Methimazole interferes with the progression of experimental autoimmune myocarditis in rats

In order to ascertain whether methimazole, a drug commonly used for the treatment of hyperthyroidism, interferes with the progression of autoimmune-mediated myocardial injury, we investigated the effect of methimazole on experimental autoimmune myocarditis (EAM) in rats. EAM was induced by immunization with porcine cardiac myosin. Methimazole administration markedly slowed the body weight growth in both normal and EAM rats, but did not induce morphologic change of cardiac tissue in normal rats. In EAM rats, macroscopic examination revealed discoloration of the cardiac surface, and histopathological examination by light microscopy showed extensive myocardial necrosis, infiltration by inflammatory cells and myocardial fibrosis. In the EAM rats treated with methimazole, the discolored areas on the cardiac surface were markedly diminished in size, and the myocardial necrosis, cellular infiltration and fibrosis were significantly less severe. To identify the mechanism responsible of this effect, we investigated the change of regulatory lymphocyte subsets in peripheral blood using an immunofluorescence technique with a flow cytometer. A decrease in the helper/suppressor T cell ratio as a result of the increased proportion of suppressor T cells and a decrease in the proportion of B cells were observed in normal rats after methimazole administration, and similar findings were made in the EAM rats treated with methimazole. These results indicate that methimazole interferes with the progression of EAM, and immunosuppression may, at least in part, be involved in the inhibitory effect of methimazole on EAM in rats.

The usefulness of laparoscopy-assisted distal gastrectomy in comparison with that of open distal gastrectomy for early gastric cancer

BACKGROUND

The technique of laparoscopy-assisted distal gastrectomy (LADG) was developed for early gastric cancer, but its feasibility and the associated clinical outcome remain unclear.

METHODS

We reviewed 24 patients who underwent LADG (LADG group) and 35 patients who underwent traditional open distal gastrectomy (ODG group) for early gastric cancer in our hospital, and compared the clinical data of the two groups.

RESULTS

The clinical and pathological backgrounds of the patients in the two groups were similar. The duration of surgery was not significantly different between the two groups, but the blood loss in the LADG group was significantly less than that in the ODG group. The number of removed lymph nodes was not significantly different between the two groups. The times to the first passing of flatus, first walking, and the restarting of oral intake; the length of hospital stay; and the duration of epidural analgesia were significantly shorter in the LADG group. The morbidity rate in the LADG group was lower than that in the ODG group.

CONCLUSIONS

LADG is a safe and minimally invasive surgical technique, after which we can expect a faster recovery.

The Bacillus subtilis rec-assay: a powerful tool for the detection of genotoxic substances in the water environment. Prospect for assessing potential impact of pollutants from stabilized wastes

The Bacillus subtilis rec-assay has been specially developed to detect genotoxicity in environmental water samples. The rationale of the B. subtilis rec-assay is based on the relative difference of survival of a DNA repair-recombination proficient strain and its deficient strain, which is interpreted as genotoxicity. This assay method can be very powerful in that it has higher sensitivity for the detection of mutagens in highly polluted waters than other bacterial mutation assays. Hydrophobic fractions from various environmental waters were fractionated by using XAD-2 resins and assayed, targeting the detection of organic genotoxic substances. Genotoxic response was detected in most of them, which revealed that many unknown micropollutants with genotoxicity occur in public water bodies. Positive response was also detected from a treated municipal solid waste (MSW) landfill leachate. Genotoxicity remaining in the treated effluent suggests that genotoxic micropollutants may pass through conventional water treatment processes such as activated sludge treatment process. Without proper control of waste quality and landfill facilities, waste landfill could be a heavy pollution source.

Biological iron oxidation-reduction and the effects on sulfur oxidation-reduction, denitrification and poly-P accumulation in an anaerobic-oxic activated sludge

Iron oxidation and reduction were examined using the activated sludge from a municipal plant. Iron contents of the activated sludge were 1-2%. Iron oxidation rates were correlated with the initial iron concentrations. Iron reducing rates could be described by the Monod equation. The effects of iron reducing bacteria on sulfate reduction, denitrification and poly-P accumulation were examined. Iron reduction suppressed sulfate reduction by competing with hydrogen produced from protein. Denitrification was outcompeted with iron reduction and sulfate reduction. These phenomena could be explained thermodynamically. Poly-P accumulation was also suppressed by denitrification. The activity of iron reduction was relatively high.

Effect of solution parameters on the removal efficiency of humic substances by a reuse material

This paper provides an overview of the ability of polypropylene (PPL), a synthetic polymeric adsorbent made from reused plastic material. The removal of humic substances (HS) in a solution pretreated with dedoxyltrimethylammoniumbromide (DDTMAB), a cationic quaternary ammonium compound (QAC), was studied under various conditions. The removal of HS was achieved in its solute complexed form but also as suspended solids. The conditions of the HS solution, which fluctuation was suspected to have an impact on the performance of the adsorbent, were tested. The parameters investigated included the pH, the initial concentration of the surfactant, and the presence of suspended solids in solution. The results of the laboratory scale experiments showed that PPL removal efficiency of HS is strongly pH dependant with higher removal achieved at pH greater than 7. However, the shift for pH above 7 induced an increase in the optimum doses of DDTMAB as more and more deprotonated HS become available to react with DDTMAB. Ionic strength did have the opposite effect: the increase of ionic strength by addition of NaCl decreased PPL removal of HS.

Workshop 8 (synthesis): challenges of expanding ecological sanitation into urban areas

After seven papers discussing specific examples of ecological sanitation projects, the workshop considered the background, motivation and feasibility of this technology. It was agreed that ecological sanitation could help tackle water scarcity, health protection and, by recycling water and nutrients into agriculture, food scarcity. Dense cities are probably unsuitable for its implementation, but rural, town and peri-urban areas are promising. Key issues that remains are: the microbiological and chemical risks associated with the technology; the need for major information, education and support programmes; effective linking to reuse schemes; tailoring systems to meet local physical, socio-economic and cultural circumstances.

Regulation of transcription and chromatin by methyl-CpG binding protein MBD1

DNA methylation is important for epigenetic regulation of genome, and it is interpreted by specific protein factors that contain a highly conserved methyl-CpG binding domain (MBD). There are at present five mammalian MBD family proteins: MBD1, MBD2, MBD3, MBD4 and MeCP2. In the family of methyl-CpG binding proteins, MBD1 is characterized by the presence of MBD, two or three cysteine-rich CXXC motifs, and the C-terminal transcriptional repression domain (TRD). In addition, MBD1 has at least five isoforms due to alternative splicing events, resulting in the existence of CXXC1, CXXC2, and CXXC3 in MBD1 isoform v1 (MBD1v1) and MBD1v2, and CXXC1 and CXXC2 in MBD1v3 and MBD1v4. MBD1v1 represses transcription preferentially from both unmethylated and hypomethylated promoters, while MBD1v3 inhibits hypermethylated but not unmethylated promoter activities. The MBD and CXXC3 sequences are responsible for the ability to bind methylated and unmethylated DNAs, respectively. MBD1 is also found to be a chromosomal protein that forms many foci within the nucleus. These findings suggest that MBD1 is a unique transcriptional regulator depending on the density of methyl-CpG pairs.

Signals delivered through TCR instruct IL-12 receptor (IL-12R) expression: IL-12 and tumor necrosis factor-alpha synergize for IL-12R expression at low antigen dose

Regulation of the IL-12 receptor (IL-12R) beta2 chain has been suggested to function as a molecular switch in determining T cell phenotype. However, because most studies have been carried out under conditions in which cell proliferation was occurring, it has been difficult to distinguish between instructive and selective mechanisms in regulating this key receptor. Here, in the course of trying to understand the mechanism for synergy between IL-12 and TNF-alpha in up-regulating IFN-gamma production, we find that when the stimulus through the TCR is too weak to induce cell proliferation, which would be needed for selection, IL-12 and TNF-alpha synergize to up-regulate not only IFN-gamma, but also the IL-12Rbeta2 chain, which triggers IFN-gamma production. Neither cytokine alone was sufficient. This observation held true both in the absence of antigen-presenting cells (APC), when the stimulus was anti-CD3 on plastic, and in the presence of APC presenting ovalbumin peptide to TCR-transgenic T cells. In contrast, when the TCR signal was stronger, no cytokines were necessary to up-regulate the IL-12R. Our results support the strength of signal model in instructing Th phenotype, and suggest both an instructive role and, later, through the production of IFN-gamma, a selective role, of this synergistic combination of cytokines in the preferential differentiation and expansion of Th1 cells.

[A case of multiple emphysematous bullae treated with living-donor lung transplantation from identical twin brothers]

A 30-year-old man with multiple emphysematous bullae and bronchiectasis was admitted to Toyama Medical and Pharmaceutical University Hospital because of exertional dyspnea and fever. His chest radiograph and CT scan revealed multiple large bullae in the right lung and infiltrative shadows in the left middle lung field. Pseudomonas aeruginosa was isolated from his sputum culture. Although standard therapies including various antibiotics were administered, his respiratory condition was exacerbated, accompanied with the enlargement of bullae in the right lung and the consequent shift of the mediastinum to the left. The patient and his family proposed lung transplantation, and we concluded that lung transplantation would be an appropriate treatment for his disease. We transported the patient to Osaka University Hospital. Living-donor lung transplantation from the patient's identical twin brothers was successfully performed.

Evaluation of different algal species sensitivity to mercury and metolachlor by PAM-fluorometry

In this study, the pulse-amplitude-modulation (PAM)-fluorometric method was used to evaluate the difference in the sensitivity to mercury (Hg) and metolachlor of six algal species: Ankistrodesmus falcatus, Selenastrum capricornutum, Chlorella vulgaris, Nannoplankton (PLS), Microcystis aeruginosa and Pediastrum biwae. We found that the fluorescence parameters (phiM, the maximal photosystem II (PSII) quantum yield, phi'M, the operational PSII quantum yield at steady state of electron transport, Q(P), the photochemical quenching value, and Q(N), the non-photochemical quenching value) were appropriate indicators for inhibitory effects of mercury but only phi'M and Q(N) were useful for metolachlor. The examined algal species showed very different levels of sensitivity to the effect of Hg and of metolachlor. The most sensitive species to Hg and metolachlor were respectively M. aeruginosa and A. falcatus, while the least sensitive were C. vulgaris and P. biwae. We interpreted these differences by the action mode of pollutants and by the different metabolism properties and morphological characteristics between algal species. These results related to fluorescence parameters may offer useful tool to be used in bioassay for different pollutants. Heterogeneous algal sensitivity to the same pollutant suggests the need to use a battery of species to evaluate the effects of mixtures of pollutants in aquatic systems.

Observation of B --> J/psi K(1)(1270)

We report the first observation of the exclusive decay process B-->J/psi K(1)(1270) using a sample of 11.2M BB macro meson pairs collected in the Belle detector at the KEKB asymmetric energy e(+)e(-) collider. We measure branching fractions of B[B(0)-->J/psi K(0)(1)(1270)] = (1.30+/-0.34+/-0.32) x 10(-3) and B[B(+)-->J/psi K(+)(1)(1270)] = (1.80+/-0.34+/-0.39) x 10(-3), where the first error is statistical and the second is systematic. These modes constitute approximately 15% of the total number of B-->J/psi X decays. No evidence is seen for B-->J/psi K(1)(1400) and we set an upper limit for this branching fraction.

[Significant role of cisplatin and 5-FU combination chemotherapy for first-line intensive treatment for advanced esophageal cancer]

We evaluated the efficacy of first-line chemotherapy consisting of cisplatin and 5-fluorouracil combination therapy (in the following, FP) in intensive treatment for esophageal cancer. This first-line chemotherapy was administered to 18 patients with squamous cell carcinoma. Three patients had T2 tumor, 10 had T3 and 5 had T4. Lymph node metastasis was detected in 10 patients and not detected in 8 patients. Five patients had distant metastasis. Ten patients showed a partial response and the response rate was 55.6%. Of these 10 patients, 5 were followed with surgery, 3 of whom survived without recurrence of the disease. Five patients were treated by FP, radiation therapy or combination of FP and radiation. Of these 5 patients, 2 showed a complete response. On the other hand, 8 nonresponders died from progressive disease, despite following intensive treatment. These results suggest that first-line chemotherapy by FP, which requires following intensive treatment, improves the overall long-term survival of advanced esophageal cancer patient.

[Usefulness of hepatic arterial infusion chemotherapy for liver metastasis in gastric cancer]

We have performed intra-hepatic arterial chemotherapy for 9 patients with liver metastasis arising from gastric cancer. We mainly used 5-FU and CDDP as antineoplastic drugs.

RESULTS

The median survival after gastrectomy was 600 days. Of 9 cases, 2 showed CR, 4 PR, 2 NC, 1 PD. The response rate was 67%. The 9 cases were classified into 2 groups. One group, the short-term survival group, concised of 5 patients that had no more than 2 years survival and the other, the long-term survival group, consisted 4 patients that had more than 2 years survival. We compared these 2 groups and found no difference in the primary lesions between the 2 groups. The patients in the long-term survival group had fewer and smaller metastatic lesions in the liver than the patients of the short-term survival group. The patients in the long-term survival group had no unresectable lesions except liver metastasis when gastrectomy was performed. However, 2 patients in the short term survival group had unresectable lymphatic involvement at the time gastrectomy was performed. Of 9 patients, 6 died from the extrahepatic lesion.

CONCLUSION

The intra-arterial chemotherapy was effective and useful for liver metastasis arising from gastric cancer. However, the majority of patients died from extrahepatic lesions. We should therefore consider the use of systemic chemotherapy with intra-arterial chemotherapy.

Evaluation of the treatment performance of a multistage ozone/hydrogen peroxide process by decomposition by-products

The performance of a multistage ozone/hydrogen peroxide (O3/H2O2) process was evaluated with respect to total organic carbon (TOC) removal of waste waters. An aqueous humic acid solution (5.2 mgC l(-1) as TOC) and a sand filtered secondary sewerage effluent (5.6mgC l(-1) as TOC) were used as model waste waters. Appropriate range of hydrogen peroxide (H2O2) dose at each stage depended upon the components of the tested solutions that changed as the process proceeded. Higher hydrogen peroxide dose was required at later stages in which low reactivity compounds with hydroxyl radical (HO*), low molecular fatty acids, were predominant. And, oxalic acid concentration related to H2O2 demand at later stages. This was assumed that the slow decomposition of oxalic acid was rate-determining step for TOC removal after its accumulation. Also, it is important to maintain dissolved ozone at low concentration for efficient TOC removal because rapid ozone consumption is required for the rapid formation of hydroxyl radical (HO*).

Beneficial effect of muscarinic-2 antagonist on dilated cardiomyopathy induced by autoimmune mechanism against muscarinic-2 receptor

We have previously shown that a peptide corresponding to the sequence of the second extracellular loop of the human muscarinic-2 (M2) receptor (M2-peptide) was able to induce an autoimmune cardiomyopathy in rabbits. In this study, we investigated the effect of M2-antagonist (otenzepad) on M2-peptide-induced cardiomyopathy in rabbits. New Zealand White rabbits were divided into four groups: 1) control group, saline injection; 2) M2-peptide group, M2-peptide injection; 3) M2-antagonist group, otenzepad (30 mg/day) orally and saline injection; and (4) M2-antagonist + M2-peptide group, otenzepad (30 mg/day) orally and M2-peptide injection. The study duration was 1 year. Saline or peptide was injected once a month. All rabbits in both the M2-peptide group and the M2-antagonist + M2-peptide group had high titers of anti-M2-autoantibodies in their sera. Rabbits in the M2-peptide group showed an increase in heart weight, wall thinning and dilatation of the right ventricle. On the contrary, rabbits in the M2-antagonist + M2-peptide group had normal heart weight and shape. All rabbits in the M2-peptide group showed multifocal degeneration and necrosis of myocardial cells with moderate infiltration of inflammatory cells, while four rabbits in the M2-antagonist + M2-peptide group showed slight infiltration of inflammatory cells with normal myocardial cells and interstitium, and another three showed no histological changes in the hearts. In conclusion, M2-antagonist protects the myocardium from injury induced by autoimmune mechanism against M2-muscarinic receptor.

[Evaluation of chemosensitivity testing by CD-DST, and TS and DPD activity in cases of colorectal liver]

We evaluated the usefulness of the following three in vitro assays in cases of resected colorectal liver metastases. Chemosensitivity by collagen gel droplet drug sensitivity test (CD-DST) was very low in all cases, suggesting this method is not predictive for this disease. In contrast, thymidylate synthetase (TS) activity and dihydropyrimidine dehydrogenase (DPD) activity in tumor tissue were high in many patients with recurrent disease. Thus, these enzyme activities are promising for assessment of clinical outcome following hepatic resection of colorectal liver metastases. Further analyses with large numbers of cases are needed to determine the significance of these in vitro studies.

CT demonstration of dilated gonadal vein as a portosystemic shunt of mesenteric varices

PURPOSE

The purpose of this work was to assess CT demonstration of the enlarged gonadal vein as a portosystemic shunt of mesenteric varices.

METHOD

The clinical records and CT images of eight patients with angiographically confirmed mesenteric varices were studied retrospectively. We measured the size of the right gonadal vein of these eight patients and also measured the size of the right gonadal vein in 60 patients without mesenteric varices.

RESULTS

In all eight patients, CT demonstrated that the mesenteric varices drained into the inferior vena cava through the dilated right gonadal vein (diameter 6-10 mm) in all and that the left gonadal vein was not dilated (diameter 2-3 mm). In 60 patients without mesenteric varices, the diameter of the right gonadal vein was 1-5 mm.

CONCLUSION

CT demonstrates the dilated gonadal vein as a portosystemic shunt of the mesenteric varices. Awareness of a dilated gonadal vein in patients with portal hypertension may be helpful to consider the possibility of mesenteric varices.

Observation of large CP violation in the neutral B meson system

We present a measurement of the standard model CP violation parameter sin2 phi(1) based on a 29.1 fb(-1) data sample collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. One neutral B meson is fully reconstructed as a J/psi K(S), psi(2S)K(S), chi(c1)K(S), eta(c)K(S), J/psi K(L), or J/psi K(*0) decay and the flavor of the accompanying B meson is identified from its decay products. From the asymmetry in the distribution of the time intervals between the two B meson decay points, we determine sin2 phi(1) = 0.99+/-0.14(stat)+/-0.06(syst). We conclude that we have observed CP violation in the neutral B meson system.

Indirubin and indigo are potent aryl hydrocarbon receptor ligands present in human urine

Aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that regulates genes involved in xenobiotic metabolism, cellular proliferation, and differentiation. Numerous xenobiotic and biological compounds are known to interact with AhR, but it remains an orphan receptor, because its physiological ligand is unknown. We identified AhR ligands in human urine using a yeast AhR signaling assay and then characterized their properties. Two ligands, indirubin and indigo, were both present at average concentrations of approximately 0.2 nm in the urine of normal donors. Indirubin was also detected in fetal bovine serum and contributed half of the total AhR ligand activity. The activities of indirubin and indigo were comparable with or more potent than that of the archetypal ligand, 2,3,7,8-tetrachlorodibenzo-p-dioxin, in yeast AhR activation assays. We suggest that the endogenous levels and potencies of indirubin and indigo are such that they activate AhR-mediated signaling mechanisms in vivo.

Hydrolysis of newspaper polysaccharides under sulfate reducing and methane producing conditions

The initial decomposition rates of cellulose and hemicellulose were measured using toluene to specifically inhibit the microbial uptake of hydrolysis products during the degradation of newspaper under sulfate reducing and methane producing conditions. The amount of glucose and xylose accumulation in the first 2 weeks of incubation period was higher in the sulfate reducing condition compared to the methane producing condition. It was estimated that 28 and 6% of initially loaded cellulose in the sulfate reducing condition and the methane producing condition was hydrolyzed, respectively. Accordingly, the newspaper-cellulose hydrolysis rate constant was estimated to be 6.7 times higher in sulfate reducing condition than in methane producing condition. Based on the glucose accumulation patterns, when sulfate reducing bacteria (SRB) were inhibited by anthraquinone and molybdate (Na2MoO4), it may be suggested that SRB might have contributed to the hydrolysis of cellulose, while their effect on the hydrolysis of hemicellulose could not be elucidated.

Mechanisms of cytokine synergy essential for vaccine protection against viral challenge

The ability of cytokines to steer CD4(+) T(h) cell responses toward a T(h)1 or T(h)2 phenotype and enhance the magnitude of both CD8(+) cytotoxic T lymphocytes (CTL) and antibody responses has clearly been demonstrated by our lab and others, but the influence of cytokines on protective immune responses is much less clear. Here we show an essential role for CD4(+) T(h)1 helper cell induction and IFN-gamma production in protection from viral challenge with a recombinant vaccinia virus expressing HIV-1MN viral envelope glycoprotein gp160. Complete protection from viral challenge is achieved only when the triple combination of exogenous cytokines granulocyte macrophage colony stimulating factor (GM-CSF), IL-12 and tumor necrosis factor (TNF)-alpha are co-administered with the peptide vaccine. In vivo depletion of CD4(+) cells or immunization of IFN-gamma-deficient mice abrogates protection. GM-CSF, IL-12 and TNF-alpha also synergize for the enhanced induction of CTL; however, adoptive transfer of a CD8(+) CTL line afforded only partial protection in this viral challenge model. As a possible mechanism of in vivo protection we show that GM-CSF increases the percentage and activity of antigen-presenting dendritic cells in draining lymph nodes where the immune response is initiated. We further demonstrate synergy between IL-12 and the proinflammatory cytokine TNF-alpha in driving IFN-gamma production. Thus, a combination of IL-12 and TNF-alpha is essential for the optimal development of T(h)1 responses and help for CTL induction in BALB/c mice, and is complemented by a third cytokine, GM-CSF, which enhances antigen presentation.

Protein kinases required for segregation of vimentin filaments in mitotic process

Vimentin, one of type III intermediate filament (IF) proteins, is expressed not only in mesenchymal cells but also in most types of tumor cells. In the present study, we introduced several types of vimentin mutated at putative phosphorylation sites in its amino-terminal head domain into type III IF-negative T24 cells. Site-specific mutation induced the formation of an unusually long bridge-like IF structure between the unseparated daughter cells, although these mutants formed the filament network similar to wild type in interphase cells. Together with sites phosphorylated by Rho-kinase and protein kinase C (PKC), vimentin-Ser72, which can not be phosphorylated by any known vimentin kinase, was one of the mutation sites essential for this phenotype. We further demonstrated that vimentin-Ser72 was phosphorylated specifically at the cleavage furrow during cytokinesis. These observations suggest the existence of a novel protein kinase responsible for vimentin filament separation through the cleavage furrow-specific vimentin phosphorylation. We propose that Rho-kinase, PKC, and an unidentified vimentin-Ser72 kinase may play important roles in vimentin filament separation during cytokinesis.

Translesional synthesis on a DNA template containing N2-methyl-2'-deoxyguanosine catalyzed by the Klenow fragment of Escherichia coli DNA polymerase I

Formaldehyde is produced in most living systems and is present in the environment. Evidence that formaldehyde causes cancer in experimental animals infers that it may be a carcinogenic hazard to humans. Formaldehyde reacts with the exocyclic amino group of deoxyguanosine, resulting in the formation of N2-methyl-2'-deoxyguanosine (N2-Me-dG) via reduction of the Schiff base. The same reaction is likely to occur in living cells, because cells contain endogenous reductants such as ascorbic acid and gluthathione. To explore the miscoding properties of formaldehyde-derived DNA adducts a site-specifically modified oligodeoxynucleotide containing a N2-Me-dG was prepared and used as the template in primer extension reactions catalyzed by the Klenow fragment of Escherichia coli DNA polymerase I. The primer extension reaction was slightly stalled one base before the N2-Me-dG lesion, but DNA synthesis past this lesion was readily completed. The fully extended products were analyzed to quantify the miscoding specificities of N2-Me-dG. Preferential incorporation of dCMP, the correct base, opposite the lesion was observed, along with small amounts of misincorporation of dTMP (9.4%). No deletions were detected. Steady-state kinetic studies indicated that the frequency of nucleotide insertion for dTMP was only 1.2 times lower than for dCMP and the frequency of chain extension from the 3'-terminus of a dT:N2-Me-dG pair was only 2.1 times lower than from a dC:N2-Me-dG pair. We conclude that N2-Me-dG is a miscoding lesion capable of generating G-->A transition mutations.

Measurement of B(0)(d)-B_(0)(d) mixing rate from the time evolution of dilepton events at the upsilon(4S)

We report a determination of the B(0)(d)-&B_(0)(d) mixing parameter Deltam(d) based on the time evolution of dilepton yields in Upsilon(4S) decays. The measurement is based on a 5.9 fb(-1) data sample collected by the Belle detector at KEKB. The proper-time difference distributions for same-sign and opposite-sign dilepton events are simultaneously fitted to an expression containing Deltam(d) as a free parameter. Using both muons and electrons, we obtain Deltam(d) = 0.463+/-0.008 (stat)+/-0.016 (syst) ps(-1). This is the first determination of Deltam(d) from time evolution measurements at the Upsilon(4S). We also place limits on possible CPT violations.