Cooperation of ATP and norepinephrine in inducing contraction in guinea pig vas deferens is not associated with change in intracellular Ca2+ level

Contractile responses and fura-2 fluorescence signals were simultaneously recorded in fura-2 loaded longitudinal muscle strips of guinea pig vas deferens to examine the relationship between cooperation of ATP and norepinephrine (NE) in the contractile response and intracellular Ca2+ level. ATP or NE induced a rapid or delayed contraction, respectively, with concomitant changes in fura-2 signal. Addition of both agonists potentiated the rapid, but not delayed contraction, while there was no potentiation in the fura-2 signal. In another series of experiments, NE (> or = 10 microM) contracted the muscle without further concomitant increase in Ca2+ level, indicating "Ca2+ sensitization" of the contractile apparatus. These findings suggest that cooperation of ATP and NE in inducing a rapid contraction of guinea pig vas deferens is mainly due to the "Ca2+ sensitization" effect of NE.

[Evaluation of chemotherapy for stage IV non-small cell lung cancer employing a regression tree type method for quality-adjusted survival analysis to determine prognostic factors]

To evaluate the effect of chemotherapy on QOL, the survival period was categorized by 3 intervals: one in the hospital for chemotherapy (TOX), on an outpatient basis (TWiST Time without Symptom and Toxicity), and in the hospital for conservative therapy (REL). Coefficients showing the QOL level were expressed as ut, uw and ur. If uw was 1 and ut and ur were plotted at less than 1, ut TOX+uwTWiST+urREL could be a quality-adjusted value relative to TWiST (Q-TWiST). One hundred five patients with stage IV non-small cell lung cancer were included. Sixty-five were given chemotherapy, and the other 40 were not. The observation period was 2 years. Q-TWiST values for age, sex, PS, histology and chemotherapy were calculated. Their quantification was performed employing a regression tree type method. Chemotherapy contributed to Q-TWiST when ut approached 1 i.e., no side effect was supposed). When ut was less than 0.5, PS and sex had an appreciable role.

[Anesthetic management for colon resection in a patient with polymyositis]

A patient was a 67-year-old female, 153 cm tall and weighing 47 kg. In 1988, she noticed sudden hypotonicity of her extremities, which led her to visit our hospital. Diagnosis of polymyositis (PM) was made. Treatment started with prednisolone 60 mg.day-1, followed by 2.5-5mg.day-1 as a maintenance dose. Her clinical symptoms were alleviated. However, in October, 1994, colon cancer was found and she underwent sigmoidectomy. For anesthesia, thoracic epidural block (Th 11/12) was performed. No problems occurred during and after the surgery. The following points must be considered for anesthesia of a patient with PM: (1) enhanced or delayed effect of muscle relaxant, (2) pulmonary complications--aspiration pneumonia and lung fibrosis, (3) cardiomyopathy--arrhythmia and cardiac failure, (4) steroid supplementation. In our case, because cardio-pulmonary functions were almost normal, epidural anesthesia without using muscle relaxant was a successful method.

Elevated progastrin-releasing peptide(31-98) concentrations in pleural effusions due to small-cell lung carcinoma

Progastrin-releasing peptide (ProGRP) is a specific and actively secreted product from small-cell lung carcinoma (SCLC) cells. Recently, an enzyme-linked immunosorbent assay, which uses monoclonal and polyclonal antibodies to recombinant proGRP(31-98), a common region of ProGRP, was established. We measured concentrations of ProGRP (31-98), neuron-specific enolase (NSE) and carcinoembryonic antigen (CEA) in carcinomatous and infectious pleural effusions. Significantly increased ProGRP(31-98) and NSE values were found in carcinomatous pleurisy due to SCLC compared to the other carcinomatous pleurisy and infectious pleurisy. CEA values were significantly increased in carcinomatous pleural effusions compared with those in infectious effusions. The ProGRP(31-98) values were not correlated to NSE values in carcinomatous pleurisy due to SCLC. The determination of ProGRP(31-98) in pleural effusions will be helpful for diagnosing carcinomatous pleurisy due to SCLC.

Endoscopic findings at the pharyngeal orifice of the eustachian tube in otitis media with effusion

Transnasal endoscopy of the pharyngeal orifice of the eustachian tube was performed on 155 ears with otitis media with effusion (77 ears of children, 78 ears of adults). In children, blockage of the orifice by mucopurulent nasal discharge was the most frequent finding (72.7%), followed by compression of the orifice by the adenoid tissue (52.0%), hypertrophy of the peritubal tonsil (16.9%), and edema around the orifice, especially at its posterior lip (10.4%). In adults, the most frequent abnormal finding was edema of the orifice (26.9%), followed by blockage of the orifice by mucopurulent nasal discharge (23.1%), and atrophy of the orifice (10.3%). In 39.7% of cases findings were normal. Thus, main pathological findings associated with tubal dysfunction involved inflammation in the nasopharynx.

[Negative repressor THZif-1 of protooncogene c-myc]

A human recombinant cDNA clone that encoded 253 amino acids residues of a zinc-finger protein (THZif-1) was cloned by screening a cDNA library prepared from human promyelocytic leukemia HL60 cells with synthetic oligodeoxynucleotide probes that corresponded to the amino acid sequences of tryptic peptides derived from the DNA-binding protein specific for the nuclease-hypersensitive element (NHE) of the human c-myc gene. The predicted amino acid sequence of THZif-1 included a DNA-binding domain that contained five tandemly repeated zinc finger motifs. The three amino-terminal sets of zinc finger motifs, including the second finger, were found to be responsible for high-affinity interactions with the triple-helical conformation of NHE, as well as for high-affinity binding to the single-pyrimidine-rich strand of NHE in a sequence-specific manner. Cotransfection, trans-activation and in vitro transcription studies using the wild-type form and THZif-1 with a mutated second zinc finger motif demonstrated that the DNA-binding activity specific for H-form DNA of NHE was a prerequisite for the negative regulation of the expression of the c-myc gene.

Substrate specificity of microsomal 1-acyl-sn-glycero-3-phosphoinositol acyltransferase in rat submandibular gland for polyunsaturated long-chain acyl-CoAs

Microsomal 1-acyl-sn-glycero-3-phosphoinositol (1-acyl-GPI) acyltransferase in the rat submandibular gland showed the highest specific activities for eicosanoid-related polyunsaturated acyl-CoAs, such as arachidonoyl-, bishomo-gamma-linolenoyl- and 5,8,11,14,17-eicosapentaenoyl-CoAs, with low Km values. High activities were also obtained with acyl-CoAs having long (more than 14 carbon atoms) and n - 6 unsaturated (more than 3 double bonds) acyl chains. This enzyme also utilized acyl-CoAs having trans-unsaturated or branched chains, but not short-chains, as substrates, although the activity levels for trans-unsaturated acyl-CoAs were lower than those for cis-unsaturated acyl-CoAs. Chronic administration of isoproterenol induced decreases of this enzyme activity and the content of arachidonic, bishomo-gamma-linolenic and 5,8,11,14,17-eicosapentaenoic acids at the sn-2 position of phosphatidylinositol. These results suggest that enrichment of arachidonic acid in the sn-2 position of phosphatidylinositol is established by the high specificity and affinity of 1-acyl-GPI acyltransferase for arachidonoyl-CoA. On the other hand, the low level of bishomo-gamma-linolenic and 5,8,11,14,17-eicosapentaenoic acids in the sn-2 position of phosphatidylinositol may be explained by their limited availability.

The significance of membrane lipids in exocytosis: control of liposome-evoked amylase release from secretory granules isolated from the rat parotid gland

We investigated the significance of the plasma membrane lipid composition in exocytosis in an in vitro interaction system using an intact secretory granular fraction (SG) isolated from the rat parotid gland. When various liposomes (as a model of plasma membranes) were added to this assay system, rapid and transient amylase release from the SG was evoked and increased by Ca2+ in a concentration-dependent manner. The extent depended upon not only the amount of liposomes but also their lipid composition. The addition of 1,2-diacylglycerol and phosphatidic acid to egg yolk phosphatidylcholine-liposomes remarkably facilitated the release. On the other hand, that of various free fatty acids had different effects depending upon their molecular species. Furthermore, a fluorescence de-quenching study demonstrated that membrane fusion actually occurred in this interaction system, and appeared to correlate with the amylase release. These results suggest that the transient alteration of the membrane lipid composition upon cell activation is a modulator of the exocytotic membrane interaction.

Necessity of newly synthesized ATP by creatine kinase for contraction of permeabilized longitudinal muscle preparations of rat proximal colon

Necessity of newly synthesized ATP by creatine kinase for synthesis of ATP as an energy source for smooth muscle contraction was studied in permeabilized longitudinal muscle preparations of rat proximal colon. In alpha-toxin-permeabilized preparations, Ca++ induced "phasic type" contraction in a normal bath solution containing 4 mM ATP and 5 mM phosphocreatine. Omission of phosphocreatine from the solution resulted in significant decrease in phasic contraction, and omission of ATP resulted in loss of the response to Ca++. When ADP, but not adenosine-5-O-(2-thiodiphosphate), with phosphocreatine was added as a substitute for ATP, Ca++ induced the same type of contraction as with ATP. The maximum tensions of the phasic and tonic phases of the contraction with ADP were approximately 60% of, and almost the same, respectively as those with ATP. A selective inhibitor of creatine kinase, 2,4-dinitrofluorobenzene, inhibited the phasic contraction induced by Ca++. After irreversible inhibition of endogenous creatine kinase by DNFB in beta-escin-permeabilized preparations, treatment of the preparations with exogenous creatine kinase restored Ca(++)-induced contraction. These findings suggest that ATP synthesized from ADP and phosphocreatine by creatine kinase was necessary for phasic contraction of permeabilized smooth muscle and that exogenous ATP was mainly used after its hydrolysis to ADP.

Gene targeting with a replication-defective adenovirus vector

Wide application of the gene-targeting technique has been hampered by its low level of efficiency. A replication-defective adenovirus vector was used for efficient delivery of donor DNA in order to bypass this problem. Homologous recombination was selected between a donor neo gene inserted in the adenovirus vector and a target mutant neo gene on a nuclear papillomavirus plasmid. These recombinant adenoviruses allowed gene transfer to 100% of the treated cells without impairing their viability. Homologous recombinants were obtained at a level of frequency much higher than that obtained by electroporation or a calcium phosphate procedure. The structure of the recombinants was analyzed in detail after recovery in an Escherichia coli strain. All of the recombinants examined had experienced a precise correction of the mutant neo gene. Some of them had a nonhomologous rearrangement of their sequences as well. One type of nonhomologous recombination took place at the end of the donor-target homology. The vector adenovirus DNA was inserted into some of the products obtained at a high multiplicity of infection. The insertion was at the end of the donor-target homology with a concomitant insertion of a 10-bp-long filler sequence in one of the recombinants. The possible relationship between these rearrangements and the homologous recombination is discussed. These results demonstrate the applicability of adenovirus-mediated gene delivery in gene targeting and gene therapy.

[Sarcoidosis with hypercalcemia and increased 1 alpha, 25-dihydroxyvitamin D in lung tissue]

A 60-year-old woman was admitted to our hospital complaining of nausea, thirst, and dyspnea on exertion. She had skin eruptions on her back and right knee. Her serum calcium level was 12.6 mg/dl. The chest roentgenogram showed diffuse nodular shadows in both lung fields. The level of angiotensin-converting enzyme in serum was markedly high, and epithelioid cell granulomas were found in the specimens obtained by skin biopsy and by transbronchial lung biopsy. Sarcoidosis was diagnosed. After administration of prednisolone, the serum calcium level decreased to within the normal range and the shadows on the chest roentgenogram resolved. Hypercalcemia complicated with sarcoidosis is caused by overproduction of 1 alpha,25-dihydroxyvitamin D in granulomas. The content of 1 alpha, 25-dihydroxyvitamin D in the transbronchial lung biopsy specimen from this patient was higher than that from a sarcoidosis patient whose serum calcium level was normal. A few case reports of sarcoidosis with hypercalcemia have been published in Japan. The association with HLA type and the possibility of overintake of dietary vitamin D are discussed in reference to hypercalcemia in this patient.

Involvement of heterotrimeric GTP-binding protein and rho protein, but not protein kinase C, in agonist-induced Ca2+ sensitization of skinned muscle of guinea pig vas deferens

We studied the involvement of protein kinase C (PKC) and a small GTP-binding protein (G-protein), rho, in receptor-mediated Ca2+ sensitization of the contractile apparatus of smooth muscle of guinea pig vas deferens. In beta-escin-permeabilized smooth muscle strips, norepinephrine (NE) in the presence of GTP caused further contraction of the preparations at a constant Ca2+ level (Ca2+ sensitization). Prazosin and GDP beta S, a nonhydrolyzable GDP analogue, inhibited NE-induced Ca2+ sensitization, indicating an alpha-1 adrenoceptor/G-protein mediated response. GTP alone (> 10 microM) and GTP gamma S, a non-hydrolyzable GTP analogue, also induced Ca2+ sensitization. Pretreatment of preparations with C3 exoenzyme of Clostridium botulinum, which is known to ADP-ribosylate rho family proteins, with NAD resulted in complete inhibition of NE- and GTP (GTP gamma S)-induced Ca2+ sensitization. AIF4-, which activates heterotrimeric G-, but not small G-protein also induced Ca2+ sensitization. Interestingly, AIF4(-)-induced Ca2+ sensitization was inhibited by not only GDP beta S but also C3-treatment, suggesting that activation of heterotrimeric GTP-binding protein precedes activation of rho protein. On the other hand, phorbol 12,13-dibutyrate, like NE, also induced Ca2+ sensitization. The sensitization was inhibited by PKC(19-31), a PKC inhibitor peptide. However, PKC(19-31) did not have any effect on NE- or AIF4(-)-induced Ca2+ sensitization.(ABSTRACT TRUNCATED AT 250 WORDS)

The influence of upper respiratory tract inflammation upon tubal function

Eustachian tube function was examined in four patients (four ears) with a traumatic perforation of the tympanic membrane when they suffered from an upper respiratory tract (URT) infection or seasonal nasal allergy and after they had recovered. Although the tubal opening pressure did not show a distinct difference on the two occasions, the active ventilatory function was apparently impaired during the upper respiratory tract inflammation; particularly the negative middle ear pressure equalizing function, and was still impaired 2-3 weeks later after recovery from the upper respiratory tract inflammation. It is concluded that URT inflammation can affect tubal ventilatory function even in normal individuals.

[Pilot study of irinotecan in refractory small cell lung cancer]

Sixteen patients with refractory small cell lung cancer (SCLC) were treated with an irinotecan starting dose of 100 mg/m2 given as a 90-minute iv infusion every week with subsequent doses based on toxicity. Mean age was 64 years; 14 male and 2 female; 4 with limited disease and 12 with extensive disease; all patients pretreated with combination chemotherapy containing etoposide. The overall response rate was 50% (95% CI 25-75%) with no CR and 8 PR. The median duration of response was 46 days. Major toxicities were leukopenia, diarrhea and pulmonary toxicity. Irinotecan was thus an effective agent in refractory SCLC.

Pharmacokinetics of human activated protein C. 2nd communication: tissue distribution study of a lyophilized purified human activated protein C after single or repeated intravenous administration in male mice and placental transfer and milk passage study after intravenous administration in pregnant and lactating mice

Tissue distribution studies of human activated protein C (CAS 42617-41-4, APC) were performed in mice after single or repeated administration, and placental transfer and milk passage study were investigated. At 15 min after a single intravenous administration of 125I-APC, radioactivity was mainly distributed to the blood and blood rich organ, such as liver, and then rapidly eliminated. The radioactivity distributed to tissues was almost negligible at 24 h after administration except for the thyroid. The qualitative study of the distribution of radioactivity to tissues by whole body autoradiography demonstrated the correspondence to the result of the quantitative assay of distribution of radioactivity after single administration of 125I-APC. The influence of repeated administration of APC on its pharmacokinetic disposition was studied by administering 125I-APC once a day to mice for 14 days. Though plasma radioactivity at 15 min in mice during repeated administration of 125I-APC was almost similar to that at 15 min after a single administration, the radioactivity at 24 h after administration was 2 times higher than that after a single administration. The profile of plasma radioactivity during and after repeated administration corresponded to the simulation curve which was described with the pharmacokinetic parameters obtained previously after the single administration. Distribution profile after repeated administration at 15 min after the 4th, 7th, 10th and 14th administration was almost similar to that at 15 min after a single administration except for the thyroid and spleen. In the thyroid, the radioactivity was 500 times higher than that after a single administration, and HPLC analysis demonstrated that the radioactivity was attributed to thyroglobulin. As to the spleen, the radioactivity was about 52% of that after a single administration. During the repeated administration, the spleen became larger than that after a single administration and the final weight was 2 times heavier than that of the non-treated animal. The decrease in radioactivity of the spleen during repeated administration was attributed to the hypertrophy of the organ. Placental transfer of 125I-APC was studied with pregnant mice quantitatively and qualitatively. Radioactivity distributed in fetuses was low at every point examined, and the result corresponded to the autoradiography. During lactation, radioactivity transferred to milk and milk to plasma ratio reached 5.7 after intravenous administration of 125I-APC. HPLC analysis of the milk radioactivity demonstrated that most of the radioactivity was present in the macromolecules produced by the lactating mother.

Molecular and genetic dissection of a reproductive isolation gene, zygotic hybrid rescue, of Drosophila melanogaster

Hybrids from the cross between males of Drosophila melanogaster and females of its sibling species (D. simulans, D. mauritiana, or D. sechellia) are embryonic lethal when they carry the wild type allele of zygotic hybrid rescue (zhr) from D. melanogaster. The zhr gene has been mapped in the proximal region of the X heterochromatin slightly distal to the proximal breakpoint of In(1)sc8, the region rich in 1.688 g/cm3 satellite DNA. Since this satellite DNA does not exist in the sibling species, the satellite DNA was considered to be involved in the hybrid lethality. We examined the hypothesis molecular cytogenetically. The results are (1) three Df(1)zhr chromosomes carried this satellite DNA, and (2) hybrids were viable even if the amount of the satellite DNA in hybrids was increased by adding minichromosomes Dp(1;f)1205 and Dp(1;f)1187 into the genome. These results do not support the above hypothesis.

Bipolal: anti-microalgal compound isolated as a candidate for marine antifouling produced by Bipolaris sp. F5206

Bipolal [1], a new compound with marine antifouling potential, was isolated from the culture broth of Bipolaris sp. The structure was determined to be an eremophilane derivative on the basis of 2D nmr spectroscopy and chemical transformations.

[A pilot study of combination chemotherapy with cyclophosphamide, adriamycin, chronic daily dosing of oral etoposide for patients with SCLC ineligible for intensive chemotherapy]

Twenty-two patients with small cell lung cancer (SCLC) ineligible for intensive chemotherapy were treated with a combination of cyclophosphamide 800 mg/m2 iv day 1, adriamycin iv 40 mg/m2 day 1, and oral etoposide 40 mg/m2 once daily day 1-21. The overall response rate was 72.7% with 2 complete and 14 partial responders. The median survival time was 272 days in LD and 231 days in ED. The side effects were acceptable but not as mild as expected.

Clinical significance of serial measurement of the serum levels of soluble interleukin-2 receptor and soluble CD8 in malignant lymphoma

We serially measured the serum levels of soluble interleukin-2 receptor (sIL-2R) and soluble CD8 (sCD8) in 36 patients with malignant lymphoma (33 non-Hodgkin's lymphoma cases and three Hodgkin's disease cases). The level of serum sIL-2R was significantly elevated in patients with active disease (18) compared to those in remission (18), and correlated with the clinical stage of the lymphoma. The temporal profile of the sIL-2R level reliably represented the disease status, which was judged clinically, during the course of the disease. In three patients, the tumor bulk paralleled the sIL-2R level. On the other hand, a less significant correlation was found between the serum sCD8 level and disease activity. The serial measurement of sCD8 appeared to be less useful for monitoring the disease activity, although there was a significant correlation between the sCD8 and sIL-2R levels. This study indicates that serial measurement of the serum sIL-2R level may be useful for monitoring the tumor burden in response to treatment and for early detection of disease progression in malignant lymphoma.

A yeast gene necessary for bud-site selection encodes a protein similar to insulin-degrading enzymes

Cells of the yeast Saccharomyces cerevisiae choose bud sites in a non-random spatial pattern that depends on mating type: axial for haploid cells and bipolar for a/alpha diploid cells. We identified a mutant yeast, axl 1, in which the budding pattern is altered from axial to bipolar. Expression of the AXL1 gene is repressed in a/alpha diploid cells. With the ectopic expression of AXL1, a/alpha cells exhibited an axial budding pattern, thus AXL1 is a key morphological determinant that distinguishes the budding pattern of haploid cells from that of a/alpha diploid cells. AXL1 encodes a protein similar in sequence of the human and Drosophila insulin-degrading enzymes and to the Escherichia coli ptr gene product. The axial budding pattern might result from degradation of a target protein by the putative Axl1 protease.

Changes in neuronal contribution to contractile responses of vas deferens of young and adult guinea pigs

The response characteristics of vas deferens to electrical hypogastric nerve stimulation at various frequencies was studied in guinea pigs of 2 to 15 weeks old. In 2-week-old guinea pigs the stimulation induced monophasic contraction, some of which remained after blocking alpha 1-adrenoceptor and desensitizing P2-purinoceptors with prazosin and alpha, beta-methylene ATP, respectively. In guinea pigs of 10 to 15 weeks old stimulation induced biphasic contraction, which was almost completely inhibited by both blockers. These results suggest that some unknown component other than ATP and norepinephrine is involved in the transmission at 2 weeks, and that its relative significance changes during development.

[Late phase II clinical study of RP56976 (docetaxel) in patients with non-small cell lung cancer]

A late phase II clinical study of RP56976 (Docetaxel) was conducted in patients with non-small cell lung cancer. Patients with non-small cell lung cancer in Stage IIIB and Stage IV not previously treated were enrolled. Docetaxel was administered at a dose of 60 mg/m2 based on the results of a phase I and an early phase II clinical study, and the efficacy and safety were examined. Of the 77 patients enrolled, 72 patients were evaluated to have completed the scheduled course of treatment by the Evaluation Committee. A partial response (PR) was seen in 18 patients, and the overall response rate was 25.0%. The response rate classified by clinical stage was 28.0% (7/25) in patients with Stage IIIB and 23.4% (11/47) in patients with Stage IV. Hematological adverse reactions included leukopenia of Grade III or more in 53.3% (40/75) and neutropenia of Grade III or more in 86.7% (65/75) as specified in the Adverse Event Reporting Form proposed by the Japan Society for Cancer Therapy. Other major adverse reactions included alopecia, asthenia, and fever, all of which were tolerable. From these results, the efficacy of docetaxel for the treatment of non-small cell lung cancer was confirmed.

Assessment of the gas exchange function of the middle ear using nitrous oxide. A preliminary study

A method for assessing the gas exchange through the middle ear (ME) mucosa using nitrous oxide is introduced. Increases in the ME pressure was determined by a tympanogram or a micropressure sensor inserted into the mastoid cavity during ear surgery under general anesthesia using 67% nitrous oxide, 33% oxygen, and sevoflurane on 30 normal ears, 12 ears with otitis media with effusion (OME), and 3 postoperative ears with chronic adhesive otitis media or cholesteatoma. All the 30 normal ears except one showed varying pressure increase, and an inverse correlation was observed between pressure increase and area of mastoid on radiographs. Pressure increase was observed in 6 (50%) ears with OME, and this finding correlated well with the presence or absence of air space in the ME on computed tomography images examined preoperatively, on ears which had ear surgery, the presence or absence of pressure increase correlated with the degree of previous surgical intervention on the mastoid. The rationale and possibility of clinical application of this method is discussed.

[Anesthetic management in a patient with Beckwith-Wiedemann syndrome]

Beckwith-Wiedemann syndrome has three major symptoms, exomphalos, macroglossia and giantism. We report the anesthetic management of a 2-year-old male, weighing 16.1 kg and with a height of 94.6 cm, associated with bilateral retention testis. The anesthesia was maintained with oxygen, nitrous oxide, and sevoflurane. The surgery was completed safely without adverse events such as difficulty in tracheal intubation or refractory hypoglycemia. The anesthetic management of this syndrome requires: an assessment of difficulty in tracheal intubation and treatment, an understanding of the capacity of the patient's glucose metabolism, and assessment of complicated deformities. In particular, it is necessary to carry out a preoperative examination of the cardiovascular system.

Differences in relaxant effects of cyclic GMP on skinned muscle preparations from the proximal and distal colon of rats

The relationship between the intracellular cyclic GMP content and relaxation of smooth muscle was studied in preparations from the proximal and distal colon of rats. Nitric oxide increased the cyclic GMP content of longitudinal muscle of both preparations to approximately the same extents. However, although nitric oxide at 0.03-10 microM induced concentration-dependent relaxation of the proximal segments, it did not induce any significant relaxation of the distal segments. The longitudinal muscle preparations were permeabilized by treatment with alpha-toxin to examine the relaxant effects of cyclic GMP on the contractile elements. Ca2+ induced contraction of the permeabilized muscle, the contraction consisting of a transient and subsequent tonic phases. Cyclic GMP (3-100 microM) reversed the tonic contractions induced by various Ca2+ concentrations (1-30 microM). The magnitude of the relaxant effect of cyclic GMP was significantly more in the proximal region than in the distal region. But in contrast to nitric oxide, cyclic GMP induced slight, but clear relaxation of the distal colon. The inhibitory effects of cyclic GMP on phasic contraction, like those on tonic contraction, were high in the proximal region and low in the distal region. These results suggest that the difference in the relaxant effects of nitric oxide in the proximal and distal longitudinal muscles is not due to a difference in extents of cyclic GMP generation, but mainly to a difference in the sensitivities of the contractile elements in the two regions to cyclic GMP.

The optimization of preparations of competent cells for transformation of E. coli

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[A case of pulmonary, pleural, and renal tuberculosis associated with DIC and a prolonged increase in D-dimer]

A 26-year-old male who had been diagnosed as pulmonary tuberculosis three years ago with an antituberculous chemotherapy of only two months, complained of tiredness, exertional dyspnea and fever since a month ago. Bloody sputum, bloody stool and hematuria have developed three days before admission. Petechiae over the body trunk and lower extremities were observed on admission. Peripheral blood examination revealed lymphocytopenia (672/microliters), low hemoglobin content (6.2 g/dl), thrombocytopenia (3,000/microliters), elevated FDP (36.2 micrograms/ml) and D-dimer (25.0 micrograms/ml) values. Chest radiograph showed a massive pleural effusion in the right hemithorax, bilateral pulmonary infiltrates and a cavity on CT scan. Together with positive acid-fast bacilli in sputum, diagnoses of relapsed pulmonary tuberculosis, tuberculous pleurisy associated with DIC (disseminated intravascular coagulation) were made. Left hydronephrosis which was presumed to be a consequence of infundibulum stenosis due to renal tuberculosis, was detected by abdominal ultrasonography. Treatment with antituberculous drugs and protease inhibitors were started with thoracic tube drainage. DIC condition was improved by the 20th hospital day and sputum culture turned to be negative after the 4th week, however, fever up to 38 degrees C continued until the end of the 7th week and a D-dimer which is a representative marker for secondary fibrinolysis, continuously showed a high level up to the 10th week of hospitalization. The patient was uneventful during the three months follow up period after discharge. DIC is a well known complication of sepsis including miliary tuberculosis, whereas it is rarely associated with cavitary tuberculosis and no case of prolonged elevation of D-dimer have been reported.(ABSTRACT TRUNCATED AT 250 WORDS)

The MCS1/SSD1/SRK1/SSL1 gene is involved in stable maintenance of the chromosome in yeast

A temperature-sensitive (ts) mutant of Saccharomyces cerevisiae was isolated in which mini-chromosomes were unstable at high temperature. The MCS1 gene (Mini-Chromosome Stability 1) was cloned by the ability of complementing the temperature sensitivity, and was found to be identical to SSD1/SRK1/SSL1. When MCS1/SSD1 was disrupted in a certain wild-type (wt) strain, mini-chromosomes were unstable, even at 30 degrees C, indicating that the gene is involved in chromosome stability. The Mcs1/Ssd1 protein was detected as a 170-kDa protein by immuno-blotting analysis and this 170-kDa protein could not be detected in the ts mutant and certain wt strains. Our results are consistent with the genetic data that there are two polymorphic forms of the gene, SSD1-v and ssd1-d [Sutton et al., Mol. Cell. Biol. 11 (1991) 2133-2148]. Furthermore, genetic backgrounds other than MCS1/SSD1 caused strain-specific phenotype. The protein, precipitated by specific antibodies, was phosphorylated.

[Hodgkin's disease initially presenting as vertebral lesions and a solitary pulmonary nodule--a case report]

Hodgkin's disease rarely involves bones and lungs without causing marked lymph node enlargement. The case of a 36 year old man, who initially presented with vertebral lesions and a solitary nodule in the lung, is reported. At the initial presentation, no apparent lymph node enlargement was observed. Pathological examination of the specimens obtained at vertebral surgery and needle biopsy of the lung suggested a presumptive diagnosis of Histiocytosis X. However, a definite diagnosis of the Hodgkin's disease was made by biopsy of a cervical lymph node which newly enlarged about two years after his initial presentation. This case suggests variability in the clinical feature of Hodgkin's disease.

Molecular cloning of the gene encoding a highly expressed protein in SFL1 gene-disrupted flocculating yeast

We identified a yeast gene encoding Flocculent Specific Protein (FSP) produced excessively in the SFL1 gene-disrupted flocculent strain. The sequenced gene encodes a 430 amino acid protein and is mainly composed of multiple repeats of Ser-Asn-Asn-X-Asp-Ser-Tyr-Gly. The FSP gene disruption of the flocculent strain decreased the degree of flocculation, so FSP may be one factor concerned with yeast flocculation. A gene database search indicated that the FSP gene is identical with the DDR48 gene.

Characterization of adherent T cells to human endothelial cells in patients with HTLV-I-associated myelopathy

To clarify the phenomenon of increased adherence of T cells to endothelial cells (EC) in patients with HTLV-I-associated myelopathy (HAM), we determined the surface markers and expression of lymphocyte function antigen-1 (LFA-1) in T cells adherent or nonadherent to EC. The percentage of activated or HLA-DR+ T cells and the expression of LFA-1 in the adherent cell population were significantly higher than those in the nonadherent cell population. Moreover, the CD4 to CD8 ratio of the HLA-DR+ cells in the EC-adherent T cells was significantly higher than that in the nonadherent cells. Collectively, these results indicate that increased adherence of T cells to EC in HAM patients is based on the increase of activated T cells with high density LFA-1 expression in the peripheral blood. Moreover, CD4+ HLA-DR+ cells exhibited more adhesive activity to EC than CD8+ HLA-DR+ cells, suggesting that activated CD4+ cells, rather than activated CD8+ cells, may be important as the first trigger for T cell-infiltration to the central nervous system in the immunopathogenesis of HAM.

[Computed tomographic appearances of pulmonary alveolar proteinosis]

We evaluated longitudinal changes in chest CT images in six cases (5 males and one female, age: 35-57 yr) of pulmonary alveolar proteinosis treated with bronchopulmonary lavage. Chest CT images on admission showed a mixed pattern of air-space consolidation and reticular or reticulonodular shadows in most cases and showed a peripheral clear zone in all cases. These shadows gradually diminished after bronchopulmonary lavage. Some cases revealed early improvement in the hilar zone while others had equal improvement in all lung lesions. In one case, consolidation was changed into reticular shadows by treatment. Previous reports have indicated that "interstitial shadows which disappeared with lavage" reflect edematous thickening of interlobular septa. However, our longitudinal evaluation suggests that interstitial shadows on CT images may reflect not only real interstitial infiltration but also inhomogeneous distribution of intralobular deposits.

Localization of a low Mr GTP-binding protein, rap1 protein, in plasma membranes and secretory granule membranes of rat parotid gland

Subcellular fractions were prepared from rat parotid gland by sequential centrifugation, Percoll gradient centrifugation and divalent-cation precipitation, and the localization of a low Mr GTP-binding protein, rap1 protein (rap1p) was analyzed by immunoblotting using a specific antibody. rap1p was found to be located in apical and basolateral plasma membranes, and secretory granule membranes in rat parotid gland. On the other hand, the beta gamma subunits of heterotrimeric Gt protein was localized in plasma membranes but not in granule membranes.

Eustachian tube compliance in cleft palate--a preliminary study

With the use of the tubal compliance test and the forced response test (FRT), the compliance and ventilatory functions of the eustachian tube (ET) were examined in 19 children with otitis media with effusion (OME) and cleft palate, in 31 children with OME but without cleft palate, and in 19 individuals with traumatic perforation of the eardrum without history of other otological disease (controls). The tubal compliance results in the group with both cleft palate and OME were significantly higher than the results obtained with the controls, but did not differ significantly from the results obtained with the patients with OME but without cleft palate; this indicated that the ETs of those patients with OME and cleft palate, and the ETs of those patients with OME but without cleft palate, appeared to be more collapsible than the ETs of normal subjects. It was speculated that such an aerodynamic property of the ET observed in the group with OME and cleft palate and in the group with OME but without cleft palate may be due mainly to possible inflammatory condition of the tubal mucosa rather than to abnormal anatomy or to an abnormal physical property of the framework (such as cartilage) of the ET.

[A case of Wegener's granulomatosis with episcleritis, mediastinal lesions, and pleural effusion and without serum anti-neutrophil cytoplasmic antibodies]

We report a 63-year-old male case of Wegener's granulomatosis. His complaints were cough and fever, and chest X-ray showed subpleural infiltrative opacities in the bilateral lungs and small nodular lesions in the middle portion of the right lung. He had been treated as bacterial pneumonia at another hospital without any improvement and was referred to this hospital. Chest CT scan disclosed several small nodular lesions in the subpleural region of the right lung, consolidation in the posterior mediastinum, and the left pleural effusion. Transbronchial lung biopsy revealed inflammatory granulation with predominantly lymphocytes and micro-necrosis in the peribronchiolar region. Although these findings suggested Wegener's granulomatosis, open lung biopsy was performed because both antineutrophil cytoplasmic antibodies (ANCA) and antibodies to proteinase-3 were negative and ear, nose, and throat abnormalities were not found. Pathologic findings consisted mainly of granulomatous inflammation with lymphocytes, histiocytes, and multinucleated giant cells, and granulomatous vasculitis with micro-necrosis. Furthermore, the patient was diagnosed as having bilateral episcleritis by an ophthalmologist. No renal involvement was found. Standard treatment with cyclophosphamide and glucocorticoid resulted in marked improvement within a couple of weeks, and the patient was in complete remission eight months after initiation of therapy. This case is of interest in that the distribution of lesions was not typical and ANCA was negative.

A mathematically designed STS primer without any mismatches for direct sequencing of cosmid DNA clones

We report here a new method for the direct sequencing of large DNA inserts of cosmid clones from human chromosomes using STS primers of 14 nucleotides without any mismatches, which are designed from results of a mathematical analysis. It is clear that STS primer of 14 nucleotides is optimum for direct sequencing of cosmid recombinant DNA clones. We also provide examples of direct sequencing of cosmid clones of human chromosome 21 using these STS primers.

Acute myeloid leukemia possibly producing thrombopoietic factor(s)

A 75-year-old man developed a cluster of differentiation (CD)4-positive but human T-cell lymphotropic virus type I (HTLV-I)-negative T lymphoid neoplasm with overwhelming cutaneous involvement and mild thrombocytosis. Twelve courses tetrahydropyranyl adriamycin, cyclophosphamide, vincristine and prednisone (THP-COP) combination chemotherapy led him to complete remission. After four months of complete remission, however, atypical immature cells (blasts) appeared in peripheral blood and bone marrow. Surface marker analysis revealed the blasts to be CD2-, CD3-, CD4-, CD5-, CD7+, CD8-, CD10, CD13 +/-, CD19-, CD20-, CD25-, CD33+ and human leukocyte antigen-DR (HLA-DR+). Staining for myeloperoxidase, esterases, PAS and platelet peroxidase were all negative. The patient was diagnosed as having both CD7 and CD33 positive acute myeloid leukemia (AML). The relation between the T cell lymphoid neoplasm and AML was not clear. Thrombocytosis became more marked after acute leukemia occurred and the platelet count varied in parallel with the blast cell count in peripheral blood. When the leukemic cell count was high, thrombopoietic activity could be detected in the serum. In addition, conditioned medium obtained from primarily-cultured blasts had detectable thrombopoietic activity, which implied the blasts directly to produce a thrombopoietic factor(s). Analysis of the serum concentration for cytokines with associated thrombopoietic activity indicated that the blasts possibly produced a thrombopoietic factor(s) distinct from interleukin (IL)6, IL3, leukemia inhibitory factor (LIF), erythropoietin and granulocyte macrophage-colony stimulating factor. To our knowledge, this is the first reported case of an acute myeloid leukemia with marked thrombopoiesis (more than 2000 x 10(3)/microliter of maximum platelet count in peripheral blood.

Application of in vitro bromodeoxyuridine labeling of oral cancers

We used immunohistochemical methods to investigate whether in vitro labeling with bromodeoxyuridine (BrdU) of oral cancer tissues is useful in pathological diagnosis. BrdU-positive cells were found around the basal region of the epithelium in normal oral mucosa, in a papilloma specimen and in tissue with moderate dysplasia. The labeling rates (percentage of BrdU-positive cells, LR) for these cases were 1.2%, 6.9% and 7.5%, respectively. In well-differentiated carcinoma, more layers of BrdU positive cells were observed from the basal layer toward the surface. The LR in this region was 13.9-17.0%. In vitro BrdU labeling of oral tumors may be useful in pathological diagnosis, since the LR is lowest in normal tissues, higher in benign tumors, and highest in malignant tumor tissues.

[Anesthetic management of a patient with polyarteritis nodosa who suddenly developed cardiac rupture after valve replacement]

We recently encountered a patient with mitral insufficiency, accompanied by PN (polyarteritis nodosa), who developed a cardiac rupture immediately after a mitral valve replacement. The patient was a 60-year-old woman. After she was diagnosed as having mitral stenosis and insufficiency in 1968, the patient developed congestive heart failure and underwent repeated hospital admissions and discharges. In 1989, she was diagnosed as having PN and began to receive a high-dose steroid therapy (prednisolone; total dose 5245 mg). Because of transient brain ischemia and exacerbation of the symptoms of heart failure, the patient underwent mitral valve replacement on December 19, 1991. For anesthesia, oxygen, fentanyl, midazolam and vecuronium were administered. During surgery, catecholamine, nitroglycerin and prostaglandin E1 were continuously infused intravenously. The patient was weaned smoothly from the cardiopulmonary bypass. The operation was completed in about 6 hours. Her postoperative course was satisfactory until she suddenly developed left ventricular rupture and died 6 hours after surgery. The rupture seemed to be attributable to a weakening of the myocardial wall following long-term, high-dose steroid therapy, and to myocardial degeneration caused by PN-associated necrotizing vasculitis of myocardial arterioles.

Changes in cell proliferative activity in granulation tissue invading the root canal

Root canal models were implanted in rats in order to investigate histologically the movement of granulation tissue invading apical canals and dead spaces and changes in cell proliferative activity as indicated by 3H-thymidine. The models were prepared to have 1, 2, and 3 mm apical canals, with and without dead spaces, to simulate preparations short of the apex and obturation to several levels. After 12 wks implantation of the models without dead spaces, granulation tissue invading 1 mm apical canals did not degenerate and cell proliferative activity remained high. However, tissue invading the 2 and 3 mm apical canals tended to be necrotic and cell proliferative activity was decreased. In the models with dead spaces, the tissue in the 1 and 2 mm apical canals developed and invaded the dead spaces, and still possessed proliferative activity 12 wks after implantation. In contrast, the tissue in the 3 mm apical canals did not invade the dead spaces, even after 12 wks, and no proliferative activity was observed.

[A case of malignant fibrous histiocytoma of jejunal origin with marked response to cisplatin, ifosfamide and adriamycin]

A case of malignant fibrous histiocytoma (MFH) of jejunal origin with brain and lung metastases was treated by jejunal resection. Four courses of sequential chemotherapy that combined cisplatin, ifosfamide and adriamycin were performed starting on day 20 following operation. Both brain and lung metastases showed marked reduction in size, and toxicity was minimal.

High-performance liquid chromatography analysis of chondroitin sulfate isomers in human periodontium

We investigated the chondroitin sulfate in human periodontal samples (gingiva, periodontal ligament, cementum and alveolar bone) collected for orthodontic reasons. Glycosaminoglycans (GAGs) were extracted from the periodontium by enzyme digestion, and unsaturated disaccharide isomers of chondroitin sulfate were obtained by chondroitinase ACII and hyaluronidase digestion. The isomers were analyzed by high-performance liquid chromatography. Chondroitin sulfate was found in all four types of periodontal tissue; its unsaturated disaccharide isomers consisted in delta Di-0S, delta Di-6S, delta Di-4S, delta Di-diSE and delta Di-triS. These four types of periodontal tissue showed different molar ratios of the unsaturated disaccharides. The ratio of delta Di-4S to delta Di-6S was greater in the calcified than in the uncalcified tissue.

Changes in synovial fluid N-acetyl-beta-glucosaminidase activity in the human temporomandibular joint with dysfunction

beta-Glycosidases (N-acetyl-beta-glucosaminidase, N-acetyl-beta-galactosaminidase, beta-glucuronidase) were assayed in temporomandibular joint (TMJ) synovial fluid obtained from 23 patients with closed lock TMJ internal derangement (ID), four with closed-lock TMJ osteoarthritis (OA), and 13 with normal controls (N). Synovial fluid was collected from the upper joint space after injecting 1.5 ml of 1% lidocaine three times. The specific activity of N-acetyl-beta-glucosaminidase increased significantly both with ID (p < 0.01) and with OA (p < 0.001), along with increases in the activity of N-acetyl-beta-galactosaminidase (p < 0.05 with ID and p < 0.01 with OA) and in beta-glucuronidase (p < 0.05 both with ID and OA). The N-acetyl-beta-glucosaminidase activity with OA was also significantly higher (p < 0.001) than with ID. These findings suggest that N-acetyl-beta-glucosaminidase activity in the TMJ synovial fluid reflects the degree of TMJ dysfunction.

Refractory otitis media with effusion from viewpoints of eustachian tube dysfunction and nasal sinusitis

INTRODUCTION

Most children with otitis media with effusion (OME) recover spontaneously before adolescence. However, some children have refractory OME. This study was undertaken to evaluate eustachian tube function and concurrent upper respiratory tract inflammatory conditions in adolescents with refractory OME.

METHODS

A group of 83 adolescent patients with refractory OME was identified. Ages range from 10 to 20 years. A control group of 108 children with OME (ages 4 to 9) serve as the basis for comparison. All underwent both passive and active eustachian tube function testing, dye clearance studies, and a sniffing test. Upper respiratory tract inflammation was assessed by roentgenograms of the paranasal sinuses and mucosalivary function.

RESULTS

High-pressure tubal opening was demonstrated in 31% of patients with refractory OME. In contrast, 84% of children with routine OME had normal opening. A marked disturbance of dye clearance was noted in refractory OME cases. Active tubal function during swallowing was disturbed in both adolescent and children's OME groups without any significant difference between them. Paranasal sinusitis was identified in 49% of adolescents with refractory OME. In contrast, 78% of children with OME had abnormality of the sinuses.

CONCLUSION

Approximately one half of adolescents with refractory OME have demonstrable organic abnormality of the eustachian tube. These data suggest tubal dysfunction may be more important in refractory OME than upper respiratory tract inflammation.

Eustachian tube compliance in sniff-induced otitis media with effusion. A preliminary study

Compliance and ventilatory functions of the eustachian tube (ET) were examined in 20 ears with sniff-induced otitis media with effusion (OME) and 16 ears with traumatic perforation of the eardrum (control) by the forced response test (FRT) including the compliance test, and by the inflation-deflation test. The tubal compliance showed no significant difference between two groups in the FRT. The inflation test revealed that the forced opening pressure was significantly lower in the sniff-induced OME group than in the controls. In the FRT, the active ventilatory dysfunction was also revealed to be significantly more common in the sniff-induced OME. These results suggested that most of the ETs with sniff-induced OME seemed to have excessive patency and poor active opening ability, but may not be hypercompliant or "floppy".

Compliance of the patulous eustachian tube

The compliance and ventilatory functions of the eustachian tube (ET) of 17 ears with patulous ETs were examined and compared to those of 16 ears with traumatic perforation of the eardrum (controls) by means of the tubal compliance test, the inflation-deflation test, and the forced response test. The tubal compliance was significantly lower in the patulous ETs than in the controls. An excessive patency of the ET was confirmed among the patients with patulous ETs by a low opening pressure during the inflation test and a low passive resistance on the forced response test. Active ventilatory dysfunction was also found to be significantly more common in the patulous ETs by the deflation test and the measure of dilation efficiency. These results indicated that the ET appeared to be rather rigid and less moveable when patulous than when normal.