[Blood gas changes in Duchenne type muscular dystrophy]

We studied changes in blood gas data from 32 patients with Duchenne type muscular dystrophy (DMD), who were followed for more than 5 years. Regression lines for each blood gas variable were obtained by the least square regression method, from 276 observations. The mean change per year was calculated by averaging the individual slopes. All blood gas variables (PaO2, PaCO2, pH, and [HCO3-]) correlated significantly with age the regression lines were: PaO2 = 95.6-0.45x Age, PaCO2 = 34.7 + 0.70x Age, pH = 7.397-0.0023x Age, [HCO3-] = 20.7 + 0.28x Age. The rates of change were -0.74 Torr/year for PaO2, 1.07 Torr/year for PaCO2, -0.0028 per year for pH and 0.55 mEq/l/year for [HCO3-]. The slope of each regression line was within the average individual yearly change +/- one standard deviation. AaDO2 did not change significantly with age, but chronic respiratory acidosis worsened because of alveolar hypoventilation. As an index of the severity of DMD, PaCO2 was better than PaO2, because the former was more strongly correlated with age and the values of PaCO2 deviated less from the the regression line.

Accumulation and massive cell death of polymorphonuclear neutrophils in the developing bone marrow of the mouse: a histological study

Accumulation and cell death of neutrophils were studied by light and electron microscopy in neonatal mouse bone marrow. At the beginning of bone marrow hematopoiesis, the marrow cavity contained a large number of polymorphonuclear leukocytes. Polymorphs comprised approximately 75% of the total nucleated cells in the hematopoietic compartment of the newborn marrow, the majority being neutrophils. Mature neutrophils were sometimes crossing the endothelium of the marrow blood sinus. Neutrophils in neonatal marrow show features typical of apoptosis, e.g. formation of nuclear pockets and blebs, margination of compact nuclear chromatin to form sharply circumscribed masses, condensation of cytoplasm, and convolution of cell outlines. Dying neutrophils were devoured and digested by phagocytes. The occurrence of large-scale neutrophil death and removal of neutrophils by phagocytes in neonatal bone marrow are discussed in relation to programmed cell death in development of the fetal hematopoietic system.

N-Alkylphthalimides: structural requirement of thalidomidal action on 12-O-tetradecanoylphorbol-13-acetate-induced tumor necrosis factor alpha production by human leukemia HL-60 cells

Phthalimide analogs N-substituted with n-butyl, tert-butyl, hexyl and adamantyl groups were designed and prepared as simplified analogs of thalidomide and methylthalidomide. All the compounds prepared except N-n-butylphthalimide showed thalidomidal activity on 12-O-tetradecanoylphorbol-13-acetate-induced tumor necrosis factor (TNF)-alpha production by human leukemia HL-60 cells. Among the investigated compounds, including thalidomide and methylthalidomide, N-adamantylphthalimide showed the most potent TNF-alpha production-enhancing activity.

In vivo morphological changes in rat lenses induced by the administration of prednisolone after subliminal X-irradiation. A preliminary report

In order to induce steroid cataracts in rat lenses, prednisolone acetate was administered together with a single subliminal dose of X-irradiation, which was applied unilaterally before steroid application started. The rats were divided into a control group (without prednisolone acetate administration), a group with a topically administered daily dose of 1 mg/kg prednisolone acetate suspension and a group with a systemically applied daily dose of 0.8-1.0 mg/kg prednisolone acetate suspension. Changes in the lens were objectively evaluated with in vivo Scheimpflug slit images during a 30-week period. Although body weight increase was significantly affected in both groups administered prednisolone, animals survived until the end of the observation period. The initial changes in the lens were the dissociation of the Y-suture and a slight increase in scattering light intensity at the posterior embryonic nucleus after both topical and systemic steroid administration.

In vivo light scattering intensity in the lens versus in vitro spectral transmission in the nuclear region

In order to understand the correlation between nuclear opacity and spectral light transmission factor, the in vivo light scattering intensity of Scheimpflug lens images and the light transmission through slices of surgically removed nucleus were examined densitometrically as well as spectrophotometrically respectively, using both human and Brown Norway rat lenses. The experiments using rat lenses showed that the increase of the light scattering intensity in the nuclear regions is correlated with a decrease of the spectral transmission factor. The transparent anterior cortical region did not influence the light transmission (T%) through the nucleus. No significant influence was seen from the application of freezing and thawing procedures to measure light transmission. The examinations of the human subjects which were based on the rat study showed that the light transmission of nuclear cataracts objectively evaluated as grade I was almost the same as that observed in noncataractous nuclei. The light transmission of nuclear cataracts graded II or above, however, showed around 50% of the spectral light transmission of noncataractous nuclei.

A mild progression type of naphthalene-induced cataract in brown-Norway rats

Naphthalene-induced rat cataract is a useful experimental cataract--however, because of its short survival period, studies using this model have been for limited purposes. Based on the consideration that the short survival might be caused by systemic toxicity of an overdose of naphthalene administration (1 g/kg body weight every other day), the authors successfully established a naphthalene-induced cataract with mild progression in Brown-Norway rats. The naphthalene administration proposed is to initially administer 0.5 g/kg and after a 1-week interval 1 g/kg of 10% naphthalene once or twice a week through a stomach tube. While the type of lens opacification induced in the two groups administered once and twice a week, respectively, was the same as that seen by the previous administration method, the progression of lens opacification seen in the groups showed a dose-dependent increase. The survival rate in the rats given naphthalene every other day according to the old method was 50% at the 6th week and 0% at the 9th week. Survival of the two new groups was 70 and 60% at the 30th week, respectively. This new type of naphthalene-induced rat cataract should be a suitable model for long-term observations.

Usefulness of Scheimpflug photography to follow up Wilson's disease

A 24-year old female with ocular changes (Kayser-Fleischer ring and sunflower cataract) indicating Wilson's disease was followed up from 9 years of age with anterior eye segment image documentation by Scheimpflug photography. A low copper diet and systemic D-penicillamine were administered after the initial diagnosis of Wilson's disease. During a 15-year follow-up period, the yellowish/brown-colored granular opacification on the anterior lens capsule and/or in the capsule has mostly disappeared and instead, the same type of opacification has emerged on the posterior lens capsule, showing rather progressive changes compared with the initial findings. These changes which had developed in the lens during the past 15 years were difficult to detect by slit lamp examination alone, but they were clearly revealed by Scheimpflug slit images. To our knowledge this is the first case report on ocular changes disclosed through the application of a newly developed anterior eye segment examination. Ergo, Scheimpflug photography is valuable for follow-up studies of ocular complications seen in patients with Wilson's disease.

Insulinotropic action of human glicentin in dogs

Glicentin has been demonstrated to be released in response to the intraluminal administration of nutrients, but its biological action remains unknown. To clarify the effect of glicentin on the endocrine function of the pancreas, the present study was performed using an in vivo local circulation system of the canine pancreas. During infusion of 0.5% solution of glucose or arginine, 100 and 400 pmol glicentin and 400 pmol glucagon were administered into the pancreaticoduodenal artery (PA) within 10 minutes at 40-minute intervals successively. During glucose infusion, blood glucose in the femoral artery did not change following administration of 100 pmol glicentin, but slightly increased following 400 pmol glicentin. Plasma insulin (immunoreactive insulin [IRI]) in the pancreaticoduodenal vein (PV) increased significantly only following infusion of 400 pmol glicentin. Plasma glucagon (immunoreactive glucagon [IRG]), measured with a specific antiserum to the C-terminal portion of glucagon, did not change following administration of 100 pmol glicentin, but was slightly elevated following 400 pmol glicentin. Plasma total IRG, measured with a nonspecific antiserum, increased promptly after administration of 100 and 400 pmol glicentin. During arginine infusion, the response of plasma IRI to glicentin was markedly exaggerated both in dosages of 100 and 400 pmol. From the present study it was concluded that human glicentin clearly increases insulin release from the canine pancreas.

Distribution of intercellular adhesion molecule-1 on leukocytes and corneal endothelium after endotoxin stimulation in rats

After stimulation with Salmonella typhimurium endotoxin, the intercellular adhesion molecule-1 (ICAM-1) was studied on the corneal endothelium and associated leukocytes in rats using immunoscanning electron microscopy. Two hundred micrograms of the endotoxin was injected in Lewis rats. The corneae were excised at 0-h and 16-h-postinjection time (n = 5, respectively). The corneae were prepared in hypothermic University of Wisconsin (UW) solution for immunoscanning electron microscopy. Histotopographical examination visualized ICAM-1 antigen on cytoplasmic processes of the corneal endothelium, arranged along microfolds, especially at the peaks. In the leukocytes, ICAM-1 was located primarily in morphologically non-specialized domains of the cell body surface, and only rarely scattered on the surface of microvillar projections. We concluded that the endotoxin stimulation can increase ICAM-1 in both corneal endothelium and associated leukocytes. Increased ICAM-1 may be an important factor for the leukocytes to form clustering and adhering to the corneal endothelium.

Topographic distribution of prednisolone in the lens after organ culture

Topographic distribution of prednisolone in the lens after organ culture was investigated. Freshly enucleated pig lenses were divided into two groups; the complete vitreous was removed from the lenses in group A, and the adherent parts of the vitreous were left in group B. Groups A and B were each divided into two subgroups which were separated according to drug application: two groups underwent drug application by a divided chamber (Iwata, 1982, DC) and two groups by a closed chamber. The incubation medium was TCM-199 with 2 micrograms/ml prednisolone, and the incubation was performed for 8 h. In order to know the participation of the vitreous in drug penetration into the lens, prednisolone was applied by a divided chamber from the anterior or posterior side, with or without vitreous, and incubated for 4 h as a first incubation. A secondary incubation was performed for another 4 h with a medium that did not contain prednisolone. After the lens incubation, the lenses were separated into single lens layers, and the drug concentration of each lens layer was measured by high performance liquid chromatography. The highest prednisolone concentration in the lens was detected by a closed chamber in the equatorial part followed by the posterior cortex, anterior cortex and nucleus. There were no significant differences in drug concentration due to the direction of drug application or the absence or presence of vitreous. The prednisolone distribution pattern in the lens by DC depended on the direction from which the drug was applied. The highest drug concentrations were detected in the lens cortex of the drug-applied side followed by the equator. No drug was detected in the side of the lens opposite the drug-applied side or in the nucleus. When a drug was applied from the posterior lens side, the presence of the vitreous made a big difference in the amount of drug penetration. The comparison of drug concentration between the absence or presence of the vitreous after secondary incubation in a medium that did not contain prednisolone indicated that the vitreous participates in the drug kinetics of the lens. The experiments suggest that while prednisolone penetration into the posterior lens part is small compared to that of the anterior part, when the steroid penetrated into the posterior part it remained there for a long period.

Tumor necrosis factor alpha production enhancers with a phenylphthalimide skeleton

N-2,6-Dialkylphenylphthalimides were found to be strong enhancers of 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced tumor necrosis factor (TNF)-alpha production by human leukemia cell line HL-60. Among these compounds, 2-(2,6-diisopropylphenyl)-1H-isoindole-1,3-dione (PP-33) showed the most potent activity (optimum concentration of 10 microM), indicating that the bulkiness of the alkyl groups at the 2 and 6-positions of the phenyl ring moiety is crucial for the activity. Its fluorinated derivative, 2-(2,6-diisopropylphenyl)-4,5,6,7-tetrafluoro-1H-isoindole-1,3-dio ne (FPP-33) showed the activity at very low concentrations (optimum concentration of 0.1 microM).

Molecular analysis of the t(1;19)(q23;p13) translocation observed in adult leukemias

We report three cases of adult leukemias with the t(1;19)(q23;p13) translocation, two with acute lymphoblastic leukemia (ALL:L2) and one with megakaryoblastic crisis of chronic myelocytic leukemia. Only one patient with ALL showed the same E2A/PBX1 fusion transcripts as those observed in childhood ALLs with the t(1;19) by RNA-based polymerase chain reaction. This patient survived for 8 months only from the time of his diagnosis. On the other hand, the other two cases were negative for the E2A/PBX1 fusion and one of them with ALL remains in remission. Our observations suggest that there could be heterogeneity in the molecular events among adult leukemias carrying the t(1;19) and that the E2A/PBX1 fusion formation might also be associated with an adverse treatment outcome in adult leukemias as in childhood leukemias.

[An autopsy case of lung cancer metastasizing to renal cell cancer and rectal villous adenoma]

A 67-year-old woman with bloody stool was admitted to our hospital. Chest radiograph on admission showed a tumor shadow in the right lower lung field. Lung adenocarcinoma of right S6 and villous adenoma of the rectum were detected. Although she was treated with chemotherapy and radiotherapy, she died of respiratory failure. At autopsy, moderately differentiated adenocarcinoma of the right lung, renal cell carcinoma, and villous adenoma of the rectum were confirmed. Lung adenocarcinomas were detected in the focus of the renal cell carcinoma and in the villous adenoma. Metastasis of a cancer into another coexisting tumor in the same individual is extremely rare, and a satisfactory explanation for this phenomenon has not yet been offered.

[The etiology of peptic ulceration in patients with chronic pulmonary emphysema]

The purpose of this study was to determine the etiology of peptic ulceration in patients with pulmonary emphysema. We performed endoscopy in 50 patients with chronic pulmonary emphysema, these were patients with and without peptic ulcer. There was no significant differences between the patients with and without ulcer, with respect to past history of pneumonia, degree of dyspnea, current drugs, nutritional status, the extent of gastric mucosal atrophy, gastric mucosal blood flow, gastric mucosal hexosamine content and serum pepsinogen levels. But patients with peptic ulcer were significantly younger than patients without peptic ulcer. Cigarettes per day in patients with peptic ulcer 29.3 +/- 11.6 cigarettes/day were significantly higher than those without peptic ulcer 22.5 +/- 10.0 cigarettes/day. We concluded that increased incidence of peptic ulceration in patients with chronic pulmonary emphysema is related to the quantity of cigarette smoking.

Essential role of myosin light chain kinase in the mechanism for MgATP-dependent priming of exocytosis in adrenal chromaffin cells

Ca(2+)-induced exocytosis in chromaffin cells now seems to consist of at least two distinct steps:MgATP-dependent Ca(2+)-dependent priming of the secretory apparatus, and Ca(2+)-dependent MgATP-independent step that triggers exocytosis (Bittner and Holz, 1992). Recently we found that a specific inhibitor of myosin light chain kinase (MLCK), wortmannin, inhibits Ca(2+)-induced catecholamine release from digitonin-permeabilized chromaffin cells, suggesting an implication of MLCK in the mechanisms of Ca(2+)-induced exocytosis (Imaizumi et al., 1992b). To elucidate further the implication of MLCK in the mechanism of exocytosis, we studied the effects of wortmannin and a peptide inhibitor (SM-1) corresponding to the pseudosubstrate domain of MLCK on MgATP-dependent and MgATP-independent release in digitonin-permeabilized chromaffin cells. Ca(2+)-induced exocytosis from the permeabilized cells in the presence of MgATP was inhibited by both SM-1 and wortmannin. Inhibitory effect of wortmannin on the rate of release induced by 10 microM Ca2+ in the presence of MgATP was much prominent in the later phase (1-10 min), although the initial rate was also decreased. SM-1 strongly inhibited ATP-dependent release without affecting Ca(2+)-dependent ATP-independent release at all. In addition, priming effect of MgATP that underlies Ca(2+)-dependent ATP-independent release was remarkably reduced by both wortmannin and SM-1. These results suggest that MLCK plays an essential role in ATP-dependent priming of Ca(2+)-induced exocytosis in chromaffin cells.

Cloning, expression and regulation of angiotensin II receptors

Angiotensin II isoform 1 (AT1) receptor cDNAs were cloned by expression cloning from bovine adrenal and rat vascular smooth muscles. Human AT1 receptor was also cloned. Seven transmembrane structures emerged. A single type of receptor seems to interact with more than one type of G-protein. AT1 consists of subtypes AT1A and AT1B, and the regulation of the receptors occurs at many stages. The isoform AT2 was also expression cloned from rat pheochromocytoma cells. Although its ligand binding is not affected by GTP analogs, it is a seven transmembrane domain receptor. It mediates the inhibition of phosphotyrosine phosphatase by angiotensin II and AT2 specific CGP42112A; the inhibition was abolished by pertussis toxin. Thus, AT2 belongs to a new class of angiotensin receptors with unique signalling and regulatory mechanisms.

Low-dose continuous subcutaneous infusion of granulocyte colony-stimulating factor for chemotherapy-induced neutropenia in acute myelogenous leukemia and its pharmacokinetics

Granulocyte colony-stimulating factor (G-CSF) shortens the duration of chemotherapy-induced granulocytopenia in acute leukemia. G-CSF is administered by 30-min intravenous infusion at a dose of 200 micrograms/m2/day or 5 micrograms/kg/day in most studies. In this study, the efficacy of a reduced dose (33 micrograms/m2/day) of continuous subcutaneous infusion of G-CSF was compared with the effects achieved by 30-min intravenous infusion of the standard dose (200 micrograms/m2/day) in neutropenia after identical chemotherapy in seven patients with acute myelogenous leukemia who were in remission. The duration of granulocytopenia (< 0.5 x 10(9)/l), thrombocytopenia (< 50 x 10(9)/l); G-CSF administration and fever (> 38 degrees C) were 10.1 +/- 5.0 days, 16.5 +/- 9.3 days, 16.6 +/- 7.4 days and 3.1 +/- 5.4 days for 33 micrograms/m2/day continuous subcutaneous infusion, and 10.7 +/- 6.8 days, 16.7 +/- 9.9 days, 16.1 +/- 7.6 days and 2.0 +/- 2.5 days for 30-min intravenous infusion of the standard dose of G-CSF. In each parameter studied, there was no statistical difference between the two methods of G-CSF administration by paired t-test. The costs for G-CSF could be substantially reduced. In most patients, plasma G-CSF concentration rose to the highest level of 1.8-3.7 ng/ml 48-72 h after starting 33 micrograms/m2/day continuous subcutaneous infusion, and gradually decreased as the peripheral granulocyte count recovered, suggesting binding of G-CSF molecules to the specific receptors on the cells of granulocytic lineage.

[A case report of rectal cancer with lymph node metastasis effectively treated by neoadjuvant chemotherapy of 5-FU oral and low-dose CDDP transarterial administration]

A 52-year-old man was diagnosed as having rectal cancer. Miles' operation with regional lymph node dissection was performed in April 1989. CT scanning and MRI examination performed in May 1992 showed local recurrence in a lymph node of the pelvic cavity (282). We implanted a catheter in the left internal iliac artery and connected it to an implanted injection port through a subcutaneous tunnel. 5-FU was administered orally at 300 mg daily. CDDP was injected through an injection port at a dose of 20 mg/body/day twelve times and 10 mg/body/day six times. CT scanning showed a change in the size of the tumor, with a reduction rate of 75%. Thereafter, we performed a radical operation in September 1992. The histopathological effect was Grade 2.