Quantitative evaluation of intraarterial lymphocyte injection therapy for lymph edema using MR imaging

Five patients with unilateral leg lymph edema had intraarterial injections of lymphocytes in the affected leg with consequent improvement in 3. To assess the degree of lymph edema, T2 and intensity ratio between the 2 legs in STIR images were used. Mean and SD of T2 values in the subcutaneous tissue were measured using a triple echo sequence and found larger on the edematous side than in the opposite extremity. The mean T2 shortening obtained after the lymphocyte therapy correlated well with the reduction of limb circumference. Mean T2 reflects the fluid content, and SD of T2 the fluid distribution in the subcutaneous tissue. The degree of lymph edema and the effect of therapy can be evaluated quantitatively by measuring the value of the T2 relaxation time.

Species-dependent expression of the hyoscyamine 6 beta-hydroxylase gene in the pericycle

The tropane alkaloid scopolamine is synthesized in the pericycle of branch roots in certain species of the Solanaceae. The enzyme responsible for the synthesis of scopolamine from hyoscyamine is hyoscyamine 6 beta-hydroxylase (H6H). The gene for H6H was isolated from Hyoscyamus niger. It has an exon/intron organization very similar to those for ethylene-forming enzymes, suggesting a common evolutionary origin. The 827-bp 5' flanking region of the H6H gene was fused to the beta-glucuronidase (GUS) reporter gene and transferred to three solanaceous species by Agrobacterium-mediated transformation systems: H. niger and belladonna (Atropa belladonna), which have high and low levels, respectively, of H6H mRNA in the root, and tobacco (Nicotiana tabacum), which has no endogenous H6H gene. Histochemical analysis showed that GUS expression occurred in the pericycle and at the root meristem of transgenic H. niger hairy roots, but only at the root meristem of transgenic H. niger hairy roots, but only at the root meristem of hairy roots and plants of transgenic tobacco. In transgenic hairy roots and regenerated plants of belladonna, the root meristem was stained with GUS activity, except for a few transformants in which the vascular cylinder was also stained. These studies indicate that the cell-specific expression of the H6H gene is controlled by some genetic regulation specific to scopolamine-producing plants.

Gd-DTPA enhanced MRI of reactive hematopoietic regions in marrow

OBJECTIVE

The purpose of this report was to study the contrast enhancement of reactive hematopoietic regions in bone marrow on Gd-diethylenetriamine pentaacetic acid (DTPA) enhanced MRI.

MATERIALS AND METHODS

We compared the contrast enhancement of reactive hematopoietic regions in the marrow of patients with aplastic anemia and drug-induced pancytopenia and that of normal bone marrow on Gd-DTPA enhanced MRI.

RESULTS

The reactive hematopoietic marrow observed in aplastic anemia of moderate grade and drug-induced pancytopenia markedly enhanced after Gd-DTPA administration; normoplastic marrow showed no enhancement.

CONCLUSION

Gd-DTPA enhanced MRI was useful in detecting the reactive hematopoietic regions in bone marrow.

[The usefulness of MRI for the diagnosis of abnormal pregnancies]

The clinical usefulness of MRI for the diagnosis of abnormal pregnancies was evaluated. Pelvic MRI was carried out on 29 cases suspected of abnormal pregnancy by ultrasonography and clinical examinations. The abnormal pregnancies were classified into three categories: (1) maternal abnormalities, (2) fetal abnormalities and (3) placental abnormalities. (1) MRI was of great value for the diagnosis of maternal abnormalities, particularly in cases of coexistent pelvic tumors. MRI allowed diagnosis of uterine leiomyomas and dermoid cyst through its excellent tissue characterization and broad range of vision. (2) MRI was useful in making diagnoses of fetal central nervous anomalies and fetal death, since the lack of fetal movement and the lesions were clear enough to be detected by MRI. However, anomalies in the fetal trunk or extremities could only be demonstrated, but not diagnosed, by MRI owing to its inferior spatial and time resolution. (3) MRI showed placenta accreta and placental hematoma. Although accurate diagnosis was difficult because of their rarity, MRI revealed the hemorrhagic component of the lesions, which was not shown by ultrasonography. The author believes MRI has potential usefulness in making diagnoses of placental abnormalities through its tissue characterization. MRI was superior to ultrasonography in the soft tissue characterization, field of view, while MRI was inferior in time and spatial resolution. In summary MRI should be used in case of abnormal pregnancies such as pelvic tumors, fetal nervous anomalies and placental hemorrhagic lesions. MRI will become useful for the diagnosis of other abnormalities as its spatial resolution and fast scan technology advances.

Hemorrhage from spontaneous rupture of a parathyroid adenoma (a case report)

A case of extracapsular hemorrhage from spontaneous rupture of a parathyroid adenoma is reported. In the case presented here, adenoma was revealed by a sudden onset of a huge ecchymosis and hematoma of the entire anterior neck and right chest, causing recurrent nerve paresis. These cases of hemorrhage from rupture of silent parathyroid adenoma mimicking a dissecting thoracic aortic aneurysm are discussed.

Malignant paraganglioma presenting as Cushing syndrome with virilism in childhood. Production of cortisol, androgens, and adrenocorticotrophic hormone by the tumor

BACKGROUND

A 12-year-old girl with intractable retroperitoneal paraganglioma experienced increased appetite, acne, obesity, "moon face," and enlargement of the clitoris during the course of the tumor. Plasma cortisol, serum testosterone, and dehydroepiandrosterone sulfate (DHEA-S) levels were increased to 34.1 micrograms/dl, 2.0 ng/ml, and 6.628 ng/ml, respectively. Adrenocorticotrophic hormone (ACTH) levels were not increased, and results of dexamethasone suppression tests were negative. Her condition was diagnosed as Cushing syndrome with virilism. Plasma cortisol levels were increased to a level of 107.1 micrograms/dl before death.

METHODS

Tumor samples were obtained at the time of autopsy. The concentrations of cortisol, androgens, ACTH, and catecholamines were assayed in the tumor extracts. The indirect immunoperoxidase procedure was performed on fixed tissues for cortisol, DHEA-S, testosterone, and ACTH.

RESULTS

Extracts of the tumor masses contained steroid hormones: the amount of immunoreactive cortisol was 1.64 micrograms/g wet weight; the amount of immunoreactive testosterone was 25.60 ng/g wet weight; immunoreactive DHEA-S, 579.00 ng/g wet weight; and immunoreactive ACTH, 891.00 pg/g wet weight in the metastatic mass of the lung. Immunohistochemically, immunoreactive cortisol, testosterone, and DHEA-S were detectable in the tumor cells. The adrenal gland was atrophic.

CONCLUSIONS

The patient is the first reported with malignant paraganglioma with the capacity to produce cortisol, androgens, and ACTH.

Stem cell factor enhances the growth of primitive erythroid progenitors to a greater extent than interleukin-3 in patients with aplastic anaemia

We examined the combined effects of stem cell factor (SCF), or interleukin-3 (IL-3) with erythropoietin on the development of haemopoietic progenitors in 19 patients with aplastic anaemia (AA) and eight normal controls by using an in vitro clonal assay. SCF significantly enhanced the growth of total erythroid colonies (erythroid bursts, mixed colonies) in 11 patients and all normal controls, whereas IL-3 did so in only three patients. The number of SCF- or IL-3-dependent erythroid colonies was substantially lower in AA patients than in the controls. Comparison of the capacity of SCF and IL-3 to increase total erythroid colony growth indicated that half of the AA patients responded more strongly to SCF than the normal controls, while few patients responded in such a manner to IL-3. These findings suggest that SCF in vivo will have a more dramatic effect than IL-3 in improving anaemia in patients with AA.

[CT and MR imaging of post-aortic left brachiocephalic vein]

The usefulness of CT and MR imaging (MRI) for the diagnosis of post-aortic left brachiocephalic vein (PALBV) is discussed. The subjects of the present study consisted of five patients with PALBV, two males and three females, aged four months to sixty years. Chest CT and MRI were performed as a follow-up study of other intrathoracic lesions in two cases, and for further examination of congenital heart diseases in two infant cases. The other patient underwent both CT and MRI to evaluate sporadic chest pain. Therefore, all PALBV were found incidentally. PALBV passes below the aortic arch in front of the trachea, draining the superior vena cava behind the ascending aorta. This finding was particularly well documented on consecutive coronal sections on MRI. In patients with intrathoracic malignant or specific inflammatory lesion, differentiation between PALBV and lymphadenopathy is necessary for treatment. From our experience, marked enhancement on CT and no signal intensity on MRI in PALBV could differentiate this anomaly from mediastinal lymphadenopathy. In two infantile cases with congenital cardiovascular anomalies such as tetralogy of Fallot, right aortic arch and pulmonary arterial stenosis, MRI was found to be superior to CT in demonstrating these anomalies.

Possible role of stem cell factor as a serum factor: monoclonal anti-c-kit antibody abrogates interleukin-6-dependent colony growth in serum-containing culture

The monoclonal rat anti-c-kit antibody (ACK2), which abrogates colony growth supported by stem cell factor (SCF), significantly inhibited the interleukin-6 (IL-6)-dependent growth of hematopoietic progenitors derived from spleen cells of normal and 5-fluorouracil (5-FU)-treated mice and from bone marrow cells of normal mice in serum-containing culture. The numbers and types of colonies supported by IL-3, granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF), however, were not influenced by the addition of ACK2 to the cultures of the bone marrow cells from normal mice. In replating experiments with pooled blast cells, ACK2 caused a partial, but significant, inhibition of GM colony growth supported by a combination of IL-6 and fetal bovine serum (FBS), which suggests that FBS is one source of the SCF activity. Conversely, the addition of SCF or FBS with IL-6 to a serum-free culture had significant synergistic effects on the total number of colonies derived from post-5-FU spleen cells and from pooled blast cells. The dose response study showed that the ability of 30% FBS to interact with IL-6 on the colony growth by post-5-FU spleen cells was equivalent to that of approximately 5 ng/mL SCF. These findings suggest that c-kit plays an important role in the growth of hematopoietic progenitors responding to IL-6, and that SCF in the serum affects the development of hematopoietic progenitors in serum-containing cultures.

[Abnormalities in regulation system of granulopoiesis]

We studied the effects of several cytokines on the development of granulocyte-macrophage (GM) progenitors using the serum-deprived culture. SCF plays an important role in the GM-CSF- or IL-3-dependent production of neutrophils and macrophages. In vitro colony assay also suggests an increase in sensitivity of GM progenitors to cytokines (GM-CSF, IL-3, G-CSF and/or SCF) in a patient with juvenile chronic myelogenous leukemia. A high level of serum IFN-gamma was associated with leukopenia and thrombocytopenia in a patient with hemophagocytic syndrome. Based on the evidence that IFN-gamma significantly inhibited the proliferation of GM progenitors, IFN-gamma-mediated suppression was suggested as one of the mechanisms causing cytopenia. In patients with aplastic anemia and neutropenia, an increase of serum G-CSF levels was observed when neutrophils decreased remarkably in number. However, the serum SCF levels were constant in these patients. A failure of SCF to enhance colony growth in some patients with aplastic anemia implies qualitative abnormalities of hematopoietic progenitors.

Hypercalcemia associated with all-trans-retinoic acid in the treatment of acute promyelocytic leukemia

Recent reports have described clinical benefits of all-trans-retinoic acid (ATRA) therapy for acute promyelocytic leukemia (APL). This paper describes severe hypercalcemia (serum calcium: 18.7 mg/dl) in association with ATRA treatment in a 14 year old girl with APL. Serum parathyroid hormone (PTH) concentrations were normal (0.21 ng/ml), which precludes the possibility of primary hyperparathyroidism or ectopic PTH secretion as a cause of the hypercalcemia. As for the factors which can accelerate mineral resorption, there were no apparent increases in the levels of PTH-related protein (PTH-rP), prostaglandins and vitamin D metabolites. In our in vitro experiment, ATRA did not stimulate the leukemic cells to produce PTH-rP. We speculate that ATRA, like PTH, may increase osteoclastic activity and induce hypercalcemia.

[RI venography for retroperitoneal hematoma following anticoagulant therapy for IVC filter thrombosis]

We presented a case of massive retroperitoneal hematoma owing to anticoagulant therapy for IVC filter thrombosis. CT showed the hematoma as high density area. RI venography demonstrated the thrombosis and collateral veins, suggesting the sites of anticoagulant induced bleeding and resultant hematoma. We suppose that RI venography is useful for the follow-up study of the IVC filter inserted cases.

Chondrosarcoma of the nasal septum: surgical considerations on Le Fort I osteotomy

A case of chondrosarcoma of the nasal septum extending into the entire nasopharynx sphenoid sinus and skull base is presented. These cartilaginous tumors are rate in the head and neck, with only 28 reported in the nasal septum. They arise in tissues known to be formed of cartilage, and in the present case tumour presumably originated from the perpendicular lamina of the septum. The treatment of choice is wide surgical excision, which requires an adequate approach for gaining the widest possible exposure of tumor. Surgical considerations are discussed.

Quaternary diltiazem can act from both sides of the membrane in ventricular myocytes

A quaternary derivative of diltiazem (quat-DTZ) was tested to determine whether diltiazem approaches L-type Ca2+ channels from the outside or inside of the cell membrane. In single ventricular myocytes, both extra- and intracellular application of quat-DTZ effectively blocked the L-type Ca2+ channel current, whereas D890 was effective only when applied intracellularly. These results strongly suggest that diltiazem binds to the channel from the outside as well as the inside of the membrane in a manner different from that of phenylalkylamines.

Inhibition by glucocorticoids of the formation of interleukin-1 alpha, interleukin-1 beta, and interleukin-6: mediation by decreased mRNA stability

The mechanism by which glucocorticoids inhibit interleukin (IL)-1 and IL-6 formation in human monocytes and a promonocytic cell line activated by Escherichia coli lipopolysaccharide was analyzed. Dexamethasone (DEX) decreased levels of IL-1 alpha and IL-1 beta mRNAs in a dose-related fashion. The DEX-induced decrease in levels of IL-1 alpha and IL-1 beta mRNAs was abolished by the steroid receptor antagonist RU486. The levels of IL-1 alpha and IL-1 beta proteins within the cells and of IL-1 beta in the culture medium were decreased by DEX to comparable extents, so that DEX had no detectable effect on cytokine secretion. DEX did not influence lipopolysaccharide-induced transcription of the IL-1 beta gene in monocytes. However, DEX markedly decreased the stability of IL-1 beta mRNA, as shown both by steady state measurements and by pulse-labeling. DEX-induced instability of IL-1 beta mRNA required protein synthesis. DEX was also found to be a potent inhibitor of IL-1-induced expression of the IL-6 gene in connective tissue-type cells from the synovium of patients with rheumatoid arthritis. Inhibition of the formation of proinflammatory cytokines, including IL-1 beta and tumor necrosis factor-alpha, is a mechanism by which glucocorticoids exert anti-inflammatory effects. Inhibition by glucocorticoids of the expression of IL-1 alpha in antigen-presenting cells could decrease the capacity of the cells to stimulate the proliferation of T lymphocytes. This activity, as well as inhibition of the production and effects of IL-1 beta, including induced formation of IL-6 and of certain lymphokines, could explain the immunosuppressive effects of glucocorticoids.

[Clinical studies on ceftriaxone in respiratory tract infections. CTRX Study Group]

We report that the results of clinical studies on ceftriaxone (CTRX) in respiratory tract infections (RTIs). Clinical efficacies and side effects of CTRX were as follows; 1. Clinical efficacies of CTRX in a total of 61 cases with RTIs were excellent in 11 cases, good in 23, fair in 11, poor in 12 and unknown in 4. Thus the overall clinical efficacy rate was 59.6%. In cases of patients with lung cancers, the efficacy rate was 42.9%. 2. Clinical efficacy rates with once daily dosage were 50.0% with a dose level of 1 g CTRX and 54.8% with that of 2 g CTRX. 3. Side effects were observed in 2 cases (3.1%) and laboratory abnormalities were observed in 1 case (1.6%). They were not serious, however. These data suggest that CTRX is one of the useful cephalosporins in treatment of RTIs.

Improvement of neutropenia and neutrophil dysfunction by granulocyte colony-stimulating factor in a patient with glycogen storage disease type Ib

Patients with glycogen storage disease type Ib (GSD Ib) suffer from recurrent bacterial infections due to neutropenia and neutrophil dysfunction. To improve the quality of life in a 9-year-old boy with GSD Ib, we subcutaneously administered recombinant human granulocyte colony-stimulating factor (G-CSF). Daily injections of 100 micrograms/m2 of G-CSF significantly increased absolute neutrophil counts and augmented neutrophil mobility. The patient was then treated with 70 and 100 micrograms/m2 of G-CSF daily and twice-weekly. The treatment maintained absolute neutrophil counts at significantly higher levels than those without treatment for 22 months and markedly decreased the frequency of infections and the necessity for hospitalisation. Weekly injections of 70 micrograms/m2 of G-CSF were less efficient. No adverse effects were observed during treatment. These findings indicate that daily and twice-weekly treatment with G-CSF of long duration are safe and effective for patients with GSD Ib. G-CSF may be a useful therapeutic agent in patients with neutrophilic impairment as a consequence of a metabolic disorder.

Interferon-gamma inhibits proliferation, but not commitment, of murine granulocyte-macrophage progenitors

We investigated the effects of interferon gamma (IFN-gamma) on the growth of murine hematopoietic progenitors. IFN-gamma inhibited granulocyte colony-stimulating factor (G-CSF)- and interleukin-3 (IL-3)-dependent colony growth by granulocyte-macrophage (GM) progenitors derived from the bone marrow cells of normal mice. However, the number of IL-3-dependent GM colonies formed by the bone marrow cells of 5-fluorouracil (5-FU)-treated mice was not influenced by the addition of IFN-gamma. Replating experiments suggested that IFN-gamma suppressed GM colony growth directly and that it exerted an inhibitory effect on the proliferation, but not on the commitment, of GM progenitors. In contrast, IFN-gamma failed to suppress colony growth by mast cell progenitors. Erythroid and megakaryocytic progenitors exhibited different responses to IFN-gamma depending on mouse strains. These results suggest that potent negative regulators are not always inhibitors of hematopoietic progenitors.

Stem cell factor enhances proliferation, but not maturation, of murine megakaryocytic progenitors in serum-free culture

The effects of recombinant rat stem cell factor (SCF/c-kit ligand) on murine megakaryocytopoiesis were studied using partially purified bone marrow cells derived from normal and 5-fluorouracil (5-FU)-treated mice in a serum-free culture system. SCF alone did not support the formation of megakaryocyte (M) and granulocyte-macrophage-megakaryocyte (GMM) colonies. However, the addition of SCF to cultures containing interleukin-3 (IL-3) resulted in a significant increase in the number of M and GMM colonies formed by bone marrow cells from normal mice, whereas IL-6 augmented only M colony growth. The stimulatory effect of SCF was approximately three to four times as high as that of IL-6 on the primitive progenitors capable of megakaryocytic-lineage expression derived from 5-FU-treated mice. In addition, SCF, but not IL-6, significantly increased the number of constituent cells in the individual M colonies supported by IL-3. On the other hand, SCF did not exert any effect on the size and DNA content of megakaryocytes in IL-3-dependent M and GMM colonies, whereas IL-6 enhanced the maturation of megakaryocytes. These results suggest that SCF stimulates the proliferative process in megakaryocytic progenitors and that the main activity of IL-6 is the promotion of megakaryocyte maturation.

A phage in Bartonella bacilliformis

Bacteriophage-like particles were found in Bartonella bacilliformis culture. The particles consisted of head (icosahedral), 40 nm in diameter, and tail, 16 nm in length.

Photolabeled sites with a tetrodotoxin derivative in the domain III and IV of the electroplax sodium channel

Forty three percent of the labeled sites, at least, in the electroplax sodium channel with a photoactivable tetrodotoxin derivative were identified by probing protease-digested labeled fragments with several sequence-directed antibodies. They are located in the loop between segments S5 and S6 of domain IV, as well as the region containing transmembrane segment S6 and adjacent extracellular and cytoplasmic sequences in domain III. No photolabeled fragments were detected in the corresponding region of domain I. These results suggest that C-11 of tetrodotoxin where the photoreactive moiety is attached orients to the region between S5 and S6 in domain III and IV. Probable orientation of the tetrodotoxin molecule in sodium channels is considered by taking together with the recent report of the site-directed mutagenesis.

[Suppression of in vitro hemopoiesis by the monocytes in a patient with aplastic anemia associated with hepatitis]

The cause of aplastic anemia associated with hepatitis (AAH) is as yet still unknown. There is a supposed relation to the immune mechanisms, however few reports have shown the effects of monocytes on the pathogenesis in the patients with AAH. We have reported a case of a 12-year-old boy with AAH related to cytomegaloviruses, and studied the hemopoietic progenitors. He showed pancytopenia and hypoplasia of the bone marrow on admission to our hospital. The culture studies showed that mononuclear cells (MNC) of the bone marrow produced few hemopoietic colonies in all cell lineages. However, the depletion of adherent cells from the MNC increased numbers of erythroid, neutrophil-macrophage and megakaryocyte colonies. Furthermore, the addition of adherent cells of the peripheral blood suppressed the colony formation in the aforementioned cell lineages by marrow MNC from which adherent cells, phagocytic cells and T-cells were abrogated. The results way suggest that monocytes play some soles in the pathogenesis of aplasia through inhibitor of hemopoiesis.

Interleukin-6 supports human megakaryocytic proliferation and differentiation in vitro

The effect of interleukin-6 (IL-6) on cells of human megakaryocyte (MK) lineage from cord blood was explored. In semisolid colony assays containing human plasma, a greater number of both MK colonies and cells per colony was seen in the presence of IL-6 and IL-3 than in the presence of IL-3 alone. This stimulatory effect of IL-6, observed on both small and large MK colonies, was completely eliminated by the addition of anti-IL-6 antibody to the culture. IL-6 alone had no effect on MK colony formation. In the primary culture, MKs showed larger cell size and DNA content in the presence of both IL-3 and IL-6 than IL-3 alone. The replating experiments using immature MKs grown in the presence of IL-3 showed that IL-6 significantly augmented both cell size and DNA content. This effect was also neutralized by an anti-IL-6 antibody. IL-3 had no tangible effect on MK differentiation. Synergism between IL-6 and IL-3 on MK differentiation was not confirmed. These results suggest that IL-6 is a synergistic factor in the proliferation of MK progenitors and a direct effector of differentiation of immature MKs on in vitro human megakaryocytopoiesis.

[Epidemiological study on Chlamydia trachomatis infection in obstetrics and gynecology field in Tokyo]

In conjunction with the Tokyo Branch of Japan Association for Maternal Welfare, we have been carrying out examinations of Chlamydial infection on women, especially pregnant women, living in Tokyo. Specimens were collected from 212 gyneco-obstetric clinics in Tokyo during 4 years from January 1987-December 1990. A total of 13,925 swab specimens from patients who were suspected of sexually transmitted diseases from clinical findings and pregnant women who requested the examination were tested for the presence of antigen to C. trachomatis with EIA (Chlamydiazyme). Epidemiological analysis based on the results and case cards that were described sex, age, occupation and clinical findings were conducted. The results obtained are briefly summarized as follows. 1) C. trachomatis antigen was detected in 12.8% (1,237/9,657) of the female patients, 31.0% (124/400) of the male patients and 6.8% (10/168) of the infants. The detection rates of C. trachomatis antigen in the male patients was significantly higher than that in the female and the infants patients. C. trachomatis antigen was detected in 6.1% (226/3,683) of pregnant women. 2) The detection rates of C. trachomatis antigen were compared by occupation of female patients. Most high rate was 26.6% (53/199) in bar hostess , subsequently 20.1% (102/508) in students, 19.8% (59/298) in prostitutes, 13.6% (455/3,348) in office girls and 7.2% (471/6,573) in house-wives. It was noteworthy that the detection rates of C. trachomatis antigen in students was as similarly high as that in prostitutes. 3) The detection rates of C. trachomatis antigen was also compared by age groups. The detection rate had a tendency to be high in younger people.(ABSTRACT TRUNCATED AT 250 WORDS)

[Marked bone marrow necrosis preceding acute myeloblastic leukemia in childhood]

A 3-year-old boy was transferred to our hospital because of fever, abdominal pain and severe systemic bone pain on October 16, 1989. Hematological examination showed hemoglobin 8.7 g/dl, white blood cell count 5300/microliters with 9% neutrophils and platelet count 5.5 x 10(4)/microliters. Bone marrow aspiration and biopsy revealed markedly necrotic cells. Blood chemistry showed transient elevation of CRP, serum LDH, FDP, FDP-Ddimer and fibrinogen. Tc99m pyrophosphate bone scanning showed multiple uptake spots in various bone. Although the sign of fever, abdominal pain and bone pain disappeared spontaneously after three weeks, anemia persisted. About two months later from bone marrow necrosis, abnormal cells appeared in the bone marrow. A diagnosis of AML (M3) was made and a combination chemotherapy started. This case is remarkable for elevation of acute phase protein in association with bone marrow necrosis.

[Bone marrow transplantation in a pediatric case of acute nonlymphocytic leukemia with hepatitis C]

An allogenic bone marrow transplantation (BMT) in an acute nonlymphocytic leukemia (ANLL) patient with post-transfusion hepatitis C is presented. A 13-year-old girl was admitted to our hospital on May 1988, and diagnosed as having ANLL M2 according to the FAB classification. During the induction and post-induction chemotherapy, 116 units of blood products were transfused to her as the supportive therapy until October 1988, when non-A non-B hepatitis developed. As the persistent liver dysfunction interfered with anti-leukemic chemotherapy on the protocol, allogeneic BMT from her HLA identical MLR nonreactive brother was done on July 1989. Preconditioning regimen consisted of busulfan and cyclophosphamide. GVHD prophylaxis consisted of cyclosporine A and short term methotrexate. After the BMT, her liver dysfunction once improved; her serum amino-transferase levels were normal for about 3 months. Soon after discontinuation of cyclosporine A, however, her liver function deteriorated again. The examination of hepatitis C virus antibody in her sera, which had been harvested sequentially and stored at -40 degrees C, on November 1989 revealed that she had been already seropositive at the time of BMT. The BMT-induced immunologic changes may have influenced the natural course of hepatitis C virus infection in the patient.

[Antibiotic sensitivity and serotypes of group A hemolytic streptococci isolated from clinical specimens and healthy pupils in Japan, 1986-1988]

As an epidemiological survey for streptococcal infection, antibiotic sensitivity test and T-serotyping were made on 2,735 strains of group A hemolytic streptococci isolated from clinical specimens and healthy pupils between 1986 through 1988 in Japan. Most dominant serotype in clinical isolates was T-4 (26.8%) and it was followed T-12 (25.5%), T-1 (11.2%) and T-3 (8.5%), on the other hand, dominant serotypes of the isolates from healthy pupils were T-12 (30.4%), T-1 (19.3%), T-4 (15.3%) and T-28 (13.4%). All of the isolates tested were sensitive to the beta-lactam antibiotics which was found as same as consequence of the previous surveys. However 36.4% to tetracycline, 2.1% to chloramphenicol and 1.4% to oleandomycin of the clinical isolates were resistant. Similarly, 16.2% to tetracycline, 2.3% to chloramphenicol 1.7% to oleandomycin, of the isolates from healthy pupils were resistant. Multi-resistant strains were found 1.4% in clinical isolates and 1.7% in the isolates from healthy pupils. Relation between distribution of multiresistant strain and T-serotypes was found. In T-12, multiresistant strains were encountered at a relatively high rate compared with other serotypes, representing 3.5% in clinical isolates and 5.6% in the isolates from healthy pupils. However this tendency was decreased than previous surveys, while incidence of tetracycline resistant strains in T-4 remained at high level, representing about 94% as same as in the past.

Syntheses of 5,7,8- and 5,6,7-trioxygenated 3-alkyl-3',4'-dihydroxyflavones and their inhibitory activities against arachidonate 5-lipoxygenase

5,6,7- and 5,7,8-Trioxygenated 3',4'-dihydroxyflavones were derivatized by introducing alkyl groups of various chain lengths at the 3-position of the flavone skeleton. These compounds were tested as inhibitors for arachidonate 5-lipoxygenase purified from porcine leukocytes. Modification of the 3-position with an alkyl group of 6-10 carbons markedly decreased the IC50 values. 3-Hexyl-3',4'-dihydroxy-5,7, 8-trimethoxyflavone inhibited 5-lipoxygenase with an IC50 value of 58 nM. The platelet and leukocyte 12-lipoxygenases, 15-lipoxygenase of reticulocytes, and cyclooxygenase of vesicular gland were inhibited less potently (IC50 = 0.4, 0.4, 2.7, and 30 microM). Thus, the compound was a relatively selective inhibitor for 5-lipoxygenase.

[Three cases of psittacosis]

Case 1 was a 55 year old female whose primary complaint was pyrexia. Anamnesis consisted of a fever at a 39 degrees C level beginning on September 15, 1987 with headache and muscle pain. The patient was examined by a nearby physician. Despite taking medication, there was no break in the fever. The patient was examined and admitted to this institution on September 18. Case 2 was a 32 year old female whose primary complaint was pyrexia and an abnormal sensation in the pharynx. Anamnesis consisted of a fever at a 39 degrees C level beginning on February 13, 1989 and the manifestation of a cough beginning on February 17. Although the fever broke on February 20, as the abnormal sensation in the pharynx persisted, the patient was examined and admitted to this institution on February 21. Case 3 was a 42 year old male whose primary complaint was pyrexia. Anamnesis consisted of a fever of 38 degrees C, cough and a sensation of pressure in the right precordia beginning on November 18, 1989. The patient was examined and admitted to this institution on November 21. Chest X-rays revealed the presence of atypical pneumonia in all three cases. As a significant rise in antibodies to the Chlamydia of parrot fever was observed in the cases at the time of admittance as well as after admittance, treatment was begun by administration of Minocycline.(ABSTRACT TRUNCATED AT 250 WORDS)

Cryoglobulinemia in a horse

Cryoglobulin was isolated from a horse which had glomerulo-nephritis and a history of swelling and skin ulcers of the limbs in the winter. The isolated cryoglobulin showed a single peak on a gel permeation chromatography column with an apparent molecular mass (Mr) of 180,000 which could be divided into two gamma bands by cellulose acetate electrophoresis. Immunoelectrophoretic analysis revealed that the cryoglobulin formed two precipitation lines with anti-horse IgG. Spur formation was observed when the cryoglobulin and the IgG purified from a normal healthy horse were cross-reacted with anti-horse IgG on a double diffusion gel. In addition, sodium dodecyl sulfate-polyacrylamide gel electrophoresis under the reduced conditions showed that the isolated cryoglobulin consisted of two doublets of polypeptides with Mr values of 52,000 and 50,000, and 31,000, and 30,000, corresponding to the heavy chain and the light chain of the horse IgG molecules, respectively. These results suggest that the isolated cryoglobulin might consist of two different IgG molecules, and that the manifestations such as foot swelling with skin ulcers and renal failures were all induced by the cryoglobulin in the serum.

[Usefulness of the mailed specimens for mass examination of Chlamydia trachomatis and Neisseria gonorrhoeae with EIA]

The infections with C. trachomatis and N. gonorrhoeae have recently been determined routinely with the commercial kits for detecting the antigens of these organisms in both the clinical and mass examination laboratories. In mass examination, a change during transporting the specimens must be avoided. Hence, a study on whether the antigens were changed with atmospheric temperature was carried out. As for C. trachomatis, no change in antigen was found on the enzyme immunoassay (EIA) absorbance of the antigen quantity corresponding to the cell of 4.8 x 10(4), 2.4 x 10(4) and 6.0 x 10(3) (IFU/ml) until 5 days at 4, 25 and 37 degrees C respectively after sampling. The coefficient variation was found out to be ca. 10%. In a test on antigen stability of N. gonorrhoeae, similar results to that of C. trachomatis were obtained on the following antigen quantity: 2.4 x 10(3), 3.3 x 10(2) and 9.0 x 10 (CFU/ml) under the same conditions as in the above. The coefficient variation was found out to be 10% or less. To investigate whether there is any difference on the stability of C. trachomatis antigen between mailing and hand carrying, a total of 133 specimens collected from many clinics were subjected to the detection of antigen with the commercial EIA kits. The results of comparison on both transport methods were as follows: agreement rate 96.2%, positive rate 100% and negative rate 95.2%. The highly correlation between the both transportation was confirmed in the detection of antigen; that is, Y = 1.03X + 0.03, r = 0.936.(ABSTRACT TRUNCATED AT 250 WORDS)

Hyoscyamine 6 beta-hydroxylase, an enzyme involved in tropane alkaloid biosynthesis, is localized at the pericycle of the root

Hyoscyamine 6 beta-hydroxylase (H6H; EC 1.14.11.11) catalyzes the first reaction in the biosynthetic pathway from hyoscyamine to scopolamine in several solanaceous plants. Four monoclonal antibodies were raised against H6H purified from cultured roots of Hyoscyamus niger. The IgG1 antibody mAb5 inhibited H6H activities present in cell-free extracts of H. niger roots and specifically recognized 38-40-kDa proteins from six different scopolamine-producing plant species in Western blot analysis after sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. The other three monoclonal antibodies all recognized SDS-denatured H6H protein from Hyoscyamus species, but did not bind to native H6H. Western blot analysis of protein extracts from various tissues of H. niger using these antibodies showed that H6H is abundant in cultured roots, present in plant roots, but absent in leaf, stem, calyx, cultured cells, and cultured shoots. Immunohistochemical studies using monoclonal antibody and immunogold-silver enhancement detected H6H only in the pericycle cells of the young root in several scopolamine-producing plants. Mature roots that underwent secondary growth and lacked the pericycle did not react with the antibody. This pericycle-specific localization of scopolamine biosynthesis provides an anatomical explanation for the tissue-specific biosynthesis of tropane alkaloids and may be important for translocation of tropane alkaloids from the root to the aerial parts.

Hereditary high-potassium erythrocytes with high Na, K-ATPase activity in Japanese shiba dogs

The sodium (Na) and potassium (K) concentrations and Na, K-ATPase activity were examined in erythrocytes from 24 Japanese shiba dogs and 79 dogs of 24 other breeds. Eleven of the shibas had erythrocytes with high K and low Na concentrations, together with high Na, K-ATPase activity (HK RBCs), while red cells from the remaining shibas and all of the other breeds examined showed low K and high Na concentrations, with no enzyme activity (LK RBCs). The concentration of reduced glutathione in HK RBCs was about five times that in LK RBCs. All the findings from HK shibas were in good agreement with those from HK mongrel dogs found in Japan previously. Since the shiba is a Japanese breed of dog, the results of the present study strongly suggest that the gene for HK RBCs may be inherent in dogs indigenous to Japan, particularly in shiba dogs.

[HLA antigens in 11 cases of patients with recurrent erythema and anti-SS-B antibody]

HLA antigens were studied in 11 cases of patients with recurrent erythema and anti-SS-B antibody. Among DR antigens positive associations with DR5, DRw6 (including DRw13), and DRw52 were obtained. These data demonstrated that 11 cases of this report are immunogenetically closely related to each other and appear to be related to Sjögren's/lupus erythematosus overlap patients.

[Hemangioma of the hypopharynx; a case report and value of MRI]

A case of 23-year-old female with histologically verified hemangioma of the hypopharynx was reported. MRI revealed slight hyper-intense mass on T1-weighted image while it was very high-signal intensity on T2-weighted image. The dynamic MRI showed peak contrast at 80 seconds after administration of Gd-DTPA. In the present paper the value of MRI for diagnosing hemangioma of the hypopharynx is discussed.

[Comparison between two systems for assaying the level of antibody against Streptococcus agalactiae (GBS) type III]

Levels of antibody against GBS type III in pregnant women have been determined using ELISA assay method that we originally deviced. Toyo Jozo Co. have also introduced an assay system (the Toyo kit) that resembles ours. The present study was performed to compare our system with the Toyo kit. Correctivity between the two systems was good, giving a regression curve of Y = 1.18X - 0.60 and a correlation coefficient of r = 0.794. Antibody levels in pregnant women were determined by the Toyo kit, and were found to be less than 10 micrograms/ml in almost all samples. Among 19 serum samples from vaginal carriers of GBS type III, the antibody levels ranged from 1.5 to 93.8 micrograms/ml. Among seven maternal serum samples in cases of GBS type III infection, the maximum level was 6.0 micrograms/ml. Thus, the Toyo kit showed satisfactory sensitivity for determining the level of antibody against GBS type III. Hereafter, we intend to use the Toyo kit for determining antibody levels in pregnant women.

Two novel molecular isoforms of band 4.2 in Japanese Sika deer (Cervus nippon yesoensis, Heude) erythrocytes

Two molecular isoforms of band 4.2 were identified in erythrocyte membranes from 25 Japanese Sika deer (Ceryus nippon yesoensis, Heude) based on specific immunorecognition with anti-human band 4.2. These two variants, designated 4.2/78 and 4.2/76, had respective relative molecular weights (Mr) of 78,000 and 76,000 on sodium dodecyl sulfate-polyacrylamide electrophoresis gels and showed similar profiles after limited proteolysis, exhibiting identity in primary structure. 25 adult Sika deer could be divided into two groups according to the 4.2/78:4.2/76 ration, indicating a genetic control in the expression of the molecular isoforms of band 4.2. Both polypeptides were completely retained in cytoskeletal protein-depleted membranes and could be removed by alkaline extraction, suggesting that both proteins contribute to the association of membrane proteins.

[Assessment of plasma inactive renin by trypsin and thermolysin treatment during open heart surgery]

Plasma inactive renin (IRA) were assayed through open heart surgery by trypsin treatment in twenty-two patients. Postoperatively plasma renin activities and IRA increased, remarkably in IRA, however total renin activities were lesser than plasma renin activities during extracorporeal circulation. From the results of addition of 125I-angiotensin I before trypsin treatment, the presence of unknown enzyme was assumed, which was activated by trypsin and catalyzed angiotensin I in extracorporeal circulation. Bacterial enzyme, thermolysin, also activated plasma inactive renin, more stably until 60 min at 0-37 degrees C than trypsin. By trypsin, activities were in peaks at 1 min and gradually decreased thereafter. Conclusively we could assess the superiority of thermolysin treatment over trypsin treatment.

[A case of rheumatoid arthritis associated with polyneuritis]

A 57-year-old woman suffered from polyarthralgia for 7 years, and was treated by using NSAID with the diagnosis of RA. From Jan. 20th 1987, she complained of back pain and numbness of both hands, and from May 7th 1987, she also complained of dysphagia and dysarthria, and she was not able to button up. Soon afterwards she could eat only one custard pudding a day, so she admitted to our hospital on March 17th 1987. The neurological examination showed hyporeflexia and muscle weakness of the four extremities; and hypesthesia of the 7th to 11th intercostal nerve area and both lateral sides of the dorsum pedis. The laboratory examination showed ESR 17 mm/h, gamma-glob 1.66 g/dl, CRP(+), RAHA 80 x, CH50 24.0 U/dl, HLA-antigen; DR 4(+). Cerebrospinal fluid examination showed cell 5/mm3, protein 63 mg/dl, IgG 13 mg/dl, IgG% 20.6%. X-ray examination indicated destruction of both wrists, left elbow, right 2-5th MTP, and left 5th MTP joints. A light microscopic examination of the left sural nerve showed perivascular infiltration with lymphocyte, occasional macrophages and giant cells at the epineurium, and no demyelination or Wallerian degeneration at the nerve fiber. These histological findings were the same as type-I arteritis in nerves in RA proposed by D.L. Conn. Clinical improvement was obtained after administration of prednisolone 30-60 mg/day.

Substrate specificities of exo- and endo-type cellulases in the hydrolysis of beta-(1----3)- and beta-(1----4)-mixed D-glucans

An exo-type cellulase (Ex-1) was extracted from Irpex lacteus (Polyporus tulipiferae) and purified essentially to homogeneity. This cellulase attacked cellulosic substrates in an exo-wise fashion to produce almost exclusively cellobiose. In contrast, Ex-1 was found to attack beta-glucans having beta-(1----3)- and beta-(1----4)-mixed linkages in a way similar to an endo-type cellulase. The products formed from barley glucan by Ex-1 were 3(2)-O-beta-D-cellobiosyl-cellobiose much greater than 3(2)-O-beta-D-glucosyl-cellobiose greater than cellobiose much greater than or equal to cellotriose much greater than glucose in the early stage, but no laminaribiose was produced. An endo-type cellulase (En-1) obtained from the same fungus also hydrolyzed beta-glucans but in a typical endo-wise fashion and the products from barley glucan were 3(2)-O-beta-D-glucosyl-cellobiose much greater than 3(2)-O-beta-D-cellobiosyl-cellobiose greater than cellobiose much greater than laminaribiose; no glucose or cellotriose was produced. Thus, it seems likely that En-1 can attack any intramolecular linkage of beta-glucan, while Ex-1 requires the presence of at least cellobiosyl residues adjacent to a beta-(1----3)-D-linked glucosyl residue. This finding, together with the mode of hydrolysis of cellulosic substrates by Ex-1, suggests that the stereochemical structure of successive beta-(1----4)-cellobiosyl residues inserted by beta-(1----3)-D-glucosidic linkage is permissible in the action of Ex-1, although this enzyme prefers the beta-(1----4)-linked cellobiosyl sequence.