Developmental regulation of the chicken beta B1-crystallin promoter in transgenic mice

The cis-elements responsible for the high-level, lens-specific expression of the chicken beta B1-crystallin gene were investigated by generating mice harboring beta B1-crystallin promoter/chloramphenicol acetyl transferase (CAT) transgenes. Deletion of promoter sequences -434/-153 and -152/-127 as well as site-directed mutagenesis of the PL1 (-116/-102) and Pl2 (-90/-76) elements significantly decreased CAT gene expression in the lenses of adult transgenic mice. Transfection studies using multimerized PL1 and PL2 elements fused to the chicken beta-actin basal promoter indicated that PL1 is a general activating element while PL2 is involved in the lens-specificity of the chicken beta B1-crystallin promoter. CAT histochemistry demonstrated that the chicken beta B1-crystallin promoter (-434/+30) was active in both primary and secondary lens fiber cells from 12.5 days post coitum (dpc) until adulthood. Activity of the -152/+30/CAT transgene was relatively low and confined to the primary lens fiber cells of 16.5 dpc mice. Together, these data suggest that the reduced activity of this promoter in the adult lens is due both to this developmentally restricted expression pattern and a reduction in promoter activity. RNA hybridization studies demonstrated that the chicken beta B1-crystallin/CAT (-434/+30) transgene was expressed at similar levels in the same cells as the endogenous mouse beta B1-crystallin gene in 16.5 dpc transgenic mouse embryos. These data show a strict conservation of the lens-specific spatial and temporal regulation of the chicken and mouse beta B1-crystallin genes.

Demonstration of infectious bovine rhinotracheitis virus antigen by immunoperoxidase method in tissues of aborted bovine fetuses preserved for 25 years in paraffin blocks

Infectious bovine rhinotracheitis (IBR) virus antigen was demonstrated by the immunoperoxidase method in tissues of two aborted bovine fetuses, which had been stored for 25 years after fixing in formalin and embedding in paraffin. Necrotic foci were detected in the liver, kidney, adrenal gland, and thymus of the fetuses. Coincidenting with the distribution of the necrotic foci, IBR virus antigen was demonstrated by immunostaining. The present study proved the immunoperoxidase method in one of useful techniques to demonstrate IBR virus antigen in tissue sections from preserved paraffin blocks.

[Surgical treatment of double-orifice mitral valve associated with incomplete-type endocardial cushion defect]

We report surgical treatment of double-orifice mitral valve (DOMV) associated with incomplete-type endocardial cushion defect. All three cases had "central type DOMV classified by Cascos" with bridging tissue between two mitral orifices. We closed mitral cleft in the two cases with moderate mitral regurgitation, although we left the bridging tissue. It is thought to be beneficial to leave the bridging tissue undivided to avoid postoperative mitral regurgitation in such cases.

Pathology of bovine abortion and newborn calf death caused by dual infection with Chlamydia psittaci and infectious bovine rhinotracheitis virus

Nine aborted fetuses and one newborn calf, diagnosed as Chlamydia psittaci (C. psittaci) infection, were pathologically examined. The characteristic lesions in the liver were focal necrosis in 9 aborted fetuses and granulomatous necrotic foci in the newborn calf. Moderate numbers of intranuclear inclusion bodies were found in necrotic foci of the liver, spleen, thymus, lymph nodes, adrenal gland, kidney, lung and forestomach. Immunohistologically, a small number of C. psittaci antigens was demonstrated in necrotic foci of the liver and correlated with distribution of elementary bodies. Moderate numbers of infectious bovine rhinotracheitis (IBR) virus antigens were also detected in degenerating and necrotizing parenchymal cells in various organs and correlated with distribution of intranuclear inclusion bodies. Thus, these aborted bovine fetuses and newborn calf were interpreted as being dually infected with C. psittaci and IBR virus during pregnancy.

Effects of chenodeoxycholic and ursodeoxycholic acids on interferon-gamma production by peripheral blood mononuclear cells from patients with primary biliary cirrhosis

Ursodeoxycholic acid (UDCA) administration can obtain marked improvement of primary biliary cirrhosis (PBC). Recently, UDCA has been demonstrated to have a direct effect on immunological reactions in patients with PBC in that the aberrant expression of major histocompatibility complex (MHC) class I molecules was markedly reduced after UDCA treatment. To understand the immunological effect of UDCA, we analyzed interferon (IFN)-gamma production in peripheral blood mononuclear cells (PBMCs) from 29 patients with PBC treated with UDCA (group 1), 19 patients with PBC who were not treated with UDCA (group 2), 11 healthy subjects (group 3), and 12 patients with chronic viral hepatitis (group 4). IFN-gamma production was investigated because the excess production of this cytokine is associated with the aberrant expression of MHC molecules. Whereas IFN-gamma production in the patients in group 2 was significantly increased, the level of production in group 1 was similar to that in the control groups (groups 3 and 4). There was significant improvement in IFN-gamma production in 6 patients with PBC after UDCA treatment. The effect of UDCA and chenodeoxycholic acid (CDCA) on IFN-gamma production in PBMCs from 12 normal subjects was also analyzed. IFN-gamma was produced dose-dependently according to concentrations of CDCA ranging from 0.1 to 10 microM, but the increase in production was markedly suppressed by the addition of UDCA. We conclude that low doses of CDCA enhance IFN-gamma production and may therefore lead to the aberrant hepatic expression of MHC molecules, and that the increase in IFN-gamma production is suppressed by UDCA.

Organic solvent-tolerant bacterium which secretes an organic solvent-stable proteolytic enzyme

A bacterial strain which can be grown in a medium containing organic solvents and can secrete a proteolytic enzyme was isolated and identified as Pseudomonas aeruginosa. The strain was derived by the following two-step procedures: high proteolytic enzyme producers were first isolated by the usual method, and then the organic solvent-tolerant microorganism was selected from these high-rate proteolytic enzyme producers. The proteolytic activity of the supernatant of the culture was stable in the presence of various organic solvents. The stability of the enzyme in the presence of organic solvents, of which the values of the logarithm of the partition coefficient (log P) were equal to or more than 3.2, was almost the same as that in the absence of organic solvents. It is expected that both the solvent-tolerant microorganism and the solvent-stable enzyme produced by this strain can be used as catalysts for reactions in the presence of organic solvents.

[Successful surgical treatment for ruptured distal aortic arch aneurysm into lung]

We report successful aortic arch replacement using continuous retrograde cerebral perfusion (CRCP) for the three cases of ruptured distal aortic arch aneurysm (DAAA) into the left lung. All of them, who had preoperative episodes of hemosputum and hemoptysis, were diagnosed rupture of DAAA into the lung with computed tomography, magnetic resonance image, aortography or transesophageal echo. Following urgent graft replacement of the aortic arch or repair of the rupture on the suture line in the previous arch vessel reconstruction was carried out safely through median sternotomy approach. The left upper lobe of lung adherent tightly to the DAAA wall was not dissected to prevent the lung from bleeding, air leakage and infection. All of them, who awoke smoothly after CRCP, did not developed any pulmonary complications and survived uneventually. We concluded that median approach and not tearing lung from DAAA wall might be key-points for successful operation in cases of ruptured DAAA into lung and that CRCP is an safe and useful method to protect brain in such cases.

Three cases of primary biliary cirrhosis associated with bronchial asthma

The association of primary biliary cirrhosis (PBC) and bronchial asthma was observed in three patients. All of these patients were female (53, 54, and 41 years old, respectively), and were positive for antimitochondrial antibodies. The patients fulfilled the diagnostic criteria of both PBC and bronchial asthma. Bronchial asthma preceded PBC in two patients, and the reverse order was seen in the other. Patient the clinical symptoms were mainly due to the bronchial asthma. Two patients had asymptomatic PBC and the third patient complained of pruritus. The liver histology showed mild to moderate eosinophilic infiltration in addition to the ductal and hepatic parenchymal changes characteristic of PBC. A survey of 266 cases of PBC referred to us disclosed that, in 6 of these, the PBC was associated with bronchial asthma, while no association with bronchial asthma was the material of found in 166 patients with viral hepatitis in our liver biopsy files. The 3 present cases we experienced suggest that bronchial asthma may be included in the list of extrahepatic diseases associated with PBC. The significance of this association is unclear and may merit further study. Steroid therapy, which is known to cause adverse effects in PBC, was employed for bronchial asthma in these 3 patients. Another therapeutic approach will have to be considered in patients with bronchial asthma associated with PBC.

[A rare case of coronary artery perforation by a PTCA guide wire complicating with postinfarction cardiac rupture after thrombolytic therapy]

We report a rare case of coronary artery perforation by a guide wire for percutaneous transluminal coronary angioplasty (PTCA) complicating with postinfarction cardiac rupture (oozing type). The patient had acute myocardial infarction on the extensive anterior wall and developed cardiac rupture followed by serious cardiac tamponade during the emergency PTCA several hours after tissue plasminogen activator (t-PA) given intravenously. The meandering left anterior descending artery (LAD) was found injured by a PTCA guide wire apart from a small oozing-type cardiac rupture near the apex. We repaired urgently the perforated LAD as well as the ruptured left ventricle. It is thus suggested that coronary artery perforation by a PTCA guide wire may occur on meandering coronary arteries and develop a serious hemorrhagic complication, particularly after thrombolytic therapy.

Chronic bronchobronchiolitis obliterans associated with Stevens-Johnson syndrome

We report a case of bronchobronchiolitis obliterans associated with Stevens-Johnson syndrome diagnosed using bronchography and bronchoscopy in a 25-year-old man with dyspnea. Eighteen months prior to admission, the diagnosis of Stevens-Johnson syndrome due to anticonvulsant therapy was made at another hospital. On admission, the patient was wheezing and had overinflation of the lungs, with marked obstructive pulmonary dysfunction. Ventilation and perfusion scintigrams revealed multiple ventilation and perfusion defects but not mismatch. Bronchography revealed central bronchiectasis and obstruction of the peripheral bronchi. Occlusion of the fifth right basal bronchus was observed with fiberoptic bronchoscopy. Bronchography and bronchoscopy provide useful information for the diagnosis of this disease.

Humoral immune response to human aortic valve homografts

The humoral response to homograft valves in humans is largely unknown. The anti-human lymphocyte antigen (HLA) antibody production, specificity, and immunoglobulin class were examined sequentially in 73 patients undergoing aortic valve replacement. In addition, the long-term production of antibodies was examined in a cross-sectional study of 160 patients at periods varying from 1 to 15 years postoperatively. Human lymphocyte antigen antibodies were produced in 17 of 30 antibiotic-sterilized homografts (56%) and in 15 of 15 "homovital" homograft recipients, compared with 6 of the 28 control xenograft recipients (21%) (p < 0.001). The HLA antibodies were immunoglobulin G in all 15 homovital homografts, in 11 of 17 antibiotic-sterilized homografts, and in four of the six xenograft cases. Human lymphocyte antigen specificities could be assigned to the antibodies in 21 cases. In 10 of 11 cases in which donor HLA typing data were available, the antibodies detected were directed against donor HLA class I antigens. Of six possible determinants of HLA antibody production, the type of homograft valve implanted (homovital or antibiotic sterilized) correlated with antibody formation. In the cross-sectional study, 66 of the 85 homovital homograft recipients tested for HLA antibodies after 1 year were found to have antibodies, compared with 29 of 75 antibiotic-sterilized homograft recipients (p = 0.00003). We conclude that homografts appear to stimulate a strong donor HLA-specific antibody response, particularly of the immunoglobulin G class. This is most common in homovital valve recipients. These antibodies can persist for 15 years after operation. The clinical significance of this response requires further investigation.

[Long-term results of mitral valvuloplasty for mitral regurgitation]

From July 1979 to February 1995, 126 patients, including 4 reoperations, aged between 6 months and 77 years underwent mitral valve repair for mitral regurgitation. The patients were divided in two groups, 46 patients aged less than 16 years in pediatric age group and the other 80 patients in a dult group. The methods consisted of asymmetric annuloplasty (Kay-Reed method) in 98 patient, Carpentier-Edwards ring annuloplasty in 14, quadrangular resection of the posterior leaflet with annuloplasty in 9, and chordal and leaflet repair in 5. There was no hospital nor late death in pediatric age group. Three hospital deaths and one late death were in adult group. Follow-up was 96% complete and totaled 812.1 patient years. Reoperations underwent in 3 pediatric patients and 9 adults. At 15 years' follow-up, freedom from reoperation was 91.5 +/- 4.7% in pediatric age group and 67.1 +/- 12.7% in adults. Freedom from event was 63.5 +/- 12.1% in adult group. These results suggest that mitral repair with Kay-Reed method in pediatric age group is favorable for long-term. In contrast, indications for mitral reconstraction with other methods including ring annuloplasty should be extended for aged patients with severely dilated annuls and degenerated leaflets.

[A case of post-traumatic arteriovenous fistula of the subclavian artery]

A 67-year-old woman was admitted to our hospital for a complete medical evaluation of a pulmonary nodule on a chest X-ray film, which was found during an annual check-up. A loud bruit was audible over the left chest and the supraclavicular region. Computerized tomography (CT) scan and magnetic resonance imaging revealed an arteriovenous fistula from a branch of the left subclavian artery into the paravertebral veins. Angiography disclosed that the arteriovenous fistula was fed by the left costocervical artery. Transarterial embolization of the arteriovenous fistula was done with 5 mechanical detachable coils and 2 micro coils. Postembolization angiography showed a marked decrease in blood flow and near-elimination of the arteriovenous fistula. The shrinkage of the arteriovenous fistula was also observed on CT scan. This patient had been in a traffic accident, and had been clinically well before the accident. Post-traumatic arteriovenous fistula was strongly suspected, because a pulmonary nodule on chest X-ray film and a bruit were found after a traffic accident.

Influence of the compliance of the pump housing and cannulas of a paracorporeal pneumatic ventricular assist device on transient pressure characteristics

The dependence of transient pressure characteristics of a ventricular assist device (VAD) on the compliance of its housing and cannulas was investigated in a mock circulation. The peak rate of change of pressure (dP/dtmax) values was greater in the cannulas than other compartments and was associated with valve closure-induced pressure oscillations. When cannula compliance was increased from 0.0057 to 0.0129 cm3/mm Hg, these values decreased by approximately 20%, and outflow cannula pressure oscillation frequency decreased from 17.5 Hz by 35%. This trend was also apparent in the inflow. A VAD housing compliance increase from 0.0162 to 0.0483 cm3/mm Hg caused a dP/dtmax decrease of 30% in both the blood chamber and the outflow cannula. The effect of this change on the inflow was weaker implying that housing absorbs the energy associated with outflow deceleration more effectively than the inflow. These findings suggest that increasing VAD housing and cannulas compliance can improve hydrodynamic performance.

[Diagnostic and therapeutic problems in vestibular neuronitis: clinical implications for sudden vertigo]

We defined sudden vertigo as a sudden, unilateral peripheral vestibular dysfunction. The criterion for its diagnosis is a single episode of vertigo without cochlear and central symptoms. Among 20 patients with sudden vertigo there was no difference in clinical aspects between those with CP (canal paresis) (CP% > or = 25%) and those without CP (CP% < 25%). This suggests that sudden vertigo with CP is due to sudden vestibular dysfunction with predominant involvement of the lateral semicircular canal. Basically, vestibular neuronitis is considered to be due to acute unilateral neuropathy of the vestibular nerve. However, since we have no routine examination for evaluating vestibular nerve function, sudden vertigo with CP should be diagnosed as vestibular neuronitis. We then assessed the prognosis of sudden vertigo with CP (vestibular neuronitis). About two years after the onset of CP 4 of 10 patients had recovered. However, patients with persistent CP had a handicap in their everyday life because of the dizziness induced by head movements. The possibility of recovery of vestibular function in response to steroid therapy may improve the prognosis in vestibular neuronitis.

The interactions of E2F with pRB and with p107 are regulated via the phosphorylation of pRB and p107 by a cyclin-dependent kinase

It has been postulated that the product (pRB) of the retinoblastoma gene dissociates from the E2F-pRB complex upon phosphorylation by cyclin-dependent kinase(s) (cdk). However, there is no direct evident for the regulation of formation of the E2F-pRB complex via phosphorylation by purified cdk. Therefore, we investigated the regulation of formation of this complex by phosphorylation using pRB and purified cyclin A-cdk2, cyclin E-cdk2 or cyclin D1-cdk4. Purified pRB was incubated with nuclear extracts prepared from pRB-defective cells and then subjected to gel mobility shift assays. We confirmed that unphosphorylated pRB associated with various types of E2F but pRB has been phosphorylated by cyclin A-cdk2 did not. We found that E2F-pRB complexes were disrupted as a consequence of phosphorylation by cyclin A-cdk2, and the levels of the free forms of E2Fs increased. We also found that not only the E2F-pRB complexes but also the E2F-p107 complexes were disrupted upon phosphorylation by cyclin A-cdk2. Furthermore, E2F-pRB complexes were disrupted through phosphorylation by cyclin D1-cdk4 and cyclin E-cdk2, as well as by cyclin A-cdk2. These results clearly demonstrate that the phosphorylation of pRB and p107 by cdks regulates the formation of complexes between E2F and pRB or p107.

[Effect of a newly developed corneal storage medium on corneal endothelium--morphological study by scanning electron microscopy]

We compared the effects on corneal endothelium of the new storage mediums I and II with those of OPTISOL. Storage mediums I and II had the same formula, i.e., 0.1% hyaluronic acid, except for the concentration of basic medium TC-199. I contained 70% of the TC-199 concentration of OPTISOL and II contained 80%. Rabbit corneas were stored in storage mediums I and II for 3, 7, 10 and 14 days and in OPTISOL for 7, 10 and 14 days at 4 degrees C. After the 3-day storage period, endothelial cells were preserved in good condition. After the 7-day storage period, medium I showed better preservative ability in endothelial configuration than the other two storage media. Medium II and OPTISOL showed a similar storage potential morphologically. With increasing storage time, endothelial cells showed an irregular surface and a less defined cellular edge in both media II and OPTISOL.

Continuous retrograde cerebral perfusion aids repair of aortic laceration during sternal re-entry

We successfully repaired an anticipated large laceration of the ascending aorta occurring during sternal re-entry in a 68-year old woman undergoing replacement of a prosthetic aortic valve. Cerebral protection was ensured by using continuous retrograde cerebral perfusion via femoro-femoral bypass with deep hypothermia. The cooling time was 20 minutes. The minimum nasopharyngeal temperature was 15 degrees C and the duration of the retrograde perfusion was 11 minutes at a rate of 600 ml per minute. The postoperative course was uneventful and no neurological deficits occurred.

Different time-course production of peptidic and nonpeptidic leukotrienes and prostaglandins E2 and F2 alpha in the ovary during ovulation in gonadotropin-primed immature rats

Temporal changes in ovarian leukotrienes (LTs) and prostaglandins (PGs) were examined during ovulation to assess roles they may play in this process. Ovulation was induced in immature rats by injection with human chorionic gonadotropin (hCG; 10 IU, s.c.) 2 days after they had been primed with pregnant mare serum gonadotropin (10 IU, s.c.). The ovaries were extirpated at various intervals after hCG administration and assayed for LTB4, and LTC4/D4/E4, as well as PGE2, and PGF2 alpha. Ovarian concentration of LTB4 increased (P < 0.01) rapidly, reaching a peak at 1 hour after hCG administration, then declined (P < 0.05) by 4 hours and remained low thereafter. In contrast, LTC4/D4/E4 peaked (P < 0.01) between 1 and 2 hours, declined (P < 0.05), and then increased (P < 0.01) to achieve a second, larger peak at 10 hours. Prostaglandin E2 increased (P < 0.01) at 6 hours after hCG and did not decrease from the peak value until (P < 0.01) 14 hours after hCG. Concentrations of PGF2 alpha increased (P < 0.01) at 4 hours after hCG, but decreased (P < 0.01) from the peak by 10 hours. Although LTB4, LTC4/D4/E4, PGE2, and PGF2 alpha all increased during ovulation, the time-course differed. This suggests that each eicosanoid may play a distinct role in the process of follicular rupture.

Pharmacological profile of ME3221, a novel angiotensin II receptor antagonist

The pharmacological profile of a new surmountable angiotensin AT1 receptor antagonist, ME3221, 3-methoxy-2,6-dimethyl-4-[[2'-(1H-tetrazol-5-yl)-1,1'-biphenyl-4- yl]methoxy]pyridine, was studied in several animal models, and was compared with that of losartan. EF2831, 3-hydroxy-2,6-dimethyl-4-[[2'-(1H-tetrazol-5-yl)-1,1'-biphenyl-4- yl]methoxy]pyridine, a metabolite of ME3221, is also a surmountable angiotensin AT1 receptor antagonist, whose potency was 1/30 that of ME3221 in vitro, but equal to or 1/3 of that of ME3221 in in vivo experiments. In rats and marmosets, ME3221 antagonized angiotensin II-induced pressor responses, but did not affect bradykinin-induced depressor responses. ME3221 lowered the blood pressure in renal hypertensive rats and spontaneously hypertensive rats (SHR), and its ED25 value was 3 times that of losartan. Repeated administration of ME3221 to SHR had a stable and long-lasting antihypertensive effect without influencing heart rate. Thus ME3221, like losartan, may be useful in the treatment of renal and essential hypertension.

[Multivariate analysis of everyday handicap of patients with dizziness]

A preliminary questionnaire consisting of 30 questions was developed to evaluate handicaps in everyday life for 105 patients with dizziness. Factor analysis divided the questions into 5 principal factors of handicap due to dizziness: 1) disturbance of social activity, 2) body motion precipitating dizziness, 3) limitation of physical activity, 4) emotional disturbance, and 5) disturbance of interpersonal communications. The score of each factor was calculated as the sum of the scores of three principal questions in the corresponding factor. There was no contribution of clinical diagnosis, patient's age or gender, or duration of the disease to the score of each factor. Thus, it is concluded that the reorganized questionnaire which consists of three principal questions in 5 factors can be used for evaluating dizziness handicaps in everyday life. The score of the emotional factor in patients with Meniere's disease was higher than that for other vestibular disease. The score of the body motion factor in patients with vestibular neuronitis was higher than that for vertebro-basilar artery insufficiency. Thus, the re-organized questionnaire can also be used for evaluating the contribution of each factor to dizziness handicaps in everyday life.

Left main bronchus compression after aortic reconstruction for interruption of aortic arch

A case of the left main bronchus obstruction after an aortic reconstruction for interruption of the aortic arch is reported. Clinical features and successful management are described, and a mechanism for this complication is speculated on.

Protective effect of continuous retrograde cerebral perfusion on the brain during deep hypothermic systemic circulatory arrest

Deep hypothermic circulatory arrest has been widely used as an adjunct for surgery of the aortic arch to protect the brain and other vital organs. We introduced the use of continuous retrograde cerebral perfusion via the superior vena cava during deep hypothermic circulatory arrest in 1987 and have used it in 33 patients. Continuous retrograde cerebral perfusion times ranged from 10 to 89 minutes (mean 40.2 +/- 22.5), and minimal nasopharyngeal temperatures ranged from 14 to 25 degrees C (mean 17.4 +/- 2.0). Two patients with a ruptured aneurysm died during operation due to bleeding and two other patients, with continuous retrograde cerebral perfusion time of 24 and 35 minutes, died 1 month postoperatively due to preoperative liver cirrhosis and sepsis. Two patients suffered from stroke. The remaining 27 patients, including 6 with from 60 to 82 minutes of continuous retrograde cerebral perfusion, had no complications related to continuous retrograde perfusion. During continuous retrograde cerebral perfusion, 66 pairs of blood samples from the perfusate and from the drainage back to the arch vessels were obtained. Analysis of these samples revealed that partial pressure of oxygen, saturation of oxygen, and oxygen content significantly decreased (p < 0.001), and partial pressure of carbon dioxide (CO2) and CO2 content significantly increased (p < 0.001). The nasopharyngeal temperature gradually increased at the rate of 0.01 to 0.03 degree C/min, but was maintained below 20 degrees C. These results reflect the fact that the aerobic metabolism of the brain is maintained during continuous retrograde cerebral perfusion due to oxygen and substrate availability. This technique offers the potential of metabolic support to the brain during deep hypothermic circulatory arrest and prolongs the safe time limits of deep hypothermic circulatory arrest in surgery of the aortic arch.

A cyclin-dependent kinase inhibitor, butyrolactone I, inhibits phosphorylation of RB protein and cell cycle progression

Butyrolactone I is a selective inhibitor of the cyclin-dependent kinase (cdk) family. It inhibits both cdk2 and cdc2 kinase, but scarcely affects C-kinase, A-kinase, casein kinases, MAP kinase or EGF receptor-tyrosine kinase (Kitagawa et al., 1993, Oncogene, 8, 2425-2432). We studied the effects of butyrolactone I on the cell cycle as well as on phosphorylation of retinoblastoma protein (pRB). Butyrolactone I inhibited phosphorylation of pRB catalyzed by cyclin A-cdk2 produced by baculovirus in vitro. Furthermore, it inhibited phosphorylation of pRB and cell cycle progression from G1 to S phase in WI38 cell cultures. WI38 cells arrested at the G0 phase by serum starvation progressed in the cell cycle after serum stimulation. pRB was phosphorylated after 10 h serum stimulation. Incorporation of [3H]thymidine into the cells began to increase after 16 h serum stimulation. These processes were inhibited by butyrolactone I. Flow cytometric analysis showed that exposure to butyrolactone I inhibited progression of the cell cycle from G1 to S phase. These data suggested that initiation of DNA synthesis was inhibited by butyrolactone I and that the cell cycle was arrested in the G1 phase. Butyrolactone I also inhibited H1 histone phosphorylation in human WI38 cells and their G2/M progression. tsFT210 cells, a temperature-sensitive cdc2 mutant cell line, were synchronized at G2/M at a nonpermissive temperature, butyrolactone I inhibited the cell cycle progression of these cells at G2/M at the permissive temperature. Thus butyrolactone I, a cyclin-dependent kinase family inhibitor, which prevented the phosphorylations of the cell cycle-regulating proteins pRB and H1 histone, inhibited the cell cycle at G1/S and G2/M, respectively. These results suggest that the phosphorylations of pRB and H1 histone may play crucial roles in G1/S and G2/M progression, respectively, although it is possible that phosphorylations of other proteins by cdks are involved in G1/S and G2/M progression.

[A chronic case of summer type hypersensitivity pneumonitis]

A 59-year-old woman complaining of progressive dyspnea on exertion was admitted to our hospital in August 1992. In 1983 she had experienced exertional dyspnea from August to November, then improved spontaneously. In August 1984, she was admitted to our hospital due to the recurrence of the symptom. She was diagnosed as summer type hypersensitivity pneumonitis based on the following findings, 1) detection of non-caseous granuloma by transbronchial lung biopsy, 2) detection of precipitating antibody to Trichosporon cutaneum in the serum, 3) induction of the symptom by provocation test with the fungi, 4) isolation of the fungi from her house. In spite of moving from her house after discharge, she continued to visit her former house once a week to clean it. During the period, fibrotic changes on the chest roentgenogram were slowly progressive. In August 1992, ten years after the onset, she was re-admitted to our hospital with a complaint of exacerbated dyspnea on exertion. Open lung biopsy revealed granulomatous lesions with fibrotic changes, which was compatible with chronic type hypersensitivity pneumonitis. This patient was diagnosed as a chronic case of summer type hypersensitivity pneumonitis because of the clinical course and findings of open lung biopsy as well as laboratory data at the first admission. We consider that this case offer various information in considering the mechanism of chronic progress of summer type hypersensitivity pneumonitis.

Association of thrombosis-inducing activity (TIA) with fatal hypercoagulable complications in patients with lung cancer

We previously reported that thrombosis-inducing activity (TIA) is present in plasma from patients with advanced lung cancer. Of 73 patients with non-small cell lung cancer, stages IIIb and IV, 41 (56 percent) had such activity in plasma. The median survival time was significantly shorter in the TIA-positive vs the TIA-negative group. When 34 of those 73 patients who had died at Kyushu University Hospital were evaluated for the incidence of disseminated intravascular coagulation (DIC) and adult respiratory distress syndrome (ARDS), they were significantly higher in the TIA positive group (p < 0.05). The DIC occurred in 7 of 20 patients positive for TIA and 5 died of ARDS. In contrast, in the 14 TIA-negative subjects, only 1 patients experienced DIC and none died of ARDS. Peripheral platelet counts, which had been rather elevated on the day of hospital admission, were below normal within 1 week of death in 40 percent of the 20 patients who were positive for TIA. These observations suggest that TIA may be responsible at least in part for the increased activity of the coagulation system and the high incidence of DIC and ARDS in patients with advanced lung cancer.

Extracellular ATP regulates the proliferation of alveolar macrophages

We examined the effects of extracellular ATP on the proliferation and synthesis of DNA by guinea pig alveolar macrophages (AM). AM proliferated spontaneously in vitro, their number doubling in 72 h. Such proliferation was completely inhibited by adding 1 mM ATP to the culture. The inhibition was dose dependent. ATP also suppressed the spontaneous synthesis of DNA by AM. The inhibitory effect of ATP was not related to cell damage, as the viability and the superoxide anion-generating activity of these cells were unaffected by treatment with ATP for 24 h. The order of potency of the adenosine nucleotides (ATP > ADP > AMP) reflected the character of the P2 purinoceptor. Theophylline inhibited the effect of ATP on the synthesis of DNA by AM to a level produced by the nonhydrolyzable analogue, ATP gamma S, but did not influence the effect of ATP gamma S. These data suggest that the effect of ATP on the synthesis of DNA was exerted mainly via the P2 purinoceptor (82.0%) and to a lesser extent via the P1 purinoceptor (12.6%). We found that small molecules in the lavage fluid inhibited the synthesis of DNA by AM. Thus, the extracellular ATP present in the alveolar lining fluid may participate in controlling the proliferation of AM.

Tyrosine-specific protein kinase participates in the pathogenesis of acute immune complex alveolitis in rats

Rabbit IgG antibodies against ovalbumin (OA) was injected intravenously into Wistar rats. When the animals were challenged with OA aerosolized by ultrasonic nebulization, acute lung injury occurred as reflected by increased recovery of bronchoalveolar cells, especially polymorphonuclear leukocytes (PMN) in bronchoalveolar lavage fluid (BALF). Lung morphology demonstrated cellular infiltration in the alveolar septa and intra-alveolar hemorrhage. When the rats were administered ST-638, a novel tyrosine kinase inhibitor, intraperitoneally prior to nebulization, the number of PMN in BALF decreased in a dose-dependent manner and superoxide anion (O2-)-producing activity in peripheral leukocytes was significantly suppressed. Furthermore, the reagent inhibited migration of human peripheral blood neutrophils induced by the chemotactic peptide f-met-leu-phe in vitro. These studies strongly indicate that tyrosine kinase plays an important role in immune complex-triggered neutrophil-related lung disorders, and the novel tyrosine kinase inhibitor ST-638 attenuates lung injury by preventing superoxide production and neutrophil migration.

Selective Desulfurization of Dibenzothiophene by Rhodococcus erythropolis D-1

A dibenzothiophene (DBT)-degrading bacterium, Rhodococcus erythropolis D-1, which utilized DBT as a sole source of sulfur, was isolated from soil. DBT was metabolized to 2-hydroxybiphenyl (2-HBP) by the strain, and 2-HBP was almost stoichiometrically accumulated as the dead-end metabolite of DBT degradation. DBT degradation by this strain was shown to proceed as DBT → DBT sulfone → 2-HBP. DBT at an initial concentration of 0.125 mM was completely degraded within 2 days of cultivation. DBT at up to 2.2 mM was rapidly degraded by resting cells within only 150 min. It was thought this strain had a higher DBT-desulfurizing ability than other microorganisms reported previously.

The role of hepatitis C virus in hepatocellular carcinoma in Japan

Increasing numbers of patients with hepatocellular carcinoma (HCC) have been reported in Japan. In this paper, we investigated the role of hepatitis C virus (HCV) in HCC and the reason for the increase, using patients admitted to our university hospital from 1945 to 1992. 99 (73%) of 135 patients with HCC were positive for anti-HCV. Prospective studies demonstrated that 22 of 158 (14%) patients with chronic hepatitis C, and 31 of 70 (44%) cirrhotic patients with anti-HCV developed to HCC during the follow-up period (10.1 +/- 3.3 and 7.3 +/- 3.5 years, respectively). Prolonged survival of cirrhotic patients during past decades would also contribute to the increasing number of HCC cases as well as the number of HCV infections in Japan.

Mixed types of chronic active hepatitis and primary biliary cirrhosis associated with the anti-phospholipid antibody syndrome: a case report

An understanding of the pathogenesis of mixed types of chronic active hepatitis and primary biliary cirrhosis is important for the treatment of the patients. A 40-year-old Japanese woman with antiphospholipid syndrome has been treated with prednisolone for two years since she was diagnosed as having a mixed type of chronic active hepatitis and primary biliary cirrhosis. Biochemical tests for liver function were normal during treatment. Laparoscopy revealed a white liver, and histology demonstrated disappearance of the findings of piecemeal necrosis or chronic nonsuppurative destructive cholangitis in the specimen. Steroid treatment of patients with mixed types of chronic active hepatitis and primary biliary cirrhosis is controversial, since it is contra-indicated in some. Although the clinical features of the patients varies from one to another, this case suggests that the autoimmune mechanism of some patients may resemble autoimmune hepatitis rather than primary biliary cirrhosis, and treatment with steroid is effective.

[Development and medical application of Er-YAG laser]

Result of developments of Er-YAG laser and its delivery system were reported. Er-YAG laser's wavelength is 2.94 microns, the beam absorption rate by water is higher than other laser beam. Er-YAG laser has repeated pulse oscillation, pulse width is 400 mu, sec, the repeat frequency is between 5 to 10 pulse per second. The mean power is 4 W maximum, 10 pps. The fibers of laser are made of zirconium-F-glass. We carried out a study on the possible application of the Er-YAG laser on the rabbit arteries and myocardium and human arteries were examined in vitro. Very clear cuts were observed on the histological examination. There were no evidence of thermal damage, no carbonization on the sharp cutting surface. Experimental result showed that Er-YAG lasers had good potential for angioplastic laser.

Butyrolactone I, a selective inhibitor of cdk2 and cdc2 kinase

We screened cdc2 kinase inhibitors from cultured mediums of micro organisms using purified mouse cyclin B-cdc2 kinase and a specific substrate peptide for cdc2 kinase. A selective inhibitor of cdc2 kinase was isolated from the cultured medium of Aspergillus species F-25799, and identified as butyrolactone I. Butyrolactone I inhibited cdc2 and cdk2 kinases but it had little effect on mitogen-activated protein kinase, protein kinase C, cyclic-AMP dependent kinase, casein kinase II, casein kinase I or epidermal growth factor-receptor tyrosine kinase. Its inhibitory effect was found to be due to competition with ATP. Butyrolactone I selectively inhibited the H1 histone phosphorylation in nuclear extracts. It also inhibited the phosphorylation of the product of retinoblastoma susceptibility gene in nuclear extracts and intact cells. Thus butyrolactone I should be very useful for elucidating the function of cdc2 and cdk2 kinases in cell cycle regulation.

Distant metastasis of hepatocellular carcinoma after successful treatment of the primary lesion

Recent advances in both diagnosis and treatment of hepatocellular carcinoma (HCC) have improved the prognosis and changed the clinical significance of the subsequently increasing distant metastases. Of 163 patients with HCC, 76 (47%) were treated successfully. The cumulative recurrence rate in these patients was 65% after 3 years, and 82% after 5 years. Six patients with HCC in whom distant metastases were detected after successful treatment of the primary lesion, are reported. Two patients underwent curative surgical resection, and four cases were treated medically, resulting in a 31.9 to 94.3% reduction in tumor size in the CT scan image. Distant metastases without intrahepatic recurrence were diagnosed 10 to 46 months after the treatment of the primary lesions. The sites of the metastases included bone 3; lung 2; and adrenal gland 1. Distant metastases found after successful treatment of the primary lesions are of great clinical significance for the treatment of HCC.

[Postoperative pain relief by preanesthetic administration of buprenorphine suppository in elective mastectomy]

Seventy female patients scheduled for elective mastectomy were divided into three groups: Buprenorphine suppository (BPS) 0.4 mg group (n = 29); BPS 0.2 mg (n = 23) group; and control (scopolia extract and tannic acid suppository) group (n = 18). Suppositories were administered rectally to patients of each group one hour before induction of anesthesia. Plasma buprenorphine concentrations, sedation scores at entering the operating room, postoperative pain scores and side effects were evaluated. There were no significant differences in sedation effects of suppository among the three groups. Although there were significant differences in pain scores except at the time when patients left the operating room between BPS 0.2 mg group and the control group, postoperative pain relief in BPS 0.2 mg group was judged not enough. However, postoperative pain relief was more satisfactory in the BPS 0.4 mg group. Plasma concentrations of the BPS 0.4 mg group were higher than those of the BPS 0.2 mg group. Although nausea and vomiting were observed in 5 patients (17.2%) of the BPS 0.4 mg group and 4 patients (17.4%) of the BPS 0.2 mg group, respiratory depression and changes in blood pressure and heart rate were not observed in all groups. In conclusion, preanesthetic administration of the BPS 0.4 mg seemed to be useful for postoperative pain relief after elective mastectomy.

[Introduction of intra-aortic balloon pumping catheter through left subclavian artery guided by trans-esophageal echocardiography]

It is very difficult to insert an intra-aortic balloon pumping catheter into the descending aorta through the subclavian artery by the blind technique. But the technique with the guidance by trans-esophageal echocardiography to introduce the balloon into the descending aorta was simple and useful.

Successful trimethoprim-sulfamethoxazole therapy in a patient with hyperimmunoglobulin E syndrome

A male patient with hyperimmunoglobulin E syndrome is described. Recurrent lymphadenitis and cutaneous staphylococcal abscesses were resistant to various antibiotics, and chemotaxis and hydrogen peroxide production of polymorphonuclear leukocytes were impaired. Following trimethoprim-sulfamethoxazole therapy, he was free from the above infections, and impaired polymorphonuclear leukocyte functions recovered and serum IgE decreased to approximately one-fifth of its initial level. Subsequent irregular medications, however, resulted in impairment of polymorphonuclear leukocyte functions and an increased serum IgE concentration, which recovered after regular resumption of trimethoprim-sulfamethoxazole treatment. From these results, the beneficial effects of trimethoprim-sulfamethoxazole in hyperimmunoglobulin E syndrome are clinically apparent, but in vitro studies failed to demonstrate the positive effect of trimethoprim-sulfamethoxazole on polymorphonuclear leukocytes and their mechanism still remains to be elucidated.

Demonstration of initiation potential of carcinogens by induction of preneoplastic glutathione S-transferase P-form-positive liver cell foci: possible in vivo assay system for environmental carcinogens

In a development trial for an initiation bioassay system, 7 known carcinogens and 1 suspected carcinogen were examined. In experiment 1, group 1 animals were initially subjected to partial hepatectomy (PH) 12 h before administration of diethylnitrosamine, 2-amino-3-methylimidazo[4,5-f]-quinoline (IQ), captafol, alpha-hexachlorocyclohexane or diethylstilbestrol (DES), then 2 weeks later underwent a promotion procedure comprising administration of phenobarbital (0.05% in diet) for 8 weeks and D-galactosamine (300 mg/kg, i.g.) at week 3. Group 2 received the promotion protocol alone as in group 1. Initiating potential was assayed on the basis of significant increase in values of preneoplastic placental form glutathione S-transferase-positive (GST-P+) foci of more than 3 cells in cross section at week 10. Numbers and areas of GST-P+ foci in group 1 given IQ, captafol and DES were significantly increased as compared to group 2, confirming the validity of the protocol as an initiation assay. In Experiment 2, group 1 rats were subjected to PH and 12 h later received a suspected carcinogenic mixture of opium pyrolysate (OP) or carcinogenic pesticide p,p'-dichloro-diphenyltrichloroethane or hexachlorobenzene. Application of a modified promotion procedure comprising cholic acid (0.15%) and carbon tetrachloride (1 ml/kg, i.g.) revealed significant initiation potential for OP. Overall the results indicate that the current protocols may be useful for detection of the initiation potential of carcinogens irrespective of their mutagenicity.

[Evaluation of the peripheral circulation during surgery by the difference between the central and peripheral temperature]

The peripheral circulation during surgery was evaluated by the difference between rectal and sole deep temperature (RT-SDT) in 160 patients. Moreover it was investigated whether the peripheral circulation is influenced by the operation site, the method of anesthesia, the age of patient, the volume of infusion and blood loss. In many patients during intracranial, thoracic and upper abdominal surgeries, RT-SDT dissociated with time. But the change of RT-SDT varied with the anesthetic method. During upper abdominal surgery, RT-SDT tended to dissociate wtih the halothane (H) or enflurane (E)+N2O anesthesia and the wide dissociation was observed with fentanyl+droperidol+N2O anesthesia (NLA) on and after the 4th hour during the surgery. In contrast, RT-SDT continued to converge throughout the surgery in H or E+N2O+epidural anesthesia. The influence on RT-SDT of age, volume of infusion and blood loss, varied with the anesthetic method also. RT-SDT on the 4th hour during surgery correlated with the age of the patient, the volume of infusion in the H+N2O anesthesia, and with the volume of blood loss under NLA. The peripheral circulation during the surgery is affected seriously by anesthesia and the site as well as time of the operation. Therefore the anesthetic method should be selected in consideration of the type, length and site of operation. Some counter-measures should be taken in order to maintain good peripheral circulation in long operations.

Thrombosis-inducing activity--a factor which appears in plasma of patients with allergic asthma during attack

Thrombosis-inducing activity (TIA) is a factor which was recently identified in plasma from patients with advanced lung cancer and acute respiratory tract infection. In the present study, TIA was measured during periods of attack and nonattack in patients with the allergic and nonallergic type of asthma and pulmonary emphysema with an asthmatic component. In the allergic type of asthma, the attack was accompanied by the appearance of TIA, but when the attack ended it disappeared from plasma. In the nonallergic type of asthma and emphysema with an asthmatic component, TIA remained negative even during the attack. These observations indicate that TIA has some correlations with allergic asthma.

Retinal degeneration induced by N-methyl-N-nitrosourea and detection of 7-methyldeoxyguanosine in the rat retina

Retinal degeneration induced by a single parenteral dose (40 mg) of N-methyl-N-nitrosourea (MNU) was studied in rats and rabbits. Sequential observations showed that severe pathological changes, that is, complete or widespread destruction of the photoreceptor layer and the outer nuclear layer of the retina, occurred in both animals by 72 hr after the administration of MNU. At week 5, at the end stage of the retinal degeneration induced by MNU, thin remnants remained with the inner nuclear layer in direct contact with the pigment epithelium. An additional immunohistochemistry study using antibodies against 7-methyldeoxyguanosine (7-mdGua), revealed the presence of high levels of 7-mdGua DNA adducts in the nuclei of the outer nuclear layer cells. This finding suggests that the alkylation of the outer nuclear layer by MNU was the direct cause of the retinal degeneration seen in these animals.

[Thrombosis-inducing activity (TIA) in plasma of a patient with lung cancer, which disappeared after radiotherapy]

A 58-year-old man had been suffering from persistent right shoulder pain was admitted following detection of a Pancoast tumor in the right lung. On admission, there was elevation of peripheral platelet count, plasma FDP and fibrinogen levels and thrombosis-inducing activity (TIA) was detected in his plasma. After receiving 30 Gy of Liniack, the mass shadow and the shoulder pain disappeared, which was accompanied by the normalization of laboratory data and the disappearance of TIA from plasma. However, plasma TIA became positive again one month later, in association with reappearance of shoulder pain and elevation of FDP and fibrinogen levels, which were considered due to recurrence of the tumor, 30 Gy of Liniack together with thermotherapy was again given. There was no subsequent recurrence of tumor, nor TIA has been detected for more than 3 years.

Neosporosis in the aborted fetus and newborn calf

Protozoal encephalitic lesions were found in four aborted fetuses and one dead newborn calf. The organism was identified as Neospora caninum by immunoperoxidase. The brain lesions were of two forms. One was observed in three fetuses of 5 months gestation and was characterized by multifocal necrosis. The other was found in a 7-month fetus and in a newborn calf, and showed severe infiltration with macrophages and plasma cells containing IgG. This association, between the age of fetus and inflammation, may reflect development of the immune system in bovine fetuses.

pH-dependent flagella formation by facultative alkaliphilic Bacillus sp. C-125

A facultative alkaliphilic strain of Bacillus sp. C-125 grown at alkaline pH had many sinuous peritrichous flagella and was highly motile. However, most of the cells grown initially at pH 7 were non-motile and possessed few straight flagella. The amount of flagellin was low when the organism was grown at pH 7, suggesting that non-motility is due to poor synthesis of flagellin. The molecular mass of the flagellin was 37 kDa and the isoelectric point was pH 5.0. The amino acid composition of the flagellin was similar to that found in the flagellin from neutrophilic Bacillus subtilis 168.

cdc2-like kinase is associated with the retinoblastoma protein

The growth-suppressive activity of the retinoblastoma (RB) protein is suggested to be regulated by phosphorylation. In studies on the kinase that phosphorylates the RB proteins, we have previously found that RB proteins can be phosphorylated by purified cdc2 kinase. In this study, we noted that RB proteins immunoprecipitated from human cell lysates are weakly phosphorylated in the absence of purified cdc2 kinase. Immunoblot analysis showed the presence of p34cdc2 in the immunoprecipitates with anti-RB monoclonal antibody. In addition, the coprecipitated kinase was found to have the same substrate specificity as cdc2 kinase. The associated kinase activity was particularly high in cells arrested in G1/S and S phase by aphidicolin. Furthermore, RB proteins were shown to be phosphorylated in nuclear extracts by some endogenous cdc2-like kinase(s). These results suggest that cdc2-like kinase is the main kinase for phosphorylation of RB proteins in vivo.

Arterial ketone body ratio during and after cardiopulmonary bypass

This study is the first to investigate the alteration in hepatic function during and after cardiopulmonary bypass in 30 patients by measuring the arterial ketone body ratio, an index of mitochondrial redox potential (oxidized nicotinamide-adenine dinucleotide/reduced nicotinamide-adenine dinucleotide). Although the preoperative arterial ketone body ratio was within normal limits (1.24 +/- 0.63), it decreased markedly 5 minutes after the start of cardiopulmonary bypass to 0.35 +/- 0.12 and remained at this low level throughout bypass. After bypass it continued to rise in a time-dependent fashion, returning to its preoperative level by the morning of the second postoperative day in normal convalescent patients. However, the ratio recovered more slowly in patients who required prolonged circulatory or respiratory support than in other patients. Thus we suggest that cardiopulmonary bypass had deleterious effects on the hepatic mitochondrial redox potential, which may contribute to homeostatic derangements and metabolic abnormalities.

[An experimental study of excimer laser angioplasty]

An excimer laser, which is a pulsed ultraviolet laser and ablates tissue precisely with no thermal injury, is expected to coronary laser angioplasty. We transmitted XeCl excimer laser (308 nm) via a 400 microns fused silica fiber. In the first experiment, we studied about excimer laser ablative effects to normal canine arteries and atherosclerotic rabbit aortas, and about healing responses following excimer laser irradiation in both models. Surfaces after excimer laser ablation were slightly rough but no thermal injury was found in the media. And for healing process of normal canine arteries, endothelial cells appeared at 3 weeks and completely covered surfaces with fibrointimal ingrowth at 3 months. In the rabbit aortas, at 3 weeks there was reconstruction of the surface. At 2 months no accelerated atherosclerotic or aneurysmal changes were observed. In the second, with this excimer laser (short pulse) and 400 microns fused silica fibers (distal fiber-end power: 3-6 mJ/pulse), we performed transluminal laser angioplasty to recanalize totally occluded canine femoral arteries under an angioscopic guidance. We cold recanalize 8 of 9 totally occluded arteries with no thermal injury of adjacent tissue, though perforations were observed in 7 of 9 arteries. In the third, we used a newly-developed long pulse excimer laser, with which distal fiber-end energy was about 3 to 4 times as much as the short pulse one, to recanalize totally occluded canine arteries. In result, recanalization was performed in 6 of 8 arteries rapidly with little thermal injury. However, we observed perforations in 6 of 8 arteries like the short pulse one. Multifiber catheter ("over the wire system") coupled with this long-pulse excimer laser was used to reconstruct stenotic iliac arteries of atherosclerotic rabbit models. The procedure was successful in all the 5 rabbits. In conclusion, our preliminary results suggested that further developments of a more powerful and longer pulse-duration excimer laser, optic delivery system and guidance system would make excimer laser angioplasty safer and more effective method in the near future.