Reliability of pyuria detection method

The reliability of two methods for the detection of pyuria was studied in a total of 106 urine samples obtained from patients with identifiable underlying urinary tract disease. The coefficient of variation (CV) was significantly higher in the microscopic than in the counting chamber method. The CV obtained with the use of the KOVA slide 10 grid, a disposable and less expensive counting chamber, was identical to that obtained with the Bürker-Türk counting chamber. Only 50% of the patients who were proven to have pyuria of > or = 5 WBCs/HPF by the microscopic method had significant bacteriuria of > or = 10(4) bacteria per ml of urine. On the other hand, 95% and 90% of the patients who were proven to have pyuria of > or = 10 WBCs/mm3 with the Bürker-Türk and Fuchs-Rosenthal counting chambers had significant bacteriuria. It was concluded that the counting chamber provides a reliable method for the detection of pyuria and is highly predictive for the presence of significant bacteriuria. The KOVA slide 10 grid is an acceptable alternative to the regular counting chamber.

Intrapericardial mitomycin C for the management of malignant pericardial effusion secondary to gastric cancer: case report and review

In a 57-year-old man with recurrent gastric cancer, cardiac tamponade due to malignant pericardial effusion developed. Echocardiographically guided pericardiocentesis followed by an intrapericardial instillation of mitomycin C provided a complete control of the pericardial effusion, and no adverse effects were observed with this procedure. An intrapericardial instillation with effective anticancer agents is therefore considered to be useful for the management of malignant pericardial effusion.

[A case of acetaminophen-induced pneumonitis]

A case of acetaminophen-induced pneumonitis is described. A 63-year-old woman took 2350 mg of acetaminophen for fever. She subsequently developed a non-productive cough and dyspnea. Chest X-ray revealed diffuse reticulonodular shadows in bilateral lung field and she was admitted to our hospital. PaO2 was 45.0 Torr and PaCO2 35.7 Torr while breathing room air. Bronchoalveolar lavage examination showed an increase in the percentage of lymphocytes and a decrease of CD4/CD8 ratio. Microscopic examination of a transbronchial lung biopsy specimen showed alveolar septal thickening. The lymphocyte stimulation test was positive for acetaminophen, with a stimulation index of 237%, while other drugs used were negative. Because drug-induced pneumonitis was suspected, all drugs were stopped and she was administered methylprednisolone. Consequently her symptoms, laboratory data and chest X-ray findings improved. Based on these findings, we diagnosed this case as acetaminophen-induced pneumonitis. To our knowledge, there has been only one previously reported case of acetaminophen-induced pneumonitis.

Restriction fragments homologous to mitochondrial plasmid-like DNAs are located within limited chromosomal regions on the rice nuclear genome

The chromosomal locations of restriction fragments of nuclear DNA that were homologous to four mitochondrial plasmid-like DNAs, namely, B1, B2, B3 and B4, were analyzed by restriction fragment length polymorphism (RFLP) analysis in cultivated rice. Nine kinds of fragments homologous to plasmidlike DNAs were analyzed for their segregation in three different F2 populations derived from intercrosses between rice subspecies; these were found to be localized in three chromosomal regions: three, one and five kinds of nuclear homologues were situated on chromosomes 1,3 and 8, respectively. Nuclear homologues on a given chromosome were tightly linked even though they were homologous to different plasmid-like DNAs. The loci of nuclear homologues found commonly in two or three cultivars were found to be highly conserved, a result that is consistent with their stable transmission. These results and those of the Southern analysis suggest the independent integration of these sequences during the varietal differentiation of rice. The concentration of loci for nuclear homologues on chromosomes 1 and 8 suggests that these sequences were integrated non-randomly into these chromosomal regions.

A case of xanthogranulomatous pyelonephritis in a child

We report an additional case of histopathologically confirmed xanthogranulomatous pyelonephritis in a 9-year-old boy. He was admitted to hospital with a two-day history of sustained fever. Physical examination revealed tenderness in the right upper quadrant of the abdomen. Results of a complete blood count and serum biochemical investigations showed slight anemia and positive C reactive protein. Culture of urine failed to grow any bacteria. Excretory urography revealed deformity of the right renal calyces. Computed tomography showed a focal area of low density in the right kidney. Nephrectomy was carried out as fever had been sustained despite intensive treatment with antibiotics. Sectioning revealed that the renal parenchyma had been replaced by a butter yellow nodule, which was histopathologically confirmed as xanthogranulomatous pyelonephritis. This is the nineteenth reported case in children in Japan to our knowledge.

[A case report of miliary tuberculosis with tubercular meningitis diagnosed and followed by polymerase chain reaction method]

We report here a case of miliary tuberculosis with tubercular meningitis in which the polymerase chain reaction (PCR) amplification method was useful for its rapid diagnosis and follow up. A 70 year old male was hospitalized for further examination and treatment of diffuse small nodular shadows on the chest X-ray. After receiving antimicrobial therapy shadows still remained and he gradually lost visual acuity. He had no meningeal signs, and no remarkable finding on cranial CT. Cerebrospinal fluid examination showed increased cell number with predominantly lymphocytes. Cranial MRI (Gd DTPA) showed lateral ventricular ependymitis. Pulmonary tuberculosis and secondary tubercular meningitis were suspected, but we failed to detect microorganisms from the cerebrospinal fluid, gastric juice, sputum, and urine by the conventional method. However, by the polymerase chain reaction amplification method specific DNA fragments of Mycobacterium tuberculosis complex was detected from the cerebrospinal fluid, gastric juice, bronchoalveolar lavage fluid and serum. The final diagnosis of miliary tuberculosis with tubercular meningitis was established. We administered antitubercular drugs and observed the clinical course. He recovered and the polymerase chain reaction showed negative consequences in all samples. The judgement of PCR and the clinical course were compatible and parallel with the clinical course.

[Quantitative evaluation of gene expression of IL-1 beta and IL-1 receptor antagonist (IL-1ra) from alveolar macrophages in idiopathic pulmonary fibrosis (IPF) and sarcoidosis]

Our previous studies demonstrated the concomitant release of IL-1 and IL-1ra in the culture supernatants of alveolar macrophages in both healthy subjects and patients with interstitial lung diseases. IL-1ra was decreased in healthy smokers (HS), IPF, and sarcoidosis, compared to healthy nonsmokers (HNS), although an increase in IL-1 release could not be detected. In this study, we examined whether such findings could be found at the gene level, or reflect posttranscriptional regulation in patients with IPF (n = 8), sarcoidosis (n = 7), healthy smokers (n = 6) and healthy nonsmokers (n = 5). The expression of IL-1 beta, IL-1ra and a house keeping gene (glucose 6 phosphate dehydrogenase: G6PD) was investigated using reverse transcription polymerase chain reaction (RT-PCR). After RT-PCR, analysis and quantification of PCR products were performed by high-performance liquid chromatography. We used 26 cycle for IL-1 beta and IL-ra mRNA and 29 for G6PD, because amplification of mRNA was in the exponential phase on that cycles, respectively. The results were expressed as the ratio of each mRNA to G6PD mRNA. IL-1ra/G6PD ratio in patients with IPF and sarcoidosis, was lower than that in HNS. On the other hand, IL-1 beta/G6PD ratio was similar in all groups. IL-1ra/IL-1 beta ratio was decreased in patients with IPF and sarcoidosis, compared to HNS. These results suggest that decreased expression of IL-1ra gene may contribute to the development of chronic low grade inflammation of the lung.

Effects of food, ceruletide and ranitidine on the pharmacokinetics of the oral cephalosporin S-1108 in humans

The pharmacokinetics of S-1108, an ester-type oral cephalosporin antibiotic, were studied in healthy male volunteers in a crossover study. This study focused especially on the effects on S-1108 absorption of (1) a meal, (2) concomitant administration of ceruletide diethylamine (a drug which promotes the secretion of bile) in the fasting state, and (3) concomitant administration of ranitidine hydrochloride (a drug which adjusts the acidity of the gastric juice) in the fasting state. The results show that the absorption of S-1108 after oral administration may be affected by factors such as food and ranitidine hydrochloride.

[Study of Legionella pneumophila detection by two step polymerase chain reaction]

We studied the usefulness of two sets of primers in macrophage infectivity potentiator gene sequence of Legionella pneumophila. PCR by 1st step primers produced 649 bp DNA bands and 2nd step primers 489 bp DNA bands. Two step PCR by these primers produced 489 bp DNA bands specific for L. pneumophila. Two step PCR detected 10 fg of pure DNA extracted from L. pneumophila, Philadelphia-1 strain. PCR sensitivity by these primers was superior to former primers reported by us using intratracheal aspirates collected from the patient with L. pneumophila serogroup 2 pneumonia.

[Detection of HPV infection in CIN and invasive cancers by in situ hybridization method--comparison with histopathology]

The causal association of human papilloma virus (HPV) with cervical cancer has been supported by multiple lines of evidence. Therefore, in the case of dysplasia, the presence of HPV-DNA should be detected and its subtypes identified. This is important in the determination of the prognosis for cervical disease. We reported a study in which the localization and types of HPV in cervical diseases was identified by in situ hybridization using biotin-labelled DNA probes. Seven types (3 basic forms) of HPV were used as DNA probes. HPV types used were following: 6/11, 16/18, 31/33/35. In this study, we introduced 7 new types (3 forms) of probes for a total of 14 types (6 forms). The new probes introduced were 42/43/45, 45/56, 51/52. Using these probes, the rate of detection HPV according to types was examined. In addition, localization of HPV infection and its relationship with histopathological findings of cervical disease were evaluated. 1) Types 6/11 and 45/56 were found in the lesions with less important histological findings (CIN I). Types 16/18, 31/33/35, 51/52 were found in the all lesions. Type 42/43/44 were not detected in this study. 2) The addition of 7 new types (3 new forms) of probes resulted in a 17% increase (16 cases) in the rate of detection of HPV compared to our previous study. 3) Localization and distribution pattern of the HPV is not, as has been reported so far, dependent on HPV type but rather on the histological characteristics, such as the degree of dysplasia.

[An animal model of Pneumocystis carinii pneumonia and therapeutic efficacy of interferon-gamma in this model]

To evaluate the efficacy of drugs for treatment, we tried to make an animal model of Pneumocystis carinii (P. carinii) pneumonia. Specific pathogen free (SPF) rats immunosuppressed with corticosteroid were intratracheally inoculated with P. carinii. Six weeks after the inoculation, the lung sections of infected rat lung showed increased numbers of P. carinii in the alveoli and thickening of alveolar septa with mononuclear cell infiltration. From 7 to 9 weeks after inoculation, the intensity of infection became more severe, and some rats died at this period. Then, to evaluate drug efficacy in this model, we finished the drug therapy by the 6th week and used the number of P. carinii in the lung and the inflammation score as an indicator of drug efficacy. In this P. carinii pneumonia animal model, both sulfamethoxazole-trimethoprim clinically established anti P. carinii drug and interferon-gamma which is one of the lymphokines mainly produced by T lymphocytes indicated therapeutic and synergistic efficacy against P. carinii pneumonia.

Sequence variation, differential expression and chromosomal location of rice chitinase genes

Rice chitinases are encoded by a small multigene family. To clarify the overall organization of rice chitinase genes, we have isolated and characterized the genes Cht-1, Cht-2 and Cht-3. Although all the three genes encode class I chitinase, the nucleotide sequences of the coding regions of Cht-1 and Cht-3 are very similar (90%), while that of Cht-2 is clearly more divergent (78%). Only Cht-2 has a 130 bp intron and encodes a C-terminal peptide sequence similar to that known to function as a vacuolar targeting signal. In 5' flanking regions of Cht-1 and Cht-3, but not of Cht-2, conserved sequences (GGCCGGCYGCCCYAG) were found. Related sequences were found also in the 5' flanking regions of another chitinase gene and a beta-glucanase gene which has also been reported to be stress-induced in rice. RNA blot hybridization analysis demonstrated that the stress-induced expression patterns of the Cht-1 and Cht-3 genes are similar, but quite different from that of Cht-2. However, all three genes are active in unstressed roots. By restriction fragment length polymorphism (RFLP) linkage analysis, Cht-1 and Cht-3 were mapped onto chromosome 6 and shown to be closely linked (0.8 cM). Cht-2 was mapped onto chromosome 5. All these features suggest that the expression patterns of rice class I chitinase genes may be correlated with their levels of sequence divergence and their chromosomal location.

Expression of a rice homeobox gene causes altered morphology of transgenic plants

We have isolated a cDNA clone encoding a homeobox sequence from rice. DNA sequence analysis of this clone, which was designated as Oryza sativa homeobox 1 (OSH1), and a genomic clone encoding the OSH1 sequence have shown that the OSH1 gene consists of five exons and encodes a polypeptide of 361 amino acid residues. Restriction fragment length polymorphism analysis has shown that OSH1 is a single-copy gene located near the phytochrome gene on chromosome 3. Introduction of the cloned OSH1 gene into rice resulted in altered leaf morphology, which was similar to that of the maize morphological mutant Knotted-1 (Kn1), indicating that OSH1 is a rice gene homologous to the maize Kn1 gene. RNA gel blot analysis has shown that the gene is primarily expressed in the shoot apices of young rice seedlings. This finding is supported by results of transformation experiments in which the 5' flanking region of the gene directed expression of a reporter gene in the shoot apex, particularly in stipules, of transgenic Arabidopsis. To elucidate the biological function of the OSH1 gene product, the coding region was introduced into Arabidopsis under the control of the cauliflower mosaic virus 35S promoter. Almost all transformants showed abnormal morphology. The typical phenotype was the formation of clumps of abundant vegetative and reproductive shoot apices containing meristems and leaf primordia, which did not form elongated shoots. Some transformants with a less severe phenotype formed elongated shoots but had abnormally shaped leaves and flowers with stunted sepals, petals, and stamens. The abnormal phenotypes were inherited, and the level of expression of the introduced OSH1 correlates with the severity of the phenotype. These findings indicate that the abnormal morphologies of the transgenic plants are caused by the expression of the OSH1 gene product and, therefore, that OSH1 is related to the plant development process.

[Differential detection of IL-1 beta and TNF-alpha mRNA on lung macrophages from patients with pulmonary sarcoidosis]

In pulmonary sarcoidosis or experimental granuloma formation, interleukin-1 beta (IL-1 beta) or tumor necrosis factor alpha (TNF-alpha) are considered to play important roles during inflammatory evolution. In order to examine whether IL-1 beta or TNF-alpha mRNA expression on lung macrophages relates to the disease activity or clinical course, ten cases with pulmonary sarcoidosis were divided into two groups: five cases who had a disease duration of more than 10 years (14.6 +/- 4.4 years; group A), and 5 cases with duration of less than 3 years (1.7 +/- 1.1 years; group B). All cases showed both abnormal radiographs and elevated serum angiotensin converting enzyme activities. We compared the 10 cases with 12 healthy individuals as normal control (6 nonsmokers: NS and 6 current smokers: S), and 5 cases with idiopathic pulmonary fibrosis (IPF) as disease control. Lavage macrophages were purified by rosette forming method and plastic adhesion was then performed for 1 hour. Thereafter mRNA was extracted by AGPC method and amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) (20 cycles). The results showed that IL-1 beta mRNA was detected in all materials studied, but TNF-alpha mRNA expression was different among the groups: 5/5 (100%) in group A, 1/5 (25%) in group B, 5/5 (100%) in IPF, and 12/12 (100%) in normal controls. The absence of detection of TNF-alpha mRNA (rapid down regulation) in pulmonary sarcoidosis may relate to spontaneous regression, because a substantial number of cases in group B showed spontaneous regression in their natural course.(ABSTRACT TRUNCATED AT 250 WORDS)

Thoracoscopic stapled bullectomy supported by suturing

In 1985, a thoracoscopic technique for closing bullae with hemostatic clips was developed. However, the method was limited, and therefore clinical application was small. A linear endoscopic stapler (Endo-GIA) was developed in 1990. The advent of the Endo-GIA nearly made thoracoscopic treatment of spontaneous pneumothorax practicable, and ended the use of clipping. In addition, a new operative technique was developed, the 3-cm minithoracotomy bullectomy for the treatment of spontaneous pneumothorax. This technique has now become obsolete. The current method is that of a thoracoscopic stapled bullectomy using the Endo-GIA, supported by suturing. The recurrence rate was 2.7% (1/37) using this method. The one recurrence occurred in a case where no bullae were observed during the operation. Our findings suggest that thoracoscopic stapled bullectomy supported by suturing is a practicable treatment of spontaneous pneumothorax. An economical use of the endoscopic stapler and complementary suturing may be less expensive than using a laser. Pleurodesis should be performed in the patients in whom no distinct bullae are discovered thoracoscopically.

Immunohistochemical detection of proliferating cell nuclear antigen in hepatocellular carcinoma: relationship to histological grade

Proliferating cell nuclear antigen (PCNA), also known as cyclin, is an auxiliary protein of DNA polymerase-delta and is found only in the nuclei of proliferating cells in the late G1 and S phases. The proliferation of hepatocellular carcinoma (HCC) by immunohistochemical staining for PCNA using paraffin sections of 20 surgically resected HCC specimens was analysed. The mean percentage of PCNA-positive nuclei in the HCC tissue was 10.3% in grade I of Edmondson and Steiner's classification, 25.5% in grade II, 28.4% in grade III and 41.5% in grade IV. In early HCC, we observed only a few PCNA-positive tumour cells. However, PCNA-positive nuclei were numerous in the tumour thrombi found in portal vein branches, in regions of extracapsular tumour growth, and in the inner nodules of tumours with a nodule-in-nodule formation. Proliferating cell nuclear antigen positivity was correlated with an increase of the nucleocytoplasmic ratio of tumour cells as determined by image analysis. Our findings showed that PCNA positivity was correlated with the histological grade and invasiveness of HCC, suggesting that this antigen may be used as an indicator to predict tumour invasion in patients with HCC.

Hepatitis C virus antibody in patients with primary liver cancer (hepatocellular carcinoma, cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma) in Japan

BACKGROUND

In hepatocellular carcinoma (HCC), a high prevalence of hepatitis C virus antibody (anti-HCV) has been reported, indicating that it may be an important etiologic factor in the pathogenesis of HCC. In this study, the authors investigated the prevalence of anti-HCV in HCC patients, as well as the same prevalence in patients with cholangiocarcinoma (CC) and combined hepatocellular-cholangiocarcinoma (combined HCC-CC), to study the clinicopathologic features of anti-HCV-positive cases.

METHODS

The authors examined 141 patients with primary liver cancer who were pathologically diagnosed as having HCC (121 cases), CC (13 cases), or combined HCC-CC (7 cases). Hepatitis B surface antigen (HBsAg) and anti-HCV were measured in these patients.

RESULTS

Of 121 HCC cases, 85 (70.3%) were found to be anti-HCV positive, 16 (13.2%) were HBsAg positive, and 5 (4.1%) were both anti-HCV and HBsAg positive. In 13 cases with CC and in 7 with combined HCC-CC examined, 4 (30.8%) and 5 (71.4%), respectively, were anti-HCV positive.

CONCLUSIONS

The anti-HCV-positive rate was high in combined HCC-CC as well as in HCC. These three types of primary liver cancer, which were anti-HCV positive, shared two common features: male dominance and high incidences of complication with liver cirrhosis.

A cardiac clathrin assembly protein forms a potassium channel in planar lipid bilayers

A novel clathrin assembly protein (designated cardiac AP-3) has been isolated from dog heart which forms a K+ channel in planar lipid bilayers. AP-3 facilitated the in vitro formation of clathrin cages, which is diagnostic for clathrin assembly proteins. AP-3 consists mainly of 100-, 97-, and 55-kDa bands. A GTP-binding protein of approximately 25 kDa also co-purifies. The 100-kDa band was recognized by a monoclonal antibody to the gamma-adaptin of bovine brain clathrin assembly protein AP-1. A polyclonal antibody to the approximately 100-kDa doublet (alpha- and beta-adaptins) of bovine brain AP-2 did not cross-react with the purified protein. Western blot analysis of cardiac subcellular fractions showed that anti-AP-1 immunoreactivity was strongest in a sarcolemma-enriched fraction. Little immunoreactivity was detected in other cardiac subfractions, including sarcoplasmic reticulum, intercalated discs, and mitochondria. When reconstituted into planar lipid bilayers, AP-3 displays ion channel activity. Permeability ratios were PK/PCl approximately 16 and PK/PNa approximately 3, indicating a cation-selective channel somewhat selective for K+ versus Na+. The K+ channel displays several subconductance states (9 and 12 picosiemens in the main) and was blocked by CaCl2 (mM), inositol 1,3,4,5-tetrakisphosphate (20 microM), inositol 1,4,5-trisphosphate) (40 microM), and guanosine 5'-O-(3-thiotrisphosphate) (mM). Thus, the cardiac AP-3 appears to act as a K+ channel modulated by inositol polyphosphates and a small GTP-binding protein.

[Treatment of severe pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) and Candida krusei with granulocyte colony-stimulating factor (G-CSF): a case report]

A 24-year-old male with chronic renal failure on Continuous Ambulatory Peritoneal Dialysis (CAPD) complained of cough and dyspnea. Chest X-ray film showed a pneumonia shadow and MRSA and Candida krusei were detected in the sputum. Pneumonia improved with vancomycin and fluconazole. Treatment with methylprednisolone was needed for retinodialysis. After this treatment, pneumonia deteriorated. Pneumonia did not improve with vancomycin and anti-fungal agents. This severe pneumonia was improved with a combination therapy of vancomycin, miconazole and G-CSF. A combination therapy of antibiotics and G-CSF is considered to be effective for severe pneumonia.

Synthesis and anthelmintic activity of 13-alkoxymilbemycin derivatives

The synthesis of milbemycin derivatives having alkyloxy groups at the C-13 position was studied and a series of these analogs of milbemycin A4 and A3 was prepared by the reaction of 13-iodomilbemycin with a variety of alcohols. 13 beta-Phenethyloxy derivatives were found to possess excellent anthelmintic activity. Especially, the activities of derivatives with N-substituted 4-aminophenethyloxy groups were comparable to or superior to ivermectin against Nippostrongylus brasiliensis in rats.

Protective immune response of Isospora felis-infected mice against Babesia microti infection

Protective response against Babesia microti was studied in Isospora felis-infected mice. Isospora felis-infected mice which were exposed to B. microti on the 28th day post-infection showed absolute resistance against Babesia microti. Interestingly, these mice showed no anti-B. microti antibodies. Mice that received spleen cells from I. felis-infected donors that were subsequently exposed to B. microti showed lower peak parasitemia (10.3% +/- 2.6) compared to those mice that received normal spleen cells (60.9% +/- 15.0), and no spleen cells at all (47.3% +/- 8.5). Treatment of I. felis-infected mice with monoclonal antibodies against L3T4+ cells resulted to a depression of their resistance to B. microti, as clearly manifested by high levels of parasitemia. Findings of the present study demonstrate the role of cell mediated immunity, specifically by L3T4+ T-cells induced by I. felis infection, in providing mice protection against B. microti.

Hepatitis C virus antibody in patients with primary liver cancer (hepatocellular carcinoma, cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma) in Japan

BACKGROUND

In hepatocellular carcinoma (HCC), a high prevalence of hepatitis C virus antibody (anti-HCV) has been reported, indicating that it may be an important etiologic factor in the pathogenesis of HCC. In this study, the authors investigated the prevalence of anti-HCV in HCC patients, as well as the same prevalence in patients with cholangiocarcinoma (CC) and combined hepatocellular-cholangiocarcinoma (combined HCC-CC), to study the clinicopathologic features of anti-HCV-positive cases.

METHODS

The authors examined 141 patients with primary liver cancer who were pathologically diagnosed as having HCC (121 cases), CC (13 cases), or combined HCC-CC (7 cases). Hepatitis B surface antigen (HBsAg) and anti-HCV were measured in these patients.

RESULTS

Of 121 HCC cases, 85 (70.3%) were found to be anti-HCV positive, 16 (13.2%) were HBsAg positive, and 5 (4.1%) were both anti-HCV and HBsAg positive. In 13 cases with CC and in 7 with combined HCC-CC examined, 4 (30.8%) and 5 (71.4%), respectively, were anti-HCV positive.

CONCLUSIONS

The anti-HCV-positive rate was high in combined HCC-CC as well as in HCC. These three types of primary liver cancer, which were anti-HCV positive, shared two common features: male dominance and high incidences of complication with liver cirrhosis.