[The critical appraisal of QOL questionnaire for prostate cancer patients]

BACKGROUND

Prostate cancer is a common malignancy that affects Japanese elderly men. Its incidence is increasing, recently, and its treatments are various. The measurement of quality of life (QOL) has become important for the evaluation of and selection of treatments. In Japan, however, there is no standard way of measuring QOL for prostate cancer patients, except the Japanese version of the EORTC QOL questionnaire for prostate cancer patients. We examined the validity and feasibility of this translated EORTC QOL questionnaire for prostate cancer patients.

METHODS

Sixty-nine prostate cancer patients who were under treatment in 4 hospitals were selected for this study. We applied the content validity, the factorial validity which was analyzed by the oblique principal component cluster analysis, the internal consistency analyzed by the alpha coefficient of Cronbach, the convergent validity which was used GHQ, IPSS and PS as external measures, and the feasibility.

RESULTS

This questionnaire showed good internal consistency, as the alpha coefficient was 0.61 to 0.90 in all domains, except for sex life, which was the lowest. This questionnaire was classified into 7 clusters by the oblique principal component cluster analysis. Consequently, the factorial validity was good, except for items regarding sex life. As domains correlate well with external measures except in sex life, the convergent validity was good. It was suggested that only two items were not acceptable in regard to the content validity and the feasibility, and that the translation into Japanese of 2 items was inadequate.

CONCLUSIONS

Our study suggests that the Japanese version of the EORTC QOL questionnaire for prostate cancer patients demands improvement for the practical employment in clinical trials, as there is a problem of translation and feasibility.

Protein W, a spore-specific protein in Myxococcus xanthus, formation of a large electron-dense particle in a spore

The gene for the major spore-specific protein, termed protein W, was cloned, and it was found that protein W is composed of 426 amino acid residues including 31% charged (133 residues) and 39% hydrophobic (166 residues) amino acids. In the protein, a motif consisting of five amino acid residues [(V/L/I)-R-E-R-(V/L/I)] is repeated 28 times, and another motif [M-M-(P/G)-Q-G] five times. Protein W is synthesized during a very late stage of development, forming a single, large electron-dense particle (200-400 nm in diameter) inside a spore. X-ray microanalysis of the particle revealed that it contains a high amount of phosphate in addition to calcium and magnesium. It is proposed that protein W consisting of highly charged repetitive sequences is a polyphosphate storage protein to store energy in spores. The disruption of the gene for protein W resulted in delayed fruiting body formation and a lower spore yield.

Co-integration, co-expression and co-segregation of an unlinked selectable marker gene and NtFAD3 gene in transgenic rice plants produced by particle bombardment

Using the scutellar tissue of rice mature embryos as a target tissue, a selectable marker gene, bar, and an unselectable gene, fatty acid desaturase gene from tobacco (NtFAD3), on separate plasmids, were introduced by particle bombardment. Co-integration, co-expression and inheritance of these genes were analyzed as well as seed fertility of the transgenic plants. Twenty-three out of 32 bialaphos-resistant plants integrated the NtFAD3 gene, which was confirmed by Southern-blot analysis of R0 plants, and showed one to more than 20 hybridizing bands of exogenous DNA, indicating a 72% (23/32) co-integration frequency. However, the frequency of the transgenic plants containing the 1.4-kb fragment of NtFAD3 gene was 34% (11/32). Northern-blot analysis revealed that seven out of ten fertile transgenic rice plants which had a 1.4-kb fragment of NtFAD3 cDNA expressed NtFAD3 mRNA. The NtFAD3 gene under the control of CaMV35S promoter stably expressed in the transgenic rice plants and modified the proportions of linoleic acid (18:2) and linolenic acid (18:3) in fatty acids; the content of 18:2 decreased and that of 18:3 increased. Fourteen out of 32 (44%) transgenic plants set seeds and 18 (56%) showed low fertility or sterility. Molecular analysis of the selfed progeny indicated that all copies in almost all R0 plants were inherited as a single dominant hemizygous locus.

Expression of the neural cell adhesion molecule in astrocytic tumors: an inverse correlation with malignancy

BACKGROUND

Cell adhesion molecules are among the key factors in the development of the malignant potential of brain tumors. The aim of this study was to investigate the expression of the neural cell adhesion molecule (NCAM) in human astrocytic tumors and assess any relationship between NCAM expression and the degree of malignancy.

METHODS

The expression of NCAM was examined in 52 astrocytic tumors by Western blot analysis. From them the authors selected 23 adult supratentorial ordinary astrocytic tumors and performed quantitative Western blot analysis for each isoform (NCAM 172-180, NCAM 145, NCAM 125-130) to investigate any correlation between the expression of each NCAM isoform and the histologic and biologic malignancy (histology, proliferating cell indices [PCIs] determined by MIB-1 immunohistochemistry, and manifestation on magnetic resonance images [MRIs]). Immunohistochemistry with antihuman NCAM monoclonal antibody was also performed on the tumors from which cryostat sections were available.

RESULTS

Most of the astrocytomas and anaplastic astrocytomas revealed 3 bands at 180, 145, and 125-130kD, whereas in glioblastomas the bands tended to diminish. The expression of each NCAM isoform in astrocytic tumors decreased in proportion to the progression of the histologic malignancy, and the results were also corroborated by immunohistochemical evaluation. An inverse correlation was also observed between the amount of NCAM expression and MIB-1 PCIs. NCAM expression was hardly detectable in those tumors with highly invasive manifestation on MRIs.

CONCLUSIONS

To the authors' knowledge, this study provides the first direct evidence that NCAM is down-regulated in the development of the malignancy of astrocytic tumors; and it is suggested that reduced NCAM expression might be involved in the development of biologic malignancy.

Expression of the neural cell adhesion molecule in astrocytic tumors: an inverse correlation with malignancy

BACKGROUND

Cell adhesion molecules are among the key factors in the development of the malignant potential of brain tumors. The aim of this study was to investigate the expression of the neural cell adhesion molecule (NCAM) in human astrocytic tumors and assess any relationship between NCAM expression and the degree of malignancy.

METHODS

The expression of NCAM was examined in 52 astrocytic tumors by Western blot analysis. From them the authors selected 23 adult supratentorial ordinary astrocytic tumors and performed quantitative Western blot analysis for each isoform (NCAM 172-180, NCAM 145, NCAM 125-130) to investigate any correlation between the expression of each NCAM isoform and the histologic and biologic malignancy (histology, proliferating cell indices [PCIs] determined by MIB-1 immunohistochemistry, and manifestation on magnetic resonance images [MRIs]). Immunohistochemistry with antihuman NCAM monoclonal antibody was also performed on the tumors from which cryostat sections were available.

RESULTS

Most of the astrocytomas and anaplastic astrocytomas revealed 3 bands at 180, 145, and 125-130kD, whereas in glioblastomas the bands tended to diminish. The expression of each NCAM isoform in astrocytic tumors decreased in proportion to the progression of the histologic malignancy, and the results were also corroborated by immunohistochemical evaluation. An inverse correlation was also observed between the amount of NCAM expression and MIB-1 PCIs. NCAM expression was hardly detectable in those tumors with highly invasive manifestation on MRIs.

CONCLUSIONS

To the authors' knowledge, this study provides the first direct evidence that NCAM is down-regulated in the development of the malignancy of astrocytic tumors; and it is suggested that reduced NCAM expression might be involved in the development of biologic malignancy.

Plasma cell granuloma extending from the extracranial to the intracranial space associated with Epstein-Barr virus infection

A 70-year-old male presented with a plasma cell granuloma extending from the extracranial to the intracranial space. Findings of preoperative magnetic resonance imaging and intraoperative observation indicated that the lesion extended from the temporal muscle to the subarachnoid space, penetrating the frontal bone. The subarachnoid lesion was composed of neutrophils indicating the presence of acute or subacute inflammation. The final diagnosis of the resected tumor was plasma cell granuloma. High levels of antibodies against Epstein-Barr (EB) virus in the cerebrospinal fluid and the immunohistochemical demonstration of EB nuclear antigens in the plasma cell granuloma suggested that EB virus infection was associated with the development of plasma cell granuloma in this patient.

Living related partial liver transplantation for primary biliary cirrhosis--a case report

An adult living related partial liver transplantation was performed on a 49 year old female with terminal hepatic failure due to primary biliary cirrhosis (PBC). The donor was her 53 year-old sister. A sufficient volume of graft tissue was obtained, which comprised 1.5% of the body weight of the recipient. The recipient had an excellent recovery without any major complications, and was discharged 35 days after the operation. At 15 months after the operation, the patient has shown no signs of rejection while using FK506 and prednisolone as immunosuppressants. The progression of symptomatic PBC can be predicted, and the timing of the transplantation can be easily determined. In addition, the results of liver transplantation for PBC are good. Therefore, adult living related partial liver transplantation is an excellent treatment for primary biliary cirrhosis.

Correlation between MIB-1 staining indices and recurrence in low-grade astrocytomas

Although low-grade astrocytomas are histologically benign, some of them recur frequently. We retrospectively investigated the relationship between MIB-1 staining index (SI) and recurrence in 47 low-grade astrocytomas that were treated in Keio University Hospital from 1981 to 1991. We found a correlation between SI and recurrence. MIB-1 SIs recurrent low-grade astrocytomas have been shown to be almost similar to those of astrocytoma grade 3. We concluded that it was very important to examine MIB-1 SI in all astrocytomas especially in low-grade astrocytomas, because MIB-1 SI is one of the factors from which we could predict-recurrence and decide whether radiotherapy or chemotherapy should be performed.

[Assessment of reproducibility and unidimensionality of International Prostate Symptom Score Japanese version]

BACKGROUND

International Prostate Symptom Score (IPSS), which is a self-administered questionnaire consisting of 7 questions with 6 categories, has been used in many countries as the standard scale of subjective urinary symptoms of patients with prostatism. In Japan, although we have already used the Japanese version at daily clinical situations, the reproducibility and validity of it have never been examined. We tried to assess the reproducibility and unidimensionality of the questionnaire.

PATIENTS AND METHODS

64 out-patients with benign prostatic hyperplasia were asked to fill the self-administered questionnaires, first at the hospital, and second at home.

RESULTS

The weighted kappa statistics were low in almost all the items (0.10-0.75), so the reproducibility was evaluated to be poor. For as reasons, it was suggested that understandings of Japanese translation and recognition of frequency about chronic urinary symptoms were difficult for the respondents. The results of principal component analysis showed that the item for nocturia measures a different aspect from what the other items measured. So the unidimensionality of the scale was also not confirmed.

CONCLUSION

These results suggested that IPSS Japanese version should be further modified, especially on its Japanese translation, and then the unidimensionality should be examined again.

Long-term stress degenerates, but imipramine regenerates, noradrenergic axons in the rat cerebral cortex

Exposed to a forced walking stress for 2 weeks, some rats became persistently inactive (depression-model rats), whereas others gradually recovered from exhaustion (spontaneous recovery rats). We also studied rats exposed to short-term stress, rats without stress, and the model rats treated with imipramine or saline. We examined the density of noradrenergic axons in the frontal cortex using retrograde labeling of the locus coeruleus with horseradish peroxidase injected into the cortex and immunohistochemical staining of cortical axons with dopamine beta-hydroxylase antiserum. The density was significantly lower in the depression-model rats, but tended to be higher in the recovery rats and short-term stressed rats. Chronic treatment with imipramine significantly increased the density in the model rats. There was also a correlation between the density of noradrenergic axons and the recovery rate of activity. Our results suggest that cortical noradrenergic degeneration is involved in the pathogenesis of depression.

[The physical, mental and social impacts of telling prostate cancer patients the true diagnosis]

BACKGROUND

Telling cancer patients the true diagnosis is inevitable to acquire informed consent especially in the Western world. In Japan, however, no such consensus has been established yet. We investigated the influence of telling the true diagnosis on QOL of prostate cancer patients.

METHODS

We measured physical, mental and social aspect of prostate cancer outpatients by the General Health Questionnaire (GHQ) and the international Prostate Symptom Score (I-PSS). Using the general linear models we tried to explore which variables would attribute to "severe depression", "anxiety and insomnia" and "social dysfunction".

RESULTS

No significant differences were found in any of the eight variables (age, performance status, clinical stage, I-PSS and Goldberg's four factors of GHQ) among the two groups that were informed the true diagnosis or not. The correlation structures of "severe depression", "somatic symptoms" and I-PSS are significantly different in the two groups. As a result of the analysis by the GLM, "somatic symptoms", I-PSS and clinical stages had main effect on "severe depression". Also, there was an interaction between the effect of telling the true diagnosis and "somatic symptoms".

CONCLUSION

These results suggest that the mental condition of prostate cancer patients remain stable when they are in good physical condition regardless of being informed the true diagnosis or not. However, the patients who weren't told the true diagnosis have a tendency to get depression accompanying deterioration of physical condition. It is therefore considered that telling the true diagnosis makes the patients understand the changes of their physical conditions and help their mind to be stable.

Molecular cloning of cDNAs for mouse low-molecular-weight and high-molecular-weight prekininogens

We isolated cDNAs encoding low-molecular-weight (L-) and high-molecular-weight (H-) prekininogens from a mouse liver cDNA library using rat T-kininogen cDNA and rat H-kininogen cDNA respectively, as probes. The signal peptide, the heavy chain, and the bradykinin moiety, which are common between the two prekininogens, consist of 20, 359, and 9 amino acids, respectively, while the light chains of the L- and H-prekininogens are composed of 44 and 273 amino acids, respectively. All 19 cysteine residues present in both mouse prekininogens are located at the same positions relative to those of human origin. The light chain of H-prekininogen contains a characteristic 15-repeated His-Gly sequence and a conserved sequence for binding prekallikrein or factor XI. Northern blotting or reverse transcription-polymerase chain reaction followed by Southern blotting using mouse L- and H-kininogen cDNAs demonstrated that both L- and H-kininogens are predominantly expressed in the liver and kidney. L-Kininogen mRNA was also expressed in other tissues, such as the adrenal gland, brain, spinal cord, testis, lung, heart, and skin, while levels of H-kininogen mRNA in these tissues were too low to detect, suggesting that L-kininogen is synthesized in various tissues of mouse, while H-kininogen is exclusively synthesized in the liver and kidney. A genomic Southern blot using H-prekininogen cDNA revealed that the L- and H-prekininogen mRNAs in mouse are probably encoded by a single gene, as is the case in both human and bovine.

Identification of the replication region of the Lactobacillus acidophilus plasmid pLA106

The complete nucleotide sequence of plasmid pLA106 (2862 bp) from Lactobacillus acidophilus TK8912 was determined. Based on this sequence, the location of the genes for mobilization-plasmid recombination protein (mob), replication origin (ori), transcriptional repressor protein (repA) and replication initiation protein (repB) were predicted. Deletion analysis showed that the 1.4-kb PstI-EcoRV fragment carrying the ori, repA and repB genes is able to replicate in Lactobacillus and Escherichia coli cells. The plasmid pLA106 appears to have most features of the pLS1/pE194 plasmid family.

Cytokine-induced selective increase of high-molecular-weight bFGF isoforms and their subcellular kinetics in cultured rat hippocampal astrocytes

Cytokines such as interleukin-1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF-alpha) and epidermal growth factor (EGF) are probable factors responsible for up-regulation of basic fibroblast growth factor (bFGF) expression in reactive astrocytes following brain damage, however the effect of these cytokines on the expression of each bFGF-isoform has not been elucidated. Western blot analysis revealed the expression of 18, 22 and 24-kD bFGF isoforms in cultured rat hippocampal astrocytes, and the expression of high molecular weight (HMW)-isoforms (22 and 24-kD isoforms) but not of 18-kD isoform was selectively increased by cytokines. Immunofluorescent analysis demonstrated that bFGF content in the cytoplasm of astrocytes is initially increased by cytokines followed by nuclear targeting and localization in agreement with the previous evidence that HMW-isoforms possess a nuclear targeting signal. The present results suggest the important role of HMW-bFGF isoforms in the response of nervous tissue to injury.

Surgical approaches for vertebro-basilar trunk aneurysms located in the midline

Fourteen cases of midline vertebro-basilar trunk aneurysms were operated on by four routes of surgical approach: middle fossa anterior transpetrosal approach (ATP), presigmoid transpetrosal approach (PTP), conventional lateral suboccipital approach (LSO) or suboccipital transcondylar approach (STC). There was no mortality, but the morbidity was different depending on the surgical approach. In basilar trunk aneurysms located higher than the internal auditory canal, excellent results were obtainable by ATP, especially in the case of posteriorly projecting aneurysms. For midline vertebral aneurysms located lower than the internal auditory canal, STC resulted in less surgical complications than LSO. Extradural resection of the jugular tubercle was necessary for aneurysms located on the distal vertebral artery at or close to the vertebro-basilar junction. For vertebro-basilar junction aneurysms located at the level of the internal auditory canal, hearing was preserved by STC, but not by ATP or PTP. However, choice of the surgical approach may depend on the direction of the aneurysm and the technical accessibility of the skull base. All these skull base approaches reduced surgical complications of retraction damage to the cranial nerves and the brain stem. This holds true for all aneurysms arising from the midline vertebro-basilar trunk.

Strategy for breast conserving treatment--analysis of recurrence and prognosis after breast cosnserving treatment

Two hundred and four patients with small breast cancer (T < or = 3.0 cm. N0 or N1a) were given breast conserving treatment (radiation group: 101, non-radiation group: 103) during the period from Feb. 1988 to Jan. 1995. Survival analysis of breast conserving treatment radiation group versus non-radiation group revealed the following: 1) Breast conserving treatment had a good prognosis, and a 5-year overall survival rate of 96.2%. 2) There was no significant difference of 5-year overall, disease-free and ipsilateral breast disease-free survival rate between the radiation group and non-radiation group. 3) Surgical margin involvement was the most significant risk factor in local recurrence after breast conserving treatment, and non-radiation was a possible risk factor. 4) Local recurrence was a significant risk factor for distant metastases after breast conserving treatment the same as node positive. These results suggested as follows: 1) Lumpectomy with a clear margin and radiation is the best choice for small breast cancer (T < or = 3.0 cm, N0 or N1a). 2) Adjuvant therapy after surgical treatment is necessary for local recurrence.

Lipomas of the frontal lobe

An extremely rare case of lipomas on the cerebral surface in a 65-year-old female is reported. The tumors were located both in an unusual fissure of the right frontal convexity and under the right frontal lobe associated with and surrounded by areas of focal cortical dysplasia. Angiograms revealed dilated branches of the right anterior cerebral artery associated with angiomatous tumor blushes. The etiology of the combination of the lipomas and the anomalies, and the angiographic features, are briefly discussed.

[Comparison of clinical effects between granisetron alone and combination of granisetron and methylprednisolone against the nausea and vomiting induced by CDDP chemotherapy--comparative study by the cross-over trial. University of Tsukuba Antiemetics Study Group]

A cross-over clinical trial was carried out to compare the antiemetic effect and safety between granisetron alone (40 micrograms/kg) and the combination of granisetron and methylprednisolone (MP: 10 mg/kg) in urological cancer patients treated with cisplatin. Forty-eight courses were given with granisetron alone and 47 courses with both granisetron and MP. The antiemetic effect of nausea and vomiting was evaluated in the acute emetic phase. during the 24 hours following the CDDP administration, and in the delayed emetic phase, 2 to 7 days after the administration. Combination therapy of granisetron and MP demonstrated a greater antiemetic effect during the 72 hours following the CDDP administration than by granisetron alone. But there was no significant difference in antiemetic effect between combination therapy and granisetron alone after the 3rd day. Combination therapy also demonstrated more efficacy in complete antiemetic effect, with no emesis and less than moderate nausea, than by granisetron alone. Both treatments showed no side effects and were safe.

Interleukin-1β and tumor necrosis factor-α co-operatively enhance a novel trophic activity of astrocytes for pontine cholinergic neurons in vitro

Insulin and insulin-like growth factors (IGFs) are the only known trophic factors for pontine cholinergic neurons. The present study revealed that astrocyte-extract pretreated with IL-1β and TNF-α significantly enhanced choline acetyltransferase (ChAT) activity of the pontine neurons in the presence of a supramaximal dose of insulin, while various trophic factors including IGFs failed to increase the ChAT activity under the same culture conditions, suggesting that IL-1β and TNF-α co-operatively enhanced the expression of a novel trophic factor for pontine cholinergic neurons in astrocytes.

[Effects of androgen regulation system on bladder carcinogenesis in male mice]

PURPOSE

In several previous reports, it has been suggested that the androgen system is related to bladder carcinogenesis. In this study, to understand the mechanism underlying this relationship, we administered a LH-RH agonist depot (Leuprolide depot), a pure-antiandrogen (flutamide) or a 5 alpha-reductase inhibitor (finasteride) to the mice in the promotion state of bladder carcinogenesis by N-butul-N-(4-hydroxybutyl) nitrosamine (BBN).

MATERIALS AND METHODS

177 C3H/He male mice were divided into 7 groups. All mice were treated with 0.05% BBN for 10 weeks and were maintained over the subsequent 12 weeks with the following treatments. Group 1 was a control group; in group 2, castration was performed at the 11th week; in group 3, finasteride was administered starting the 11th week; in group 4, a LH-RH agonist depot was administered starting the 11th week; in group 5, flutamide was administered starting the 11th week; in group 6, both finasteride and a LH-RH agonist depot were administered simultaneously starting the 11th week; and in group 7, both flutamide and a LH-RH agonist depot were administered simultaneously starting the 11th week.

RESULTS AND CONCLUSIONS

(1) We confirmed that castration significantly suppressed bladder carcinogenesis. (2) Finasteride or flutamide administration as monotherapy had no effect on the results; however, the dosages of these drugs may have been too low, so we are planning a study with higher doses. (3) Conversely, the LH-RH agonist depot significantly promoted bladder carcinogenesis, we believe that the high levels of testosterone immediately after the administration were responsible for this promotion. (4) Simultaneous administration of flutamide suppressed this LH-RH induced promotion of carcinogenesis.

Histiocytoid cardiomyopathy with hypotonia in an infant

A 15 month old female, who had suffered from ventricular tachycardia from the prenatal period, experienced cardiac arrest at home. Once she had recovered, ventricular tachycardia occurred repeatedly. She died 7 months after admission. At autopsy, the heart showed many yellowish white nodules in the endocardium. Histologically these nodules consisted of granular or foamy histiocyte-like cells, which had spread to all four chambers. Electron micrographs showed mitochondrial hyperplasia in these cells. The cells had some myofibrils in their cytoplasm. These findings were compatible with histiocytoid cardiomyopathy. Interestingly, the present case showed hypotonia. Her muscle biopsy revealed decreased activity of cytochrome c oxidase, suggesting that histiocytoid cardiomyopathy is related to mitochondrial cytopathy.

Release of ciliary neurotrophic factor from cultured astrocytes and its modulation by cytokines

CNTF rescues various types of lesioned neurons in vivo, and it needs to be released from astrocytes into the extracellular space to have the effect. However, direct evidence for CNTF release has not been unequivocally demonstrated. We hypothesized that the rapid sequestration by CNTF receptor present on cultured astrocytes might be the cause of the inability to detect CNTF released into astrocyte-conditioned medium (ACM). Therefore, we measured CNTF immunoreactivity in medium conditioned by astrocytes treated with phosphatidylinositol-specific phospholipase C (PI-PLC) which was used to prevent released CNTF from binding to the CNTF receptor, since PI-PLC cleaves glycosyl-phosphatidylinositol anchor of CNTFR alpha, the unique component involved in CNTF binding. CNTF was not detectable in untreated ACM, but was detectable in PI-PLC-treated ACM. These results together with the evidence that PI-PLC treatment did not have a toxic effect on astrocytes prove the fact that CNTF can be released from astrocytes without cell lysis. Subsequently, the effect of cytokines such as IL-1 beta, TNF-alpha, and EGF on CNTF release was examined. These cytokines increased CNTF protein levels in ACMs without increasing CNTF protein levels in astrocyte-extracts, indicating that they enhanced CNTF release from astrocytes.

Germination of myxospores from the fruiting bodies of Myxococcus xanthus

Germination of myxospores from fruiting bodies of Myxococcus xanthus was examined under a light microscope as well as by analyzing the incorporation of [3H]uracil into the RNA fraction. Efficient germination was observed in 0.2% Casitone containing 8 mM MgSO4 and 1 mM CaCl2 at 30 degrees C. Under this condition, spherical myxospores were converted into rod-shaped vegetative cells within 5 to 6 h. The germination was severely inhibited in the presence of 1 mM phenylmethylsulfonyl fluoride, a protease inhibitor, indicating that a serine protease(s) is required for the myxospore germination. EGTA (1 mM) also completely blocked germination, indicating that Ca2+ plays an important role in myxospore germination. In 1% Casitone without added Mg2+ and Ca2+ or 0.2% Casamino Acids with 8 mM MgSO4 and 1 mM CaCl2, myxospores lost their refractility under a phase microscope, while no RNA synthesis took place within 6 h, as judged by the incorporation of [3H]uracil. A group of proteins were found to be specifically synthesized during an early stage of germination. In addition, a new major spore-associated protein with a size of 41.5 kDa became detectable in the spore shell fraction 3 h after germination. The present results demonstrate that myxospore germination occurs in at least two steps: the loss of myxospore refractility, followed by an outburst of metabolic activities. The first step can occur even in the absence of energy metabolism, while the second step was blocked by rifampin, EGTA, and protease inhibitors.

Accumulation of nerve growth factor in cerebrospinal fluid and biological activity following neurosurgery

Perioperative nerve growth factor (NGF) levels in cerebrospinal fluid (CSF) of patients with acoustic neurinoma (14 cases), tentorial meningioma (1 case), or subarachnoid hemorrhage (1 case) were examined. Preoperative NGF levels in CSF were below the level of detection in all patients. However, NGF was found to accumulate transiently in CSF following neurosurgery. Pre- and postoperative CSF obtained from a patient with acoustic neurinoma enhanced the proliferation of astrocytes in neuronal cell cultures derived from embryonic rat cortex grown in serum-free defined medium, and increased choline acetyltransferase activity of cholinergic neurons derived from embryonic rat septal area and brainstem. The effect of postoperative CSF on septal and brainstem neurons was more potent than that of preoperative CSF. These results indicate that NGF and non-NGF-type neurotrophic activities accumulate in the CSF following neurosurgery. These neurotrophic activities are probably important in the regeneration of damaged neural networks in the central nervous system.

A case report of nephrotic syndrome associated with rifampicin therapy

We describe nephrotic syndrome occurring in a 53-year-old male patient on continuous rifampicin (RFP) therapy for pulmonary tuberculosis. After the pulmonary tuberculosis was improved by chemotherapy that included RFP, administration of Isoniazid and RFP was continued. After 16 weeks, he suddenly developed nephrotic syndrome, but never developed acute renal failure. He was admitted to hospital and renal biopsy was performed revealing minor glomerular abnormalities and few interstitial changes in light microscopy. No positive immunofluorescent microscopic findings were obtained without fibrinogen. Thus, minimal change nephrotic syndrome (MCNS) was diagnosed. In contrast, electron microscopy showed several injurious glomerular changes, such as the elevation of the endothelial layer, local widening of the subendothelial space which was filled with fine granular or fibrillar materials, irregularity of the endothelial investment, swelling or shrinkage of the endothelial cells, compatible with those seen in many diseased conditions supposedly caused by clinical or subclinical localized intravascular coagulation. Discontinuation of RFP administration completely relieved the patient of MCNS with the aid of predonisolone therapy. Thus, this patient might not have been a case of incidental, but rather drug (RFP)-induced MCNS.