Interleukin-1 beta independently stimulates production of prostaglandin E2 and cyclic AMP from human decidual cells

Interleukin-1 beta (IL-1 beta) increased the production of cyclic AMP and prostaglandin E2 (PGE2) by cultured human decidual cells during 24 h of stimulation, but not over short incubation times (< 6 h). At concentrations of IL-1 beta ranging from 1 to 100 pg/ml, there were parallel changes in cyclic AMP and PGE2 levels, but 1000 pg of IL-1 beta/ml inhibited cyclic AMP production while still stimulating PGE2 synthesis. The possible link between cyclic AMP and PGE2 was therefore studied further. Inhibition of IL-1 beta-stimulated PGE2 synthesis by indomethacin and direct addition of PGE2 had no effect on cyclic AMP levels, indicating that PGE2 did not increase cyclic AMP production by human decidual cells and confirming the independent synthesis of cyclic AMP and PGE2. The increase in cyclic AMP production induced by IL-1 beta is dependent on protein synthesis, but it is not known which component of the adenylate cyclase is increased. A phosphodiesterase inhibitor potentiated the effects of IL-1 beta on cyclic AMP synthesis, indicating that the cytokine may increase cyclic AMP metabolism. We suggest that high concentrations of IL-1 beta activate phosphodiesterase activity more than adenylate cyclase, which gives rise to the low levels of cyclic AMP noted above. IL-1 beta also decreased forskolin-stimulated cyclic AMP production, which again indicates increased cyclic AMP metabolism. Since most concentrations of IL-1 beta alone increased cyclic AMP levels, this stimulation must out-weigh the increase in metabolism apparent in the presence of forskolin, phosphodiesterase inhibitor or high levels of interleukin. It is clear that IL-1 beta increased decidual PGE2 production independently of cyclic AMP, and that other second messenger must mediate the action of this cytokine.

Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: comparison with electrocardiographic and thallium exercise stress test results

OBJECTIVES

This study was designed to compare the usefulness of electron beam computed tomography for prediction of coronary stenosis with that of electrocardiographic (ECG) and thallium exercise tests.

BACKGROUND

Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet to be established.

METHODS

Using the volume mode of electron beam computed tomography, we studied 251 consecutive patients who underwent elective coronary angiography because of suspected coronary artery disease and compared the results with those of ECG and thallium exercise tests. The total coronary calcification score was calculated by multiplying the area ( > or = 2 pixels) of calcification (peak density > or = 130 Hounsfield units) by an arbitrarily weighted density score (0 to 4) based on its peak density. The mean of two scans was log transformed.

RESULTS

Calcification was first noted in women in the 4th decade of life, approximately 10 years later than its occurrence in men. Among patients with advanced atherosclerosis (two- and three-vessel disease), calcification scores were uniformly high in women but ranged widely in men. Nine percent of patients with significant stenoses ( > or = 75% by densitometry) had no calcification. The calcification scores of patients with significant stenosis in at least one vessel were significantly higher than those of patients without significant stenosis in the study group as a whole and in most patient subgroups classified according to age and gender. A cutoff calcification score for prediction of significant stenosis, determined by receiver operating characteristic curve analysis, showed high sensitivity (0.77) and specificity (0.86) in all study patients; sensitivity was similarly high even in older patients ( > or = 70 years) and was enhanced in middle-aged patients (40 to < or = 60 years). The difference in specificity between calcification scores and ECG exercise test results had borderline significance (p = 0.058) and that between calcification scores and thallium test results was significant (p = 0.001). The latter difference became small but remained significant (p = 0.01) even after the reevaluation of thallium test results in light of each subject's clinical data.

CONCLUSIONS

Quantification of coronary artery calcification with electron beam computed tomography noninvasively predicted angiographically confirmed coronary stenosis. Results obtained with this method were at least as useful and potentially better in some patient groups than those obtained with thallium and ECG exercise testing.

Effects of cervical spinal cord stimulation on glucose consumption in patients with posttraumatic prolonged unconsciousness

The effects of cervical spinal cord stimulation (CSCS) on glucose consumption were examined in two patients with prolonged disturbance of consciousness due to head injuries. Several clinical parameters, including glucose consumption using positron emission tomography (PET) with [18F]2-fluoro-2-deoxy-D-glucose (FDG), were compared before and after CSCS. After a 4-month period of stimulation, one patient (Case 1) regained consciousness and began to speak, but the other patient (Case 2) showed no improvement in consciousness level. Computed tomography and magnetic resonance imaging showed Case 1 had no abnormalities in the thalamus and brainstem and no diffuse brain atrophy. Case 2 had a low density area in the left thalamus and enlargement of the aqueduct with diffuse atrophy of the left cerebral hemisphere. Cerebral blood flow studies and electrophysiological examinations revealed no remarkable change after CSCS. The PET study showed an increase in FDG uptake in the hypothalamus and the thalamus in both patients, but an increase in FDG uptake in the left cingulate gyrus and left frontal lobe was observed only in Case 1. These observations suggest that activation of the ascending reticular activating system, hypothalamus, thalamus, cingulate gyrus, and frontal cortex, and the preservation of the fiber connections between the limbic system and the thalamus and hypothalamus are important for CSCS treatment to improve the level of consciousness.

Endothelin-1 regulates human decidual cells through both A- and B-type receptors

The aims of this study were to investigate the effects of endothelin-1 (ET-1) on first trimester human decidual cells, identify the ET receptor sub-types through which these effects are mediated and assess the role of cyclic AMP in any effects of ET-1. ET-1 increased prostaglandin production by first trimester decidual cells, which was consistent with similar studies in third trimester decidual cells. The endothelin A-type receptor (ETA) was coupled to the increased prostaglandin production from first trimester cells, as shown by the inhibitory effects of BQ610, an ETA receptor antagonist. The time course of this effect was unusual, with a rapid increase peaking after 6 h of stimulation, followed by a longer effect over 12-24 h, which was paralleled by changes in cyclic AMP production. No evidence was obtained for any involvement of cyclic AMP in mediating the effects of ET-1 on prostaglandin production. ET-1 also increased decidual prolactin production with a maximum effect after 6 h of stimulation. This was mediated through the ETB receptor and may be linked to increased cyclic AMP production, indicating that the ETA and ETB receptors were coupled to different second messenger systems and affected decidual cell function in different ways.

Delineation of producing ability of IgG and IgA subclasses by naive B cells in newborn infants and adult individuals

Neonatal B cells with the naive (sIgD+) phenotype are able to generate IgG- and IgA-producing cells as well as IgM production in the presence of memory CD4+ T cells expressing L-selectin (CD62L) in pokeweed mitogen-stimulated cultures. We used this system to examine comparatively the ability of naive B cells to produce IgG and IgA subclasses in newborn infants and adult individuals. Naive B cells were enriched from both donors on the basis of sIgD positivity, and memory (CD45RO+) CD4+ T cells with CD62L expression were isolated from adults. We here demonstrate some differences in profiles of IgG and IgA subclass production between neonatal and adult naive B cells. In neonatal B cells, IgG1 and IgG3 were predominantly produced, but IgG2 and IgG4 production was virtually absent. Similar to neonatal B cells, adult naive B cells produced mainly IgG1 and IgG3, although memory (sIgD-) B cells from adults secreted all of the IgG subclasses. It should be noted that low but detectable levels of IgG2 and IgG4 were found in adults' naive B cell cultures. Although IgA produced by neonatal B cells was exclusively IgA1, IgA2-secreting cells were identifiable in adult naive B cells. The results suggest that further class switch of naive B cells to IgG2, IgG4 and IgA2 in addition to IgG1 and IgG3 may be controlled by their own age-dependent maturation process.

[Expression of proliferating cell nuclear antigen (PCNA) in renal cell carcinoma]

PURPOSE

The objective of this study is to evaluate the relationship among PCNA positive ratio, pathological findings, nuclear DNA contents, and prognosis in renal cell carcinoma. Immunohistochemical analysis using the monoclonal antibody of PCNA were performed on a total number of 151 formalin-fixed paraffin-embedded samples (1-7 samples with a mean of 3.8) from 40 renal cell carcinomas. The percentage of PCNA positive cancer cells to the total amount of cancer cells was expressed as labeling index (LI; %). By means of flow cytometry we analysed nuclear DNA contents from the same samples.

RESULTS

1) LIes in pathological grades were 2.79 +/- 3.33% (mean +/- SD) for grade 1 (n = 16), 5.63 +/- 4.08% for grade 2 (n = 20), and 9.95 +/- 4.59% for grade 3 (n = 4). There was significant difference between grade 1 and grade 3 (p < 0.05). 2) LIes in pathological stage were 3.22 +/- 3.05% for pT2 (n = 22) and 7.01 +/- 4.99% for pT3 and pT4 (n = 18) (p < 0.05). 3) There was no significant correlation between LI and lymph node involvement. And there was no significant correlation between LI and distant metastasis, either. 4) LIes in nuclear DNA contents were 2.41 +/- 3.14% for DNA diploid (n = 17) and 6.80 +/- 4.29% for DNA aneuploid (n = 23) (p < 0.05). 5) It was suggested that LI was shown to vary according to the parts in a given tumor examined in parallel with tumor heterogeneity of nuclear DNA content. 6) The 5-year cause-specific survival rate of the patients with LI > or = 5.0% (n = 15) was 40%, while that with LI < 5.0% was 74% (n = 25) (p < 0.05).

CONCLUSION

These findings suggest that LI, which was determined by immunohistochemical analysis using PCNA antibody indicates a growth potential of renal cell carcinoma and is available for estimating malignant potential.

An essential role of prostaglandin E on mouse mast cell induction

We previously established a system for induction of mucosal-type mast cells from mouse spleen cells by long term culture without exogenous IL-3. FCS was important and was able to be divided into mast cell-inducible and non-mast cell-inducible sera. LPS contaminated in FCS was responsible for the mast cell induction. However, we unexpectedly found that both supernatants recovered from the cultures with mast cell-inducible and non-mast cell-inducible sera contained endogenous IL-3. Furthermore, addition of rIL-3 to the cultures with non-mast cell-inducible sera had no effect or induced only a small number of mast cells. This indicates that IL-3 alone is not enough for mast cell induction and that some inflammatory factor(s) induced by LPS is also essential. Prostaglandin E1 (PGE1) and PGE2 induced mast cells in a dose-dependent manner when added into the cultures. The activity of LPS for mast cell induction was inhibited by indomethacin. However, indomethacin failed to inhibit the mast cell induction by exogenous PGE. Exogenous PGE antagonized the indomethacin-induced inhibition of mast cell induction by LPS. Cholera toxin and dibutyryl cyclic AMP (cAMP) also induced mast cells. The A and B subunits of cholera toxin, PGF2 alpha, PGD2, and dibutyryl cGMP failed to induce mast cells. Furthermore, mast cell induction by PGE was dose-dependently suppressed by inhibitors for cAMP-dependent A kinase. The above results show that for mast cell induction, IL-3 needs the cooperation of PGE or other stimulants that can elevate the production of the second messenger cAMP in mast cell precursors.

An essential role of prostaglandin E on mouse mast cell induction

We previously established a system for induction of mucosal-type mast cells from mouse spleen cells by long term culture without exogenous IL-3. FCS was important and was able to be divided into mast cell-inducible and non-mast cell-inducible sera. LPS contaminated in FCS was responsible for the mast cell induction. However, we unexpectedly found that both supernatants recovered from the cultures with mast cell-inducible and non-mast cell-inducible sera contained endogenous IL-3. Furthermore, addition of rIL-3 to the cultures with non-mast cell-inducible sera had no effect or induced only a small number of mast cells. This indicates that IL-3 alone is not enough for mast cell induction and that some inflammatory factor(s) induced by LPS is also essential. Prostaglandin E1 (PGE1) and PGE2 induced mast cells in a dose-dependent manner when added into the cultures. The activity of LPS for mast cell induction was inhibited by indomethacin. However, indomethacin failed to inhibit the mast cell induction by exogenous PGE. Exogenous PGE antagonized the indomethacin-induced inhibition of mast cell induction by LPS. Cholera toxin and dibutyryl cyclic AMP (cAMP) also induced mast cells. The A and B subunits of cholera toxin, PGF2 alpha, PGD2, and dibutyryl cGMP failed to induce mast cells. Furthermore, mast cell induction by PGE was dose-dependently suppressed by inhibitors for cAMP-dependent A kinase. The above results show that for mast cell induction, IL-3 needs the cooperation of PGE or other stimulants that can elevate the production of the second messenger cAMP in mast cell precursors.

The possibility of clinical application of the thromboxane A2 synthase inhibitor, ozagrel, for the treatment and prevention of preeclampsia: a preliminary report

OBJECTIVES

This study was performed to investigate whether the TXA2 synthase inhibitor, ozagrel, was effective in the treatment and prevention of pre-eclampsia.

STUDY DESIGN

Ozagrel was administrated therapeutically to 4 severely pre-eclamptic women, and prophylactically to 5 pregnant women with histories of severe preeclampsia and complications.

RESULTS

The therapeutic administration (TA) of ozagrel improved hypertension and proteinuria. Two patients delivered appropriate-for-date (AFD) infants, whereas the other 2 patients delivered light-for-date (LFD) infants. Mean plasma concentrations of TXB2 (plasma TXB2) decreased, whereas plasma 6-keto PGF1 alpha were almost unchanged. The prophylactic administration (PA) of ozagrel prevented the occurrence of preeclampsia in 3 of the 5 patients. All delivered AFD infants. The duration of pregnancy was prolonged more than that of previous pregnancies in all patients. Plasma TXB2 decreased, whereas plasma 6-keto PGF1 alpha increased.

CONCLUSIONS

PA prevented preeclampsia and intrauterine growth retardation, whereas TA improved only maternal symptoms. These results might justify a large prospective study to determine whether ozagrel is an effective prophylactic.

Differential protective action of cytokines on radiation-induced apoptosis of peripheral lymphocyte subpopulations

It is established that soluble factors involved in cell growth can prevent apoptosis of hematolymphoid cell lines in factor-deprived situations. The present study investigates the possible protective effects of various cytokines on radiation-induced apoptosis of apparently quiescent lymphocyte subpopulations. The exposure to gamma-irradiation resulted in appreciable apoptotic changes in all of lymphocyte subpopulations. Natural killer (NK) cells were the most radiosensitive, whereas CD8+ T and B cells showed weaker susceptibility to radiation and CD4+ T cells were relatively radioresistant. The radiation-induced apoptosis in NK cells was significantly inhibited by IL-2. In addition to IL-2, IL-4 and IL-7 rescued both CD4+ and CD8+ T cells from radiation-induced cell death. The viability of B cells was maintained by the presence of IL-4 but not others in culture. Furthermore, we conclude that the protective effect by each cytokine on radiation-induced apoptosis might be partly attributed to enhancement of cellular expression of bcl-2 protein.

[A case of duodenal duplication and a review of reported cases]

We report a case of duodenal duplication and review of literatures on 43 cases reported in Japan including ours. A 34-year-old female who was admitted with chief complaints of epigastric pain and hematoemesis. An endoscopic examination and a hypotonic duodenography revealed a protruding tumor with bleeding ulcer. Wedge resection of the duodenum, including the lesion, was performed. A diagnosis of duodenal duplication was made by histopathological examination.

Deterioration of mechanical properties of composite resins

The deterioration of the mechanical properties of composite resins was examined. The bending strength and the stress relaxation rate for sixteen experimental composite resins with different filler shapes, particle sizes and filler contents immersed in distilled water for 0-60 days were measured. The bending strength of all of the composites decreased with the increase of the immersion time in water. The composites with a high filler content (65 vol%) showed a greater decreasing ratio of bending strength than those with low filler content (40 vol%). The stress relaxation rate also increased with and increase of immersion time. The phenomena may be caused by the hydrolytic degradation of the silane coupling agent (gamma-MPTMS).

Metabolism of gemcitabine in rat and dog

1. The metabolism of 14C-gemcitabine in the male rat has been studied after intravenous administration of a single dose (10 mg/kg) or five doses (1 mg/kg/day) of 14C-gemcitabine. The metabolism in male dog has been studied after only single dosing. The effects of gemcitabine on hepatic drug-metabolizing enzymes in rat has also been studied. 2. The concentration of gemcitabine in the plasma was 11.84 micrograms/ml at 5 min, and then rapidly decreased after a single administration to rat. A deaminated uracil analogue of gemcitabine progressively increased with time. Gemcitabine and the uracil metabolite accounted for 80.0 and 11.8% of the radioactive dose in the 0-24-h urine samples respectively. Gemcitabine was the major component identified in lung, liver and kidney at 5 min after administration. 3. After repeated administration to rat, metabolites in the plasma and tissues were not remarkably different from those found after a single administration. 4. After a single administration to dog, the plasma concentration of gemcitabine was 12.39 micrograms/ml at 5 min. Gemcitabine and the uracil metabolite accounted for 8.3 and 71.8% of the dose in the 0-24-h urine samples respectively. 5. No differences were observed in enzymatic activities per whole liver between the gemcitabine-treated and control rat.

Neural cell adhesion molecule and perineural invasion in gallbladder cancer

To clarify the role of neural cell adhesion molecule (NCAM) in perineural invasion, NCAM expression was studied by immunohistochemical staining in 26 cases with gallbladder cancer. In gallbladder cancer, the incidence of perineural invasion and that of positive NCAM expression was 42% and 31%, respectively, which are less frequent than those of bile duct cancer in our previous report. Perineural invasion was observed in 88% of the patients with positive expression of NCAM and in 22% of those with negative expression. The former is similar to that of bile duct cancer but the latter is significantly lower. Eighty percent of the cancer cells that invaded the perineural space were positive for NCAM, when the primary tumor was positive for NCAM expression. Therefore, in gallbladder cancer, positive cells in NCAM expression likely invade the perineural spaces. However, the perineural invasion of negative cells in NCAM expression is not likely to occur as compared to bile duct cancer. In conclusion, perineural invasion in gallbladder cancer is not as common as in bile duct cancer, but the role of NCAM in perineural invasion is more important in gallbladder cancer than in bile duct cancer.

Interleukin-1 beta-stimulated prostaglandin synthesis by human decidual cells is independent of protein kinase C

Basal prostaglandin E2 (PGE2) synthesis by human decidual cells was stimulated by phorbol myristate acetate (PMA) which activates protein kinase C. Staurosporine, which is an inhibitor of protein kinase C in most systems, also increased basal PGE2 synthesis. Further work is needed to explain this finding, as another inhibitor of protein kinase C, H7, inhibited PGE2 production under similar culture conditions. Interleukin-1 beta (IL-1 beta)-stimulated PGE2 synthesis was potentiated by coincubation with PMA or staurosporine, indicating that IL-1 beta and protein kinase C increase decidual PGE2 synthesis through different mechanisms. Desensitization of the decidual cells for 24 h with PMA did not affect IL-1 beta-stimulated PGE2 synthesis. The complex roles of protein kinase C in regulating decidual prostaglandin synthesis require further investigation, but it is clear that the effects of IL-1 beta are not mediated by protein kinase C.

Kawasaki disease with a concomitant primary Epstein-Barr virus infection

A two year old boy exhibited not only clinical manifestations which suggested a recurrence of Kawasaki disease (KD) but also evidence of a primary infection by Epstein-Barr virus (EBV) including tonsillitis, splenomegaly and atypical lymphocytosis in the peripheral blood. An inverted CD4/CD8 ratio in lymphocyte subsets suggested the presence of infectious mononucleosis (IM). Epstein-Barr virus titers (viral capsid antigen-immunoglobulin G 1:20; Epstein-Barr virus-associated nuclear antigen < 1:10) showed an acute EBV infection and the presence of EBV genome in the blood was determined by the polymerase chain reaction technique. In Japan, the peak incidence of KD and IM is in children under 4 years of age. From the investigation of EBV titers, it has been reported that some patients with KD develop an associated, unusual primary EBV infection. Kawasaki disease concurrent with a primary EBV infection as in this case, suggests the possibility of an etiologic agent related to the KD rather than to the EBV infection itself.

Activities of phospholipase A2, cyclooxygenase, and PGI2 synthase of umbilical venous endothelial cells in preeclamptic women

To elucidate the cause of low prostacyclin (PGI2) production in severe preeclampsia (PE), we studied the activities of phospholipase A2, cyclooxygenase, and PGI2 synthase in umbilical venous endothelial cells obtained from healthy pregnant women and from patients with mild or severe PE. Umbilical venous endothelial cells homogenized in a buffer solution were analysed by calculating the apparent Vmax (mean +/- SEM: p mol/min mg protein) and Km (mean +/- SEM: microM) values for phospholipase A2 activity by the release of arachidonic acid from phosphatidylcholine, for the activity of a complex of cyclooxygenase and PGI2 synthase by the conversion of arachidonic acid to PGI2, and the activity of PGI2 synthase by conversion of PGH2 to PGI2. The phospholipase A2 activity of normal-pregnancy cells (Vmax: 17.0 +/- 2.7 Km: 0.26 +/- 0.04) (n = 10) significantly exceeded that of cells from women with either mild PE (5.8 +/- 0.5, 0.12 +/- 0.02) (n = 4) or severe PE (6.3 +/- 2.0, 0.08 +/- 0.03) (n = 5). The apparent combined activity of cyclooxygenase and PGI2 synthase in mild PE (552 +/- 142, 0.29 +/- 0.07) (n = 8) significantly exceeded that of a normal pregnancy (176 +/- 42, 0.76 +/- 0.25) (n = 7), whereas that in severe PE (326 +/- 36, 3.26 +/- 0.78) (n = 3) was significantly lower than that of a normal pregnancy. PGI2 synthase activity in mild PE (305 +/- 50, 0.12 +/- 0.07) (n = 4) exceeded that of a normal pregnancy (220 +/- 45, 0.13 +/- 0.06) (n = 5), whereas that in severe PE (55 +/- 12, 0.16 +/- 0.04) (n = 3) was lower than that of a normal pregnancy. The phospholipase A2 activity in cells of normal pregnant women exceeded that of cells of women with mild or severe PE. The combined activity of cyclooxygenase and PGI2 synthase in a normal pregnancy was lower than in mild PE, but higher than in severe PE. Similar results were found for PGI2 synthase activity; in normal pregnancy the activity was less than in mild PE, but higher than in severe PE.(ABSTRACT TRUNCATED AT 250 WORDS)

Ionizing radiation induces apoptotic cell death in human TcR-gamma/delta+ T and natural killer cells without detectable p53 protein

The p53 tumor suppressor gene has been shown to be involved in programmed cell death, apoptosis, in murine immature thymocytes after treatment with ionizing radiation. Ionizing radiation also induces apoptosis in peripheral mature lymphocytes. In this work, we investigated the p53 participation in radiation-induced apoptosis in human peripheral blood lymphocytes (PBL) subpopulations. Exposure to gamma-irradiation resulted in an appreciable induction of apoptotic cell death in TcR-alpha/beta+ (CD4+ and CD8+) T cells, TcR-gamma/delta+ T cells, B cells and natural killer (NK) cells, as assessed by DNA fragmentation as well as the morphological characteristics. Importantly, it was found that there was a marked difference among PBL subpopulations as regards the induction of p53 protein by gamma-irradiation. Similar to previous observations for murine thymocytes, p53 induction in TcR-alpha/beta+ T cells and B cells after gamma-irradiation was evident by Western blot analysis. Radiation-induced apoptosis in TcR-alpha/beta+ T cells and B cells was efficiently inhibited by cycloheximide, indicating the requirement of de novo protein synthesis, including p53 protein, for radiation-induced apoptosis in both subpopulations. In marked contrast, no identifiable levels of p53 protein were induced in either TcR-gamma/delta+ T or NK cells after gamma-irradiation. In addition, it was demonstrated that radiation-induced cell death in TcR-gamma/delta+ T and NK cells could be prevented by interleukin-2, but not by cycloheximide. These results imply that radiation-induced lymphocytic apoptosis can be mediated by p53-dependent or -independent mechanisms.

[Clinical study of autologous blood transfusion in pregnant women]

The effect of autologous blood donation during the third trimester of pregnancy on the maternal circulation, the properties of blood collected in a phosplatebuffered citrate anticoagulant solution, and the clinical outcome of autologous blood donation and transfusion for pregnant women were investigated in this study. Thirty-four pregnant women with placenta previa or previous cesarean delivery underwent phlebotomies in an autologous transfusion program. Three hundred ml of blood was collected under the observation of fetal heart rate patterns and uterine contractions from 3 weeks prior to the planned date of cesarean section and a total of 900 ml of blood was stored. Electronic fetal monitoring tracings were all normal and changes in blood pressure and pulse rates were minimal during the blood donation. The decrease in hemoglobin after the removal of 900 ml of blood was only 0.6g/dl on average during the 3 weeks, since the concentration of erythropoietin in serum and the counts of reticlocyte increased in a few days after blood removal. But there were no significant changes in TAT levels in serum. Twelve out of 34 pregnant women received the autologous blood transfusion during or after cesarean delivery and the homologous transfusions were avoided. The results of this study suggested that autologous blood transfusion for pregnant women with a high incidence of blood loss at delivery, such as placenta previa or previous cesarean delivery was safe and advantageous in avoiding homologous blood transfusion.

Placental transfer, lacteal transfer and plasma protein binding of gemcitabine

1. The placental transfer, lacteal transfer and plasma protein binding of gemcitabine have been studied in rat and dog after single intravenous administration of 10 mg/kg 14C-gemcitabine. 2. Radioactivity was distributed to the foetuses at 5 min after administration to rat on days 12 and 18 of gestation. The concentrations of radioactivity in the foetal liver, lung and kidney on day 18 of gestation were 4.0-6.4 times higher than in the maternal blood at 4 h after administration. Relatively high levels of radioactivity were noted in foetal tissues 24 h after administration, indicating slow elimination from the foetus. 3. The concentration of radioactivity in milk reached a maximum at 15 min after administration to the lactating rat on day 10 after delivery, then declined in a biphasic manner, and was below the detection limit at 48 h. The concentrations of radioactivity in milk were lower than plasma concentrations of radioactivity. 4. Plasma protein binding ratios were 10-16 and 1-7% between 5 min and 8 h after administration to the male rat and dog respectively. When fresh plasma from male rat, dog and adult man was spiked with 14C-gemcitabine at concentrations of 0.1-25 micrograms/ml, the plasma protein binding ratios were about 7% in both rat and dog, and 10% in man.

Malignant pleural mesothelioma presenting as achalasia

A 65-year-old man with an occupational history of asbestos exposure developed dysphagia and vomiting. Clinical examinations at onset revealed a dilated esophagus with smooth narrowing at the gastroesophageal junction and no apparent tumor in and around the esophagus. Achalasia was suspected. Dysphagia progressed gradually and examinations performed three months after the onset disclosed a tumor in the pleural and the peritoneal cavities. At laparotomy, the tumor extended from the pleural cavity into the peritoneal cavity. Histological examination of the biopsied specimen demonstrated malignant mesothelioma. We report the first case of malignant pleural mesothelioma presenting as achalasia.

Differential expression of bcl-2 and susceptibility to anti-Fas-mediated cell death in peripheral blood lymphocytes, monocytes, and neutrophils

The recently identified Fas antigen (Ag) is a cell surface molecule that can mediate apoptosis. The cytoplasmic product of proto-oncogene bcl-2 has been shown to prolong the cellular survival by inhibiting apoptosis. To elucidate the physiologic significance of expression of both molecules, we examined the expression of Fas Ag and bcl-2 on blood leukocyte populations and evaluated their sensitivity to the cytolytic action of anti-Fas antibody. Although Fas Ag was expressed on a fraction of lymphocytes, both neutrophils and monocytes expressed Fas Ag constitutively. In contrast, there was marked difference among these leukocytes regarding bcl-2 expression. Lymphocytes expressed bcl-2 intensely, but monocytes showed weaker bcl-2 expression, and neutrophils were essentially absent for bcl-2 expression. Seemingly reflecting this lack of bcl-2-expression, neutrophils more easily underwent apoptotic cell death in vitro as compared with monocytes and lymphocytes. We showed that anti-Fas antibody affectively accelerated apoptotic cell death in neutrophils. However, the apoptosis-inducing effect of anti-Fas antibody was minimal on monocytes, and lymphocytes were resistant to this antibody. These results suggest that anti-Fas-mediated cell death may, in part, be determined by bcl-2 expression status in Fas+ lymphoid and hematopoietic cells.

Disposition of gemcitabine in rat and dog after single and multiple dosings

1. The disposition of radioactivity has been studied in rat and dog after intravenous administration of a single 10 mg/kg dose or multiple 1 mg/kg/day doses of 14C-gemcitabine. 2. Radioactivity was eliminated from the blood in a biphasic manner with half-lives of approximately 2 and 15 h in both the male and female rat. The concentration of radioactivity in the blood 24 h after the fifth dose was 4.4 times higher than that found after the first dose. In the male dog, the concentration of radioactivity in the blood showed a plateau during the first 2 h post-dose administration. 3. Radioactivity was rapidly and widely distributed throughout the body in both the male and female rat at 5 min after administration. Radioactivity was rapidly eliminated from the tissues with no evidence of accumulation. 4. After 120h, male rat excreted 95.2 and 1.9% of the dose in the urine and faeces respectively. Similar excretion patterns were observed in female rat and male dog. In rat, excretion of radioactivity in the urine 24 h after daily dosing was nearly constant, but excretion of radioactivity in the faeces slightly increased with increasing number of doses.

Cushing's disease associated with adrenal myelolipoma, adrenal calcification and thyroid cancer

A 51-year-old woman with Cushing's disease associated with adrenal myelolipoma is reported. A further characteristic feature was the coexistence of bilateral adrenal calcification and thyroid cancer. Previously several cases of adrenal myelolipoma associated with endocrine dysfunction were reported. The combination of Cushing's disease and adrenal myelolipoma has only been described in two cases of recurrent Cushing's disease but never in an initial occurrence of Cushing's disease. Continued stimulation by excessive adrenocorticotropic hormone (ACTH) not only developed adrenal hyperplasia but also might be involved in the pathogenesis of adrenal myelolipoma.

Autologous blood transfusion for the patient with placenta previa complicated by placenta increta: a case report

The patient, who was 34 years of age, had previously had a transverse incision of the lower uterine segment cesarean section because of placenta previa. She was admitted to the hospital due to placenta previa again at 27 weeks of gestation in the current pregnancy. Ultrasound examination revealed placenta increta as well as placenta previa. In an attempt to avoid homologous blood transfusion at the time of profuse hemorrhage anticipated to occur during cesarean section, an autologous blood transfusion was planned. Fifteen hundred ml of autologous blood was collected by a leap-frog method during the 8 weeks prior to cesarean section. A cesarean hysterectomy was performed at 37 weeks of gestation because of placenta increta. Blood loss was estimated at 1,830 ml, and 1,500 ml of autologous blood was transfused. A leap-frog method of autologous blood collection for this pregnant woman with risk of massive hemorrhage was simple and beneficial, resulting in the preservation of more than 1,500 ml of autologous blood for transfusion.

Efficient induction of immunoglobulin production in neonatal naive B cells by memory CD4+ T cell subset expressing homing receptor L-selectin

The humoral response in newborns is mainly restricted to IgM production, which may be attributable to the naive nature of both B and T cells at birth. In light of the current evidence that memory (CD45RO+) CD4+ T cells help B cell differentiation, the present study was undertaken to examine whether a specified population within memory CD4+ T cells could induce the maturation of neonatal naive B cells. In the conventional PWM-stimulated cultures, the generation of IgG- and IgA-producing cells in addition to IgM production by neonatal B cells was significantly enhanced by co-cultures with memory, but not naive, CD4+ T cells. Memory CD4+ T cells were further divided into two populations based on expression of homing receptor L-selectin. These memory CD4+ T cell subpopulations appeared to behave in different fashions concerning help for Ig production by naive (sIgD+) and mature (sIgD-) B cells. L-selectin-negative memory CD4+ T cells exhibited helper function for Ig secretion by mature B cells. Intriguingly, Ig production by neonatal B cells as well as adult naive B cells, although less than that by mature B cells, was efficiently promoted by L-selectin-positive memory CD4+ T cells rather than L-selectin-negative ones. The results suggest that the capability of neonatal naive B cells to secrete IgG and IgA can be elicited by appropriate T-cell signals, especially from the L-selectin-positive population within memory CD4+ T cells, seemingly indicating its possible role for isotype switching in B cells.

Efficient induction of immunoglobulin production in neonatal naive B cells by memory CD4+ T cell subset expressing homing receptor L-selectin

The humoral response in newborns is mainly restricted to IgM production, which may be attributable to the naive nature of both B and T cells at birth. In light of the current evidence that memory (CD45RO+) CD4+ T cells help B cell differentiation, the present study was undertaken to examine whether a specified population within memory CD4+ T cells could induce the maturation of neonatal naive B cells. In the conventional PWM-stimulated cultures, the generation of IgG- and IgA-producing cells in addition to IgM production by neonatal B cells was significantly enhanced by co-cultures with memory, but not naive, CD4+ T cells. Memory CD4+ T cells were further divided into two populations based on expression of homing receptor L-selectin. These memory CD4+ T cell subpopulations appeared to behave in different fashions concerning help for Ig production by naive (sIgD+) and mature (sIgD-) B cells. L-selectin-negative memory CD4+ T cells exhibited helper function for Ig secretion by mature B cells. Intriguingly, Ig production by neonatal B cells as well as adult naive B cells, although less than that by mature B cells, was efficiently promoted by L-selectin-positive memory CD4+ T cells rather than L-selectin-negative ones. The results suggest that the capability of neonatal naive B cells to secrete IgG and IgA can be elicited by appropriate T-cell signals, especially from the L-selectin-positive population within memory CD4+ T cells, seemingly indicating its possible role for isotype switching in B cells.

Synthesis and in vivo evaluation of [11C]semotiadil, a benzothiazine calcium antagonist

A carbon-11 labeled benzothiazine calcium antagonist, (+)-(R)-2-[5-methoxy-2-[3-[methyl[2-[(3,4- methylenedioxy)phenoxy]ethyl]amino]propoxy]phenyl]-4-methyl-2H-1,4- benzothiazin-3(4H)-one (semotiadil), and its enantiomer were prepared by N-methylation of the corresponding norderivatives with 11CH3I: decay-corrected radiochemical yields of 16-27% based on 11CH3I, radiochemical, chemical and optical purity of > 99%, sp. act. of 11-50 GBq/mumol and preparation time of 35-40 min. In mice, saturable and stereo-selective uptake in the hippocampus, striatum and hypothalamus was observed. The potential of the compound to visualize the regional brain calcium channels in vivo by positron emission tomography was indicated; however, no promising sign was found in the myocardium.

[Assessment of tumor extent in extrahepatic bile duct cancers--utility of intraductal ultrasonography]

Intraductal ultrasonography (IDUS) were performed in patients with extrahepatic bile duct cancer and compared to other diagnostic modalities and to resected specimens. Endoscopic ultrasonography (EUS) is a non-invasive diagnostic method useful for screening patients with bile duct cancers and determining whether they are resectable or not. While, EUS was not useful for the differential diagnosis of advanced and early tumors, and less useful in case of bile duct tumors located at the hilus hepatitis. IDUS proved useful without blind spot even in case of bile duct cancers at the hilus hepatis. IDUS was especially useful for the differential diagnosis of advanced and early tumors. IDUS is the very accurate diagnostic modality which make up for EUS and essential to determine the appropriate operation plan.

[Prognostic significance of DNA ploidy pattern on bile duct cancer]

Of 33 patients surgically treated for bile duct cancer, nuclear DNA content of cancer cells was assessed by flow cytometry in order to determine whether DNA ploidy pattern was a prognostic indicator. Thirteen patients (40%) had diploid tumors and 20 patients (60%) had aneuploid tumors including 12 patients with DNA heterogeneity. No significant correlation was found between DNA ploidy pattern and clinicopathological features. Survival of patients with diploid tumor was significantly longer than those with aneuploid tumor (p < 0.01). In aneuploid cases, the prognosis of patients with DNA heterogeneity was similar to those without DNA heterogeneity. In the patients who underwent a curative resection, 5-year survival rate of diploid cases was 100%, as opposed that no patients with aneuploid tumor survived longer than 4 years. These results suggest that DNA ploidy pattern is a important prognostic determinant for bile duct cancer.

[Analysis of growth fractions of renal cell carcinoma by the monoclonal antibody Ki-67]

The monoclonal antibody Ki-67 recognizes a human nuclear antigen that is present in proliferating cells (G1, S, G2 and M cycling stages of cell division) exclusively, but is absent in G0 cycling stage. We performed immunohistochemical analysis of renal cell carcinomas using Ki-67 antibody, and investigated the relationship between the proportion of Ki-67 positive cells and pathological findings of renal cell carcinomas. The tissues were obtained from 36 patients with renal cell carcinoma who underwent radical nephrectomy. Cryostatfrozen sections were cut at 5 microns and stained with avidin-biotin-peroxidase complex method. The percentage of Ki-67 positive cancer cells to the total amount of cancer cells was expressed as growth fraction (GF). We obtained the following results with regard to the relationship between GF and pathological findings of renal cell carcinomas. 1) GFs in pathological grades were 6.58 +/- 4.57% (mean +/- SD) for grade 2 (n = 13) and 1.20 +/- 0.70% for grade 1 (n = 21). GF in grade 2 was significantly higher than that in grade 1 (p < 0.01). GF for Grade 3 (n = 2) were 9.2% and 27.8% respectively. 2) GFs in the pathological stages were 8.12 +/- 7.64% for pT3 (n = 13) and 1.84 +/- 1.30% for pT2 (n = 23). GF in pT3 was significantly higher than that in pT2 (p < 0.01). 3) GFs in the cancers with and without lymph node involvement were 13.84 +/- 8.48% (n = 5) and 2.80 +/- 2.74% (n = 27), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of recurrent intramural uterine stromal tumor with epithelial differentiation effectively treated with oral low-dose administration of etoposide

A 66-year-old woman was diagnosed as having myoma of the uterus and total hysterectomy with bilateral salpingo-oophorectomy was performed. The histopathological findings were puzzling, and the case was finally diagnosed as intramural uterine stromal tumor with epithelial differentiation. Three years after the operation, a firm tumor developed in the pelvic cavity. Laparotomy failed to remove the tumor and neither CAP (cyclophosphamide 500 mg, adriamycin 50 mg, CDDP 70 mg) therapy nor radiation therapy was effective. Oral administration of etoposide (25 mg/day), however, showed PR (50% decrease) as determined by CT scanning, and ultrasonography, and no metastatic lesions were found. This tumor was coincident with the endometrial stromal tumor with epithelial elements classified by Clement and Scully. The histological feature of the tumors and the efficacy of oral etoposide therapy are discussed in this study.

[Clinical study of fluconazole-injectable and -granules in pediatric patients]

In this study, we have investigated the clinical effectiveness of fluconazole (FLCZ) given intravenously or orally to pediatric patients with systemic fungal infections. FLCZ was administered intravenously to two patients with acute leukemia (multiple hepatosplenic candidiasis and aspergillosis) and orally to two mycosis complicated with neuroblastoma and aplastic anemia, respectively. Clinical efficacies were excellent and no side effects were observed in any patients. Pharmacokinetic analysis in 6 neonates revealed that the plasma half-life is 37-41 hours after administration of single dose of intravenous infusion of 3 mg/kg of FLCZ.

Successful peritransplant therapy in children with active hepatosplenic candidiasis

Two pediatric leukemic patients with hepatosplenic candidiasis during multidrug antileukemic chemotherapy successfully underwent bone marrow transplantation (BMT) after aggressive antifungal chemotherapy employing fluconazole and amphotericin B with or without splenectomy. One patient received allogeneic marrow graft and the other received an autologous graft. One patient has been disease-free for more than 21 months after BMT without any recurrence of Candida infection. The other patient showed tentative reactivation of hepatic lesions just after BMT by CT scanning, but these lesions disappeared again by continuous administration of the antifungal agents. The second patient died of leukemia relapse without recurrence of fungal infection. Our cases indicate the possibility of successful BMT once a fungal infection is well controlled by antifungal chemotherapy and surgical resection.

Mature helper T cell requirement for immunoglobulin production by neonatal native B cells injected intraperitoneally into severe combined immunodeficient (SCID) mice

It is accepted that human neonatal naive B cells produce mainly IgM in vivo as well as in vitro. Our previous work has demonstrated that i.p. injection of neonatal B cells together with adult mature T cells induces substantial levels of human IgG in the serum of SCID recipient mice. The present study was further attempted to determine the cellular components required for immunoglobulin production by neonatal B cells in SCID mice. When neonatal B and adult T cells were transferred into the SCID mice, human immunoglobulins, largely of IgG, were maximally detected in the serum around 6 weeks after a cell transfer. Depletion of CD4+ T cells from adult T cells resulted in undetectable levels of human immunoglobulin in the serum. By contrast, CD4+ T cell-enriched populations exhibited an enhancing effect on immunoglobulin production by neonatal B cells. Higher levels of immunoglobulin, including IgA and IgM, were detected in the peritoneal fluid than in the serum as early as 2 weeks after the cell transfer. Human T cells expressing activation antigens such as CD45RO and HLA-DR antigens were identified in the peritoneal lavages. These results suggest that neonatal naive B cells are able to differentiate into cells producing all classes of immunoglobulin in the presence of mature CD4+ T cells in a SCID mouse environment. The peritoneal cavity of SCID mice appears to provide a suitable place for immune responses by human cells, possibly in association with a certain xenogeneic reaction.

Acute cervical spinal epidural hematoma with spontaneous resolution--case report

A 54-year-old male presented with spontaneous acute epidural hematoma in the ventral cervical spine. The neurological deficits gradually improved spontaneously before surgery commenced. Serial magnetic resonance imaging demonstrated disappearance of the hematoma. He was managed conservatively and was discharged without deficits about 1 month after onset. Immediate surgical decompression may not be necessary if neuroimaging and clinical examinations suggest that spinal epidural hematoma will resolve spontaneously.

[Event related potentials and reaction time on auditory discrimination tasks (2nd report)--a study by trial-to-trial analysis]

Latency variability for single trial in the 4 components (N100, P200, N200 and P300) of the auditory event related potentials (ERP) and the temporal relationship to the choice reaction time (RT) were investigated in 11 normal subjects. Identification of each latency on single trials was derived by using a correlational-template procedure. Results showed that the mean value of the single trial latency in the 4 components was close to the peak latency in the averaged waveform. Significantly larger coefficient of variation was obtained for the N100 component and RT, when compared to the other components. Higher correlation between single trial latency and RT was found for N200 and P300 components. The P300 component latency yielded a significant temporal effect across trials (p < 0.05) showing increases in its latency in the later trials, whereas none of the RT did. These results may indicate that the P300 component latency is influenced directly by subtle changes in cerebral activities during an initial stage of human cognitive function occurring in each trial, whereas RT is additionally influenced by greater functional fluctuation during the process of motor execution for making responses.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Quantification of coronary artery calcification using ultrafast computed tomography: reproducibility of measurements

BACKGROUND

Ultrafast computed tomography (CT) is a non-invasive method of visualizing and quantifying coronary artery calcification; its reproducibility, however, has not been fully elucidated.

METHODS

To assess intra-observer, inter-observer, and inter-study reproducibility, 75 consecutive patients (51 men and 24 women) were studied. CT images were obtained using the volume mode of ultrafast CT (Imatron C-100). A total coronary calcification score (TCS) was calculated from the lesion area (> or = 2 pixels) and its peak CT density (> or = 130 HU).

RESULTS

There was no intra-observer variability in two experienced observers. The TCS provided by these observers disagreed in 18 out of 75 (24%) cases, and the differences were -5.1 +/- 53 (mean +/- SD) for TCS and 0.014 +/- 0.13 for In(1 + TCS). They resulted from either 10 incorrect identifications of small coronary branches, or eight variations in determination of the ostial margin. The former was much smaller than the latter in TCS (0.66 +/- 3.0 and -48 +/- 165, respectively), but both were quite similar in In(1 + TCS) (0.082 +/- 0.31, 0.017 +/- 0.22, respectively). Between two scans, 50 out of 75 patients (67%) had different TCS values. The mean differences (95% confidence interval) were 1.8 +/- 106 (-210 to 214) in TCS, and -0.015 +/- 0.46 (-0.94 to 0.91) in In(1 + TCS). Because the differences increased with the mean values, the determination of TCS assumed a constant variance with increasing mean level. A comparison of scan images indicated that partial volume effects were responsible for this constant variance.

CONCLUSION

Partial volume effects play a key role in producing the variability of TCS determination, and log transformation should be used to interpret TCS values. Thus, for clinical purposes, we recommend that two scans be performed in rapid succession, and that the average of these two scans be used to determine TCS.

Assessment of proliferating cell nuclear antigen (PCNA) immunoreactivity in exocrine pancreatic carcinomas

Twenty patients with exocrine pancreatic carcinomas were studied immunohistochemically, using a monoclonal antibody against PCNA. The percentage of tumor cells with positive staining was defined as PCNA Labelling Index (L.I.), and ranged from 13.8% to 92.8%. PCNA LI was found to correlate significantly with grading and more specifically with mitotic activity and degree of nuclear anaplasia. No correlation was found with glandular differentiation or with vessel invasion, lymphatic vessel invasion, lymph node metastasis, perineural invasion or size of tumor. Our results indicate that mitotic activity and degree of nuclear anaplasia might be the most important parameters to take into consideration, when studying the role of PCNA in exocrine pancreatic carcinomas.

Synthesis and characteristics in tumor-bearing mice of N-[11C]methyl-1-deoxynojirimycin and N-[11C]methyl-1-deoxymannojirimycin

N-[11C]Methyl-1-deoxynojirimycin ([11C]MDNM) and N-[11C]methyl-1-deoxymannojirimycin ([11C]MDMM) were prepared by 11C-methylation of 1-deoxynojirimycin (DNM) and 1-deoxymannojirimycin (DMM), which are specific inhibitors of glucosidase and mannosidase, respectively. In mice bearing Ehrich ascitic tumor, the highest uptake of the [11C]MDNM was observed in the kidney, followed by the liver and small intestine, while the tumor uptake was moderate. By MDNM loading, saturable uptake was observed in these tissues. In homogenates of the kidney and tumor tissues, a considerable amount of radioactivity was detected in a high-molecular weight fraction. These results demonstrate that the [11C]MDNM has a potential for imaging the glucosidase activity by positron emission tomography. On the other hand, [11C]MDMM showed lower uptake than [11C]MDNM in the kidney, liver and small intestine and no effect of carrier DMM, suggesting that the [11C]MDMM would not reflect mannosidase activity.

Increased levels of urinary interleukin-6 in Kawasaki disease

Kawasaki disease (KD) often presents with abnormal urinary findings, such as aseptic pyuria, mild proteinuria and microscopic haematuria. In this study, we measured urinary interleukin-6 (IL-6) by a sensitive sandwich ELISA assay using mouse monoclonal antibodies against recombinant IL-6 to elucidate the role of IL-6 in the pathogenesis of renal lesions in KD. Serum IL-6 levels were increased in acute KD as well as in febrile controls. Importantly, urinary IL-6 levels were consistently elevated in patients with acute KD, but much lower in febrile controls. Urinary IL-6 levels returned steadily to normal during the convalescent phase. In addition to IL-6, urinary levels of N-acetyl-beta-D-glucosaminidase (NAG) and beta 2-microglobulin (beta 2-mg) were also elevated during the acute phase of this disease. Eosinophils and macrophages were identifiable in urinary sediments from these patients. The increased levels of urinary IL-6 in combination with increased NAG and beta 2-mg seemed to suggest the presence of certain renal parenchymal lesions with cellular infiltration during the acute phase of the disease. IL-6 may serve as clinically useful parameter for the detection and monitoring of the renal involvement in KD.

Close phylogenetic relationship between Vestimentifera (tube worms) and Annelida revealed by the amino acid sequence of elongation factor-1 alpha

To clarify the phylogenetic position of Vestimentifera (tube worms), 346-bp fragments of the elongation factor-1 alpha (EF-1 alpha) gene (939-1286 according to the numbering of the human gene) of a vestimentiferan, Lamellibrachia sp., a sternaspid polychaete, Sternaspis scutata, an earthworm, Pheretima sp., and a gastropod, Alviniconcha hessleri, were sequenced. From the amino acid sequences of these EF-1 alpha, and those of two other vertebrates and two arthropods, phylogenetic relationships were deduced by the maximum likelihood (ML) method, by which the phylogenetic tree can be inferred without assuming constancy of the molecular evolutionary rate. For the ML tree and all of seven alternative trees, whose log-likelihoods could not be discriminated from that of the ML tree by the criterion of the standard error, the vestimentiferan, the polychaete, and the oligochaete formed a clade, excluding the arthropods and the gastropod as outgroups. This result is convincing evidence that Vestimentifera are protostomes that are closely related to Annelida. The ML tree suggests that Vestimentifera are more closely related to Polychaeta than to Oligochaeta, though the data were not sufficient to discriminate these three groups at a significant level. From recent evidence such as morphological characteristics and molecular information, it may safely be said that vestimentiferans should be included in the Annelida provided this phylum contains polychaetes and oligochaetes.

The auditory evoked middle-latency responses (MLRs): their normative variation and generators

Auditory evoked middle-latency responses (MLRs) to clicks were recorded in 68 normal adults (ages from 21 to 59 year-old) at 16 scalp locations, all referred to a balanced non-cephalic reference. Both Na and Pa components were clearly demonstrated in all the subjects studied through the digital high-pass filtering. Both Na and Pa components were distributed dominantly over the frontal area in all subjects. The amplitudes of Na and Pa were significantly higher with binaural stimulation than with a monaural stimulation, and the existence of binaural interaction was also suggested. Binaural effect was more prominent in Pa than in Na component. When the data recorded from F3 and F4 electrodes were compared, most of F3/F4 amplitude ratios of Na and Pa were included between 0.7 and 1.5. The F3/F4 ratio should be useful indices for the diagnosis of excessive laterality. We also demonstrated gradual phase shifts of Na and Pa between the frontal and temporo-occipital area in about one-third of the records. This phenomenon strongly suggests that both Na and Pa components are derived from complex generators.