Monoclonal antibodies against human thrombomodulin whose epitope is located in epidermal growth factor-like domains

Thrombomodulin (TM) on endothelial cells is a glycoprotein that functions as a cofactor for thrombin-catalyzed activation of protein C. The structural requirement for thrombin binding and cofactor activity were investigated using monoclonal antibodies (moAbs) against TM and site-directed mutagenesis of recombinant human soluble TM (rsTM). Results showed that moAb 2A2 inhibited thrombin binding to rsTM and also abolished its functions as a cofactor in thrombin-catalyzed activation of protein C and as an anticoagulant by modifying thrombin-induced fibrinogen clotting and platelet aggregation, moAb 1F2 did not affect its activity as an anticoagulant, but inhibited its cofactor activity, and moAb 10A3 did not inhibit either activity. Epitope analysis was carried out by site directed mutagenesis of rsTM expressed in CHO cells. Some proteins with mutations within the second disulfide loop of the fourth EGF-like domain showed reduced affinity for moAb 1F2, but retained cofactor activity. These results suggest that the epitope of moAb 1F2 includes the second disulfide loop of the fourth EGF-like domain, which is close to a region required for cofactor activity. Mutant proteins of the third disulfide loop of the fifth EGF-like domain showed loss of interaction with moAb 2A2. Thus the epitope of moAb 2A2 may include the third disulfide loop of the fifth EGF-like domain. Furthermore, replacement of Asn-439 by Gln decreased the cofactor activity and anticoagulant activity, and resulted in low affinity for either moAb 1F2 or 2A2, suggesting that Asn-439, which is located in the second disulfide loop of the sixth EGF-like domain, is critical for determining the functional conformation of the EGF-like domains 4-6.

Synthesis of alpha-L-mannopyranosyl-containing disaccharides and phenols as substrates for the alpha-L-mannosidase activity of commercial naringinase

In order to clarify the substrate specificity of the alpha-L-mannosidase activity of naringinase (Sigma), the following disaccharides and phenol glycosides were freshly prepared: methyl 2-O-(alpha-L-mannopyranosyl)-beta-D-glucoside (1), methyl 3-O-(alpha-L-mannopyranosyl)-alpha-D-glucoside (2), methyl 4-O-(alpha-L-mannopyranosyl)-alpha-D-glucoside (3), methyl 5-O-(alpha-L-mannopyranosyl)-beta-D-glucoside (4), methyl 6-O-(alpha-L-mannopyranosyl)-alpha-D-glucoside (5), 6-O-(alpha-L-mannopyranosyl)-D-galactose (6), p-nitrophenyl alpha-L-mannoside (7), and 4-methyl umbelliferone alpha-L-mannoside (8). These compounds, except for 3 and 5 were hydrolyzed with naringinase.

Establishment of gastric surface mucous cell lines from transgenic mice harboring temperature-sensitive simian virus 40 large T-antigen gene

We succeeded in establishing two gastric surface mucous cell lines (designated as GSM06 and GSM10), which produce periodic acid-Schiff (PAS)- and concanavalin A (Con A)-positive glycoproteins, from a primary culture of gastric fundic mucosal cells of adult transgenic mice harboring a temperature-sensitive simian virus 40 large T-antigen gene. At the permissive temperature (33 degrees C), GSM06 and GSM10 cells grew until confluent monolayers were formed and have now been in culture for more than 9 months with regular passaging. Con A-horseradish peroxidase- and PAS-positive staining indicated that these cells retain the characteristics of gastric surface mucous cells. GSM06 cells showed temperature-sensitive growth in culture and expressed SV40 large T-antigen at the permissive temperature but not at a nonpermissive temperature (39 degrees C). In contrast, GSM10 cells showed temperature-insensitive growth and expressed T-antigen at both permissive and nonpermissive temperatures. To our knowledge, this is the first report of the establishment of gastric surface mucous cell lines from animals. These immortalized cell lines with normal characteristics may serve as good experimental models for the basic and applied biology of gastric surface mucous cells.

Effect of and indication for tonsillectomy in IgA nephropathy

Although more than 20 years have passed since the initial report of IgA nephropathy, the etiology of this disease is still unclear. Some reports suggest that the tonsil is an important etiological factor. We performed tonsillectomy on 26 patients with IgA nephropathy associated with chronic tonsillitis, and followed up the patients for two years after the operation to evaluate its clinical effect on this disease. Twelve patients (efficacy rate 46%) showed distinct improvement in urinary findings after the operation, although the efficacy rate went down as renal injury advanced. Serum IgA levels decreased significantly after the operation both in patients who improved and in those who did not; the decrease was especially evident in patients who had high levels of serum IgA before tonsillectomy. In 4 patients who improved, the level of circulating immune complex (CIC) was extremely high before, and decreased significantly after, the operation. One patient suffered renal failure three years after tonsillectomy. When renal injury has advanced to the clinically apparent degree, as occurred in this patient, tonsillectomy is absolutely contraindicated. In reaching a decision as to whether tonsillectomy is indicated in mild cases, the change in the number of erythrocytes in urinary sediments may be a sensitive parameter of the tonsillar provocation test.

Clinicopathological study of the effectiveness of tonsillectomy in IgA nephropathy accompanied by chronic tonsillitis

Tonsillectomy is often effective in reducing proteinuria in patients with IgA nephropathy (IgAN), which might otherwise lead to renal failure. Twenty-eight patients with IgAN accompanied by chronic tonsillitis were observed for more than 2 years after tonsillectomy and studied clinicopathologically. Tonsillectomy was effective in 17 patients (effective group), but not effective in 11 (noneffective group). Many patients in the effective group showed mild proteinuria, whereas proteinuria of 1 g/24 h or higher was found in a few cases. In comparison with the noneffective group, the levels of serum IgA, polymeric IgA and circulating immune complex (CIC) in the effective group were significantly higher prior to tonsillectomy. Histopathologically, there was only a slight increase in mesangial cells and matrixes in the effective group compared with the noneffective group, and global glomerular sclerosis, small glomerular crescents and interstitial scarring were seldom found. Rupture of the glomerular basement membrane (GBM) occurred more frequently in the noneffective than in the effective group. In a study of IgA subclasses in the mesangial area of the glomerulus, IgA1 was predominantly stained in the effective group.

[Studies on genetic differentiation of Salmonella enteritidis isolates by plasmid profile]

Since 1989, the number of salmonellosis cases caused by S. Enteritidis has increased considerably in Japan. Genetic differentiation of 385 strains isolated from January 1982 to December 1988 and January 1989 to April 1991 were used for plasmid profiles. Plasmids were found in 377 out of 385 strains; therefore, only 8 strains carried no plasmid. Among 377 strains, 15 different plasmid profile types (OP-1 to OP-15) were classified. The most common plasmid profile types from 1982 to 1988 were OP-7 (70 kbp) and OP-8 (70 kbp and 2 kbp). On the other hand, the most common plasmid profile types from 1989 to 1991 were OP-1 (60 kbp) and OP-2 (60 kbp and 54 kbp). Serovar-specific virulence 60 kbp plasmids of S. Enteritidis were identified in 7 plasmid profile types (A total of 200 strains). In the other plasmid profile types, 70 kbp plasmids were found in 5 plasmid profile types (A total of 173 strains). In restriction enzyme analysis of 70 kbp plasmid DNAs obtained from 5 plasmid profile types of S. Enteritidis, we found that these plasmid DNAs shared both 60 kbp and 10 kbp fragments. These results indicate that these plasmid profile types also carried serovar-specific virulence plasmids of S. Enteritidis. The strains of plasmid profile type OP-2 were SA (sulfisoxazole) and SM (streptomycin) resistance, and the 54 kbp plasmids in the strains of OP-2 were transferred by bacterial conjugation into the E. coli strains. All transconjugants acquired SM resistance.

Immunohistochemical distribution of lipoprotein epitopes in xanthomata from patients with familial hypercholesterolemia

Human xanthomas derived from four subjects with familial hypercholesterolemia (3 homozygotes and 1 heterozygote) were studied by immunohistochemical methods to determine the presence and distribution of lipoproteins, which have been implicated in the pathogenesis of atherosclerosis. Oxidatively modified low-density lipoprotein (OxLDL) epitopes detected with anti-OxLDL monoclonal antibodies, appeared to have a similar distribution in xanthomata to that of macrophages, detected by a cell-specific monoclonal antibody. Double antibody labeling with both an anti-macrophage antibody and an anti-OxLDL antibody demonstrated that OxLDL epitopes are associated with macrophages and occurred intracellularly. Low-density lipoprotein (LDL) epitopes were detected extracellularly, with a distribution that was different from that of OxLDL. In addition, apo(a) epitopes detected by an apo(a) specific monoclonal antibody, had a distribution similar to that of LDL in the dermis and subcutaneous tissues. The observed epitope distribution of LDL, OxLDL, or apo(a) was the same regardless of the method of treatment of the patients from whom the xanthomas were obtained (probucol, simvastatin, LDL apheresis). These findings suggest that OxLDL is likely to play a pathogenetic role in the lipid accumulation by macrophages in xanthomas, and suggest that Lp(a) also may play a role in their pathogenesis.

Preparation and biological activity of 2-[4-(thiazol-2-yl)phenyl]propionic acid derivatives inhibiting cyclooxygenase

A series of 2-[4-(thiazol-2-yl)phenyl]propionic acids substituted at various positions were prepared by the reaction of diethyl 2-methyl-2-(4-thiocarbamoylphenyl)malonates with alpha-bromoaldehyde diethyl acetals or alpha-haloketones followed by hydrolysis of esters. The inhibition of prostaglandin H synthetase (cyclooxygenase) was assayed by use of an enzyme preparation from guinea pig polymorphonuclear leukocytes. Examination of the structure-activity relationship of these compounds indicated that the substitution pattern with halogens at position 3 (R1) of the benzene ring and a methyl group in position 4 (R2) and/or 5 (R3) of the thiazole ring were favorable for inhibitory activity. The compounds bearing bulky alkyl or polar functional groups at the R2 position were weak inhibitors. The potent inhibitors of cyclooxygenase were tested for their ability to reduce carrageenin-induced inflammation of rat paws. These derivatives had strong anti-inflammatory activity based on their strong inhibition of cyclooxygenase, with some exceptions, including those with a thiomethyl group at R1.

Analysis of acylcarnitines in maternal urine for prenatal diagnosis of glutaric aciduria type 2

The urinary acylcarnitine profiles of two mothers whose first children were diagnosed to have glutaric aciduria type 2 (multiple acyl-CoA dehydrogenation deficiency, electron transfer flavoprotein (ETF) deficiency) were analysed in the second pregnancy. Large volumes of tigrylcarnitine and isovalerylcarnitine and a little glutarylcarnitine were detected. Each fetus was also diagnosed to be abnormal by enzyme activity and immunoassay of ETF protein. The acylcarnitines in the mothers' urine disappeared in 1 week after labour or artificial abortion. Acylcarnitines were never detected in the urine of controls.

[Carnitine palmitoyltransferase deficiency in a patient with severe psychomotor retardation]

A 13-year-old girl who had severe brain damage due to unknown prenatal cause presented rhabdomyolysis triggered by a mild viral infection. Her muscle biopsy revealed mild variation in fiber size and type 2 fiber atrophy without excess lipid storage. Biochemical analysis of the biopsied material showed decreased carnitine palmitoyltransferase (CPT) activity (15% of the control). Serum and urinary carnitine levels were normal. Skeletal muscle CT scanning showed multiple low density spots. The patient was diagnosed as having CPT deficiency. She recovered from rhabdomyolysis without renal failure after a month with conservative therapy. CPT deficiency is usually found in young healthy persons. This is the first case report of CPT deficiency which presented severe psychomotor retardation since neonatal period.

Macro creatine kinase in a case of carnitine palmitoyltransferase deficiency

A stout man was admitted to the hospital with acute rhabdomyolysis associated with macro creatine kinase (macro-CK, EC 2.7.3.2). This anomaly of CK was detected by gel electrophoresis as an atypical band between CK-MB and CK-MM, classified according to Stein's criteria (Clin Chem 1982; 28:19-24) as type 1, and identified by immunofixation electrophoresis as containing CK isoenzymes MM and MB and immunoglobulin A. Muscle biopsy showed that the etiology of rhabdomyolysis in this case was deficiency of carnitine palmitoyltransferase (CPT, EC 2.3.1.21) in the muscle. We report the first observation of macro-CK in a case of CPT deficiency; its presence may result from recurrent rhabdomyolytic attacks owing to CPT deficiency, and may suggest underlying enzymic abnormality in muscle.

Macro creatine kinase in a case of carnitine palmitoyltransferase deficiency

A stout man was admitted to the hospital with acute rhabdomyolysis associated with macro creatine kinase (macro-CK, EC 2.7.3.2). This anomaly of CK was detected by gel electrophoresis as an atypical band between CK-MB and CK-MM, classified according to Stein's criteria (Clin Chem 1982; 28:19-24) as type 1, and identified by immunofixation electrophoresis as containing CK isoenzymes MM and MB and immunoglobulin A. Muscle biopsy showed that the etiology of rhabdomyolysis in this case was deficiency of carnitine palmitoyltransferase (CPT, EC 2.3.1.21) in the muscle. We report the first observation of macro-CK in a case of CPT deficiency; its presence may result from recurrent rhabdomyolytic attacks owing to CPT deficiency, and may suggest underlying enzymic abnormality in muscle.

Anti-allergic effect of N-acetylneuraminic acid in guinea-pigs

The in-vivo anti-allergic effect of N-acetylneuraminic acid (NANA) in guinea-pigs passively sensitized with anti-ovalbumin rabbit serum has been studied. NANA (20 mg kg-1 i.v.) inhibited bronchial anaphylaxis and the release of histamine into bronchoalveolar lavage fluid. NANA dose-dependently inhibited heterologous passive cutaneous anaphylaxis and haemorrhaging in the passive Arthus reaction. However, it did not inhibit the release of histamine from sensitized minced lung tissue.

Presence and function of chondroitin-4-sulfate on recombinant human soluble thrombomodulin

We constructed a human soluble thrombomodulin (sTM) expression vector using the RSV promoter. Recombinant sTM (rsTM) was expressed in CHO cells and was recovered from culture medium by ion exchange chromatography. Two active fractions, designated as rsTM alpha (low salt elution) and rsTM beta (high salt elution), were detected and further purified by immunoaffinity chromatography. Purified rsTM beta contained bound chondroitin-4-sulfate as judged by HPLC detection of the chondroitinase ABC and AC I digestion product, 2-acetamido-2-deoxy-3-O-(beta-D-gluco-4-enepyranosyluronic acid)-4-O-sulfo-D-galactose. The apparent Kd values for thrombin of alpha and beta were 7.4 and 1.4 nM respectively. RsTM beta was more effective at inhibition of thrombin clotting activity and had antithrombin III-dependent anticoagulant activity which was not possessed by rsTM alpha. Both anticoagulant activities were lost after chondroitinase treatment of rsTM beta.

Carnitine deficiency in inherited organic acid disorders and Reye syndrome

A large quantity of propionylcarnitine in the urine of patients with propionic acidemia and methylmalonic aciduria was demonstrated. The amount excreted depended on the administered L-carnitine dose from 25 to 75 mg/kg/day. A high level of propionylcarnitine was also detected in the amniotic fluid of fetuses at risk of methylmalonic aciduria. Glutaric aciduria type 1 was characterized by excessive urinary excretion of glutarylcarnitine. In a neonate with glutaric aciduria type 2, several specific acylcarnitines were detected in the urine. These included isovaleryl-, acetyl-, isobutyryl-, and butyrylcarnitine as major carnitine esters and glutaryl-, and octanoylcarnitine as minor components. However, the pattern of acylcarnitines excreted changed from isovalerylcarnitine (via leucine) to isobutyrylcarnitine (via valine) during early life. In patients diagnosed as Reye syndrome, tissue carnitine deficiency was not always recognized and no decrease in the free/total carnitine ratio was found in the liver or muscle. The clinical and pathophysiological manifestations seen in these disorders are considered to relate to mitochondrial activity. Therefore, it is necessary to measure acylcarnitine fractions in the urine in order to obtain more precise information about mitochondrial function because carnitine and acylcarnitine compounds may express the metabolic state of mitochondria.

[Three cases of spontaneous rupture of the oesophagus (Boerhaave's syndrome)]

We reported three cases of spontaneous rupture which were surgically treated with direct suture method. One patient was operated on within eight hours after rupture with good results. In two patients diagnoses were made more than two days after rupture. One had esophageal fistula, but completely recovered after cervical oesophageal fistula, and another died of multiple organ failure. In this syndrome, early diagnosis and surgical treatment are essential for acceptable results. For early diagnosis, we emphasized on the presence of roentgenologic mediastinal and cervical emphysema. In patients for whom diagnosis was delayed and post-operative leakage at the oesophageal suture line occurred, temporarily fistulation of the cervical oesophagus proved to be effective in exclusion and diversion of the ruptured segment.

Effect of N-acetylneuraminic acid on respiratory tract secretion and inflammation in the bronchitic rabbit

Long-term exposure of rabbits to SO2 gas caused the following changes in the respiratory tract system: decreases in the respiratory rate and pO2 blood level; an increase in the viscosity of sputum associated with increases in protein, unsaturated phosphatidylethanolamine and sphingomyelin; subacute rhinitis, tracheitis and multiple bronchopneumonia. Pretreatment with repeated administrations (inhalations) of N-acetylneuraminic acid remarkably prevented these inflammatory changes. The significance of this finding is discussed.

An auto-inducible vector conferring high glucocorticoid inducibility upon stable transformant cells

A new gene expression system in mammalian cells was developed by using the glucocorticoid receptor (GR) as an inducible positive feedback factor. Mouse Ltk- cells were transfected with plasmids carrying the GR-encoding gene and the lacZ reporter gene, both of which were fused with the glucocorticoid-inducible enhancer/promotor of the mouse mammary tumor virus (MTV). The GR gene was first induced to supply the receptor protein, which further induced the expression of both GR and reporter genes. Stable transformants induced with dexamethasone, a synthetic glucocorticoid hormone, demonstrated beta-galactosidase activity 60-140-fold higher than uninduced controls. Similarly, the human alpha-interferon-encoding gene fused with the MTV enhancer/promoter was induced more than 12,000-fold. This system allowed us to increase the expression of the reporter or target genes without augmenting basal levels of expression significantly, and may be useful to investigate the unknown function of a cloned gene, particularly when the gene product of interest is cytotoxic or growth-inhibiting.

Identification of benzoylcarnitine in the urine of a patient of hyperammonemia

Benzoylcarnitine was identified in the urine of a patient with a carbamoyl-phosphate synthase I deficiency for whom sodium benzoate and L-carnitine had been used to treat hyperammonemia. This is a newly identified metabolite of benzoate. Its excretion in the urine was increased day by day at the administration of both sodium benzoate and L-carnitine from 0.10 to 2.25 mmol/g creatinine. Since there is the possibility of a secondary carnitine deficiency and an increase of benzoyl toxicity after long-term therapy with benzoate supplementation and protein restriction, it is important to monitor the urinary excretion of benzoylcarnitine.

[A case of dumbbell neurogenic tumors of the mediastinum]

A 49-year-old man was admitted for the further examination of the abnormal shadow of the left posterior mediastinum, which was incidentally detected on routine chest X-ray. He has no complaints, and no abnormalities on neurological examination. Thoracic spine X-ray showed the destruction of the T12 vertebral body and the dilatation of the left intervertebral foramen between T12 and L1. Myelography showed no abnormalities, but contrast-enhanced CT scanned just after myelography revealed the extradural dumbbell-formed tumor. One stage removal of the tumor was safely performed through left posterolateral thoracotomy and transthoracic partial laminectomy. Postoperative course was uneventful. The tumor was histologically schwannoma, originated from the left thoracic sympathetic trunk. We think that this procedure is available for the operation of a kind of dumbbell tumor of the posterior mediastinum.

[A female case of carnitine palmitoyltransferase deficiency]

A 17-year old woman noted myalgia after taking a long distance walk at the age of 10. In adolescence, she had several episodes of myalgia and pigmenturia after athletic activity or infection. At age 17, myoglobinuria and abnormally increased serum creatine kinase were documented after one of these episodes. The neurological examination revealed mild proximal muscle weakness of upper extremities. Electromyography showed myogenic patterns, such as brief, small abundant potentials on them. Venous lactate was raised normally on the ischemic exercise test. During prolonged fasting, plasma ketone bodies increased normally but there were abnormal elevations of plasma creatine kinase and myoglobin. Morphometric analysis of electron microscopy in muscle showed few lipid deposits and that of light microscopy revealed no abnormality. CPT activity in muscle was only 15% of normal value by the isotope-exchange assay. These results were consistent with the diagnosis of CPT deficiency. Although several cases of CPT deficiency with recurrent myoglobinuria have been reported in Western countries, our patients is the first case of Japanese showing recurrent myoglobinuria. CPT deficiency should be considered as a differential diagnosis in cases of recurrent myoglobinuria.

Disproportionate deficiency of iron-sulfur clusters and subunits of complex I in mitochondrial encephalomyopathy

To investigate the molecular abnormality in the mitochondria from various tissues of an autopsied patient exhibiting mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes, we have examined the enzymatic activity, iron-sulfur cluster, and subunit composition of the NADH-ubiquinone oxidoreductase (complex I). Rotenone-sensitive NADH-cytochrome c reductase activity was found to be decreased in all the tissues examined. A detailed study of the liver mitochondria has shown that NADH-ubiquinone oxidoreductase activity was greatly diminished. Analysis of the electron paramagnetic resonance spectra of the liver submitochondrial particles revealed a disproportionate deficiency of iron-sulfur clusters in the complex I segment of the respiratory chain. Signals from the clusters N-2 and N-3 diminished more drastically than those from clusters N-1b and N-4. Immunoblotting analysis showed that the 75-kD, 51-kD, and several other subunits were markedly diminished among multiple subunit polypeptides of complex I. These findings suggest that the underlying bases for mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes are defects, at least, in the complex I subunits containing a flavin and/or iron-sulfur cluster(s), which resulted in deficiencies of some iron-sulfur clusters.

Distribution of free N-acetylneuraminic acid in rat organs

The concentration of free N-acetylneuraminic acid in various rat organs was estimated by gas chromatography/mass spectrometry. Its concentration was in the range of 3.95 to 104.72 micrograms/g wet tissues, being particularly high in the endocrine glands. The ratio of free N-acetylneuraminic acid to total N-acetylneuraminic acid varied from 0.031 to 0.183, being especially high in the adrenal gland (0.181) and heart (0.183).

Urinary acylcarnitines in a patient with neonatal multiple acyl-CoA dehydrogenation deficiency, quantified by a carboxylic acid analyzer with a reversed-phase column

A quantitative analysis for urinary acylcarnitines in a patient with neonatal multiple acyl-CoA dehydrogenation deficiency is described. This method (liquid chromatography) can quantify twelve acylcarnitines including glutarylcarnitine and 3 isomeric acylcarnitines (butyryl-1, valeryl- and octanoylisomer) in urine. Before and up to the 15th hour of DL-carnitine therapy, isovalerylcarnitine was the largest single component existing in urinary acylcarnitines. Its excretion increased approximately 10 times within 1 day of DL-carnitine therapy. However, the acetyl-, the isobutyryl- and the butyrylcarnitine values increased gradually. From the 8th day of the therapy, the isobutyrylcarnitine value exceeded the isovalerylcarnitine. The patient's dominant urinary specific acylcarnitine derived from amino acids oxidation deficiency was changed from isovalerylcarnitine(leucine) to isobutyrylcarnitine(valine) during the early period of DL-carnitine therapy. Glutarylcarnitine was a minor component in the urine. Its degree of increase was as small as that of octanoylcarnitine. 2-Methylbutyrylcarnitine and propionylcarnitine were not detected.

A high-precision selective determination method for free N-acetylneuraminic acid in human serum

We established a high-precision selective determination method for free N-acetylneuraminic acid in human serum, involving capillary gas chromatography-mass spectrometry with selected ion monitoring and specific separation on a Sep Pak silica cartridge. In contrast to the value of 800 ng/ml of N-acetylneuraminic acid previously reported by Haverkamp et al. (J. Haverkamp, R. Schauer, and M. Wember (1976) Hoppe-Seyler's Z. Physiol. Chem. 357, 1699), who used the thiobarbituric acid method, the present method gave a value of 194 +/- 96 ng/ml for 22 serum samples from normal Japanese male volunteers aged between 20 and 30 years. The mass fragmentogram of serum showed a good signal/noise ratio, and the measurement was very specific, accurate, and reproducible.

Atypical form of Menkes kinky hair disease with mitochondrial NADH-CoQ reductase deficiency

A male infant with an atypical form of Menkes kinky hair disease showed mitochondrial NADH-CoQ reductase (complex I) deficiency in a femoris muscle biopsy. His clinical features consisted of hypotonicity of the upper limbs, hyper-reflexia of the lower extremities, abnormal hair and fine myoclonic movement of the hands. The serum levels of copper and ceruloplasmin were just below normal range, and the copper concentration in fibroblastic cells was much increased (101.2 ng/mg of protein). The occurrence of this case suggests that there may be a mild form of Menkes disease with a NADH-CoQ reductase deficiency or other mitochondrial enzyme defects.

[A case of bronchial carcinoma showing regression upon intratumoral administration of OK-432]

A 38-year-old female suffering from chronic respiratory symptoms due to lung cancer occupying the left main bronchus was treated by frequent intratumoral injections of OK-432. The immune-modifying therapy was performed as follows; 0.2 KE of OK-432 was injected intracutaneously once a week, then the dose was gradually increased to 3.0 KE once a week. Following immunization, intratumoral injection was done under endoscopy at a dose of 3.0 KE every two weeks. Three months later, the tumor showed remarkable regression, and clinical symptoms were diminished. In conclusion, intratumoral injection of OK-432 was considered to be very beneficial in lung cancer.

Binding site of alpha 2-plasmin inhibitor to plasminogen

Peptide T-11, a carboxyl terminal tryptic fragment of alpha 2-plasmin inhibitor, inhibits the reversible first step of the reaction between plasmin and alpha 2-plasmin inhibitor. To elucidate which amino-acid residues played a important role in the inhibitory activity of peptide T-11, we prepared the various synthetic derivatives of peptide T-11 and determined the peptide concentration that inhibited the apparent rate constant of the reaction between plasmin and alpha 2-plasmin inhibitor by 50% (IC50). Peptide III, which lacked the residues Gly-1 to Pro-7 of peptide I (peptide T-11), had a strong inhibitory activity, like peptide I (IC50: peptide I, 7 microM; peptide III, 13 microM). The peptides that lacked the Leu-9 and Lys-10 or Lys-26 of peptide III showed much weaker activity, and the loss or amidation of the C-terminal lysine of peptide III also markedly reduced the inhibitory activity. Peptide III competitively inhibited the binding of [14C]tranexamic acid to kringle 1 + 2 + 3 (K1-3) and kringle 4 (K4) in a binding assay performed by the gel-diffusion method. The respective dissociation constants (Kd) of peptide III for K1-3 and K4 were 0.85 microM and 35.2 microM. These data suggest that the amino residue of Lys-10 and the carboxylic acid of Lys-26 in peptide T-11 play crucial roles in the ionic binding of alpha 2-plasmin inhibitor to the tranexamic acid-binding site (lysine-binding site) of plasminogen. Peptide T-11: H-G-D-K-L-F-G-P-D-L-K-L-V-P-P-M-E-E-D-Y-P-Q-F-G-S-P-K-OH.

Effects of human pancreatic polypeptide on exocrine pancreatic function in conscious rats

The effect of newly synthesized human pancreatic polypeptide (hPP) on pancreatic secretion stimulated by a diversion of bile-pancreatic juice (BPJ) from the intestine, and plasma hPP concentration were examined in conscious rats. Exogenous hPP infusion (1, 10 micrograms/kg/hr) inhibited pancreatic protein, bicarbonate and fluid outputs during BPJ diversion in a dose-dependent manner. During 1 and 10 micrograms/kg/hr hPP infusion plasma hPP immunoreactivity increased to 369 +/- 22.9 and 1,125 +/- 90.2 pg/ml, respectively. These results suggest that newly synthesized hPP has an inhibitory activity on exocrine function of the pancreas.

Clinical and immunological study of IgA nephropathy before and after tonsillectomy

The clinical course and the changes of the levels of immunological factors after tonsillectomy in several cases of IgA nephropathy associated with chronic tonsillitis are presented in this paper. In the first study, here called Part I, 16 cases of IgA nephropathy were observed with regard to the clinical course and the changes of immunological factors after the operation. Postoperatively, proteinuria disappeared in 9 cases and improved in 3 and the levels of serum IgA, the circulating immune complex (CIC) and serum polymeric IgA decreased. In the next study, Part II, 10 cases of IgA nephropathy were investigated regarding the changes of the levels of serum IgA, C3, C4, CH50, APCH50 and CIC after the provocation test and tonsillectomy. A tendency of decreasing levels of C3 and APCH50 combined with an increase of CIC was observed within one week after provocation. Decreases in the levels of serum IgA, polymeric IgA, C3 and APCH50 were also observed after the operation. From these results, it is suggested that the tonsillar lesion has a tendency to continue the pathogenetic effect on the disease and exacerbate its clinical symptoms.

[Two cases of persistent primitive artery associated with anterior communicating aneurysm]

Two aneurysm patients who have persistent primitive artery are reported. Both patients were admitted to our hospital under the diagnosis of subarachnoid hemorrhage. Carotid angiograms revealed saccular aneurysms in the anterior communicating artery. One case had the right persistent trigeminal and the other had the right persistent hypoglossal artery. Both patients were treated by aneurysmal neck clipping successfully. The incidence of association of persistent primitive trigeminal artery with intracranial vascular disease is 25%, in which 14% of cases have the intracranial aneurysms. Other congenital anomalies of the intracranial artery co-existent with intracranial aneurysm have been considerably reported so far. Our cases might suggest that congenital factors have taken part in the formation of the intracranial aneurysm.