Diacylglycerol accumulation is involved in the potentiating effect of A23187 on carbachol-stimulated amylase secretion from parotid gland

We studied the role of sn-1, 2-diacylglycerol (DAG) accumulation in the potentiating effect of A23187 on carbachol (CCh)-stimulated amylase secretion from rat parotid acinar cells. A23187 (0.1 microM) linearly increased DAG accumulation with time for at least 30 min. At concentrations higher or lower than 0.1 microM, DAG levels increased for up to 20 min, but declined at 30 min. Dose-response curve for DAG accumulation induced by A23187 was similar to that for amylase secretion. A23187 augmented CCh-stimulated DAG accumulation and amylase secretion. These results suggest that DAG accumulation is involved in the potentiating effect of A23187 on CCh-stimulated amylase secretion.

A protein kinase C-dependent mechanism(s) is involved in atropine-resistant accumulation of diacylglycerol in rat parotid gland

We investigated the atropine-resistant accumulation of sn-1,2-diacylglycerol (DAG) on stimulation of 1 microM carbachol (CCh) in parotid acinar cells. CCh-induced DAG accumulation was biphasic, peaking at 5 and 20 min. Atropine inhibited two peaks in a dose-dependent manner, but the first peak was inhibited much more than the second one. Atropine (10 microM) completely inhibited both DAG accumulation and the breakdown of phosphatidylinositol 4-monophosphate and 4,5-bisphosphate (PIP2) 5 min after stimulation with CCh. In contrast, the breakdown of PIP2 at 20 min was completely inhibited by 10 microM atropine, but DAG accumulation was not. This atropine-resistant component at 20 min is significantly inhibited by staurosporine, a protein kinase C inhibitor. These results suggest that atropine-resistant accumulation of DAG at 20 min derives directly from other lipids rather than phosphoinositides and is regulated by a protein kinase C-dependent mechanism(s).

Effects of adenosine and pertussis toxin on lipolysis in adipocytes from exercise-trained male rats

The sensitivity and responsiveness of adipocyte lipolysis to adenosine and pertussis toxin were studied in exercise-trained male rats. Exercise training (9 weeks of treadmill running) significantly increased lipolytic response of adipocytes to noradrenaline (NA). Addition of adenosine deaminase (ADA) to reaction mixture effectively enhanced NA-stimulated lipolysis in adipocytes from both conditioned rats. However, under these conditions, the difference due to exercise training was still evident, although the difference was less pronounced. The inhibition curves of the R-site adenosine analogue N6-phenylisopropyladenosine (PIA) against "basal" (lipolysis in the presence of ADA) and NA-stimulated lipolysis were almost comparable between two groups. Only a small (approx. 2-fold) increase in IC50 of adipocyte lipolysis was observed in each inhibition curve in exercise-trained rats. Within 120 min of addition of pertussis toxin to adipocytes from control rats, "basal" lipolysis was significantly increased as compared to "basal" lipolysis in the absence of toxin at the same point. Similarly, pertussis toxin significantly increased "basal" lipolysis in exercise-trained adipocytes. However these were relatively sensitive to pertussis toxin, since significant effect of toxin was seen within 60 min. An addition of NA (0.1 uM) to the medium in the presence of ADA and toxin significantly increased adipocyte lipolysis in both conditioned rats. Again, under these conditions, we observed that the maximal rate of lipolysis of adipocytes from exercise-trained rats was increased as compared to control rats. These results suggest that the decreased input through the inhibitory pathway in lipolytic cascade may be not rate limiting for the amplified lipolytic responsiveness of adipocytes to hormonal stimuli in exercise-trained rats.

Follow-up study of atlanto-axial instability in Down's syndrome without separate odontoid process

Clinical and roentgenologic studies were performed in 69 children with Down's syndrome, without the separate odontoid process, that could be followed for more than 5 years. At the follow-up examination, the atlanto-odontoid process interval (AOI) in flexion, neutral, and extension of the cervical vertebrae significantly decreased when compared with the one at the initial examination. This was particularly obvious up to 5 years of age. Although 14 of 69 cases (20.3%) had atlanto-axial instability at the initial examination, this decreased to four cases (5.8%) at the follow-up examination. However, there were two cases of atlanto-axial instability who were over 10 years of age. There was no significant difference in the minimum sagittal diameter (MSD) at the atlantal level between each position at both the initial and follow-up examinations. Moreover, there was a tendency for the MSD of the cases of positive instability at the follow-up examination to be smaller than those of the cases of negative instability. The degree of ligament laxity improved with increasing age and there was statistically the negative correlation. Although there was a tendency for the AOI to decrease with improvement of the degree of ligament laxity, the correlation could not be confirmed.

Beta-adrenergic receptor adaptation after an acute exercise in rat myocardium

An acute dynamic exercise provokes the translocation of beta-adrenergic receptors (beta-AR) from light vesicle fractions to sarcolemmal membranes in rat myocardium. However, 15 min after an acute exercise the density of beta-AR in both fractions returned to the pre-exercise level. The mean maximal activity of adenylate cyclase in response to isoproterenol roughly paralleled the redistribution of beta-AR. The dose-response curves, however, were substantially shifted to the right with increase in EC50 for isoproterenol stimulation of adenylate cyclase. Thus, the sensitivity of sarcolemmal beta-AR was found to be blunted 15 min afterwards.

Discontinuing therapy in childhood acute lymphoblastic leukemia treated with a chemoimmunotherapy protocol

We examined the results of discontinuing therapy in Japanese children with acute lymphoblastic leukemia. Of the 209 patients in the chemoimmunotherapy study, 120 (57.4%) had all chemotherapy stopped after 3 years of complete remission, and 72 (34.4%) reached the point of discontinuing immunotherapy after 5 years of complete remission. Of the 120 children removed from chemotherapy, 14 (11.7%) have relapsed, mainly in the extramedullary sites (5: testis, 5: bone marrow, 3: central nervous system, 1: bone); relapses occurred 1-23 months after cessation of chemotherapy (median 11 months). Boys had higher post-chemotherapy relapse rate than girls (0.21 versus 0.08, P less than 0.05). None of the 72 children removed from immunotherapy have yet relapsed. Long-term remission and possibly cure can be expected in approximately one-half of newly diagnosed Japanese patients. Although the active immunotherapy had no beneficial effect on the overall outcome for leukemic children, it could be of benefit to the elimination of bone marrow relapses after cessation of chemotherapy.

An acute exercise-induced translocation of beta-adrenergic receptors in rat myocardium

The effect of acute exercise (treadmill running) on rat myocardium beta-adrenergic receptors (beta-AR) was studied. beta-AR was identified in purified sarcolemmal membrane fractions and light vesicle fractions. In control hearts, the number of beta-AR was 21.25 +/- 2.25 and 20.89 +/- 2.89 fmol/mg protein (mean +/- SE) in sarcolemmal membranes and light vesicles, respectively. Immediately after a single bout of dynamic exercise, about 35% of beta-AR was transferred from light vesicles to sarcolemmal membranes (p less than 0.05); concomitantly, isoproterenol-stimulated adenylate cyclase activity also significantly increased in sarcolemmal membranes (p less than 0.05). These results suggest that acute exercise provokes the translocation of beta-AR from a presumably intracellular site (light vesicles) to functional membrane fractions (sarcolemmal membranes) in rat myocardium.

Some characteristics of the beta-adrenergic system in rat adipocyte membranes after the chronic administrations of isoproterenol

The effects of chronic administrations of isoproterenol (IPR) on adipocyte beta-adrenergic system were investigated. A 21-days in vivo administration of IPR (2.5 mg/kg BW/day) reduced (-)-IPR- and 5'-guanylylimidodiphosphate-stimulated adenylate cyclase activities. Moreover, the number of beta-adrenergic receptors (beta-AR) and (-)-IPR-stimulated [3H]GDP release from adipocyte membranes were significantly depressed in the treated rats compared to controls. These results suggest that the desensitized response of adenylate cyclase to beta-agonists, induced by chronic in vivo administrations of IPR, may result from impaired coupling efficiency between beta-AR and adenylate cyclase with the significant loss of the number of beta-AR and possible change(s) of guanine nucleotide regulatory proteins.

Effects of cyclic nucleotide derivatives on the Na+ pump activity and the release of sialic acid in dog submandibular glands

The effects of dibutyryl cyclic AMP (DBcAMP) and cyclic GMP (DBcGMP) on the Na+,K+-ATPase activity and the release of sialic acid were investigated in dog submandibular gland pieces. The Na+,K+-ATPase activity and the release of sialic acid were significantly stimulated in the presence of 100 microM DBcAMP or in the combination of 3 mM NaF and 50 microM 1-methyl-3-isobutylxanthin but were not by DBcGMP. When the pieces were incubated in the Ca2+-free medium, the DBcAMP-induced Na+,K+-ATPase activity slightly decreased but the sialic acid release was unaffected. The corresponding results were also observed in the Ca2+-free medium supplemented with 2 mM EGTA. These results suggest that the cytosolic cyclic AMP modifies the Na+ pump activity.

Possible mechanism of regulating adenylate cyclase activity in adipocyte membranes from exercise-trained male rats

(-)-Isoproterenol-stimulated adenylate cyclase activities were significantly greater in membranes from exercise-trained male rats than in sedentary male rats. GTP-inhibition of forskolin (10 microM)-stimulated cyclase activities were observed in sedentary membranes, whereas the inhibitory actions of GTP were significantly reduced in membranes from trained rat adipocytes. Treatment of membranes with islet-activating protein, a pertusis toxin, completely abolished the differences in GTP-inhibition of forskolin-stimulated cyclase activities between the two groups. The amounts of the inhibitory regulatory protein (41kDa/40kDa polypeptides) were about 40% less in membranes from trained rats than in sedentary membranes, whereas that of the stimulatory regulatory protein (a 45kDa polypeptide) was equivalent. It is concluded that the enhanced cyclase activities of adipocyte membranes from trained male rats appear to result from, in part, an attenuation of the inhibitory pathway due to a specific decrease in the amount of the inhibitory regulatory proteins.

Does calmodulin participate as an intermediate in the process of glycogenolysis in rat submandibular gland?

A role of calmodulin in the process of the glycogenolysis induced by adrenaline was investigated in rat submandibular gland. When the slice was incubated in the Ca2+-free medium, the adrenaline-induced glycogenolysis was significantly inhibited. Moreover, the inhibition of glycogenolysis induced in the Ca2+-free medium was further enhanced by addition of 2 mM EGTA. Chlorpromazine, trifluoperazine and W-7, calmodulin antagonists, had no effect on the glycogenolysis induced by adrenaline. These results suggest that the adrenaline-induced glycogenolysis is dependent on the presence of Ca2+ and that calmodulin does not participate in the process of glycogenolysis in rat submandibular gland.

Effects of Ca2+ and calmodulin antagonists on the Na+ pump activity induced by pilocarpine in dog submandibular gland

The effects of Ca2+ and calmodulin antagonists on the Na+,K+-ATPase activity were investigated in dog submandibular gland pieces. The Na+,K+-ATPase activity of the gland pieces which were incubated in the presence of 5 microM A23187, a Ca2+ ionophore, was about 2-fold of that seen in the control medium. Verapamil, diltiazem and La3+ (Ca2+ antagonists) and chlorpromazine, trifluoperazine and W-7 (calmodulin antagonists) had no significant effect on the Na+,K+-ATPase activity in the control medium, but significantly inhibited that induced by pilocarpine. These results suggest that the Na+ pump activity is modified by the Ca2+ influx from the extracellular spaces and the intracellular Ca2+-calmodulin complex.

Effects of monensin on the Na+ pump activity and the release of amylase and sialic acid in dog submandibular glands

The effects of monensin on the Na+,K+-ATPase activity and the release of amylase and sialic acid were investigated in dog submandibular gland pieces. Monensin stimulated the Na+,K+-ATPase activity and amylase release in a dose-dependent manner. Moreover, this agent increased the Na+,K+-ATPase activity and the release of amylase and sialic acid induced by pilocarpine. These results suggest that monensin increases the release of amylase and sialic acid in dog submandibular glands, in part, through the Na+ pump activated due to the Na+ influx.

The plasmin heavy chain-urokinase conjugate: a specific thrombolytic agent

Low molecular weight urokinase (LMW-UK) was coupled to the heavy chain of plasmin to make it able to bind to fibrin. The purified conjugate (PHC-UK conjugate), which consisted of equimolar concentrations of each starting material had a molecular weight of 93,600, bound tightly to fibrin-monomer-Sepharose and was not washed off with 1 M NaCl, but was eluted specifically with epsilon-amino caproic acid. The conjugate showed higher fibrinolytic activity than HMW-UK. A control conjugate prepared by coupling human serum albumin to LMW-UK (HSA-UK conjugate) showed the same fibrinolytic activity as HMW-UK. The half-lives of these two conjugates in rabbits were about 3 times that of HMW-UK. In an experimental pulmonary embolism model in rabbits, the PHC-UK conjugate showed about 10 times higher thrombolytic activity than HMW-UK, while the HSA-UK conjugate showed similar thrombolytic activity as HMW-UK, and moreover caused severe systemic fibrinogen breakdown. Thus the significant increase in thrombolytic activity after injection of PHC-UK conjugate into rabbits may be due to its newly acquired fibrin binding activity, and not to increase in its half-life. It is concluded that the PHC-UK conjugate may be useful in treatment of thrombosis.

31P-NMR studies of energy metabolites in rat pancreas treated with trypsin inhibitor

The energy metabolites and the composition of rat pancreas treated with trypsin inhibitor (T.I.) were investigated. T.I. treatment significantly induced the hypertrophy of pancreatic acinar cells and the increase in the amylase and sialic acid contents. However, when the pancreas was perfused by control solution or the solution containing acetylcholine (10(-7) M), the 31P-NMR spectra of energy metabolites in the pancreas treated with T.I. were similar to those of normal rats.

Augmentation of catecholamine-stimulated [3H]GDP release in adipocyte membranes from exercise-trained rats

The effects of exercise training on the catecholamine-stimulated [3H]GDP release in rat adipocyte membranes prelabeled with [3H]GTP and the adenylate cyclase activity were investigated. Exercise training significantly increased the release of [3H]GDP in response to (-)isoproterenol. The adenylate cyclase activity induced by a nonhydrolyzable guanine nucleotide analogue, Gpp(NH)p, was significantly greater in exercise-trained rats.

Effects of K-76 monocarboxylic acid, an anticomplementary agent, on various in vivo immunological reactions and on experimental glomerulonephritis

K-76 monocarboxylic acid (K-76 COOH) caused rapid reduction in hemolytic activities of complement and some of its components, especially C5, when injected into guinea pigs or rats. K-76 COOH suppressed Forssman shock in guinea pigs and mice and heterologous passive cutaneous anaphylaxis in guinea pigs. It also reduced the amount of protein excreted in the urine of rats with nephrotoxic nephritis and greatly prolonged the survival of (NZB X NZW) F1 female mice with a spontaneous systemic lupus erythematosus-like disease. The glomeruli of mice treated with K-76 COOH retained almost the normal histological appearance even at 1 year of age. K-76 COOH-treated mice became less sensitive to the infection of Escherichia coli, staphylococcus aureus, or Streptococcus pneumoniae, probably by enhancement of phagocytosis due to inhibition of factor I. K-76 COOH did not have any significant effect on a delayed-type contact skin reaction in mice, or on experimental allergic encephalitis in guinea pigs.

[The effect of methotrexate on intracellular nucleotide pools]

In a previous study, we showed that methotrexate (MTX) enhanced the intracellular production of ara-CTP. The study described in the present paper has elucidated the mechanism of this MTX-enhanced ara-CTP production, which occurs as a result of MTX reducing the intracellular dCTP pool, and the decreased dCTP pool then allowing activation of deoxycytidine Kinase. One of the mechanisms of synergistic interaction between 1-beta-D-arabinofuranosylcytosine (ara-C) and MTX might therefore be the stimulated phosphorylation of ara-C with MTX-activated deoxy-cytidine kinase. Using high-pressure liquid chromatography, the sequential changes occurring in the acid-soluble intracellular nucleotide pools of L1210 mouse leukemic cells were analysed after treatment with MTX (12mg/kg). At 3 hr after treatment with MTX a reduction of the dTTP pool to 46% of the control level was observed. The dCTP pool was also reduced to 36% of the control level after treatment with MTX. The levels of the dATP and dGTP pools were not significantly changed, at least during the observation period. Pyrimidine ribonucleotide pools were almost unchanged at 3 hr, but in the sequential changes observed in purine ribonucleotide pools after treatment with MTX, both diphosphate and triphosphate pools were seen to be on the decline, the reduction of triphosphate pools being especially marked. A decline in ATP and GPT to 24-30% of control levels was observed at 3 hr after treatment with MTX.

Effects of Ca2+ and calmodulin antagonists on the oxygen uptake induced by acetylcholine or substance P in rat submandibular gland slices

Effects of Ca2+ and calmodulin antagonists on the oxygen uptake induced by acetylcholine (ACh) or substance P (SP) were investigated in rat submandibular gland slices. The oxygen uptake induced by ACh or SP was significantly inhibited by removing Ca2+ from the medium and the slices. The oxygen uptake by ACh in the Ca2+-deficient slices was almost completely recovered by the addition of 3.0 and 5.0 mM Ca2+, whereas that by SP was not recovered by the addition of 3.0 mM Ca2+, but recovered by 5.0 mM Ca2+. Ca2+ antagonists, diltiazem, verapamil and La3+, significantly inhibited the ACh-induced oxygen uptake. On the other hand, the SP-induced oxygen uptake was inhibited by diltiazem and La3+, but not by verapamil. Calmodulin antagonists, trifluoperazine, chlorpromazine and W-7, had no inhibitory effects on the ACh-induced oxygen uptake. The SP-induced oxygen uptake was not affected by trifluoperazine, chlorpromazine and low concentrations of W-7, but was inhibited by high concentrations of W-7. These results suggest that the ACh- or SP-induced oxygen uptake is dependent on the presence and permeability of Ca2+ with a subtle difference between the ACh and the SP mechanisms and that the oxygen uptake is independent of calmodulin.

Screening for bacteriuria in healthy Japanese school children

Bacteriuria was screened among 28,202 healthy school children, 14,575 boys and 13,627 girls by dipstick and dipslide methods and also by pour plate culture method. Prevalence of bacteriuria was 0.06% in boys and 0.54% in girls after third screening. A high rate of false negative results with dipstick test and a high rate of false positive results with dipslide culture method using Microstix-3 were observed. About 60% of screened children continued to have bacteriuria persistently for 9 months after third screening followed by monthly urine culture. Anomalies of urinary tract were detected in 9 of 26 children with persistent bacteriuria.

Two cases of the Langer-Giedion syndrome with the same interstitial deletion of the long arm of chromosome 8: 46, XY or XX, del (8) (q23.3q24.13)

Two cases of the Langer-Giedion syndrome (LGS) are reported. Chromosome analysis by high-resolution banding with 850 bands revealed the same abnormal karyotype, 46,XY or XX,del(8)(q23.3q24.13), which was the smallest deletion among those of LGS patients with 8q deletion. The deleted segments found in three patients with LGS analyzed by high-resolution banding have a part of 8q23.3 and 8q24.11 in common.

[Pharmacokinetics and clinical evaluation of ceftizoxime (author's transl)]

Pharmacokinetics of ceftizoxime (CZX), a new cephalosporin antibiotic, was investigated in 9 children with normal renal and hepatic function. In addition, the clinical effect of CZX was evaluated in 26 pediatric patients with various infections. In 4 of the 9 children with normal renal and hepatic function, intravenous bolus injection of CZX in a dose of 20 mg/kg yielded a mean peak serum level of 36.5 micrograms/ml at 1/2 hour after infusion, and mean serum levels of 12.5 micrograms/ml at 2 hours and 6.0 micrograms/ml at 4 hours after infusion. The biological half-lives of CZX were estimated to be 1.25--2.55 hours. In another child, serum levels of CZX at 1/2, 2 and 4 hours after intravenous bolus injection in a dose of 10 mg/kg were 19.60, 5.96 and 2.06 micrograms/ml, respectively. The clear difference in dose response between 20 mg/kg and 10 mg/kg reflected the doubled dose levels. In the remaining 4 children, drip infusion of CZX in a dose of 20 mg/kg (1 child 17 mg/kg) over 0.5--1.5 hours yielded peak serum levels at the end of infusion. The biological half-lives of CZX were estimated to be 0.95--1.50 hours. About 80% of CZX was excreted in the urine within 6 hours after infusion in the 4 children tested. Twenty-six pediatric patients with various infections were treated with CZX intravenous doses of 20 mg/kg to 118 mg/kg b.i.d.--q.i.d. for 3--14 days. Of the 12 patients with acute bronchitis and pneumonia, 5 showed excellent response, 6 good and 1 fair response. Of the 5 patients with urinary tract infection, 4 showed excellent response and 1 good response. One patient each with colitis, tonsillitis and facial cellulitis, pharyngitis showed excellent response and 1 patient each with purulent thyroiditis and gluteal abscess showed good response. The single patients with sepsis showed excellent response. One patient each with pyothorax, purulent arthritis and cerebral abscess showed poor response. Overall effectiveness rate was 84.6%. although 22 of all 26 patients treated had serious underlying diseases such as APL, AML. A mild increase in GOT and GPT was observed in 1 patient during treatment with CZX, and the values returned to normal after discontinuation of the drug. These results suggest that ceftizoxime is 1 of the most important antibiotics for treating a wide range of infections in children as well as in adults.

[Laboratory and clinical studies of cefoxitin in pediatrics (author's transl)]

Laboratory and clinical studies of CFX were conducted on 30 pediatric inpatients at the Department of Pediatrics of Mie University. The results of the sensitivity evaluation conducted on 37 clinical isolates consisting of 16 species were in accordance with the findings reported hitherto in the literature, i.e., CFX was superior to CEZ and CET in terms of the growth inhibitory effect against Gram-negative rods. The serum peak level was obtained 5 minutes after an intravenous injection of 25 mg/kg, and 15 minutes after a drip infusion of 30 minutes using the same dose. The average terminal half life was 13 minutes 15 seconds for the former and 20 minutes for the latter. Clinical evaluation was made on a total of 22 eligible patients. The results were classified as follows: Excellent in 4 cases, good in 12, fair in 4 and poor in 2. The effective rate of CFX was 72.7%. Side effects observed were vascular pain, rash and vomiting, all of which were mild in nature and disappeared immediately after discontinuation of, or change in the routine of drug administration.

A complement inhibitor produced by Stachybotrys complementi, nov. sp. K-76, a new species of fungi imperfecti

A complement inhibitor, K-76, was isolated and purified from the culture supernatant of a fungus, Stachybotrys complementi, nov. sp. K-76, isolated from soil of Ishigaki Island, Okinawa. K-76 is a sesquiterpene compound and it can be oxidized to a monocarboxylic derivative (K-76 COOH), the sodium salt of which is very soluble and much less toxic than K-76. K-76 and K-76 COOH both inhibited complement activation by either the classical or alternative pathway. They inhibited generation of the factor chemotactic to human polymorphonuclear leukocytes from human serum by aggregated immunoglobulin. When sensitized erythrocytes were treated with complement in the presence of K-76 COOH, the resulting unlysed cells were found to be in the state of EACl, 4b, 2a, 3b. Thus K-76 COOH is considered to block mainly the C5 intermediate step. K-76 COOH did not inhibit any proteases or esterases tested, except when tested at high concentration.

[Fundamental and clinical studies of cefoperazone in pediatric patients (author's transl)]

1. Susceptibility, concentrations in serum and spinal fluid, and clinical effect of cefoperazone (CPZ), a newly developed cephalosporin in Japan, were examined in 28 infants from 2 days to 12 years of ages with various infections. 2. The overall clinical evaluation in 22 cases received CPZ alone was found to be markedly effective in 11 cases and effective in 6 cases; the efficacy rate was as good as 85.0%. 3. The mean half-life following a single intravenous injection of 25 mg/kg to 3 infants was 80.7 minutes. 4. The side effects observed during the therapy were 2 cases of rash and 1 case of vascular pain and these symptoms improved after interruption of therapy. The side effects of CPZ seemed to be not more noticeable than other cephalosporins.

An anticomplementary agent, K-76 monocarboxylic acid: its site and mechanism of inhibition of the complement activation cascade

A monocarboxylic acid derivative (K-76 COOH) of K-76, purified from the culture filtrate of Stachybotrys complement I nov. sp. K-76, inhibits complement (C) activity. Its inhibitory action is mainly on C5 step. It strongly inhibits the generation of EAC1,4b,2a,3b,5b from C5 and EAC1,4b,2a,3b, and accelerates the decay of EAC1,4b,2a,3b,5b. It also causes some inhibition of the reactions of the reactions of C2,C3,C6,C7 and C9 with their respective preceding intermediate cells. It has no effect on the generation of EAC1,4b from C4 and EAC1, or of EAC-8 from C8 and EAC-7, and apparently increases the generation of EAC1,4b from C1 and EAC4b probably by inhibiting transfer or turnover of C1. It does not affect the rate of decay of EAC1,4b,2a or the T max of generation of EAC1,4b,2a, and it inhibits immune adherence only at high concentration. K-76 COOH also strongly inhibits hemolysis through the alternative pathway of C activation by cobra venom factor, but it does not seem to inhibit the early steps of the alternative pathway, because it has little affect on the consumption of C3 or the conversion of beta 1C to beta 1A on treatment of C serum with zymosan. K-76 COOH probably combines with C5 molecules, forming the inactive complexes, or it causes the structural alteration of C5.

Diagnostic skin test reactions with varicella virus antigen and clinical application of the test

Varicella virus antigen was prepared and used in skin testing of 75 children one to 17 years old. Results of skin tests were analyzed in relation to history of varicella, presence of absence of neutralizing antibody, and susceptibility to clinical varicella. All 22 children with no history of varicella and no neutralizing antibody were negative in the skin test when an erythematous change of greater than or equal to 5 mm in diameter was taken as a positive result. Of the 53 children with neutralizing antibody, only three were negative in the skin test. The skin test was applied clinically in an institution for mentally retarded children immediately after varicella infection occurred in a patient. A total of 65 patients were examined by the skin test, and 24 children with negative results were given live varicella virus vaccine. As a result, no spread of varicella was observed except for three cases, which developed two weeks after onset of illness in the index case. Thus the skin test seems clinically useful in the determination of susceptibility of individuals to clinical varicella.

Application of a live varicella vaccine in children with acute leukemia or other malignant diseases

A live varicella vaccine was used in 11 susceptible children in remission from acute leukemia, ten of whom had been in remission for six months or less, and in 6 children with neuroblastoma and retinoblastoma. In the immunological checkup before vaccination, most of them showed a positive reaction in the skin tests with dinitrochlorobenzene, phytohemagglutinin, purified protein derivative, and viral antigens. Leukopenia (three cases, less than 3,000/cu mm) and decreased IgG level (two cases, 380 mg/dl and 445 mg/dl) were observed in the children with leukemia. Anticancer medication was suspended from one week before vaccination to one week after vaccination. The only clinical reaction was a minute rash that appeared three weeks after vaccination in two children with leukemia and that disappeared within three days. Serological responses by complement fixing and neutralizing (NT) tests were detected in all the vaccinated children four weeks after vaccination, and NT antibody was still detected 28 months after vaccination in the two patients tested. Three of the vaccines were exposed to natural varicella at home and in the classroom 2 to 18 months after vaccination, but they were free from any varicella symptoms.

Five-year survivors among children with acute leukemia in Japan

This Japanese nation-wide survey was carried out on long-term survivors among children with leukemia, i.e. those who had survived more than 5 years by October of 1974. Eighty-three children were surveyed. This was about 2.5 times as many as the 31 children surveyed in the first Japanese nation-wide survey in 1971. Clinical and laboratory data were also analyzed statistically and compared to that of the first survey. Most of the children had received inductive therapy according to the old protocol, but 10 children were treated with a combination of VCR and steroids. Nine of these 10 were still in a state of remission. CNS involvement occurred in 15.3% of the cases and a late onset of this complication implied a prognostic significance: among the 9 children whose complication had occurred 3.5 years after onset of the disease, 6 died. The relapse rate decreased between the 4th and 5th year after initiation of maintenance therapy. The percentage of the risk of death became zero after the 9th year.