hearing loss can occur in antigen-induced otitis media.

Interaction of bacteria with the immune system of Waldeyer's ring in otitis media with effusion

An in vitro assay was used to study the adherence of Haemophilus influenzae (HI) to human nasal, nasopharyngeal, and buccal mucosal cells from patients with otitis media with effusion (OME). Adherence of unencapsulated HI was stronger than that of type b HI. HI adherence to both nasal and nasopharyngeal mucosal cells is stronger than that of buccal ones, indicating the presence of an important route of HI infection from the nose to the nasopharynx in OME. Specific antibodies against outer membrane vesicles (OMV) of HI were also examined using enzyme-linked immunosorbent assay. No significant correlation could be observed between specific secretory IgA or IgG titers and HI adherence to the nasopharyngeal mucosal cells, which suggests that HI adherence to the mucosal cells seems to depend on various factors including the local immunological defense system in OME patients. Anti-OMV IgA antibody producing cells were identified in the adenoid using the three-step immunoperoxidase method. These results suggest that non-typable strains of HI adhere more readily to epithelial cells and consequently are better suited to colonize the nasopharynx or to cause local infections.

Biochemical and cytological studies of immune-complex-induced otitis media in the chinchilla

The pathogenesis of immune complex (IC)-induced otitis media in the chinchilla was studied through cytological and biochemical analyses of middle ear fluid (MEF) recovered after instillation of premade IC. The number to total leukocytes was 3.03 +/- 2.13 X 10(6)/cm3, and mainly involved neutrophils (72.3%) and macrophages (22.7%). The mean value of total protein, alpha 1-antitrypsin (alpha 1-AT) and alpha 2-macroglobulin (alpha 2-M) was 27.1 mg/ml, 189.5 and 75.2 mg/dl. The number of leukocytes had a significant correlation with the levels of total protein, alpha 1-AT and alpha 2-M (P less than 0.01). The inflammatory reaction induced by premade IC is characterized by an increased vascular leakage and an infiltration of leukocytes into the locus. The percentage of macrophages in the total leukocytes was larger in IC-induced otitis media than that in antigen-induced otitis media. These findings suggest that cellular events in the early stage of IC-induced otitis media may be different from antigen-induced otitis media.

Review of round window membrane permeability

The round window membrane (RWM) is permeable to certain biological substances. Those substances that can pass through the RWM have the potential to cause inner ear damage, leading to functional disturbances. The RWM is permeable to water, and the existence of osmotically active substances in the middle ear cavity can induce an alteration of inner ear fluid osmolality, leading to membrane displacement. However, several limiting factors exist that prevent free passage of substances from the middle ear to the inner ear. These include the morphological barrier of the three-layered RWM, the molecular weight of the substances, and the nature and concentration of substances in the middle ear cavity. The degree and duration of the inflammation in the middle ear cavity, as well as the morphological integrity of the RWM, also play an important role in controlling the passage of noxious substances into the inner ear. Further characterization of the factors involved in RWM permeability, and clarification of the mechanisms of the inner ear damages caused by substances passing into the inner ear through the RWM, are necessary for an understanding of the inner ear dysfunction caused by middle ear inflammation.

Vascular permeability of the middle ear mucosa in otitis media with effusion

Vascular permeability (VP) of the middle ear mucosa (MEM) in chronic otitis media with effusion (OME) was estimated in both pediatric and adult patients by calculating the middle ear effusion (MEE) to serum concentration ratios of albumin and of four protease inhibitors: alpha 1-antitrypsin (alpha 1-AT), alpha 1-antichymotrypsin (alpha 1-X), inter-alpha-trypsin inhibitor (I-alpha-I) and alpha 2-macroglobulin (alpha 2-M). The levels of albumin and alpha 1-AT in MEE were higher while those of I-alpha-I and alpha 2-M were lower than their serum levels in both adult serous and pediatric mucoid groups. There was a negative correlation between molecular weight and the mean value of the ratio (MEE/serum) of the four inhibitors in both serous (r = -0.989) and mucoid (r = -0.924) groups. Vascular permeability of the MEM seems to be variable in both serous and mucoid groups during middle ear inflammation. Selective leakage of proteins by molecular weight appears to occur in MEM. Our findings further indicate that a high level of the high-molecular-weight inhibitor alpha 2-M in MEE may be a significant index reflecting the remarkably enhanced VP of the MEM.

Kinetics of lysosomal protease activity in human otitis media with effusion

Hydrolytic activity of various lysosomal proteases--elastase, collagenase, and cathepsins B and H--were measured in 125 middle ear effusions from patients with chronic (serous and mucoid) and acute otitis media with effusion (OME). The levels of cathepsin B activity and alpha-2-macroglobulin during the course of clinical therapies (myringotomy and tympanostomy tubing) were analyzed in 10 chronic OME cases where follow-up evaluation was possible. It is found that the level of lysosomal protease activity (elastase, collagenase and cathepsin B) was higher in acute OME than that in chronic OME; the hydrolytic activity of cathepsin B in middle ear effusions could be used as an indicator to reflect the level of lysosomal proteases activity in the middle ear; in chronic OME, inflammatory reaction including lysosomal protease activity of the middle ear mucosa at the time of the first myringotomy appeared to be more active than that at the time of the final myringotomy, but less than that in acute OME; and the proteolytic damage of lysosomal thiol proteases to the middle ear mucosa, which may be related to the chronicity of OME, could be reduced by both therapeutic myringotomy and tympanostomy.