Detection of Mycobacterium tuberculosis in clinical specimens by polymerase chain reaction method

An insertion sequence repeated multiple times in the chromosome of Mycobacterium tuberculosis was used as a target for amplification using the polymerase chain reaction (PCR) assay for detecting Mycobacterium tuberculosis in clinical specimens. The sequences of primers were 5'-CCTGCGAGCGTAGGCGTCGG-3' (primer 1) and 5'-CTCGTCCAGCGCCGCTTCGG-3' (primer 2). One cycle of amplification consisted of denaturing at 94 degrees C for 2 min, primer annealing at 68 degrees C for 2 min, and extension at 72 degrees C for 2 min. DNA (5 fg) extracted from M. tuberculosis was detected by gel electrophoresis and Southern blot hybridization after 40 cycles of amplification. The amplification products were not obtained by DNA extracted from M. kansasii, M. intracellulare, M. avium, M. fortuitum, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Legionella pneumophila and Staphylococcus aureus; only from the M. tuberculosis complex. PCR results were compared with conventional cultural, pathological and microscopic findings in the detection of M. tuberculosis in 112 clinical specimens. There were 25 specimens that were positive for M. tuberculosis by cultural or pathological examination, of which 20 (80%) were positive by PCR. PCR detected the organism in 5 (83%) of 6 smear-positive specimens and 15 (79%) of 19 smear-negative specimens in which culture or pathology revealed M. tuberculosis. In addition, 2 smear-negative specimens and 8 smear-negative and culture-negative specimens were positive by PCR. These 10 samples were collected from the patients suspected as having tuberculosis by the clinical diagnosis based on the clinical history, characteristic radiographs, a positive PPD skin test and the effectiveness of anti-tuberculous drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

Lobectomy for traumatic pulmonary pseudocysts with disseminated intravascular coagulation: case report

A 10-year-old boy was injured in a traffic accident, and computed tomography revealed cavitary pulmonary lesions in the left lower lobe. Although there was no evidence of bacterial infection, thrombocytopenia due to disseminated intravascular coagulation progressed. We performed a left lower lobectomy, and the patient improved rapidly.

Effects of alcohols on the hydrolysis of colominic acid catalyzed by Streptococcus neuraminidase

Regulation of the activity of neuraminidase of Streptococcus sp. (group K) was evaluated by examining the effects of alcohols on the hydrolysis of colominic acids catalyzed by the neuraminidase. Two kinds of alcohol binding site, activation and inhibition sites, were proposed to exist. Competitive inhibition was observed with alcohols smaller than polyethylene glycol #300 (average molecular weight: 300), so the inhibition site is considered to be the substrate binding site, the size of which was estimated to be 10 A in diameter. On the contrary, polyethylene glycols larger than this size activated the enzyme by 1.5-1.8 times. The activity could be raised by binding of the polyethylene glycols to the activation site. This activation was shown to be due solely to the decrease in the Michaelis constant, Km. The smaller polyethylene glycols (#200 and #300) were also considered to bind to the activation site, although activation was not clearly observed due to compensation with inhibition. Strong substrate inhibition by colominic acid was also observed. The activity of Streptococcus neuraminidase was shown to be regulated intricately by the substrate colominic acid and alcohols contained in the reaction medium.

Concurrent radiotherapy and chemotherapy with protracted continuous infusion of 5-fluorouracil in inoperable esophageal squamous cell carcinoma

PURPOSE

The feasibility of a concurrent chemoradiotherapeutic protocol for patients with inoperable esophageal squamous cell carcinoma was tested.

METHODS AND MATERIALS

Concurrent chemoradiotherapy using protracted low-dose continuous infusions of five-fluorouracil (5-FU; 250-300 mg/m2/24 h) and standard external beam irradiation was given to 28 patients with inoperable esophageal squamous cell carcinoma between November 1991 and June 1993.

RESULTS

For 25 patients receiving a total dose of > or = 60 Gy and concurrent 5-FU infusion for more than 5 weeks, the complete response rate was 52%. Local progression-free rate in this chemoradiotherapy group was significantly higher than the historical controls treated by radiotherapy alone (p < 0.05). A multivariate analysis revealed the treatment scheme (concomitant chemoradiotherapy vs. radiotherapy alone) to be a significant factor in local control (p < 0.01). Swallowing pain (39%), anorexia (39%), and nausea (32%) were the most frequent early reactions. Serious late radiation complications have not been observed.

CONCLUSION

The concurrent chemoradiotherapy using protracted low-dose continuous infusion of 5-FU and standard radiotherapy is an effective and safe method to obtain a local control in inoperable esophageal squamous cell carcinoma.

[HPV infection of the uterine cervix by cytodiagnosis, histodiagnosis and dot blot hybridization method]

Human papilloma virus (HPV) infection is diagnosed by morphological methods (including cytodiagnosis, histodiagnosis and electron microscopy) and DNA diagnostic methods. One of the DNA diagnostic methods, Dot blot hybridization (DBH), is generally regarded to be superior to the morphological methods in terms of specificity and sensitivity. There have recently been reports showing that such morphological methods as cytodiagnosis [for koilocytotic atypia (KC) or koilocytosis] and histodiagnosis are best for HPV detection in laboratories because they have better sensitivity, and are cheaper, and procedurally simpler than the DBH method. We compared detection rates by morphological methods (cytodiagnosis and histodiagnosis) and the DBH method. (Materials and Methods) The subjects were 377 patients who came to the Department of Obstetrics and Gynecology of Juntendo University Urayasu Hospital and had abnormal findings in the uterine cervix by cytodiagnosis of colposcopy. Uterine cervix swabs were scraped during colposcopic examination, and specimens for Papanicolaou and Giemsa staining were prepared on 2 slides. Scraping was again performed for the DBH (Vira pap. and type, Toray Industries, Inc.) method using swabs specified for the kit, and cells were obtained in a collection kit. At the same time, at least 3 sites including, possible atypical conversion zones, were biopsied, followed by paraffin embedding and hematoxylin-eosin staining of the specimens. (Results) 1) Comparison of detection rates by cytodiagnosis and the DBH method The positive rates by the DBH method were determined according to cytodiagnostic category in 377 patients. HPV-DNA was detected in every category and in 86 (22.8%) of all of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Possible involvement of smoking in the development of asthma-like conditions in patients with chronic obstructive pulmonary disease]

Indicies of asthma were measured in smokers with chronic bronchitis (CB) + pulmonary emphysema (PE), smokers with CB only, and non-smokers with CB, to examine whether smoking is involved in the development of asthma-like condition in patients with chronic obstructive pulmonary disease (COPD). Airway hypersensitivity was measured with an Astrograph method, and the reversibility of airway obstruction was measured as improvement in FEV1.0 and as percent change in FEV1.0 after inhalation of a beta-agonist. Both hypersensitivity and reversibility were significantly higher in smokers with CB+PE and in smokers with CB only than in non-smokers with CB. The number of eosinophils in sputum, but not in peripheral blood, was slightly higher in the smokers than in the non-smokers. The serum levels of IgE were significantly higher in the smokers than in the non-smokers. No significant difference in the rate of positive skin tests for common allergens was observed among the three groups, but the rate of positive tests for Broncasma Berna was very high in the smokers, and all such tests were negative in the non-smokers. These results indicate that among patients with COPD an asthmatic component is more frequently found in smokers than in non-smokers, and suggest that smoking plays some part in the development of asthma-like condition in these diseases.

[Foveal cone densitometer and changes in foveal cone pigments with aging]

A foveal cone densitometer was built for measuring the kinetics of foveal cone pigments in human eyes. The light from a 500-W xenon lamp was divided into reference, measuring, and bleaching beams, and projected through an optical fiber leading to a modified fundus camera. After the light was projected into the ocular fundus, the reflected light (central 1 degree) was measured by a photomultiplier and the regeneration time and the two-way density were abstracted from the records. The two-way density, which is the decadic logarithm of the measuring-reference beam ratio under bleached conditions divided by the measuring-reference beam ratio under dark conditions, eliminated the artifacts caused by eye movement of blink. Reliable curves were obtained in 45 eyes out of 53 healthy Japanese subjects (age range, 9 to 82 years). The mean +/- standard deviation SD of the two-way density (log) and the time constant (sec) were 0.34 +/- 0.09 and 139.9 +/- 79.3, respectively. The time constant significantly increased with aging.

T cell-dependent activation of macrophages and enhancement of their phagocytic activity in the lungs of mice inoculated with heat-killed Cryptococcus neoformans: involvement of IFN-gamma and its protective effect against cryptococcal infection

Previous investigations have demonstrated that macrophages play a critical role in the first-line cellular defense mechanism against infection with Cryptococcus neoformans. In the present study, to elucidate the way in which anticryptococcal activity of macrophages is regulated at the site of infection, pulmonary intraparenchymal macrophages were directly analyzed for expression of their surface molecules and their phagocytic activities against the organism, and the effects of depletion of T cells and endogenous IFN-gamma in vivo on these parameters were examined. In the lungs of mice intratracheally inoculated with heat-killed C. neoformans, macrophages were activated, as indicated by augmented expression of MHC class II, intercellular adhesion molecule-1 (ICAM-1) and Fc receptor (FcR), and about two-thirds of macrophages were found to have ingested an average of 3.77 +/- 0.12 yeast cells per macrophage. In mice depleted of both CD4+ and CD8+ T cells by injecting the specific monoclonal antibodies (mAbs) or anti-IFN-gamma mAb, not only augmentation of the expression of macrophage activation markers but also phagocytosis of C. neoformans was significantly reduced. These results suggest that anticryptococcal activity of macrophages is regulated by IFN-gamma endogenously produced by T cells. Additionally, treatment with IFN-gamma were shown to significantly prolong the survival time of mice infected with viable C. neoformans. Additionally, preimmunization with heat-killed C. neoformans significantly prolonged the survival time of mice which received the following infection.

Video-assisted right lower lobectomy for a lung cancer with mini-thoracotomy

We report a case of T1N0M0 lung cancer in which we successfully performed video-assisted right lower lobectomy and mediastinal lymph node dissection. The lobectomy was done on a 64-year-old woman who had a 2-cm adenocarcinoma in the right lower lobe. The procedure could be done safely and adequately using three trocars and a 5-cm mini-thoracotomy. The patient had an uncomplicated postoperative course and was satisfied with minimal postoperative pain, quick recovery, and minute skin scars. Video-assisted lobectomy may be a reasonable approach in selected patients of primary lung carcinoma.

[Investigation on change of acquired antibodies in responders against hepatitis B vaccine]

Changes of titers of acquired hepatitis B surface (HBs) antibodies against HB vaccine were investigated by measuring them again after a long lapse of time. Ten micrograms of the recombinant HB vaccine was intramuscularly injected respectively to the staff of the authors' hospital three times. Four weeks after a full course of the vaccination 185 persons could acquire antibodies, whose titers were 2.0 or more in cut off index (C.I.) by radioimmunoassay (RIA). Of these members titers of antibodies of 48 subjects could be remeasured for the first time 38 months after the measurement of the titers in the 4th week after a full course of the vaccination. Four weeks after the last vaccination 7 persons were high responders whose titers of antibodies were 50 or more in C.I. 29 were medium responders with their titers from 49 to 10, and 12 were low responders having titers of less than 10. However, 38 months after the course the titers of those responders decreased so much that nobody remained highly responders, 22 were low responders, and the remaining 22 turned to be negative again with titers less than 2.0. Supposing that the titer of antibody enough to protect the infection of HB virus is 10 or more in C.I., 32 of 36 persons needed booster shots 38 months later because their titers dwindled down to less than 10.(ABSTRACT TRUNCATED AT 250 WORDS)

Transcutaneous blood glucose monitoring system based on an ISFET glucose sensor and studies on diabetic patients

A transcutaneous blood glucose monitoring system consists of an ion-sensitive field-effect transistor (ISFET) glucose sensor unit and a suction effusion fluid (SEF) collecting unit. The SEF is directly collected by a weak suction (400 mmHg absolute pressure) through the skin from which the corneum layer of the epidermis has been previously removed. An ISFET glucose sensor unit is able to measure glucose concentrations in a microliter order sampling volume. The system was applied to three diabetic patients during a 75 g oral glucose tolerance test for monitoring blood glucose levels. During the experiments, glucose changes in the SEF followed actual blood glucose levels with 10 min delays. Results suggest the feasibility of utilizing quasi-continuous, transcutaneous blood glucose monitoring for individual patients with various diabetic histories or diabetic complications.

Interferon-gamma (IFN-gamma) production by human T lymphocytes upon Legionella pneumophila stimulation in vitro

In vitro immune responses to Legionella pneumophila were investigated. When human peripheral blood lymphocytes (PBL) from healthy volunteers were stimulated with formalin-killed L. pneumophila for 7 days in vitro, strong proliferative responses were observed. The responding cells were shown to be a CD4 T cell subset. It was also found that the CD4 T cells secreted significant amounts of IFN-gamma into the PBL culture supernatant. The production of IFN-gamma and IL-4 by PBL was measured semiquantitatively by reverse transcriptase-assisted polymerase chain reaction (RT-PCR) methods. Formalin-killed or live L. pneumophila-stimulated PBL expressed the mRNA for IFN-gamma but not the mRNA for IL-4. The results suggest that the whole bacterium, as opposed to the supernatant, predominantly stimulates Th1 type helper T cells. The cloned T cells specific for L. pneumophila expressed the mRNA for IFN-gamma but not for IL-4. In contrast to formalin-killed or live L. pneumophila stimulation, when PBL were stimulated with the bacterial culture supernatant, the proliferating T cells produced the mRNA for IL-4 as well as for IFN-gamma. A significant correlation between the proliferative response to formalin-killed L. pneumophila and IFN-gamma release in culture was observed (r = 0.6932, P < 0.001) in PBL from 30 healthy volunteers. From these in vitro studies, it is suggested that the whole L. pneumophila bacterium and their soluble antigens stimulate T cells in a manner which results in a different pattern of cytokine production.

Effect of RANTES on eosinophil adhesion to plates coated with recombinant soluble intercellular adhesion molecule-1 and expression of beta 2-integrin adhesion molecules on eosinophils

RANTES, a member of the 8-kDa cytokine family, has been shown to possess chemotactic activity for eosinophils. In this study, RANTES augmented isolated human eosinophil adhesion to plates coated with recombinant soluble intercellular adhesion molecule 1. In addition, RANTES did not augment the expression of beta 2-integrin adhesion molecules (lymphocyte function associated antigen-1 alpha (LFA-1 alpha), LFA-1 beta, complement receptor type 3 (CR3)) on human eosinophils. These findings suggest that RANTES not only modulates the chemotactic activity of eosinophils but also intensifies the function of eosinophil adhesion without augmenting the expression of beta 2-integrin adhesion molecules.

Maintaining low concentrations of plasma beta 2-microglobulin through continuous slow haemofiltration

As a first step in the development of a future wearable artificial kidney, we conducted three forms of treatment with continuous haemofiltration (CHF) on a group of 10 patients in an attempt to determine what plasma values of small molecules and beta 2-microglobulin (beta 2-M) could be maintained. In the first system, one ordinary 4-h haemodialysis, followed by 7-day CHF with 51 exchange per day, was repeated. The second system consisted of CHF with 51 exchange/day and thrice weekly slow nocturnal dialysis. The third system used CHF with 101 exchange per day. The first, second and third systems were used with three, four and four patients, respectively, for at least 4 weeks each. PAN-DX and FH-66 haemofilters were used eight and three times, respectively, with continuous infusion of heparin at 500-700 units/h. In the first system, the pre-CHF plasma beta 2-M was 45.5 +/- 3.1 mg/l, against a much lower 18.8 +/- 1.0 mg/l 4 weeks later. With the second system, this decrease was from 43.5 +/- 5.7 mg/l to 18.1 +/- 1.1 mg/l with 4 weeks treatment, and from 44.7 +/- 3.4 mg/l to 18.1 +/- 1.4 mg/l with 3 weeks treatment. Pre-haemodialysis treatment levels of urea nitrogen, plasma creatinine and uric acid in the first system were greater than ordinary pre-haemodialysis levels. On the second system, these were kept at -54 +/- 8.3%, -52.2 +/- 6.7% and -47.6 +/- 4.4% of the ordinary pre-haemodialysis levels, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of cellular response and gamma interferon synthesis in bronchoalveolar lavage fluid and lung homogenate of mice infected with Pneumocystis carinii

The cellular and cytokine responses in the lungs of mice infected with Pneumocystis carinii were examined on both lung homogenates and bronchoalveolar lavage (BAL) fluids. In the lungs of infected mice, the number of P. carinii cysts rapidly decreased by day 7, then started to increase with a peak on day 14, and thereafter decreased gradually. When the presence of P. carinii was examined at the DNA level by dot blot hybridization, a similar clearance curve was obtained, and the organisms were shown to be completely eliminated on day 28. In the late phase of infection, leukocytes, mainly lymphocytes, increased in number when analyzed on lung homogenates, while no significant increase of inflammatory cells was observed in BAL fluids. An accumulation of both CD4+ and CD8+ T cells and an increase of activated T cells expressing IL-2R alpha were observed in lung homogenates of the infected mice. In addition, a considerable amount of IFN-gamma was detected in lung homogenates, but not in BAL fluids. These data indicate that lung homogenates are more suitable than BAL fluids for the analysis of cellular and cytokine responses in the lungs of mice infected with P. carinii. To define the involvement of IFN-gamma in host defense against P. carinii, the effect of this cytokine on the killing activity of macrophages against P. carinii was examined in vitro. IFN-gamma was found to augment this activity by increasing nitric oxide synthesis of the macrophages. Thus, it is suggested that IFN-gamma plays an important role in the protection of mice from P. carinii infection.

[Identification of Legionella pneumophila strains by polymerase chain reaction method which isolated from cooling tower water]

We studied the polymerase chain reaction (PCR) method with 5 strains of Legionella pneumophila serogroup 4, 7 strains of L. pneumophila serogroup 5, 7 strains of L. pneumophila UT and 15 strains of Legionella like organisms (LLO). We used mip-primers reported by Mahbubani et al and LEG-primers reported by Starnbach et al. Positive PCR results were obtained by all strains of L. pneumophila serogroup 4, L. pneamophila serogroup 5, L. pneumophila UT and 11 strains of LLO using mip-primers. Using LEG-primers, positive results were obtained by 2, 6, 5 and 8 strains respectively. All strains that showed positive results using LEG-primer PCR, were contained by the strains that showed positive results using mip-primer PCR. Conversely, there were some strains that were positive in mip-primer PCR and negative in LEG-primer simultaneously. Therefore, mip-primers is recommended to detect L. pneumophila in clinical specimens by PCR method.

Relationship between multidrug resistant gene expression and multidrug resistant-reversing effect of MS-209 in various tumor cells

MS-209 is a novel quinoline compound which can overcome multidrug resistance (MDR) both in vitro and in vivo, while having a low level of side effects, and is now being evaluated in a clinical phase II study. Reverse transcription-polymerase chain reaction (RT-PCR) was used to quantitate the expression levels of MDR genes in various mouse and human tumor cell lines. The MDR gene and the beta actin gene, as the internal reference standard, were coamplified separately, and the relative expression of the MDR gene was represented by the MDR/beta actin ratio. The in vitro MDR-reversing effect of MS-209 was then compared with the MDR gene expression (MDR/beta actin ratio). We found a significant correlation between these two parameters. Moreover, a significant correlation was also observed between the level of expression of the MDR1 gene and that of P-glycoprotein in human cell lines. Therefore, the efficacy of MS-209 seems to specifically depend on the level of MDR gene expression (P-glycoprotein). From these observations, it is suggested that RT-PCR assays of MDR1 gene in tumor biopsy specimens might be an effective means to predict the response of tumor cells to combination therapy with MS-209.

Effect of RANTES on intracellular expression of EG2 antigen in eosinophils

RANTES, which is released from thrombin-stimulated platelets, is a member of the 8-kDa cytokine family that has been shown to possess chemotactic activity for eosinophils. The effect of RANTES on the intracellular expression of EG2 antigen in eosinophils was examined in this study. RANTES augmented the intracellular expression of EG2 antigen in eosinophils. These findings suggest that RANTES not only modulates the chemotactic activity of eosinophils but also intensifies the function of eosinophil activation.

Plasma sulpho-conjugated catecholamine dynamics up to 8 h after 60-min exercise at 50% and 70% maximal oxygen uptakes

The prolonged effects of steady-state exercise and meals on plasma sulpho-conjugated catecholamines (CA) after exercise were examined. Seven male subjects exercised on 2 separate days for 60 min at 50% and 70% of maximal oxygen uptake (VO2max) on a cycle ergometer and then rested, for 8 h sitting in an armchair. A control trial without any exercise was also performed. At 2 h after the end of exercise the subjects were given a meal. The plasma free and sulphated CA, oxygen uptake (VO2) and heart rate (HR) were all measured before exercise, during exercise and hourly during the 8-h recovery period. The sulphated noradrenaline (NA-S) and adrenaline (A-S) concentrations increased after exercise, and, furthermore, only the NA-S concentrations remained elevated for 6 h after exercise at 50% VO2max and for 8 h at 70% VO2max trial, compared with the control trial. There were no changes in either the plasma NA-S or A-S concentrations after consuming a meal, whereas the dopamine sulphate concentration demonstrated a dynamic change. A significantly higher excess postexercise VO2 was observed at 2 h postexercise at 50% VO2max and at 6 h postexercise at 70% VO2max trials. The mean HR was still elevated at 6 and 8 h after exercise, which closely correlated with the duration of the elevated NA-S concentrations. These results suggest that sulphated CA, especially NA-S, could represent an additional index of sympathetic nerve activity after exercise, and that a meal containing small amounts of the amines would seem to have no effect on plasma NA-S and A-S concentrations.

Optical implementation of a translation-invariant second-order neural network for multiple-pattern classification

A novel approach to the optical implementation of second-order neural networks that can recognize multiple patterns is reported. The systems issues, especially the accuracy required for the weighted interconnections, are discussed for numeric character (0-9) recognition. It is shown that the accuracy of the weighted interconnections has a far greater influence on the network performance during training than on classification. To lessen the problem, we introduce an adaptive learning rule, whereby the optical power is adjusted during training. Finally, numeric character recognition using an experimental system with a liquid-crystal display is demonstrated.