Ambulatory blood pressure of adults in Ohasama, Japan

We performed a cross-sectional study in a small town in northern Japan to evaluate the distribution, reference values, and daily variation in ambulatory blood pressure. A total of 705 subjects (229 men aged 61.3 +/- 13.4 years [mean +/- SD] and 476 women aged 57.5 +/- 13.3 years; 41.1% of the regional adult population, n = 1716), including those treated with antihypertensive drugs (n = 231, 66.5 +/- 9.5 years) as well as untreated subjects (n = 474, 55.0 +/- 13.5 years), participated in the study. Both ambulatory and screening blood pressures were measured in 659 subjects. Ambulatory blood pressure was measured with an automatic device (Colin ABPM-630). The 24-hour ambulatory blood pressure in the total population was 121.7 +/- 13.0/71.1 +/- 7.6 mm Hg (95th percentile value [95%] = 146/85 mm Hg). The corresponding value in the untreated subjects was 119.4 +/- 12.5/70.1 +/- 7.4 mm Hg (95% = 144/83 mm Hg). The 24-hour average ambulatory blood pressure was 118.0 +/- 11.1/69.4 +/- 6.8 mm Hg (95% = 139/81 mm Hg) in subjects identified as normotensive by their screening blood pressure (n = 448, 57.2 +/- 13.1 years) and 133.6 +/- 14.2/78.9 +/- 8.8 mm Hg in those identified as hypertensive by their screening blood pressure (n = 73, 63.1 +/- 10.6 years). Based on the mean+SD of the 24-hour ambulatory blood pressure in the normotensive subjects by their screening blood pressure (129/76 mm Hg), the 24-hour ambulatory blood pressures in 25 (34.2%) of these 73 hypertensive subjects by screening blood pressure were below this level. Nine (2%) of 448 normotensive subjects by screening blood pressure were above the mean+2 SDs (140/83 mm Hg) of the 24-hour ambulatory blood pressure in the normotensive group by screening blood pressure. Ambulatory and screening blood pressures increased with age. The age-dependent increase in ambulatory blood pressure was less apparent in men. The 24-hour average pulse rate decreased with age. The daily variation in ambulatory blood pressure (standard deviation) increased with age, whereas that of pulse rate decreased with age. Increases in blood pressure variation were observed in nighttime and daytime blood pressure values. The differences between day versus night ambulatory blood pressures decreased with age in men but not in women.(ABSTRACT TRUNCATED AT 400 WORDS)

Characteristics of a community-based distribution of home blood pressure in Ohasama in northern Japan

OBJECTIVE

To evaluate the distribution, reference values and day-to-day variation of blood pressure of untreated subjects measured at home.

DESIGN

Cross-sectional study of a cohort.

SETTING

General community in northern Japan.

SUBJECTS

Blood pressure was measured in 871 subjects (mean +/- SD age 46.0 +/- 19.5 years, range 7-98, constituting 38.7% of the local population of Uchikawama region, Ohasama) who were not receiving antihypertensive medication.

METHODS

Subjects measured their own blood pressure at home at least three times (mean +/- SD 19.7 +/- 8.4) each morning using a semi-automatic oscillometric blood pressure measuring device. Screening blood pressure was measured once.

MAIN OUTCOME MEASURES

Distribution of home blood pressure in the study population as a whole and with respect to age and sex, and the distribution of day-to-day variation of home blood pressure were determined.

RESULTS

Mean home blood pressure was 117.3 +/- 13.4/69.3 +/- 9.7 mmHg (95% confidence interval 116.4-118.2/68.7-70.0). The 95th centile value was 143/85 mmHg, mean+SD 131/79 mmHg and mean + 2SD 144/89 mmHg. Mean screening blood pressure was 126.2 +/- 18.9/72.1 +/- 11.7 mmHg (95th centile 159/92 mmHg). Age- and sex-specific 95th centile values as well as mean +/- SD were obtained. Mean+SD, mean + 2SD and the 95th centile values obtained as reference upper limits of home blood pressure from subjects identified as normotensive by screening blood pressure (n = 707) were 125/77, 137/86 and 134/83 mmHg, respectively. Home blood pressure increased gradually with increasing age in both men and women, although blood pressure was significantly higher in men until 50 years of age. Day-to-day variation of home systolic blood pressure also increased with age.

CONCLUSION

Since the distribution of home blood pressure values was affected by age and sex, age- and sex-matched reference values for home blood pressure should be established. Home blood pressure values in elderly subjects should be evaluated carefully, since these exhibit greater day-to-day variation.

Nitric oxide production from macrophages is regulated by arachidonic acid metabolites

In activated macrophages the inducible form of the enzyme nitric oxide (NO) synthase generates high amounts of the toxic mediator NO. After 20 h of treatment with LPS rat peritoneal macrophages release 12-16 nmol NO2-/10(5) cells which is detectable in the culture supernatant by the Griess reaction as a measure of NO formation. The addition of aminoguanidine (1 mM), a preferential inhibitor of the inducible NO-synthase, completely abolished NO2-accumulation. Incubation with indomethacin or acetyl-salicylic acid, preferential inhibitors of the cyclooxygenase pathway of the arachidonic acid metabolism, did not influence NO2- levels. Nordihydro-guaiaretic acid (50 microM), a preferential inhibitor of the lipoxygenase pathway, caused strong reduction of NO2- accumulation to 1.9 +/- 0.3 nmol/200 microliter. Simultaneous inhibition of cyclo- and lipoxygenase by BW755c resulted in an intermediate effect (7.3 +/- 1.1 nmol/200 microliter NO2-). These results show that the induction of NO production in activated macrophages is regulated by products of the lipoxygenase-pathway of the arachidonic acid metabolism.

Opioid peptide release evoked by noxious stimulation of the hind instep of rats

Previous studies showed that opioids and opioid peptides modulate vascular reactions such as plasma extravasation and vasodilatation through inhibition of substance P release from peripheral nerve endings of primary afferent fibers, and suggested the existence of endogenous opioid peptide activity related to regulation of inflammatory responses. Here we examined the effect of heat stimulation and antidromic stimulation of primary afferent fibers on the release of immunoreactive opioid peptides into the perfusate of the subcutaneous space in the rat instep. Antidromic stimulation of sectioned sciatic and saphenous nerves did not have any significant effect on the release of Met-enkephalin (Met-EK), while immersion of the hind paw in hot water (47 degrees C) for 30 min caused an increase in Met-EK release into the perfusate. High-pressure liquid chromatography of the perfusate revealed that noxious heat stimulation induced increase in release of Leu-enkephalin (Leu-EK) as well as Met-EK, although the maximal concentration of Leu-EK was less than 16% of that of Met-EK. No beta-endorphin was detected in the perfusate before, during or after heating. We conclude that noxious heat stimulation mainly leads to increase in Met-EK, and that this peptide originates mainly, from peripheral cells containing opioid peptides such as immune cells and/or Merkel cells, not from primary afferent fibers.

Induction of neonatal immunologic tolerance to heart transplantation by intrathymic myocardial cell inoculation in rats

To induce immunologic tolerance, intrathymic inoculation of myocardial cells in rats was performed during the neonatal period. Isolated myocardial cells from Wistar-Lewis (LEW/Crj) rat hearts were inoculated into the thymi of incompatible neonatal Wistar-King (WKAH/HKm) rats without use of immunosuppressants. Ten weeks later the heart from the LEW donor was transplanted heterotropically to the pretreated male WKAH rat (group 1, n = 14). As controls (groups 2 through 4), heart transplantation was performed in each of 10-week-old rats as follows: (1) The syngeneic heart was transplanted (group 2, n = 4); (2) the allogeneic heart was transplanted without use of immunosuppressants (group 2, n = 12); and (3) the allogeneic heart was transplanted with use of immunosuppressants (cyclosporine, 20 mg/kg/day, for 10 days after transplantation, (group 4, n = 5). In groups 1 through 3, four rats with heart transplants in each group were killed on the seventh day after transplantation and were histopathologically examined. No early rejection was seen in group 1. Hematoxylin-eosin staining of the thymus from the inoculated recipient revealed that donor myocardial cells continued to survive in the thymic tissue. The remaining rats in groups 1, 3, and 4 were saved for study of graft survival time. The longest proven graft survival in group 1 was 390 days, whereas it was only 7 days in group 3. These results indicated that intrathymic inoculation of donor myocardial cells in rats into incompatible neonatal recipients induced donor-specific tolerance for subsequent heart transplantation.

Benign, non-parasitic hepatic cyst causing obstructive jaundice

A 71-year-old woman with an hepatic cyst that led to obstructive jaundice is reported. Percutaneous intracystic fluid aspiration was useful in transiently decreasing the jaundice. Thereafter, the cyst was extirpated, and was found to be large (nearly 10 cm), benign and non-parasitic. This patient and 15 similar cases reported in the literature, indicate that the risk of jaundice induced by a simple hepatic cyst is related to its size (larger than 10 cm) and location near the common hepatic duct.

mu opiate receptor: cDNA cloning and expression

mu opiate receptors recognize morphine with high affinity. A 2.1-kb rat brain cDNA whose predicted translation product displays 63% identity with recently described delta and kappa opiate receptor sequences was identified through polymerase chain reaction and cDNA homology approaches. This cDNA recognizes a 10.5-kb mRNA that is expressed in thalamic neurons. COS-cell expression confers naloxonazine-, Na(+)-, and GTP-sensitive binding of mu but not delta or kappa opioid ligands. Expressing cells bind morphine, [D-Ala2,N-methyl-Phe4,glyol5]enkephalin (DAMGO), and [D-Ala2,D-Leu5]enkephalin (DADLE) with nanomolar or subnanomolar affinities, defining a mu opiate receptor that avidly recognizes analgesic and euphoric opiate drugs and opioid peptides.

[Pre and postoperative left ventricular volume and function in infants and children with total anomalous pulmonary venous return]

From January, 1989, to December, 1991, 36 consecutive patients with total anomalous pulmonary venous return (TAPVR) underwent intracardiac repair (ICR) in our institute. We studied the relationship between the size of atrial septal defect (ASD), age and preoperative left ventricular end-diastolic diameter (LVEDD) in 28 patients with regression analysis. There was no statistical relationship between the size of ASD, age and LVEDD. We measured LVEDD, RV to LV pressure ratio (RVP/LVP) and LV fractional shortening (LVFS) using two dimensional echocardiography in 15 patients, prior to and following ICR. LVEDD increased from 1.16 +/- 0.40 cm to 1.62 +/- 0.28 cm immediately following ICR, and then increased to 1.79 +/- 0.34 cm one month following ICR again. LVFS decreased from 38% to 35% immediately following ICR but still remained within normal range (normal range 28-45%). RVP/LVP decreased from 1.0 to 0.69 immediately following ICR, and to 0.39 one month following ICR. We concluded that the decrease of preoperative LV end-diastolic volume in TAPVR was not due to the decrease of LV preload but to anterior deviation of the ventricular septum caused by high RV pressure. There was significant increase of LV volume immediately following ICR, but LVFS maintained in normal range. This study suggested that small LV volume in patients with TAPVR did not influence the surgical results.

Schizosaccharomyces pombe Spk1 is a tyrosine-phosphorylated protein functionally related to Xenopus mitogen-activated protein kinase

Mitogen-activated protein kinase (MAPK) and its direct activator, MAPK kinase (MAPKK), have been suggested to play a pivotal role in a variety of signal transduction pathways in higher eukaryotes. The fission yeast Schizosaccharomyces pombe carries a gene, named spk1, whose product is structurally related to vertebrate MAPK. Here we show that Spk1 is functionally related to Xenopus MAPK. (i) Xenopus MAPK partially complemented a defect in the spk1- mutant. An spk1- diploid strain could not sporulate, but one carrying Xenopus MAPK could. (ii) Both Spk1 and Xenopus MAPK interfered with sporulation if overexpressed in S. pombe cells. (iii) Spk1 underwent tyrosine phosphorylation as does Xenopus MAPK. Tyrosine phosphorylation of Spk1 appeared to be dependent upon mating signals because it occurred in homothallic cells but not in heterothallic cells. Furthermore, this phosphorylation was diminished in a byr1 disruptant strain, suggesting that spk1 lies downstream of byr1, which encodes a MAPKK homolog in S. pombe. Taken together, the MAPKK-MAPK cascade may be evolutionarily conserved in signaling pathways in yeasts and vertebrates.

Intraorbital arteriovenous malformation: case report

A case of intraorbital arteriovenous malformation presenting with visual loss, exophthalmos, and chemosis of the right eye is reported. Enhanced computer tomography and magnetic resonance imaging showed extraocular muscle enlargement and vascular abnormality in the right retrobulbar space. Angiography revealed an abnormal intraorbital vascular stain with an extremely dilated right ophthalmic artery. Total removal of the intraorbital contents was performed after unsuccessful endovascular and surgical treatment of arteriovenous malformation (AVM). Histopathological examination disclosed an AVM in the retrobulbar fatty tissue with extension into the extraocular muscles and optic nerve.

Molecular breeding of a biotin-hyperproducing Serratia marcescens strain

We previously reported that an acidomycin-resistant mutant of Serratia marcescens Sr41, SB304, and a mutant that was derived from SB304 and was resistant to a higher concentration of acidomycin, SB412, produced 5 and 20 mg of D-biotin, respectively, per liter of a medium containing sucrose and urea (N. Sakurai, Y. Imai, M. Masuda, S. Komatsubara, and T. Tosa, Appl. Environ. Microbiol. 59:2857-2863, 1993). In order to increase the productivity of D-biotin, the biotin (bio) operons were cloned from strains SB412, SB304, and 8000 (wild-type strain), and pLGM412, pLGM304, and pLGW101, respectively, were obtained through subcloning. These plasmids harbored 7.2-kb DNA fragments coding for the bioABFCD genes on a low-copy-number vector and were introduced into SB304, SB412, and 8000. Among the resulting recombinant strains, SB412(pLGM304) exhibited the highest D-biotin production (200 mg/liter) in the production medium. The plasmid was stably maintained in cells. Unexpectedly, SB412(pLGM412) grew very slowly, and the D-biotin productivity of this recombinant strain was not evaluated because pLGM412 was unstable.

Dynamics and participation of type II phospholipase A2 in rat zymosan-induced pleurisy

Intrapleural injection of zymosan into rats induces acute inflammation characterized by plasma leakage and cellular influx. The level of type II phospholipase A2 (PLA2) increased in the pleural fluid as well as in exudating leukocytes after the injection of zymosan. Rather low PLA2 activity was found in cell lysates, though treatment of such lysates at low pH increased the PLA2 activity drastically. The appearance of "acid-extracted" PLA2 activity in leukocytes preceded that of the extracellular enzyme activity, suggesting that pleural leukocytes might be one of the origins of the extracellular enzyme. Treatment of exudating pleural leukocytes with purified rat type II PLA2 elicited the production of prostaglandin E2, but not platelet-activating factor appreciably. These findings indicate that type II PLA2 might play a role in the progression of inflammation through the production of eicosanoids in the present inflammation model.

A case of chronic pancreatitis complicated by massive pericardial and right pleural effusion

A 42-year-old man was admitted complaining of dyspnea. Chest X-ray showed an increase in cardiac size, and echocardiography revealed a large volume of pericardial effusion. Pancreatic enzyme levels were elevated in both serum and pericardial effusion. Computed tomography and endoscopic retrograde pancreatography demonstrated a fistula connecting a pancreatic pseudocyst with the pericardium and the right pleural cavity. Massive pericardial and right pleural effusion is an extremely rare complication of chronic pancreatitis. In this case, computed tomography and endoscopic retrograde pancreatography were useful for diagnosing the fistula.

LFA-1 expression on exocrine glands as a potential novel marker of malignant disease

The lymphocyte function associated antigen 1 has been found only on leukocytes and lymphoid tissues; however, the expression of lymphocyte function associated antigen 1 on nonhematopoietic cells has not been reported previously. In this study, immunohistochemical expression of lymphocyte function associated antigen 1 was examined on various tissues from 35 patients with malignant diseases and 36 patients with benign diseases including benign tumors. The expression of lymphocyte function associated antigen 1 was found on various exocrine tissues (eg, gastric glands, bronchial epithelium, alveolar epithelium, duodenal glands, bile ducts, pancreatic acini, and salivary glands) uninvolved by tumor in patients with malignant diseases. Localization of lymphocyte function associated antigen 1 was limited to the exocrine glands and differed from tissue-infiltrating leukocytes. The expression of lymphocyte function associated antigen 1 on exocrine tissues was confirmed in all 35 cases of malignant diseases that were examined. These included a wide spectrum of carcinomas and hematopoietic tumors. In contrast, none of the 36 cases with benign diseases examined expressed lymphocyte function associated antigen 1 on their exocrine glands. These results indicate a strong correlation between lymphocyte function associated antigen 1 expression on exocrine glands and malignant disease. The expression of lymphocyte function associated antigen 1 on nonhematopoietic cells was further confirmed in nonhematopoietic cell lines. Two of 19 nonhematopoietic cell lines (MKN45 and PANC-1; exocrine gland cell lines) examined expressed lymphocyte function associated antigen 1 on both cell surface and cytoplasm. These results suggested that immunohistochemically defined lymphocyte function associated antigen 1 molecules on nontumorous exocrine gland cells are a potential marker for the presence of malignant diseases.

Purification and characterization of a form of P450 from horse liver microsomes

A form of P450 [termed P450(h-1)] was purified from the liver microsomes of a male horse to electrophoretic homogeneity. The specific content of the final P450(h-1) preparation was 14.8 nmol/mg of protein and the recovery was 0.38% of the microsomal P450. The apparent molecular weight of P450(h-1) was 52,000 Da. The absorption spectra of P450(h-1) indicated that P450(h-1) was a low- and high-spin mixed type P450 in the oxidized form. The reconstituted system containing P450(h-1) could catalyze benzphetamine N-demethylation, 7-ethoxycoumarin O-deethylation, and testosterone 16 alpha-hydroxylation. In the horse hepatic microsomes, aniline p-hydroxylation and testosterone 6 beta-hydroxylation, in addition to the above reactions, were detected. The N-terminal amino acid sequence of P450(h-1) was highly homologous to that of rat P450 2C11. Western blot analysis using anti-P450(h-1) antibody revealed that this antibody most strongly recognized P450 2C13 among ten rat P450s belonging to eight different subfamilies involved in hepatic drug metabolism. This anti-P450(h-1) antibody inhibited the testosterone 16 alpha-hydroxylase activity in horse liver microsomes. These results suggest that P450(h-1) belongs to the P450 2C subfamily and contributes to the testosterone 16 alpha-hydroxylation in horse liver microsomes.

Balloon angioplasty for postoperative pulmonary artery stenosis in transposition of the great arteries

OBJECTIVES

This study was designed to assess the success rate and determinants of success or failure of balloon angioplasty for postoperative pulmonary stenosis in patients with transposition of the great arteries.

BACKGROUND

Previous reports have suggested that pulmonary stenosis that develops after the arterial switch operation is not likely to be dilated.

METHODS

Twenty-eight patients with transposition of the great arteries underwent 39 balloon angioplasty procedures after the arterial switch operation. The mean age at dilation was 4.5 +/- 2.2 years (range 0.7 to 9.8), and the interval between operation and balloon dilation was 3.6 +/- 1.8 years. The criterion of successful dilation was a > or = 50% increase in predilation diameter or a > or = 50% decrease in predilation pressure gradient. If the right ventricular/aortic pressure ratio decreased by > or = 0.2, so that the ratio became < 0.68, reoperation was thought to be not indicated.

RESULTS

The success rate of balloon angioplasty for pulmonary artery stenosis was 51% (20 of 39 dilations). The mean age at dilation in the group with successful dilation (3.6 years) was significantly younger than that in the group with unsuccessful dilation (5.4 years). The interval between operation and dilation in the successful dilation group (2.4 years) was significantly less than that in the unsuccessful dilation group (4.6 years). In 13 patients who underwent balloon angioplasty < 3.5 years after operation, balloon dilation was successful in 92%. The balloon/artery ratio was significantly greater in the successful than in the unsuccessful dilation group. A right ventricular/aortic pressure ratio > or = 0.68 was observed in 20 patients, and reoperation was not indicated in 10 patients (50%). There was no death, but one pulmonary artery rupture that did not require surgical intervention occurred. Aneurysmal dilation of the pulmonary artery was observed in three patients.

CONCLUSIONS

These data indicate that although the success rate of balloon angioplasty for pulmonary artery stenosis after the arterial switch operation is low (approximately 50%), balloon angioplasty can be the first therapeutic choice owing to the low complication rate and the potential benefit of the procedure. The success rate can be high if angioplasty is performed < 3.5 years after operation and a balloon of adequate size is used.

Construction of a Biotin-Overproducing Strain of Serratia marcescens

We have isolated mutants resistant to acidomycin, a biotin analog, from Serratia marcescens Sr41. Strain SB304, resistant to 0.5 mg of acidomycin (frequently called actithiazic acid) per ml, produced 5 mg of d -biotin per liter of a medium containing sucrose and urea. Strain SB412, which was isolated from SB304 on a minimal agar plate containing 2 mg of acidomycin per ml and 0.1 mg of 5-(2-thienyl)-valeric acid per ml, produced 20 mg of d -biotin per ml. The two enzymes related to biotin synthesis were found to be released from biotin-mediated feedback repression in these mutants. Transductional analysis revealed that SB412 had acquired at least two mutations, one in the biotin operon locus and the other in an unknown locus distant from the biotin operon locus.

Importance of successive prolines in the carboxy-terminal region of P450 2C2 and P450 2C14 for the hydroxylase activities

Proline-480 and proline-481 are highly conserved in the P450 2 family. When these successive prolines of P450 2C2 were replaced by Ala-Thr, its activities of laurate (omega-1)-hydroxylation and benzphetamine N-demethylation were lost. On the other hand, the mutated P450 which retained one of the proline residues was 60-100% active in the (omega-1)-hydroxylation and 100-120% active in the N-demethylation. Pro-Pro (480, 481) to Ala-Thr mutated P450 2C14 was also inactive in testosterone 16 alpha-hydroxylation and benzphetamine N-demethylation, the activities of the wild-type P450 2C14. In the carboxyterminal region of the P450 2C subfamily, the sequence of P450 2C2 from residues 469-473 is noticeably different from those of the other members of this subfamily. The Ser-473 to Val mutation of P450 2C2 caused a decrease in the (omega-1)-hydroxylase activity to one-fifth but the N-demethylase activity was not much affected. When the sequence of P450 2C2 from residues 469-473 was replaced by that of P450 2C14 (mutation at four residues), the 16 alpha-hydroxylase and N-demethylase activities were increased by seven- and three-fold, respectively, and the (omega-1)-hydroxylase activity was decreased to one-third. The mutated P450 2C2, in which the carboxy-terminal four residue sequence or the proline cluster adjacent to the amino-terminal membrane-anchor signal sequences was deleted, was not accumulated in yeast cells transformed with plasmids directing the synthesis of such P450s.(ABSTRACT TRUNCATED AT 250 WORDS)

Tissue-specific distribution and age-dependent increase of human CD11b+ T cells

Distribution of CD11b Ag, a member of the leukocyte integrin (beta 2 integrin) family, on human T cells is not well characterized. We investigated in this study the tissue distribution and age-related alteration of human CD11b+ T cells. Significant proportions of CD11b+ cells were found in T cells from adult peripheral blood (18-58 yr) (20%), liver (32%), and spleen (16%), but were rarely observed in those from thymus, lymph nodes, intraepithelial lymphocytes, lamina propria lymphocytes, and lung. In contrast, percentages of CD28+ T cells, a counter population of CD11b+ T cells, were highest in lymph nodes (91%), modest in intraepithelial lymphocytes (82%), lamina propria lymphocytes (77%), PBL (77%), spleen (73%) and lower in thymus (62%), lung (60%) and liver (56%). The CD11b+ T cells from peripheral blood gradually increased with age, whereas the CD28+ T cells showed an age-dependent decrease. Namely, the percentages of CD11b+ T cells were 6% in newborns (cord blood), 15% in young adults (18 to 22 yr), 25% in middleaged adults (45 to 58 yr), and 27% in aged adults (72 to 86 yr), whereas those of CD28+ T cells were 96%, 83%, 72%, and 71%, respectively. Proportions of CD11b+ T cells in TCR-gamma delta+ or CD8+ T cells were, respectively, higher than those in TCR-alpha beta+ or CD4+ T cells. Age-dependent increase of CD11b+ T cells in CD8+ T cells was more obvious than that of CD4+ T cells. Furthermore, CD11b+ CD28+ T cells increased in the peripheral blood only of aged adults. The percentage of CD11b+ CD28+ T cells in TCR-gamma delta+ T cells was highest in young adults (25%), whereas that in CD4+ T cells was highest in aged adults (15%). CD11b+ CD28+ T cells expressed much potent IFN-gamma, IL-2, and IL-4 at mRNA level than CD28+ CD11b- T cells or CD11b+ CD28- T cells, and had potential cytotoxic activity. Roles of CD11b+ T cells in vivo were discussed.

Tissue-specific distribution and age-dependent increase of human CD11b+ T cells

Distribution of CD11b Ag, a member of the leukocyte integrin (beta 2 integrin) family, on human T cells is not well characterized. We investigated in this study the tissue distribution and age-related alteration of human CD11b+ T cells. Significant proportions of CD11b+ cells were found in T cells from adult peripheral blood (18-58 yr) (20%), liver (32%), and spleen (16%), but were rarely observed in those from thymus, lymph nodes, intraepithelial lymphocytes, lamina propria lymphocytes, and lung. In contrast, percentages of CD28+ T cells, a counter population of CD11b+ T cells, were highest in lymph nodes (91%), modest in intraepithelial lymphocytes (82%), lamina propria lymphocytes (77%), PBL (77%), spleen (73%) and lower in thymus (62%), lung (60%) and liver (56%). The CD11b+ T cells from peripheral blood gradually increased with age, whereas the CD28+ T cells showed an age-dependent decrease. Namely, the percentages of CD11b+ T cells were 6% in newborns (cord blood), 15% in young adults (18 to 22 yr), 25% in middleaged adults (45 to 58 yr), and 27% in aged adults (72 to 86 yr), whereas those of CD28+ T cells were 96%, 83%, 72%, and 71%, respectively. Proportions of CD11b+ T cells in TCR-gamma delta+ or CD8+ T cells were, respectively, higher than those in TCR-alpha beta+ or CD4+ T cells. Age-dependent increase of CD11b+ T cells in CD8+ T cells was more obvious than that of CD4+ T cells. Furthermore, CD11b+ CD28+ T cells increased in the peripheral blood only of aged adults. The percentage of CD11b+ CD28+ T cells in TCR-gamma delta+ T cells was highest in young adults (25%), whereas that in CD4+ T cells was highest in aged adults (15%). CD11b+ CD28+ T cells expressed much potent IFN-gamma, IL-2, and IL-4 at mRNA level than CD28+ CD11b- T cells or CD11b+ CD28- T cells, and had potential cytotoxic activity. Roles of CD11b+ T cells in vivo were discussed.

Infantile neuroaxonal dystrophy--immunohistochemical and ultrastructural studies on the central and peripheral nervous systems in infantile neuroaxonal dystrophy

We performed pathological studies on the central and peripheral nervous systems of cases with infantile neuroaxonal dystrophy (INAD). Numerous spheroid bodies in the central and peripheral nervous systems, were seen and divided into large spheroid bodies (LSB) and small spheroid bodies (SSB) photo-microscopically. LSB had a relation to some specific neurons with weak expression of neuron specific enolase, neurofilament and chromogranin using PAP method. SSB showed a relation to the axon without immunohistochemical expression of neuron specific enolase, neurofilament, glial fibrillary acidic protein, myelin basic protein, chromogranin, S 100 protein or antitrypsin. LSB were prominent in the posterior column, gracile nucleus, cuneate nucleus, and the tegmentum of the midbrain and the pons associated with neuronal loss and gliosis. SSB were observed in the thalamus, basal ganglia and the cerebral cortex. The cerebellum was sclerotic with few microtubule-like structures disposed in a dense network in association with degenerated mitochondria. Similar changes were observed in the sural nerves, autonomic nerve endings in the skin, and the nerve plexus of the digestive tract. Although INAD is a generalized neurodegenerative disease, it is suggested that the primary disorder might occur in the neurons and axons of the sensory tracts.

Cell-mediated immune-pancytopenia complicating primary Sjögren's syndrome

A 64-year-old woman with mild bilateral parotid gland swelling and bilateral lower extremity purpura was admitted for evaluation of xerostomia and pancytopenia. The patient had an increased erythrocyte sedimentation rate, pancytopenia, and positive tests for antibodies to nuclear antigen, SS-A, and SS-B. Impaired cell-mediated immunity was also present. Bone marrow aspiration showed a hypoplastic marrow with an increased percentage of lymphocytes. A positive Schirmer's test and keratoconjunctivitis were also noted. A diagnosis of primary Sjögren's syndrome was made by sialography and histological salivary gland findings. Therapy with prednisolone improved the pancytopenia. Addition of the patient's peripheral blood mononuclear cells to cultures of bone marrow mononuclear cells derived from a healthy volunteer dose dependently inhibited colony formation, including mixed hemopoietic colonies. On the other hand, addition of the patient's serum failed to inhibit colony formation by normal bone marrow mononuclear cells. These results suggested that one of the causes of pancytopenia in primary Sjögren's syndrome might be mediated by the inhibition of mononuclear cells to the hemopoietic progenitors.