[Two case reports of recurrent mediastinitis with chronic mediastinal fistula successfully treated with muscle flap re-transposition]

We experienced two cases of recurrent poststernotomy mediastinitis with chronic mediastinal fistula. Both cases had already received muscle flaps for post operative mediastinitis. However, chronic mediastinal fistula appeared after nine months in the first case, and eleven months in the second case. We removed the infected tissue and the predgets, which were used on the ascending aorta. Then closed the wound by the muscle flap closure. The chronic fistula were closed, and the functional and cosmetic results were excellent.

Derivation and application of monoclonal antibodies recognizing several epitopes on bovine serum albumin

Three (AB-3, AB-4 and AB-6) monoclonal antibodies (mAb) to bovine serum albumin (BSA) were derived and characterized for their physicochemical and immunological properties. AB-3 recognized an epitope distinct from epitopes recognized by AB-4 and AB-6 as determined by binding inhibition assay. AB-4 and AB-6 mAbs recognized similar but not identical epitopes on BSA. Based on the antigenic specificity, we applied these mAbs to quantitative analysis of BSA in medium and to depletion of BSA from culture medium containing fetal calf serum (FCS). For quantitative analysis, we employed a sandwich enzyme-linked immunosorbent assay (ELISA) using biotinylated AB-3, solid-phase of AB-6 and an avidin-biotin-peroxidase complex system. This assay was highly sensitive and quantitative in the range of BSA concentration at 10 to 1,500 ng/ml. To deplete BSA from medium, we prepared affinity-gel coupled to AB-6. Repeated treatment of FCS-containing medium with the affinity-gel efficiently depleted BSA from the medium. The depletion capacity was 0.74 to 1.0 moles of BSA/mole of coupled mAb.

Application of a new morphometry system based on SEM stereo-pairs to the study of intestinal mucosa of rodents

A new morphometry system for submicroscopic three-dimensional structures was developed on the same principles as for the aerial survey using SEM stereo-pairs. This computer graphic system was applied to the analysis of the surface features of the intestinal mucosa. After removing the epithelial layer by prolonged osmication, core structures of the intestinal villi were exposed and 100 villi each from rat and mouse were measured. Average height, basal area and surface area of a single core of the rat were 188 microns, 20,200 microns2 and 93,500 microns2, respectively. Those of the mouse were 148 microns, 7,530 microns2 and 37,100 microns2, respectively. Surface amplifications by the rat and the mouse villi, after compensating for epithelial thickness, were calculated as 3.5 and 4.3, respectively; though amplifications based on the villous core were 4.6 and 4.9, respectively. These three-dimensional features of the intestinal mucosa were illustrated as submicroscopic maps by drawing their contour lines. It was demonstrated that the present morphometry system makes it possible to know not only the average features of a large sample, but also a variety of features of individual structures which were directly observed under SEM.

Enhancement of phorbol ester-induced production of tumor necrosis factor alpha by thalidomide

The effect of thalidomide [racemic (DL-) form and optically pure (D- and L-) forms] on tumor necrosis factor (TNF) alpha production by human leukemia cell lines (HL-60, K562 and U937) stimulated with 12-O-tetradecanoylphorbol-13-acetate (TPA) was investigated. Though thalidomide has been regarded as a specific inhibitor of TNF-alpha production, our study indicated that all forms of thalidomide enhanced (but did not inhibit) the TPA-induced TNF-alpha production by the human leukemia cell lines investigated. The effects of thalidomide on TNF-alpha production might be cell type-specific.

Cold agglutinin disease following allogeneic bone marrow transplantation

We describe a case of cold agglutinin disease (CAD) following allogeneic bone marrow transplantation. This 36-year-old male developed CAD 3 weeks after allogeneic bone marrow transplantation for chronic myelogenous leukemia. Cyclosporin A and methotrexate had been administered to prevent graft-versus-host disease. Other agents administered included cytomegalovirus hyperimmune globulin and recombinant human G-CSF. Pericarditis preceded the development of CAD. The characterization of cold agglutinin (CA) was monoclonal IgM-kappa with anti-Pr antigen specificity, probably derived from the engrafted donor lymphocytes. The administration of prednisolone led to transient improvement. The CA titer decreased without further treatment 12 weeks after transplant.

The Schwann cell precursor and its fate: a study of cell death and differentiation during gliogenesis in rat embryonic nerves

We have characterized a cell, the Schwann cell precursor, that represents a distinct intermediate differentiation stage in the process by which Schwann cells are generated from neural crest cells. The Schwann cell precursor shows radical differences from Schwann cells which include death regulation, antigenic phenotype, pattern of cell-cell interaction, migratory behavior, and morphology. In the nerves of the rat hind limb, Schwann cells are irreversibly generated from these during a brief period, essentially embryonic days 15-17. We also provide evidence that the survival of Schwann cell precursors is regulated by neurons and identify basic fibroblast growth factor as a potential key regulator of apoptosis in Schwann cell precursors and of precursor to Schwann cell conversion. These findings have implications for our understanding of gliogenesis in the peripheral nervous system.

[A gastric proton pump inhibitor as preanesthetic medication]

Effect of omeprazole, a gastric proton pump inhibitor, on gastric secretion during anesthesia and surgery was evaluated in 39 elective surgical patients ranged in age from 18 to 69 years. These patients were divided into two groups according to their age either of 40 years and under or over. The patients of both groups underwent orthopedic, ophthalmic, ENT, plastic, oral or non-abdominal surgery under neuroleptanesthesia, enflurane anesthesia or total intravenous anesthesia with droperidol, fentanyl and ketamine. They all were administered omeprazole 20 mg orally at 21:00 the night before surgery and again at 7:00 on the morning of surgery. The volume and acidity of gastric juice were measured at anesthetic induction and emergence from anesthesia. The volume and pH of the gastric juice in patients of 40 years and under in age averaged to 9.8 +/- 3.2 (mean +/- SE) ml, 2.45 +/- 0.56 at the anesthetic induction and 9.3 +/- 4.1 ml, 4.66 +/- 0.60 at the emergence from anesthesia respectively. The mean volume and pH of the gastric juice in patients over 40 years of age were 5.0 +/- 1.7 ml, 4.68 +/- 0.56 at the anesthetic induction and 9.9 +/- 2.4 ml, 5.76 +/- 0.36 at the emergence from anesthesia respectively. Significant decrease in the volume and acidity of gastric juice was observed in the patients of both groups except that the average of intragastric pH of the patients under 40 years of age was below 2.50 at the induction of anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoimmune antibody in a patient with idiopathic thrombocytopenic purpura reacted to the platelet low molecular weight glycoproteins and activated platelets

The authors characterized antiplatelet membrane antibodies in the sera of patients with idiopathic thrombocytopenic purpura (ITP) and cirrhosis of the liver. Antibodies were detected in five of the 22 patients with chronic ITP and in none of the eight patients with cirrhosis of the liver. The authors report a patient with chronic ITP in complete remission. Antibody to platelet glycoproteins (GP), with molecular weights of 55 and 49 kDa, was detected in the serum. The patient's immunoglobulin G (IgG) alone could cause the aggregation of platelet-rich plasma. Anti-GPIIb/IIIa antibody (LJ-CP8) inhibited the aggregation of platelet-rich plasma induced by the patient's IgG in a dose-dependent manner. The F(ab')2 of the patient's IgG had a synergetic effect on the aggregation of PRP induced by adenosine 5-diphosphate. This demonstrates that in ITP, the binding of IgG via its fragment of antigen binding site portion may activate platelets.

Different interactions of Grb2/Ash molecule with the NGF and EGF receptors in rat pheochromocytoma PC12 cells

We have previously shown that nerve growth factor (NGF) induces a rapid and relatively continuous activation of Ras in rat pheochromocytoma PC12 cells while epidermal growth factor (EGF) activates Ras transiently, and that tyrosine kinase activity of the NGF receptor is essential for the activation of Ras (Muroya et al., Oncogene, 7, 277-281, 1992). In order to explore the signaling mechanism from tyrosine kinase to Ras activation in more detail, interactions between two adaptor molecules, Shc and Grb2/Ash, which contain Src homology regions, and their interactions with the NGF and EGF receptors were examined. Both NGF and EGF induced rapid tyrosine phosphorylation of Shc and its association with both the receptors and with Grb2/Ash. When cells were stimulated with EGF at 4 degrees C, the activation of Ras proceeded slowly and MAP kinase activation was quite low. Under such restricted conditions, tyrosine-phosphorylated Shc formed a complex with Grb2/Ash, suggesting that the complex formation may be one of the immediate early responses. In contrast to Shc, Grb2/Ash bound to EGF receptor but did not form a stable complex with the NGF receptor. These results suggest that there may be an alternative pathway for the activation of Ras in PC12 cells.

Relationship between occurrence of tremor/convulsion and level of beta-carbolines in the brain after administration of beta-carbolines into mice

Fifteen beta-carboline derivatives, including those found in the South American hallucinogenic plant Banisteriopsis caapi, were injected IP and IVC into mice. Subsequent behavioral changes were observed and the levels of the compounds in brain tissue were determined. It was found that following IP administration, tremors and/or convulsions were induced by beta-carbolines having aliphatic alkyl groups, but not by those with carbonyl and oxo groups substituted at carbon-1 of the C ring. These effects were potentiated by the presence of a methoxy group at carbon-7 of the A ring, and their duration of actions were prolonged by 3,4-dihydro derivatives. When induced, tremors/convulsions correlated with levels of beta-carbolines in the brain. The smaller ED50 values of beta-carbolines that cause tremors/convulsions showed lower levels of beta-carbolines in brain tissue.

Synthesis of oxygenated cholesterols as structural mimics of phorbol ester-type tumor promoters

We designed several oxygenated steroids in which functional groups including a hydrophobic group are arranged analogously to those of phorbol ester (12-O-tetradecanoylphorbol-13-acetate, TPA), with the aim of finding compounds with TPA-like activity, but having a different skeleton and a rigid conformation. The designed steroids, 1 beta,5 alpha-dihydroxy-3 beta-hydroxymethylcholestan-6-one (4), 3 beta,5 alpha-dihydroxycholestan-6-one (5), 3 beta-hydroxymethylcholestan-5 alpha-ol-6-one (6) and 1 beta,3 beta,5 alpha-trihydroxycholestan-6-one (7), were synthesized. A related oxygenated steroid isolated from soft coral, cholestane-1 beta,3 beta-5 alpha,6 beta-tetrol (8), was also synthesized. Among these analogs, compound 7 showed weak TPA-like activities in three biological tests: inhibition to protein kinase C and to cytosolic-nuclear tumor promoter-binding protein (CN-TPBP), and induction of differentiation of human promyelocytic leukemia cells (HL-60) to monocyte-like cells. On the other hand, compound 5 was found to be a specific ligand for CN-TPBP, but lacked the other TPA-like activities.

Transition from TCR-beta dimer to TCR-alpha beta-expressing cells by introduction of an alpha-chain in an immature thymocyte cell line

The molecular basis for the surface expression of TCR-beta chain in the absence of association with TCR-alpha, -gamma, or -delta chain by an immature thymocyte cell line was investigated. The TCR-beta chain expressed by this cell line was not encoded by any unique DNA sequence, nor was it inserted into the membrane via a glycosyl-phosphatidylinositol linkage. Transfection of two other beta-chains derived from mature T cell clones resulted in the surface expression of dimers of the transfected beta-chains in both cases. Immunoprecipitation of the beta-dimer-CD3 complex demonstrated that the association of the beta-dimer with the CD3 complex, especially the CD3 zeta chain, was so weak that they dissociated under the detergent conditions in which the TCR-CD3 complex of mature T cells is kept intact. Transfection of TCR-alpha chain resulted in the expression of a TCR-alpha beta-CD3 complex and the disappearance of beta-dimers. In accordance with the changes in TCR complex components, the association between TCR-alpha beta and CD3 complex became stable and the cells transduced signals more efficiently. The results demonstrate that the expression of TCR-beta as part of an incomplete TCR-CD3 complex is developmentally regulated and the expression of TCR-alpha chain results in normal configuration and function of TCR complex.

Transition from TCR-beta dimer to TCR-alpha beta-expressing cells by introduction of an alpha-chain in an immature thymocyte cell line

The molecular basis for the surface expression of TCR-beta chain in the absence of association with TCR-alpha, -gamma, or -delta chain by an immature thymocyte cell line was investigated. The TCR-beta chain expressed by this cell line was not encoded by any unique DNA sequence, nor was it inserted into the membrane via a glycosyl-phosphatidylinositol linkage. Transfection of two other beta-chains derived from mature T cell clones resulted in the surface expression of dimers of the transfected beta-chains in both cases. Immunoprecipitation of the beta-dimer-CD3 complex demonstrated that the association of the beta-dimer with the CD3 complex, especially the CD3 zeta chain, was so weak that they dissociated under the detergent conditions in which the TCR-CD3 complex of mature T cells is kept intact. Transfection of TCR-alpha chain resulted in the expression of a TCR-alpha beta-CD3 complex and the disappearance of beta-dimers. In accordance with the changes in TCR complex components, the association between TCR-alpha beta and CD3 complex became stable and the cells transduced signals more efficiently. The results demonstrate that the expression of TCR-beta as part of an incomplete TCR-CD3 complex is developmentally regulated and the expression of TCR-alpha chain results in normal configuration and function of TCR complex.

Determination of 16S ribosomal RNA sequences of all members of the genus Peptostreptococcus and their phylogenetic position

A comparative analysis of 16S ribosomal RNA sequences of all Peptostreptococcus species revealed that most members of the genus Peptostreptococcus should be divided into many different genera. The relationship between clostridia and peptostreptococci was analysed to find the phylogenetic position of peptostreptococci.

[A case report of interstitial pneumonia caused by granulocyte colony-stimulating factor]

Several clinical trials have demonstrated that granulocyte colony-stimulating factor (G-CSF) accelerates the recovery of neutropenia in chemotherapy-induced bone marrow suppression. In this report, we describe a 46-year-old female with glioblastoma multiforme who developed interstitial pneumonia due to administration of G-CSF during the phase of immunochemoradiotherapy-induced neutropenia. Thirty-three days after starting immunochemoradiotherapy (ACNU, VCR, IFN -beta, radiation), she developed neutropenia (1,000/microliters). Administration of G-CSF at doses of 125-250 micrograms/day led to an increase of peripheral neutrophil counts. Eleven days later, the patient developed sudden severe respiratory failure and cyanosis with worsening of lung shadows. Blood gas levels on room air were PaO2 49.3mmHg, PaCO2 28.0mmHg, and pH 7.46. At this time, her neutrophil count had risen to 26,080/microliters. LDH and alpha - HBD had also increased to 1,439 IU/l and 1,117IU/l respectively. Chest radiograph and CT scan demonstrated interstitial pneumonia. After treatment with methyl prednisolone, her respiratory symptoms were gradually resolved. A number of side-effects have been reported with granulocyte-macrophage colony-stimulating factor (GM-CSF). These include fluid retention with pericardial and pleural effusion, fever, bone pain, fatigue, and rash. This report also suggests that G-CSF might be a cause of interstitial pneumonia during the phase of immunochemoradiotherapy-induced neutropenia.

Population analysis of the dose-dependent pharmacokinetics of zonisamide in epileptic patients

The pharmacokinetics of zonisamide was studied using routine therapeutic drug monitoring data from 68 epileptic patients. The 266 serum concentration data at steady-state after repetitive oral administration were analyzed using the nonlinear mixed effects model (NONMEM) program designed for estimation of population pharmacokinetic parameters. A one-compartment model with dose-dependent clearance was used for the pharmacokinetic analysis of zonisamide. The volume of distribution (V) was estimated to be 1.27 l/kg in a typical 33-kg patient, assuming that the bioavailability of orally administered zonisamide is 100%. The maximal daily dose to be cleared (Vmax) and the concentration giving half maximal clearance (a Michaelis-Menten constant) was 27.6 mg/d/kg and 45.9 micrograms/ml, respectively. The parameter of a power function of weight to adjust V and Vmax was estimated to be 0.741. In addition, Vmax for zonisamide appears to be 13% increased in patients receiving carbamazepine concurrently. The population pharmacokinetic parameters of zonisamide will be useful for designing dosage regimens in epileptic patients.

Cloning and characterization of the hemA gene for synthesis of delta-aminolevulinic acid in Xanthomonas campestris pv. phaseoli

The gene from Xanthomonas campestris pv. phaseoli that is involved in the C5 pathway of delta-amino-levulinic acid (ALA) of Escherichia coli. Subcloning of deletion fragments from the initial 2.5-kilobase (kb) chromosomal fragment allowed the isolation of a 1.6-kb fragment that could complement the hemM mutation. Nucleotide sequence analysis of the 1.6-kb DNA fragment revealed an open reading frame that encodes a polypeptide of 426 amino acid residues, and the deduced molecular mass of this polypeptide is 46768 Da. The amino acid sequence shows a high degree of homology of the HemA protein, which is glutamyl-tRNA reductase, to other organisms. Thus, we examined the complementation test of the cloned gene from Xanthomonas with a hemA mutation of E. coli and found that the gene complemented the hemA mutation. These results suggest that the cloned gene is hemA and the gene from Xanthomonas also complements both hemA and hemM mutations, as in the case of the E. coli hemA.

Respiratory muscle strength and hemodynamics in chronic heart failure

To examine whether respiratory muscle weakness is associated with cardiac function and/or exercise capacity in chronic heart failure (CHF), 23 patients with CHF were evaluated with respiratory muscle strength, pulmonary function tests, cardiac catheterization, and exercise test. The subjects were divided into three groups on their New York Heart Association (NYHA) functional class. Group A consisted of 13 patients with NYHA functional classification class 3 or 4, group B consisted of 10 patients with NYHA classification class 2, and group C consisted of 15 age-matched normal controls. Respiratory muscle strength was assessed with maximal static inspiratory mouth pressure at residual volume level and expiratory mouth pressure at total lung capacity level (PImax, PEmax, respectively). Pulmonary functions in patients with CHF showed almost normal. PImax in group A was significantly less than that in group B or C, although PImax in group B was not significantly different from that in group C. In the patients with CHF, PImax correlated positively with cardiac index and maximal oxygen consumption (r = 0.460 and r = 0.503, p < 0.05, respectively). These findings suggest that inspiratory muscle strength, which was impaired in patients with severe CHF, may be dependent on cardiac function and may be one of the limiting factors on impaired exercise capacity in the patients with CHF.

Expression of Thy-1 on rat T cells and its relevance as a maturation marker of T cells in rats

Expression of Thy-1 and CD3 antigens on thymocytes and the nylon wool-non-adherent (nylon-nonad) fractions of peripheral lymphocytes in F344 rats was studied by flow cytometry using anti-Thy-1 and anti-CD3 antibodies. In terms of the expression and density of Thy-1 and CD3, the thymus and peripheral lymphoid tissues in rats contained different populations. Nearly all thymocytes showed a high density of Thy-1 (Thy-1hi); a small population with a low density of Thy-1 (Thy-1lo) was found in CD3 bright-positive (CD3hi) thymocytes. Three-color analysis with CD4, CD8 and Thy-1 revealed Thy-1lo thymocytes to have mainly CD4 or CD8; Thy-1hi thymocytes also contained CD4 or CD8 single-positive (SP) cells as a minor population. Thus, SP thymocytes bearing CD3 were divided into two populations by evaluation of the density of Thy-1. Of peripheral CD3+ T cells, 15% showed a low density of Thy-1+ and the others were Thy-1-. Both T cells responded to anti-CD3 monoclonal antibody (mAb). However, no Thy-1hi T cells were found in peripheral lymphoid tissues. These results suggested that SP thymocytes in rats develop with the reduction of Thy-1, but not with its loss, and are newly supplied to peripheral lymphoid tissues as the phenotype, Thy-1lo, and are altered to Thy-1- T cells. Analysis of each cell size and disappearance of peripheral Thy-1lo T cells with age supported the above conclusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Formation of alpha-helix 88-98 is essential in the establishment of higher-order structure from reduced lysozyme

Lys96 and Lys97 in lysozyme are located at the C terminus of alpha-helix 88-98. The positive charges of these residues are supposed to stabilize the helical structure, and these residues are conserved as the basic amino acids among c-type lysozymes. The renaturation rate of reduced mutant lysozyme, where both Lys96 and Lys97 were mutated together to Ala, was slower than that of native lysozyme at pH 8.0 and 37 degrees C by SH-SS interchange reactions. In order to investigate the reason, the peptide fragment 36-105 (where we can obtain information of the interaction between helix 88-98 and Trp62 and Trp63 residues) was prepared. CD spectra were compared between peptide fragment 36-105 and its acetylated form, where the positive charges of Lys96 and Lys97 were eliminated, and it was elucidated that the displacement of positive charges at the C terminus of the helix caused the shift of the advantageous structure of the fragment from alpha-helix to coil. Moreover, we obtained evidence that there was interaction of the helix with Trp62 and/or Trp63, which maintained a thermodynamically stable higher-order structure. Therefore, these results suggest that the formation of alpha-helical structure in 88-98 is a significant factor in the establishment of native structure from reduced lysozyme.

Erythroid differentiation-inducing activity of protoporphyrin IX and its analogs on human leukemia K562 cell line

Protoporphyrin IX, which had been regarded as ineffective in cell differentiation, induced erythroid differentiation of K562 cell line, and its analogs such as hematoporphyrin IX, mesoporphyrin IX, deuteroporphyrin IX and protoporphyrin IX dimethyl ester were also differentiation inducers. The differentiation induced by these compounds was augmented by a retinoid, as is hemin-induced differentiation.

Epidermal growth factor-receptor mutant lacking the autophosphorylation sites induces phosphorylation of Shc protein and Shc-Grb2/ASH association and retains mitogenic activity

Epidermal growth factor (EGF) receptor (EGFR) can induce cell growth and transformation in a ligand-dependent manner. To examine whether the autophosphorylation of EGFR correlates with the capacity of the activated EGFR to induce cell growth and transformation, we truncated the human EGFR just after residue 1011, removing all three major autophosphorylation sites (DEL1011). Further, a point mutation was introduced at another autophosphorylation site, Tyr-992-->Phe (DEL1011+F992). The wild-type and mutant receptors were stably expressed in a NIH 3T3 variant cell line that expresses an extremely low level of endogenous EGFR and does not grow with EGF. As expected, DEL1011 and DEL1011+F992 were found to be severely impaired in EGF-induced autophosphorylation, due to the deletion of the appropriate target tyrosines. However, mutant receptors still could induce EGF-dependent DNA synthesis, morphological transformation, and anchorage-independent growth, although the extent of these was significantly reduced when compared with wild-type EGFR. EGF-induced tyrosine phosphorylation of Ras-GTPase activating protein-associated protein p62 and phospholipase C gamma 1 was dramatically reduced in the cells expressing DEL1011 and DEL1011+F992. On the other hand, tyrosine phosphorylation of Shc, complex formation of Shc-Grb2/Ash, and activation of microtubule-associated protein kinase were still fully induced upon EGF stimulation without binding of Shc or Grb2/Ash to the mutant receptor. Thus, tyrosine phosphorylation of Shc may play a crucial role for activating Ras and generating mitotic signals by the activated EGFR mutant.

Clearance mechanisms of atrial and brain natriuretic peptides in rats

To assess clearance mechanisms of atrial and brain natriuretic peptides in the circulation, we examined the effects of a neutral endopeptidase (NEP) inhibitor and a clearance receptor ligand on plasma concentrations of the peptides in normal rats. Plasma concentrations of endogenous alpha-rat atrial natriuretic peptide (alpha-rANP) were not significantly elevated by intravenous infusion of a NEP inhibitor, phosphoramidon, but were elevated threefold by intravenous infusion of a clearance receptor ligand, des(Gln18-Gly22)-rANP(4-23)-NH2 [C-ANF(4-23)]. On the other hand, the clearance of alpha-rANP given intravenously at the pharmacological dose, 600 pmol/min/kg for 2 min, was decreased to one-third by the administration of phosphoramidon, although the administration of C-ANF(4-23) did not significantly decrease the clearance. The clearance of rat brain natriuretic peptide (rBNP) given at 600 pmol/min/kg for 2 min was approximately 38% lower than that of alpha-rANP. The effect of phosphoramidon on the clearance of rBNP was not significant and was similar to that of C-ANF(4-23). These results suggest that clearance receptor is involved in the clearance of the physiological levels of alpha-rANP and that NEP plays a major role in the clearance of a pharmacological dose of alpha-rANP, at which clearance receptors are thought to be saturated, and also indicate a pharmacokinetic difference between alpha-rANP and rBNP.