[Primary testicular carcinoid tumor: a case report]

This report describes a primary testicular carcinoid. A 41-year-old male was hospitalized with an asymptomatic right testicular mass. A high inguinal orchiectomy was done after the diagnosis of the testicular tumor. Pathologically, the tumor showed the typical appearance of a carcinoid tumor. A computed tomographic scan and other studies could not demonstrate any metastasis elsewhere. He has remained well and without any evidence of recurrence.

Vgamma1+ gammadelta T cells play protective roles at an early phase of murine cytomegalovirus infection through production of interferon-gamma

Cytomegalovirus (CMV) causes severe opportunistic infection in immunocompromised hosts. The importance of conventional alphabeta T cells in protection against CMV infection has been well documented. However, the role of the second T-cell population (which express the gammadelta T-cell receptor) in CMV infection is not known. In the present study, we analysed the function and protective role of gammadelta T cells in a murine cytomegalovirus (MCMV) infection model. After intraperitoneal infection with MCMV, the number of gammadelta T cells increased in the liver and peritoneal cavity from day 3, and reached a peak on day 5. The gammadelta T cells showed an activated T-cell phenotype and predominantly expressed Vgamma1, which is known to be expressed by heat-shock protein 65 (hsp 65)-specific gammadelta T cells. Analysis of cytokine expression demonstrated that the MCMV-induced gammadelta T cells expressed interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha) but not interleukin-4 (IL-4), implying their participation in the cell-mediated immune response against MCMV. Depletion of gammadelta T cells by anti-T-cell receptor (TCR) gammadelta monoclonal antibody (mAb) treatment resulted in significant increase of virus titre and decrease of IFN-gamma in the liver on day 3 after MCMV infection, which further supports the importance of gammadelta T cells in early protection against infection. Finally, the MCMV-induced gammadelta T cells produced IFN-gamma in vitro in response to hsp 65. Our results suggest that gammadelta T cells participate in early protection against MCMV infection through recognition of hsp 65 and production of IFN-gamma.

[Endocrine therapy of stage D2 prostate cancer--comparison of drugs used for total androgen blockade]

Patients with Stage D2 prostate cancer were treated with surgical or medical (LHRH analog) castration combined with either estrogen, chlormadinone acetate or flutamide as initial therapy. The effect of each medication was compared. The overall survival, cause-specific survival and relapse-free survival were not different among the three medications. Patients given each medication were divided into two groups each according to grade, extent of diseases on bone metastases, and levels of tumor marker. Survivals of the corresponding two groups were compared with each other among different medications. No differences were revealed with any medication. There were no serious side effects in whole patients, except that grade 2 liver dysfunction was accompanied in 12% of flutamide-treated group. It is concluded that the three drugs used with castration did not make any difference in the survival of stage D2 patients, and differences between medications were seen in the frequency of side effects.

Effect of ozagrel on locomotor and motor coordination after transient cerebral ischemia in experimental animal models

The effect of ozagrel, a selective thromboxane A(2) (TXA(2)) synthetase inhibitor, on the obstruction after cerebral ischemia-reperfusion was studied in experimental animal models. The reduced spontaneously locomotor activity and the obstruction of motor coordination were improved by the administration of ozagrel in the conscious cerebral ischemia-reperfusion mouse model. Ozagrel suppressed the decrease in specific gravity of the brain tissue induced by the occlusion-reperfusion in the conscious cerebral ischemia-reperfusion SHR model, and recovered the postischemic decrease in cortical PO(2) after middle cerebral artery occlusion-reperfusion in cats. The level of TXB(2), a metabolite of TXA(2), in the brain increased after the cerebral ischemia-reperfusion, and ozagrel prevented this increase. Additionally, ozagrel also increased the level of 6-keto-PGF(1alpha), a metabolite of prostaglandin I(2) (PGI(2)), in the brain tissue after cerebral ischemia-reperfusion, and the administration of PGI(2) improved the reduced spontaneous locomotor activity in the conscious cerebral ischemia-reperfusion mouse model. Our data suggest that ozagrel suppressed the obstruction following cerebral ischemia-reperfusion by preserving the cerebral blood flow via preventing the increase in TXA(2) and causing an increase in the PGI(2) level.

[Morphometric development and the variability of neurons of the human auditory system: ventral cochlear nucleus and superior medial olivary nucleus]

The development of the human ventral cochlear and medial superior olivary nuclei was studied. We made serial sections of the brain in 10 fetuses at 16-40 weeks of gestation (WG), an infant at 2 months of age and an adult of 63 years using an electronic planimeter with a computer. Although the shape of neurons of the two nuclei was different, our morphometric analysis showed that the development of both of them accelerates between 18 and 21 WG in terms of the columnar length and volume, neuronal size and circularity ratio and the amount of Nissl bodies increases gradually.

Disulfide formation in bovine zona pellucida glycoproteins during fertilization: evidence for the involvement of cystine cross-linkages in hardening of the zona pellucida

The time for solubilization of the bovine zona pellucida in a hypotonic buffer containing 5% (v/v) beta-mercaptoethanol and 7 mol urea l-1 increased by 10% after fertilization. Coupling with a specific fluorescent thiol probe, monobromobimane (mBBr), was markedly greater in the zona pellucida of ovarian eggs compared with fertilized eggs, indicating that the cysteine residues in the zona pellucida of unfertilized eggs are oxidized to cystines during fertilization. After endo-beta-galactosidase digestion to remove N-acetyllactosamine repeats of the carbohydrate chains, three zona pellucida glycoproteins (ZPA, ZPB and ZPC) coupled with the fluorescent bimane groups were fractionated efficiently by reverse-phase HPLC. Estimation of bimane groups in the three components and SDS-PAGE revealed that intramolecular disulfide bonds in ZPA and intra- and intermolecular disulfide bonds in ZPB were formed during fertilization, but oxidation of cysteine residues in ZPC was low. Specific proteolysis of ZPA during fertilization was also observed. These results indicate that the formation of disulfide linkages together with specific proteolysis result in the construction of a rigid zona pellucida structure, which is responsible for hardening of the zona pellucida.

Effects of tranilast on cultured rabbit corneal keratocytes and corneal haze after photorefractive keratectomy

PURPOSE

In vitro and in vivo studies were performed to elucidate the effects of tranilast on cellular proliferation and collagen synthesis.

METHODS

Subculturing was carried out using keratocytes from rabbits that underwent photorefractive keratectomy (PRK) and developed corneal haze, and keratocytes from normal rabbit cornea.

RESULTS

Tranilast suppressed proliferation in cultured keratocytes from the corneal haze region at doses of 30 and 300 micromol/L and collagen synthesis at doses of 3, 30, and 300 micromol/L. Normal corneal cultures showed suppression of keratocyte proliferation and collagen synthesis only at a high dose of tranilast (300 micromol/L). Betamethasone suppressed proliferation of keratocytes in both haze and normal cornea at a dose of 10 micromol/L, as well as collagen synthesis at respective doses of 1 and 10 micromol/L. Diclofenac sodium suppressed collagen synthesis of keratocytes in haze cornea at a high dose of 100 micromol/L, and in keratocytes in normal cornea, at doses of 10 and 100 micromol/L. In an in vivo study, either 0.5% tranilast, 0.1% betamethasone phosphate eye drops, or a tranilast base solution (control) was instilled four times daily to rabbits that had undergone PRK. Weekly evaluation of the inhibitory effect of these drugs on the development of haze was performed 2 weeks after surgery. Tranilast suppressed haze 6-13 weeks after PRK, but betamethasone phosphate showed no effect.

CONCLUSION

These results indicate that tranilast is potentially effective for inhibiting the corneal haze that occurs after PRK.

[Electroconductive lithotripsy: clinical results of the Sonolith sigma]

The electroconductive lithotripter (ECL) is a new concept for shockwave generation in which a highly conductive solution channels the discharge between the anode and cathode. Out of 152 patients treated, complete follow up data were available on 151 patients. The average number of shocks per treatment was 2,138. At 3 months the overall stone-free rate was 73.5%. Success rate, defined as stone-free or asymptomatic residual fragments measuring 4 mm or less, was 84.9% for renal and 94.9% for ureteral calculi. The overall success rate for all calculi was 89%.

[Topography and number of cortical tubers in tuberous sclerosis: comparison between patients with and without West syndrome]

To reveal the role of cortical tubers in the pathophysiology of West syndrome associated with tuberous sclerosis, we studied their numbers and topography, focusing on the differences between patients with infantile spasms and without infantile spasms. We reviewed the clinical date on the seizure types, seizure evolution and developmental status of 13 patients: 8 patients with infantile spasms (the West syndrome group) and 5 patients without infantile spasms (the non-West syndrome group). The number, size and location of the cortical tubers were evaluated on 5 mm-thick T2-weighted MR images. The average number of cortical tubers of the West syndrome group was 11.4 per patient, being larger than that of the non-West syndrome group (7.8). The West syndrome group included two patients with only one tuber. The average number of the cortical tubers in the occipital lobes of the West syndrome group was 2.4, which was larger than that of the non-West syndrome group (0.8). From these results, a large number of cortical tubers, which suggest involvement of larger cerebral cortical regions, increase the possibility of the West syndrome in patients with tuberous sclerosis. On the other hand, some patients with only one or few cortical tubers developed West syndrome, which may suggest the presence of a region critical on the development of West syndrome. Our results also suggest that lesions in the occipital lobes might be more significant than those in other lobes. However, the results of this study are diverse, to some extent, which may have resulted from variable epileptogenicity of the cortical tubers. It is necessary to conduct further study, including a greater number of patients, to reveal topographic pathophysiology in West syndrome.

Strongyloides ratti: additive effect of testosterone implantation and carbon injection on the susceptibility of female mice

A sex-related difference in host susceptibility to Strongyloides ratti was previously known. Male mice were more susceptible to S. ratti infection and the difference was seen against migrating larvae under the regulation of testosterone. Against migrating larvae, macrophages were assumed to play important roles in host natural immunity. On the basis of these findings, to examine the effect of testosterone on macrophages we treated female mice with testosterone and/or carbon to block the function of macrophages. Mice were then infected with third-stage larvae of S. ratti. By counting of the migrating larvae in the cranial cavity at 36 h after infection the effect of each treatment was assayed. Testosterone treatment alone (Te) or carbon injection alone (Ca) effectively increased the worm recovery. Given together, Te and Ca (Te + Ca) significantly increased the worm recovery to levels almost equal to the sum of those achieved with Te and Ca. The serum testosterone concentration was elevated in mice that had undergone Te and Te + Ca at the time of worm recovery. Surprisingly, the serum testosterone concentration reached after Te + Ca was elevated more than that attained by Te. The same experiment with a half-dose of Te and Ca (Te half + Ca) resulted in the same testosterone concentration achieved with Te and resulted in a worm recovery almost equal to the sum of that achieved with Te and Ca. These results clearly showed that Te and Ca had an additive effect on the recovery of migrating S. ratti larvae. Testosterone had an effect after macrophages had been blocked. The relationship between testosterone and macrophage function during S. ratti infection is discussed.

Cytocidal activity of PBL, LAK, and IDEC-C2B8 and expression of HLA class 1, ICAM-1, and CD20 in vincristine-resistant hematologic cell lines

This study was designed to determine whether the cytocidal activity of immunotherapy such as cytotoxic peripheral blood lymphocytes (PBL), lymphokine-activated killer (LAK) cells, and chimeric anti-CD20 mouse/human monoclonal antibody, IDEC-C2B8, overcome vincristine (VCR) resistance in cultured cell lines derived from human leukemia/lymphoma. In addition, the relation between the susceptibility to these immunotherapies and the expression levels of HLA class 1 and ICAM-1 as well as CD20 on the cell surface was analyzed. Three of six VCR-resistant cell lines were less susceptible to PBL cytotoxicity compared with wild-type cells, whereas the susceptibility was kept in the other three VCR-resistant cell lines. Four of six VCR-resistant cell lines were less susceptible to LAK activity and the other two cell lines were as sensitive to LAK cells as their wild-type counterparts. There was no correlation between the susceptibility for PBL cytotoxicity and the expression of HLA class 1 in both wild and VCR-resistant cells. In contrast, ICAM-1 in the two cell lines that showed decreased susceptibility for LAK cytotoxicity disappeared, although that in one cell line increased. IDEC-C2B8 was effective only against B-cell lines expressing CD20. One cell line in which the expression of CD20 increased was nearly six times more sensitive to IDEC-C2B8 than wild type. Thus, we concluded that the resistance to VCR in some tumor cell lines is associated with modified susceptibility for immunotherapies by the different expression of target molecules from those of wild-type counterparts.

Evaluation of functional bladder capacity in Japanese children

BACKGROUND

Functional bladder capacity is a very important factor in the diagnosis of children with voiding disorders. Because Japanese children are thought to have somewhat smaller functional bladder capacity compared with Western children, the convenient formula (so-called Koff formula) bladder capacity (in ounces) = age (in years)+ 2 is not suitable for use in Japanese children.

METHODS

We measured the bladder capacities of 131 Japanese children aged 5-15 years without clinical voiding pattern abnormalities to develop a practical guideline for the prediction of normal bladder capacity for age.

RESULTS

An approximate formula relates age and bladder capacity as: bladder capacity (mL) = 25 x (age (years) + 2).

CONCLUSIONS

The formula presented is thought to be a useful guide for the diagnosis of small, normal or large bladder capacity and offers information on voiding disorders in Japanese children.

[Lissencephaly type I: electroencephalographic findings and neuroradiological classification]

Lissencephaly type I is a diffuse type of migration disorder that contains agyria and/or pachygyria on the brain surface. We experienced 5 cases of this disease and evaluated their electroencephalographic findings and seizure types based on the neuroradiological classification of lissencephaly. Ages at seizure onset ranged from 2 months to 4 months (mean 3.2 months). The patients with complete agyria had generalized tonic seizures, and those with pachygyria partial seizures or tonic spasms. The characteristic findings of complete agyria in electroencephalogram were high-voltage alfa activity. The amount of high-voltage slow waves increased with the ratio of pachygyria on the brain surface. The appearance of multifocal spikes and sharp waves suggested irregular arrangement of pachygyria on the brain surface.

Protective effects of hochu-ekki-to, a Chinese traditional herbal medicine against murine cytomegalovirus infection

The innate immunity against murine cytomegalovirus (MCMV) at the early phase of infection is mediated by NK cells and macrophages. We studied the effects of hochu-ekki-to (HET), a traditional Chinese herbal medicine, on the regulation of innate immunity mediated by NK cells and macrophages. We found the oral administration of HET to increase both the number of leukocytes in the spleen and liver and the splenic NK cell cytotoxicity associated with the increased induction of serum IFN-alpha/beta after an MCMV infection but it had no effect on liver NK cells. However, no differences were found in the serum IL-12, IFN-gamma, TNF-alpha and nitric oxide (NO) production in the culture of macrophages between the HET- and PBS-treated mice on day 2 after MCMV infection. In addition, HET-treated splenic and peritoneal macrophages were found to show a higher intrinsic resistance against in vitro MCMV infection than that of PBS-treated mice. Therefore, the HET-induced effects on NK cells and macrophages selectively reduced the viral load in the spleen but not in the liver at an early phase of MCMV infection. HET may thus be useful in the treatment of human cytomegalovirus infection which commonly occurs in HIV-infected AIDS patients.

[Childhood multiple sclerosis and allied demyelinative diseases]

We report five cases of multiple sclerosis (MS) and three cases of allied demyelinative diseases starting during childhood. Three of the MS patients presented with atypical initial symptoms, such as acute encephalitis or myelitis, making an early clinical diagnosis difficult. Ophthalmologic symptoms were noted in four of MS children, and in two with allied demyelinative diseases. Therefore, if a child shows ophthalmologic symptoms (i.e. optic neuritis, ophthalmoplegia), brain magnetic resonance imaging (MRI) should be conducted for the differential diagnosis of MS and other demyelinative diseases. Cerebrospinal fluid analysis is not useful for the initial diagnosis of MS, because pleocytosis and increase of oligoclonal IgG band in cerebrospinal fluid are seen in both MS and other demyelinative disorders. However, neuron specific enolase (NSE) is slightly higher in the latter than in the former. T2-weighted MRI of multiple sclerosis showed multiple high intensity areas in the white matter of the cerebrum and cerebellum, capsula interna, and crus cerebri etc. Most of these lesions were clinically silent, being characteristic of MS. In two MS cases, however, initial MRI revealed no abnormal findings. Thus, the diagnosis of MS can not be made by initial MRI only.

Effect of clot removal and surgical manipulation on regional cerebral blood flow and delayed vasospasm in early aneurysm surgery for subarachnoid hemorrhage

BACKGROUND

Effect of clot removal and surgical manipulation on cerebral blood flow (CBF) and delayed vasospasm was studied in early aneurysm surgery for subarachnoid hemorrhage (SAH).

METHODS

Thirty-two patients in this study fulfilled the following criteria: ruptured anterior communicating aneurysms, computed tomography (CT) within 2 days and unilateral pterional approach within 3 days after the ictus, bilaterally symmetrical clots without intracerebral hematoma, no postoperative complication, and CBF studies with single photon emission computed tomography (SPECT) with 123I-IMP.

RESULTS

Postoperative regional hypoperfusion due to brain retraction was frequently recognized on 123I-IMP-SPECT without infarction. The regional CBF (rCBF) showed a continuous fall during the first 4 weeks after the ictus, followed by improvement. The rCBF in the vicinity of the surgical route was significantly lower, especially in the acute stage (Day 3-7). A significant association between decrease of cisternal blood after surgery and the degree of local vasospasm and local CBF values during spasm stage was observed in the interhemispheric cisterns, A2 and medial frontal cortex, but not in the sylvian fissure or insular cisterns, M1 or M2, and frontal watershed and temporal cortex.

CONCLUSIONS

The present study provides evidence for the effectiveness of direct clot removal by early surgery for SAH on local vasospasm and CBF reduction. However, a potential improvement in local CBF with clot removal could be masked by brain retraction, which was demonstrated to affect rCBF adversely. Therefore, it is critical to perform brain retraction as gently as possible.

Detection of histo-blood group ABO mRNA in human chronic myeloid leukemia cell lines using reverse transcription-polymerase chain reaction (RT-PCR)

ABH carbohydrate antigens are cell surface carbohydrates which occur in three allelic forms, namely A, B and O blood groups. It is unknown how the ABO blood group is expressed in hemopoietic stem cells. In an attempt to verify the ABO mRNA expression in hemopoietic precursor cells, mRNAs were isolated from human chronic myeloid leukemia (CML) cell lines which are believed to be at the most immature level of hemopoietic differentiation among hemopoietic malignancies. In particular, K-562 and KOPM-28 cells were used with the reverse transcription-polymerase chain reaction (RT-PCR) technique for amplifying ABO gene transcripts. The amplified ABO cDNAs from two cell lines were characterized by the digestion of Kpn-I restriction enzyme. The blood types were determined by polymerase chain reaction of the specific allele (PASA) method. Both of the human chronic myeloid leukemia cell lines expressed ABO mRNA. The quantity of ABO mRNA in the K-562 cell line is significantly higher than that of the KOPM-28 cell line. The ABO blood type of these two cell lines was type O. Because the CML cell lines are presumed to be at the immature stem cell level of hematopoietic cell differentiation and because it is believed that the cultured cell lines from hematologic malignancy reflect the characteristics of normal corresponding hemopoietic cells, the hemopoietic stem cells should express mRNA of the ABO blood group.

Role of macrophages in acute murine cytomegalovirus infection

It has been recognized that macrophages play an important role in controlling virus infection in experimental animal models. To evaluate the role of macrophages in acute murine cytomegalovirus infection, macrophages in the spleen and the liver were eliminated by an intravenous injection of liposomes containing a cytolytic agent, dichloromethylene diphosphonate. The depletion of macrophages led to a significant increase of virus titer in the spleen and lungs in both susceptible BALB/c and resistant C57BL/6 mice during the first three days after intravenous infection. In the spleen, the increase of virus titer in macrophage-depleted BALB/c mice was much greater than that in NK cell-depleted mice. These results suggest that macrophages contribute to protection mainly by the mechanisms which are independent of NK cells during the first three days after infection. The increase of virus titer in macrophage-depleted C57BL/6 mice was as great as that in NK cell-depleted mice because of the high contribution of NK cells to protection in C57BL/6 mice. In the liver in both strains of mice, the effects of macrophage depletion on virus titer were not as much as those in the spleen and lungs. Furthermore, the local depletion of peritoneal macrophages resulted in a great increase of virus titer in the spleen at three days after intraperitoneal infection. We conclude that macrophages greatly contribute to decreasing the virus load in some organs possibly through either or both intrinsic and extrinsic mechanisms in the early phase of primary infection with murine cytomegalovirus.

[Trends of prostate cancer: comparison between 1986-90 and 1991-95 at Asahi General Hospital]

Patients with prostate cancer treated during 1986-95 were divided into two groups: the first five years as early period and the recent five years as late period. Background factors, therapeutic modality and prognosis were compared between these two groups. The number of patients during the late period (245) was about 1.5 fold that during the early period (161). The average age for each stage are similar within the same period, and also similar between early and late periods. Almost the same ratios were noticed on stage distribution and on histological grade between early and late periods. Therefore, the increase in the number of patients in recent years was due mainly to expansion with the same proportion of background factors. Patients with T2 and T3 during the late period received more aggressive treatments with/without endocrine therapy. Subsequently these patients seemed to show better prognosis than the patients during the early period. No differences in survival of patients with metastosis was revealed between these two periods. Therefore, the outcome was not improved by recent endocrine therapy.

Effect of MDR antagonists on the cidal activity of vincristine for cells expressing MDR-1 is superior to those expressing MRP

In an attempt to identify the target protein, P-GP or mrp, of each MDR antagonist, verapamyl (Ver), dipyridamole (Dip), or cyclosporin A (Cy-A), this study was designed to compare the activity of the three afore-mentioned drugs and to test their combined effect on the cidal activity of vincristine (VCR) in five types of wild and the corresponding VCR-resistant cultured cell lines from human leukemia and lymphoma. Three of the VCR-resistant cell lines are characterized by the overexpression of mdr-1, while two cell lines overexpress mrp. We found that all three antagonists additively to synergistically enhanced the cidal activity of VCR for the five wild-type and VCR-resistant cell lines in a dose dependent manner when used singly. Combinations consisting of a 20% inhibitory concentration (IC20) of VCR plus two antagonists also showed additive to synergistic effects on both wild and VCR-resistant cell lines. It is of interest that the combined effect of IC20 VCR plus MDR antagonists on the three VCR-resistant cell lines expressing mdr-1 was significantly superior to those of the two cell lines expressing the mrp gene. These results suggest that the combined effect of MDR antagonists work better than their single use and that the MDR antagonists work more efficiently in cells showing drug resistance through mdr-1 than in those utilizing mrp.

Expression of growth factor ligand and their receptor mRNAs in bovine ova during in vitro maturation and after fertilization in vitro

We analyzed the expression of mRNAs for growth factor [epidermal growth factor (EGF), insulin-like growth factor-I (IGF-I), basic fibroblast growth factor (bFGF) and platelet-derived growth factor A chain (PDGF-A)] and their receptor (R) by reverse transcription-polymerase chain reaction in bovine ova during oocyte maturation in vitro (0-21 hr) and after fertilization in vitro (6-144 hr: zygotes to blastocysts). Transcripts for EGF were not found before fertilization. Transcripts for IGF-I were present in immature oocytes immediately after collection and in embryos from the 2-cell stage onward. Transcripts for bFGF were present in all stages of oocyte maturation and after fertilization up to the 16-cell stage. Transcripts for PDGF-A were present in all stages of oocyte maturation and after fertilization up to the 2-cell stage. Transcripts for ErbB3 (a member of the EGF-R subfamily), and bFGF-R were present in all stages of oocyte maturation, after fertilization up to the 2-cell stage, and the blastocyst stage. Transcripts for IGF-I-R and PDGF-Ralpha were present in all stages of oocyte maturation and embryo development. The results of this study showed that eight different messages for growth factor and their receptor were detectable in bovine ova during oocyte maturation and/or after fertilization in vitro and their expression patterns were the gene-specific rather than the developmental stage of bovine ova.