[Evaluation of a PCR assay commercial kit for quantification of human immunodeficiency virus type-1 RNA]

We studied a basic evaluation of the reliability and usefulness of the test results to assess the validity of the kit "AMPLICOR HIV-1 Monitor" as a laboratory tool, by determining the reproducibility, linearity on dilution, possible effects of interference on the results, and correlation with the results obtained at outside facilities. Furthermore, we compared the HIV-1 RNA load between blood samples obtained from HIV-1 subtype B and E. The HIV-1 RNA load measurement was made according to the pre-determined methods of this kit, in blood samples obtained from HIV-positive outpatients. Simultaneous reproducibility was 23.08%-32.95% in C.V.% and linearity was maintained between 110 copies/ml and 2,184,277 copies/ml, demonstrating favorable performance of the kit. The institution correlation between two facilities were also favorable. Fluctuation of measurement by interference was absent for bilirubin, hemoglobin and chyle, but was significant for heparin.

Molecular cloning of a second human stanniocalcin homologue (STC2)

Stanniocalcin (STC) is a Ca- and phosphate-regulating hormone produced by the corpuscles of Stannius in bony fishes. The mammalian homologue of STC has recently been reported (STC1), which stimulates the phosphate uptake of kidney. Here we report the cloning of a second mammalian stanniocalcin (STC2) from the human osteosarcoma cDNA library. STC2 has 302 amino acid residues with 34% identity with STC1 and eel STC. STC2 has a conserved N-glycosylation site and is rich in cysteines as is the case with other stanniocalcins. STC2 has the same exon-intron boundaries as STC1. The culture medium of STC2-transfected CHO cells inhibited the promoter activity of Na-phosphate cotransporter (NaPi-3) and also inhibited the phosphate uptake of a kidney cell line (OK cells). Therefore, the function of STC2 seems to be opposite to that of STC1 on Na-phosphate cotransporter. Northern blot analysis revealed multiple transcripts in number of human tissues with high levels being present in skeletal muscle and heart. STC2 was also expressed in mice widely and its expression was lower in hypophosphatemic mice (Hyp mice) in many organs. We have cloned a widely expressed new human stanniocalcin homologue which suppressed the expression of renal Na-phosphate cotransporter.

Molecular cloning of a novel member of the eukaryotic polypeptide chain-releasing factors (eRF). Its identification as eRF3 interacting with eRF1

Yeast GST1 gene, whose product is a GTP-binding protein structurally related to polypeptide chain elongation factor-1alpha (EF1alpha), was first described to be essential for the G1 to S phase transition (GSPT) of the cell cycle, and the product was recently reported to function as a polypeptide chain release factor 3 (eRF3) in yeast. Although we previously cloned a human homologue (renamed as GSPT1) of the yeast gene, it has remained to be determined whether GSPT1 also functions as eRF3 or if another GSPT may have such a function in mammalian cells. In the present study, we isolated two mouse GSPT genes, the counterpart of human GSPT1 and a novel member of the GSPT gene family, GSPT2. Both the mouse GSPTs had a two-domain structure characterized as an amino-terminal no-homologous region (approximately 200 amino acids) and a carboxyl-terminal conserved eukaryotic elongation factor-1alpha-like domain (428 amino acids). Messenger RNAs of the two GSPTs could be detected in all mouse tissues surveyed, although the level of GSPT2 message appeared to be relatively abundant in the brain. The mouse GSPT1 was expressed in a proliferation-dependent manner in Swiss 3T3 cells, whereas the expression of GSPT2 was constant during the cell-cycle progression. Immunoprecipitation assays in COS-7 cells expressing flag epitope-tagged proteins demonstrated that not only GSPT1 but also GSPT2 was capable of interacting with eRF1. Such interaction between GSPT2 and eRF1 was also confirmed by yeast two-hybrid analysis. Taken together, these data indicated that the novel GSPT2 may interact with eRF1 to function as eRF3 in mammalian cells.

Fatty acid omega and (omega-1)-oxidation within intrasplenically transplanted fetal hepatocytes

BACKGROUND

The expression and enzymatic activity of the cytochrome P450 LAomega within intrasplenically transplanted hepatocytes was investigated.

METHODS

Fetal hepatocytes were harvested from spontaneously hypertensive rats and transplanted into recipient adult spontaneously hypertensive rat spleens.

RESULTS

Microscopic examination revealed masses of hepatocytes in the red pulp. Immunochemical studies detected cytochrome P450 LAomega in transplanted hepatocytes by 6 and 10 weeks after transplantation. Cytochrome P450 LAomega mRNA accumulates at 6 weeks after transplantation. Cytochrome P450-arachidonic acid omega/omega-1 hydroxylase activity (formation of 20/19-hydroxyeicosatetraenoic acid) was detected at 10 weeks after transplantation.

CONCLUSION

These results demonstrated that fetal hepatocytes grow in the spleen and function similarly to adult hepatocytes.

[Successful staged repair of corrected transposition of great arteries and mitral atresia associated with double aortic arch]

We report a rare case of corrected transposition of great arteries and mitral atresia associated with double aoric arch. The patient showed polypnea and cyanosis soon after birth. She underwent balloon atrioseptostomy at the age of 18 days and pulmonary artery banding (PAB) at 24 days. But she showed severe persistent stridor after PAB. Esophagography and left counter-current aortography revealed double aortic arch. At the age of 49 days, division of the left lesser arch and ligation of patent ductus arteriosus were performed through left lateral thoracotomy. Stridor disappeared completely following operation. She underwent total cavopulmonary connection using a 18 mm Gore-Tex graft as intraatrial conduit concomitant with pacemaker implantation at the age of 8 years. Postoperative course was uneventful. To our knowledge, this is the first successful case report of surgical correction of corrected transposition of great arteries and mitral atresia associated with double aoric arch.

[Evaluation of a rapid enzyme immunoassay membrane test for diagnosis of influenza A virus infection]

A rapid enzyme immunoassay membrane test, Directigen Flu A (Becton Dickinson, USA), was evaluated by using virus isolates and clinical specimens. The reference laboratory diagnosis was based on the results of virus isolation. Directigen Flu A was reactive for all subtypes of human influenza A viruses, including reference strains of H1N1, H2N2 and H3N2. Moreover, H5N1 (Hongkong/156/97) was also detected by this kit. No cross reactivity was detected with other respiratory viruses. Directigen Flu A showed positive reaction with the solution containing influenza A virus of 2.4 x 10(3) pfu/assay. The rapid test demonstrated 77.9% sensitivity and 98.4% specificity for testing of throat swabs from children with respiratory symptoms. It showed higher sensitivity and specificity (92.1% and 100%) for testing of nasopharyngeal aspirates. Directigen Flu A should be useful for the rapid diagnosis of influenza A virus infection.

Pharmacophore identification of a chemokine receptor (CXCR4) antagonist, T22 ([Tyr(5,12),Lys7]-polyphemusin II), which specifically blocks T cell-line-tropic HIV-1 infection

We have previously found that T22 ([Tyr(5,12), Lys7]-polyphemusin II) has strong anti-human immunodeficiency virus (HIV) activity, and that T22 inhibits T cell-line-tropic HIV-1 infection mediated by CXCR4/fusin. T22 is an 18-residue peptide amide, which takes an antiparallel beta-sheet structure that is maintained by two disulfide bridges. Structure-activity relationship (SAR) studies on T22 have disclosed the contributions of each region of T22 to activity or cytotoxicity, and have provided the following useful information to develop new CXCR4 antagonists: The number of Arg residues in the N-terminal and C-terminal regions of T22 is closely related to anti-HIV activity. Addition of a variety of functional groups at the N-terminal end results in increases in activity. Disulfide rings, especially the major disulfide loop, are indispensable for anti-HIV activity and maintenance of the beta-sheet structure. Trp3 can be replaced by other aromatic residues (Tyr, Phe and L-2-naphthylalanine). Between two repeats of Tyr-Arg-Lys, which are a characteristic structure in T22, Tyr-Arg-Lys in the N-terminal portion is more closely associated with anti-HIV activity and maintenance of the beta-sheet structure. A positive charge in the side chain at the (i + 1) position of the beta-turn region is necessary for strong activity. Through these studies, we have found several compounds having higher selectivity indexes (50% cytotoxic concentration/50% effective concentration) than that of T22.

Flow-dependent activation of maxi K+ channels in apical membrane of rabbit connecting tubule

The Ca2+-activated maxi K+ channel was found in the apical membrane of everted rabbit connecting tubule (CNT) with a patch-clamp technique. The mean number of open channels (NPo) was markedly increased from 0.007 +/- 0.004 to 0.189 +/- 0.039 (n = 7) by stretching the patch membrane in a cell-attached configuration. This activation was suggested to be coupled with the stretch-activation of Ca2+-permeable cation channels, because the maxi K+ channel was not stretch-activated in both the cell-attached configuration using Ca2+-free pipette and in the inside-out one in the presence of 10 mm EGTA in the cytoplasmic side. The maxi K+ channel was completely blocked by extracellular 1 microM charybdotoxin (CTX), but was not by cytoplasmic 33 microM arachidonic acid (AA). On the other hand, the low-conductance K+ channel, which was also found in the same membrane, was completely inhibited by 11 microM AA, but not by 1 microM CTX. The apical K+ conductance in the CNT was estimated by the deflection of transepithelial voltage (DeltaVt) when luminal K+ concentration was increased from 5 to 15 mEq. When the tubule was perfused with hydraulic pressure of 0.5 KPa, the DeltaVt was only -0. 7 +/- 0.4 mV. However, an increase in luminal fluid flow by increasing perfusion pressure to 1.5 KPa markedly enhanced DeltaVt to -9.4 +/- 0.9 mV. Luminal application of 1 microM CTX reduced the DeltaVt to -1.3 +/- 0.6 mV significantly in 6 tubules, whereas no significant change of DeltaVt was recorded by applying 33 microM AA into the lumen of 5 tubules (DeltaVt = -7.2 +/- 0.5 mV in control vs. DeltaVt = -6.7 +/- 0.6 mV in AA). These results suggest that the Ca2+-activated maxi K+ channel is responsible for flow-dependent K+ secretion by coupling with the stretch-activated Ca2+-permeable cation channel in the rabbit CNT.

[Quantitation of viral load in patients infected with HIV-1 subtype E or A]

Quantitation of viral load in a HIV infected person gives important information for monitoring of the clinical status of the patients and evaluation of anti viral effects of admininstred drugs. Although conventional Amplicor HIV-1 monitor system (Roche's conventional method) is used widely, the sensitivity of this system is not enough for measurement of subtype E and A giving lower titer of these subtype viruses than the actual quantity. In Japan, HIV-1 subytpe B cases used to be predominant but recently subtype E cases are increasing especially among heterosexuals thus it becomes required to increase the sensitivity of measurement of HIV-1 RNA of subtype E or A. Therefore we establised the Kanagawa primer method using newly developed subtype E and A primers added to the primers of Roche's conventional method. The results were compared with the conventional Amplicor and also with Roche's new version method which contained new primers. Kanagawa primer method gave 4 to 16 times more sensitive results as compared with Roche's conventional method for subtype E measurement. As for subtype A case, Kanagawa primer method gave a value 1.2 x 10(4) copies/ml while it was undetectable by Roche's conventional method. Roche's new version method showed equal sensitivity of Kanagawa primer method. As for subtype B, the results of these three methods showed no difference. Addition of our newly developed subtype E and A primers to the Roche's conventional method enabled to measure subtype E and A with high sensitivity. For quantitative measurement of HIV-1 RNA, it is important to consider the subtype of the virus in test samples.

Downsizing of an HIV-cell fusion inhibitor, T22 ([Tyr5,12, Lys7]-polyphemusin II), with the maintenance of anti-HIV activity and solution structure

T22 ([Tyr5,12,Lys7]-polyphemusin II) has been shown to have strong anti-human immunodeficiency virus (HIV) activity comparable to that of 3'-azido-2',3'-dideoxythymidine (AZT). T22, an 18-residue peptide amide, takes an antiparallel beta-sheet structure that is maintained by two disulfide bridges. Herein we synthesized several shortened analogs of T22 in order to search for a more suitable lead compound. A 14-residue analog having one disulfide bridge, TW70 (des-[Cys8,13, Tyr9,12]-[D-Lys10, Pro11]-T22), was found to have highly potent activity comparable to that of T22, and to take an antiparallel beta-sheet structure similar to that of T22. This indicates that the molecular size of T22 can be reduced without loss of activity or significant change in the secondary structure, and that TW70 may represent a novel lead compound. Furthermore, modifying the N-terminal alpha-amino group of TW70 with a fluoresceinthiocarbamoyl group, and the epsilon-amino group of D-Lys8 at the turn portion with a 5-aminopentanoyl group remarkably increased the selectivity index (50% cytotoxic concentration/50% effective concentration).

Sleep problems in the aged in relation to senility

As a part of an epidemiologic survey of dementia in a community of aged persons, correlation between sleep complaints and physical illness and senility were studied. A total of 3302 randomly sampled aged individuals(aged > or = 65 years) were studied using a questionnaire. In this sample the prevalence of poor sleep and habitual snoring did not increase with age. The prevalence of excessive daytime sleepiness showed an increase with age. Male predominance of habitual snoring and female predominance of poor sleep were observed. Female predominance of excessive daytime sleepiness was noted among the aged 70 and over. Age-related excessive daytime sleepiness was significantly correlated with senility.

[Topography, size and number of cortical tubers in tuberous sclerosis with West syndrome]

To predict the prognosis of tuberous sclerosis with West syndrome, we studied the relation between the cortical tubers and the neurological evolution. We reviewed the clinical data on the seizure evolution and developmental status of 7 patients (3 males and 4 females) and estimated the number, size and location of cortical tubers on 5 mm-thick T2-weighted MR images. The cortical tubers were grouped into categories: small (10 mm or less in maximum diameter), medium (10 to 25 mm) and large (25 mm or more). The first MRI study was performed at ages form 3 months to 18 years, and the follow-up study was performed on 6 out of the 7 patients. We also estimated the interval change of cortical tubers. The average number of cortical tubers was 12.1 per patient, being larger than the values previously reported for the patients of tuberous sclerosis without West syndrome. However, the numbers varied widely from 1 to 29. Two patients with good outcome had more than 10 tubers, whereas two patients with poor outcome had less than 5 tubers. All the patients with good outcome were female. Follow-up MRI in one patient revealed a marked increase in the number of cortical tubers, from 15 (at the age of 5 months) to 23 (at 4 years 2 months), which probably resulted from physiological hypomyelination during infancy. Some tubers corresponded to a electroencephalographic focus, whereas others did not. There was no difference in the topography of cortical tubers between the patients with good prognosis and those with poor prognosis. Thus, it was hard to make the prognosticate a case of tuberous sclerosis based solely on the number and topography of cortical tubers on MRI.

Optical Kerr coefficient measurement in coiled high-birefringent fibers

The optical Kerr effect in coiled high-birefringent fibers was measured based on a double-beam polarimetric method. A Q-switched Nd:YAG laser, operating at 1.064 mum (FWHM of 80 ns at 1 kHz), was used as the pump beam and a cw 0.633-mum He-Ne laser was used as the probe beam with its polarization fixed at 45 degrees with respect to the birefringent axis whereas orientation of the linearly polarized pump light varied. The phase shifts induced by an intense pump beam in a short bow-tie high-birefringent fiber were determined for different fiber lengths coiled into 15- and 30-cm-diameter drums. It was found that the induced phase shift changes drastically with the state of polarization of the pump light. A strong dependence of the phase shift on orientations of linear pump polarization is attributed to differential losses of eigenmodes peculiar to birefringent axes. Therefore, optical Kerr coefficients remain unchanged regardless of the dependence of the nonlinear response of the coiled high-birefringent fibers on pump polarization.

Quantification of cosmesis for patients affected by adolescent idiopathic scoliosis

The aim of this study was to quantify cosmesis for patients affected by adolescent idiopathic scoliosis. Eight nonmedical judges were asked to examine photographs of 40 patients with adolescent idiopathic scoliosis, and to score the cosmesis of their backs without any information. Various parameters were measured from radiographs, Moiré topographies, and physical measurements of patients, and these were compared with the cosmetic scores of the judges. The judges' scoring proved to be reliable. The cosmetic scores showed a significant correlation with the Cobb angle, hump severity, asymmetry of the waist line, circumference of the chest, and obesity. Multivariate analysis produced equations to calculate the cosmetic score for the back. This equation is thought to have a useful clinical application.

Fusion of influenza virus with the endosomal membrane is inhibited by monoclonal antibodies to defined epitopes on the hemagglutinin

Epitopes on the hemagglutinin (HA) of A/seal/Massachusetts/1/80 (H7N7) influenza virus were mapped by genetic analysis of variants selected with monoclonal antibodies (MAbs). Electron microscopic studies demonstrated that the sites and the directions to which hemagglutination-inhibiting (HI) MAbs and non-HI MAbs bound were different on the HA molecule. Morphological analysis revealed that HI MAbs blocked attachment of the virus to the cells, while non-HI MAbs did not. Virus particles bound with non-HI MAbs were then found in the intracellular vacuoles. Together with the electron microscopic findings, a fluorescence dequenching assay indicated that non-HI MAbs inhibited the fusion of virus with the intracellular vacuolar membrane. It was thus shown that non-HI neutralizing MAbs did not inhibit attachment of the virus to the host cell receptor, but inhibited the fusion step in intracellular vacuoles. The results support the hypothesis that anti-HA MAbs which lack HI activity neutralize viral infectivity by interfering with the low pH-induced conformational change in the HA molecule, resulting in inhibition of the fusion step in the viral replication process (Kida, H., Yoden, S., Kuwabara, M., Yanagawa, R., 1985. Interference with a conformational change in the HA molecule of influenza virus by antibodies as a possible neutralization mechanism. Vaccine 3, 219-222).

Effective lowly cytotoxic analogs of an HIV-cell fusion inhibitor, T22 ([Tyr5,12, Lys7]-polyphemusin II)

A tachyplesin peptide analog, T22 ([Tyr5,12, Lys7]-polyphemusin II), and its shortened congener, TW70 (des-[Cys8,13, Tyr9,12]-[D-Lys10, Pro11]-T22) have strong anti-human immunodeficiency virus (HIV) activity, comparable to that of 3'-azido-2', 3'-dideoxythymidine (AZT). T22 and TW70 are extremely basic peptides, containing 5 Arg residues and 3 Lys residues. The number of positive charges might be related in part to high collateral cytotoxicities of T22 and TW70. Here we have synthesized several analogs, in which the number of positive charges has been reduced through amino acid substitutions using Glu or L-citrulline. As a result, several effective compounds have been found which possess higher selectivity indexes (SIs, 50% cytotoxic concentration/50% effective concentration) than those of T22 and TW70. Higher SIs were attributed mainly to a decrease in cytotoxicity.

Effects of dichloroacetate in three patients with MELAS

We present the clinical and laboratory effects of dichloroacetate (DCA) in three children with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) who had not responded to other medications. Administration of DCA lowered the elevated levels of lactate and pyruvate in the serum and CSF. DCA ameliorated abdominal pain, headache, and strokelike episodes, and improved cognitive function and fatigability in the three patients during the study period. Some transient liver dysfunction, hypocalcemia, and peripheral neuropathy were observed. The use of DCA in MELAS merits further study.

Primary structure and functional expression of a novel non-selective cation channel

A non-selective cation channel is believed to play important roles in various tissues. A novel complementary DNA encoding non-selective cation channel was isolated from MIN6, a mouse insulin secreting beta-cell line. This channel (mNSC1) conducts predominantly monovalent cations in Xenopus oocytes and is selective for cations over anions (PK/PCl = 10). The current was completely blocked by lanthanum and niflumate. The mNSC1 of 423 amino acids contains a characteristic leucine repeat and unique membrane topology. The messenger RNA of this channel are abundant in the brain, heart, and lung. We may therefore conclude that studies with this channel will provide important information for understanding physiological functions of the excitable cells as well as non-excitable epithelia.

Production of inhibin A and inhibin B in human ovarian sex cord stromal tumors

OBJECTIVE

Our purpose was to examine the cellular localization of inhibin subunits and messenger ribonucleic acid expressions for the inhibin subunits and the serum levels of inhibin A and inhibin B in human ovarian sex cord stromal tumors.

STUDY DESIGN

We examined the immunohistochemical localization of the inhibin subunits and the expression of the corresponding messenger ribonucleic acids by Northern blot analysis in a granulosa cell tumor and a Sertoli-Leydig cell tumor. We also measured serum concentrations of dimeric inhibin A and inhibin B by two-site enzyme-linked immunosorbent assay.

RESULTS

Immunostaining specific for the inhibin alpha, betaA, and betaB subunits was observed in the granulosa cell tumor. In the Sertoli-Leydig cell tumor we observed immunostaining specific for the alpha subunit in Leydig tumor cells and that specific for the betaA subunit in Sertoli tumor cells and that specific for the betaB subunit in both tumor cells. Northern blot analysis revealed the presence of messenger ribonucleic acids for the alpha, betaA, and betaB subunits in the granulosa cell tumor and the Sertoli-Leydig cell tumor. The serum levels of dimeric inhibin A and inhibin B in patients were elevated preoperatively and decreased progressively after surgery.

CONCLUSION

Our results suggest that inhibin A and inhibin B are produced by the human sex cord stromal tumors and that inhibins might be the useful markers of the tumors.

Hydrophilic surroundings requisite for the solubilization of proteins related with their hydrophobicity in the AOT reversed micellar extraction

The reversed micellar extraction (AOT/isooctane system) using the phase transfer method was investigated in relation to the AOT concentration and the water solubilization for ribonuclease A, lysozyme and cytochrome c. The minimal AOT concentration required for 100% forward extraction was obtained for these proteins. At the minimal AOT concentration, the hydrophilic surroundings, i.e. the molar ratio of water to extracted protein in the organic phase, were independent of the protein concentration for each protein. The hydrophilic surroundings of these proteins were linearly related with Fisher's polarity ratio, p, as an index of the hydrophobicity of the protein. Using this linear relation, a procedure to estimate the sufficient AOT concentration for the protein extraction was proposed. In the cases of cytochrome c and lysozyme, the water concentration was larger than that in the protein-free system in spite of the same AOT condition. On the contrary, in the case of ribonuclease A, this large water uptake in the organic phase was not observed. These differences of water uptake were discussed in relation to the location of the protein in the AOT reversed micelles.

Proton secretion in the upper part of the descending limb of long-looped nephron from hamsters

The proton transport processes in the upper part of the descending limb of the long-looped nephron (LDLu) from hamsters were studied using a fluorescent dye, 2',7'-bis(carboxyethyl)carboxyfluorescein (BCECF) in microperfused single nephron preparations. Intracellular pH (pHi), as assessed by the measurement of the fluorescence of BCECF trapped in the cytoplasm, was 7.23 +/- 0.05 (n = 18) under nominally HCO3--free conditions. Ouabain, when added to the bath, decreased pHi by 0.22 units. After an NH4Cl prepulse, the initial proton extrusion rate was 1.23 +/- 0.26 (n = 9) pH units/min, and was retarded in the presence of 1 mM amiloride either in the bath or in the lumen. pHi failed to recover when Na+ was eliminated from ambient solutions. These observations suggest that Na+/H+ antiporters exist both in the apical and basolateral cell membranes. By measuring tubular fluid pH (pHt) under stopped flow conditions, we examined whether the hamster LDLu has the capacity to generate and maintain a transmural H+ gradient. After the tubular outflow was obstructed, the luminal fluid was rapidly acidified, reaching a steady-state pH of 6.84 +/- 0.09 (n = 7). The steady-state pH was influenced by bath pH. Tubular fluid acidification was not observed in the absence of Na+ and was prevented by ouabain. We conclude that the hamster LDLu has the capability to generate and maintain a transmural proton gradient by proton secretion via a luminal Na+/H+ antiporter which is secondarily driven by the Na+-K+ ATPase in the basolateral membrane.

[A case of PEHO (progressive encephalopathy with edema, hypsarrhythmia and optic atrophy) syndrome: changes in clinical and neuroradiological findings]

We reported serial clinical, radiological, and neurophysiological findings of a patient with PEHO (progressive encephalopathy with edema, hypsarrhythmia and optic atrophy) syndrome. The case was a 4-year-and-8-month-old boy. He had no apparent problems during pregnancy, but after his birth severe hypotonia and developmental delay were evident. Infantile spasms appeared at 3 months of age, and progressive opisthotonic posture and loss of his visual acuity at 8 months. Eye fixation was lost, and optic atrophy was observed. Seizures and progressive atrophy of the cerebellum and brainstem developed during the same period. These findings of our case support the hypothesis that brainstem lesions are related to infantile spasms.

[Fulminant subacute sclerosing panencephalitis: clinical and neuropathological observations]

We describe a 3-year-old boy with subacute sclerosing panencephalitis (SSPE) who died 4 months after its onset. His initial symptoms were drowsiness and left hemiplegia. He became comatose in 10 days, and developed a decortical posture after 45 days. He suffered from multiple cerebral hemorrhage and infarction 3 months later. Oligodendrocytes were positively stained by immunocytochemical stain with a complement-fixing measles antibody. Light microscopy revealed glial nodules, perivascular cuffing and reactive gliosis. Small arteries showed intimal thickening with resultant occlusion and occasional recanalization. These findings suggested vascular involvement in SSPE. This case illustrates the difference between the fulminant and chronic forms of SSPE.

[Hemodynamic effects of amrinone in children during cardiopulmonary bypass and postoperative 12 hours]

Hemodynamic effects of amrinone in children during cardiopulmonary bypass (CPB) and postoperative 12 hours were studied. In 10 patients undergoing open heart surgery, 1 mg/kg of amrinone was infused as the initial CPB dose and 5 - 10 micrograms/kg/min of amrinone was continuously administered as the maintenance dose during CPB and postoperative 12 hours. Amrinone levels ranged from 0.9 to 1.4 micrograms/ml during CPB and postoperative 12 hours. After infusion of amrinone, mean arterial blood pressure decreased significantly, but other parameters did not show remarkable change. The administration of amrinone during CPB showed enough vasodilating effect and decreased the need of conventionally used other vasodilators (nitroglycerin or prostaglandin E1). The postoperative course of 10 patients was clinically uneventful. The administration of amrinone in 10 patients did not produce thrombocytopenia compared with the control group (5 patients) in the postoperative period. In conclusion, the administration of amrinone during CPB and postoperative 12 hours in children was useful in producing enough vasodilating effect without major side effect.

Unifocalization and systemic-to-pulmonary shunt using internal mammary artery for tetralogy of Fallot and pulmonary atresia with diminutive pulmonary artery and arborization anomaly

We report successful palliation of tetralogy of Fallot and pulmonary atresia with diminutive pulmonary arteries and arborization anomaly. Unifocalization and systemic-to-pulmonary artery shunt using an internal mammary artery were successfully performed. The internal mammary artery shunt provided a sufficient blood supply for a diminutive and fragile pulmonary artery, and brought a progressive improvement of exercise intolerance and polycythemia probably due to the growth potential.

[Effects of aprotinin on blood loss reduction in children undergoing repair of tetralogy of Fallot]

The effect of aprotinin on the blood loss reduction was studied in children undergoing repair of tetralogy of Fallot. We administered aprotinin to consecutive 21 patients during the repair of tetralogy of Fallot and examined the blood loss and operative time in comparison with that in a control group of 20 patients. 30,000 KIU/kg of aprotinin was infused as the initial cardiopulmonary bypass (CPB) dose and 10,000 KIU/kg/hr was continuously administered as the maintenance dose during CPB. There was no resternotomy case due to bleeding and no operative death in both groups. Blood loss after CPB during operation and total blood loss during operation were significantly lower in aprotinin group than in control group. There were no differences between two groups in the volume of chest tube drainage in the postoperative 24 hours and the duration of chest tube drainage. Time from cessation of CPB to skin closure and total operative time were significantly shorter in aprotinin group than in control group. In conclusion, aprotinin was effective on the reduction of blood loss and the shortening of operative time in children undergoing repair of tetralogy of Fallot.

Temporary cement remnants as an adhesion inhibiting factor in the interface between resin cements and bovine dentin

This study investigated the effect of temporary cement remnants on freshly prepared dentin in the adhesion of resin cements. The tensile bond strength of three types of resin cements to dentin were measured in a control group and after the application of two types of temporary cement. Scanning electron microscopy and energy dispersive x-ray spectroscopy were used to confirm the presence of temporary cement remnants. Overall results suggest that temporary cement application significantly decreased the tensile bond strength in all adhesive systems (P = 0.0001, analysis of variance). Scanning electron micrographs presented granular elements on the dentin surfaces treated with temporary cement even after preconditioning. Energy dispersive x-ray spectroscopy results showed the presence of zinc peaks in the specimens that was not present in the control.

Enzymatic activity and expression of cytochrome P450 LA omega within intrasplenically transplanted fetal hepatocytes in spontaneously hypertensive rats

We examined the expression and enzymatic activity of cytochrome P450 LA omega within transplanted hepatocytes. Fetal hepatocytes were harvested at day 20 of gestation from spontaneously hypertensive rats (SHRs) and transplanted into recipient adult SHR spleens. Microscopic examination of the recipient spleens at 4 and 10 wk after transplantation revealed masses of hepatocytes with cord-like structures in the red pulp. Immunochemical studies detected cytochrome (cyto) P450 LA omega in the fetal hepatocytes before transplantation without prior induction. Although the cyto P450 LA omega was not detected by the second week after transplantation, by the 6th and 10th wk after transplantation, it was. Cyto P450-arachidonic acid omega/omega-1 hydroxylase activity (formation of 20- and 19-hydroxyeicosatetraenoic acid) was detected at 10 wk after transplantation, but not 2 or 6 wk after transplantation. These results demonstrated that fetal hepatocytes can be transplanted successfully into recipient spleens and then grow in the spleens, as in the case of the adult hepatocyte response.

[Simple method for typing human immunodeficiency virus type I (B, E) by PCR and chronological change of distribution of subtype (B to E) in Japan]

We analyzed the clade distribution of B and E in HIV-1 isolates in Japan by a nested PCR method using 5'-CCCACAAGATTTAAATATG-3' of the gag gene as clade B primer and 5'-CCCACAAGATTTAAACTCC-3' of the gag gene as clade E primer. Seventy-two anti-HIV-1 confirmatory positive serum samples were collected during a period of 1991-1996 in two hospitals in Yokohama City. Peripheral blood mononuclear cells were obtained from the buffy coat of these samples and extracted DNA were used for nested PCR. The 72 cases comprised of 11 Japanese hemophiliacs, 14 Japanese male homosexuals, 19 Japanese male heterosexuals, 5 Japanese female heterosexuals and 23 Thai female heterosexuals. Of these 36 were clade B and 35 were clade E and one case showed positive PCR results for both B and E primers. Almost all male Japanese hemophiliacs and homosexuals in our sample have clade B, while the female Thai heterosexuals have clade E, irrespective of the year of isolation. As for Japanese male heterosexuals, through 1993, clade B was predominant but since 1994, the predominate clade switched to clade E. Although the number of Japanese female heterosexuals in our sample is small, clade B was isolated in 2 cases even after 1994.

[DDD pacemaker implantation--cardiac pacemaker tips in the left atrium and ventricle by the left thoracotomy]

Recently DDD pacemaker implantation for the children has undergone trials world wide; though regarding the approach, ways and positions of the epicardial lead, a few problems are still remained to be discussed. Now we report 9 cases (5 males, 4 females) of DDD pacemaker implantations by the left anterolateral thoracotomy approach. The 9 patients weighing 6.5 to 33 kg, were aged 11 months to 12 years (mean 6 years) of whom male 5, female 4 with degree of Block; 2 and 7. To all patients the stab-in type epicardial tips were implanted in the left atrium, the screw-in type ventricular epicardial tips were in the left ventricle by the 4th intercostal thoracotomy, and the pacemaker generators were beneath the fascia of the abdominal rectus muscle. We have no sensing and pacing failure, all pacemakers are working in the DDD mode well.

Enzymatic Activity and Expression of Cytochrome P450 LAω within Intrasplenically Transplanted Fetal Hepatocytes in Spontaneously Hypertensive Rats

We examined the expression and enzymatic activity of the cytochrome P450 LAω within transplanted hepatocytes. Fetal hepatocytes were harvested at day 20 of gestation from spontaneously hypertensive rats (SHRs) and transplanted into recipient adult SHR spleens. Microscopic examination of the recipient spleens 4 and 10 wk after transplantation revealed masses of hepatocytes with cordlike structures in the red pulp. Immunochemical studies detected cytochrome (cyto) P450 LAω in the fetal hepatocytes before transplantation without prior induction. Although the cyto P450 LAω was not detected by the second week after transplantation, by the 6th and 10th wk after transplantation, it was. Cyto P450-arachidonic acid ω/4oM-1 hydroxylase activity (formation of 20- and 19-hydroxyeico-satetraenoic acid) was detected at 10 wk after transplantation, but not 2 or 6 wk after transplantation. These results demonstrated that fetal hepatocytes can be transplanted successfully into recipient spleens and then grow in the spleens, as in the case of the adult hepatocyte response.

Quantitative measurement of antibody inhibiting reverse transcriptase activity in cats naturally infected with feline immunodeficiency virus

Quantitative measurement of reverse transcriptase-inhibiting (RTI) antibodies in Japanese household cats naturally infected with feline immunodeficiency virus (FIV) was performed by poly A-linked colorimetric reverse transcriptase assay (PAC-RTA). Eight FIV-seropositive plasma samples were diluted twofold from 1:10 to 1:160 and incubated with FIV RT. Fifty percent RTI activity (RTI50) was calculated from a dose response PAC-RTA curve. The plasma of FIV-seropositive cats showed different RTI activities against two Japanese isolates and Petaluma strain. Six of eight plasma samples showed RTI activities against the Japanese isolates (subtype B), but only one showed RTI activity against Petaluma strain (subtype A). It is important to use the appropriate strain as a source of RT for detection of RTI antibody in cats.

[Mitral valve replacement and closure of ventricular septal defect in the first two months of life]

A 2-month-old female infant weighing 4.2 kg was admitted with severe congestive heart failure and respiratory distress. The patient was operated upon under a diagnosis of severe congenital mitral regurgitation and ventricular septal defect. There was thickening of the anterior leaflet and short thickened chordae. The valve was judged not amenable to repair and it was replaced with a 17 mm St. Jude Medical valve. She was extubated on the 5th postoperative day. Post operative anti-coagulant therapy was initiated with warfarin potassium, dipyridamole and ticlopidine hydrochloride. The postoperative course was uneventful and the patient is doing well 9 months after the operation.

CP2289, a new 5-HT3 receptor ligand: agonistic activities on gastroenteric motility

A new 5-HT3 receptor ligand, CP2289, was synthesized and pharmacologically tested. Although CP2289 inhibited the Bezold-Jarisch reflex, it contracted the excised ileal muscle of mice, rats and guinea pigs. This response may reflect a partial agonist character of CP2289 in the gut. In vivo antiemetic and gastric emptying tests gave similar results.

[Rapid detection of influenza virus A (AH1, AH3) and B by nested-polymerase chain reaction]

We applied the Nested-polymerase chain reaction (PCR) for laboratory diagnosis of influenza virus infection. We used three primer sets for detection of influenza virus A (AH1, AH3) and B. The primer sets for each type (AH1, AH3, B) was able to detect specifically each type of influenza. We measured the sensitivity for detection of vaccine strains. The PCR method was able to detect 0.9 PFU/assey of AH1 type, 1.0 PFU/assey of AH3 type and 1.8 PFU/assey of B type. Out of 46 isolation negative but antibody positive cases, 38 cases were positive for PCR (82.6%). This method is sensitive and useful for rapid diagnosis of influenza virus infection.

Measurement of reverse transcriptase of feline immunodeficiency virus by poly A-linked colorimetric assay

The method of the poly A-linked colorimetric reverse transcriptase assay (PAC-RTA) was developed and evaluated for the measurement of Mg(2+)-dependent reverse transcriptase (RT) activity of feline immunodeficiency virus (FIV). PAC-RTA was first evaluated for the detection of RT activity in the culture supernatant of FIV Petaluma strain. The detection limit of RT activity by PAC-RTA was about 10-fold better than that by the conventional non-radioisotopic RT assay kit. Then, PAC-RTA was evaluated for the indication of FIV isolation from cats naturally infected with FIV. FIV was isolated from peripheral blood mononuclear cells of 9 FIV-seropositive cats. The time course appearance of RT activity measured by PAC-RTA corresponded with the analysis of FIV antigen expression by indirect immunofluorescence. Finally, PAC-RTA evaluated the drug susceptibility of FIV. MYA-1 cells (feline T-lymphoblastoid cells) were infected with FIV and were cultured in the presence of various concentrations of anti-human immunodeficiency virus agents such as azidothymidine (AZT) or dextran sulfate. An inverse relationship between the RT activities and the concentrations of these agents in the culture supernatant was confirmed by PAC-RTA. PAC-RTA is easy to perform without using radioactive materials, and one plate can handle 96 samples at one time. By monitoring the RT activity, this assay is a useful method for FIV studies such as viral replication and drug susceptibility.

An overview of animal toxicology studies with bicalutamide (ICI 176,334)

The toxicological profile of bicalutamide in animals following acute and chronic dosing is closely associated with the drug's non-steroidal anti-androgenic pharmacological activity. Bicalutamide produces typical effects of an anti-androgen, including atrophy of the prostate, testis and seminal vesicles and Leydig cell hyperplasia resulting from inhibition of pituitary feedback by testosterone. Subsequent benign Leydig cell tumors were seen in rats, but Leydig cell hyperplasia has not been observed in patients. Bicalutamide causes liver enlargement and is a mixed function oxidase inducer in rodents and dogs, but not man. These effects lead to thyroid hypertrophy and adenoma in the rat and hepatocellular carcinoma in the male mouse. In vitro and in vivo genotoxicity studies have all given negative results. Bicalutamide also caused a reversible shortening of the electrocardiographic P-R interval in the dog without any associated pathology. This change was not detected in ECG monitoring during clinical trials. In conclusion, bicalutamide produced a range of pharmacological effects, as well as liver enlargement with enzyme induction and dog ECG changes in preclinical toxicity studies in rodents and dogs. Only the pharmacological changes were found to be relevant to human usage.

[The HIV/AIDS Epidemic in Cambodia]

In December 1995 and March 1996, we visited institutes which were conducting epidemiological studied of HIV/AIDS in Cambodia, and obtained data for further collaborative study between Japan and Cambodia. Data included information on AIDS patients and HIV infected persons, and behavioral epidemiology of CSWs (Commercial Sex Workers). The cumulative reported number of AIDS patients and HIV infected persons in Cambodia was 86 and 2,536 cases respectively in 1995. The cause of infection was mostly heterosexual contact with very few cases from injecting drug use (IDU) and other causes. The seroprevalence rate of HIV antibody among donated blood rapidly increased from 0.08% in 1991 to 4.47% in 1995, and those among CSWs and pregnant women were 37.9% and 2.6%, respectively, in 1995. The average rate of condom use among CSWs was 66%, but the rate of usual usage was only 14%. These results indicate that the HIV/AIDS epidemic had spread rapidly through CSWs, that it had been spread among peoples in communities, and that usage of condoms among CSWs was insufficient in Cambodia. Without strong countermeasures against HIV/AIDS in this country, HIV/AIDS epidemic may spread significantly to not only peoples in this country but also those in neighbouring countries in the future.

Serum levels of inhibin A and inhibin B in women with normal and abnormal luteal function

OBJECTIVE

To determine whether serum inhibin A and inhibin B concentrations are lower in patients with luteal dysfunction than in women with normal luteal function.

METHODS

Serum samples were collected from seven healthy women with regular menstrual cycles. Serum samples on days +5 to +9 after the LH surge were collected from patients with luteal dysfunction. The diagnosis of luteal dysfunction was based on a luteal phase duration less than 11 days and a single midluteal progesterone level below 10 ng/mL. Serum levels of inhibin A, inhibin B, progesterone, estradiol (E2), FSH, and LH were measured.

RESULTS

The serum inhibin A levels were increased toward the late follicular phase. The levels reached a maximum during the midluteal phase, followed by a fall during the late luteal phase. The serum inhibin B levels were high during the follicular phases and the early luteal phase. The levels decreased during the midluteal and late luteal phases. Serum levels (mean +/- standard error of the mean) of inhibin A in patients with luteal dysfunction were significantly lower than those in women during the midluteal phase (26.2 +/- 2.9 compared to 41.9 +/- 2.8 pg/mL; P < .01) in addition to the expected decrease in serum progesterone levels (6.3 +/- 0.7 compared to 14.7 +/- 1.2 ng/mL; P < .01). Serum inhibin B levels did not differ significantly between normal women and those with luteal dysfunction. There also were no significant differences in the E2, FSH, and LH levels.

CONCLUSION

Levels of inhibin A, but not of inhibin B, may reflect the human luteal function.

Successful treatment of a rectal anastomotic stenosis by transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser

We report the advantage of employing transanal endoscopic microsurgery (TEM) using the contact Nd:YAG laser for the treatment of a rectal anastomotic stenosis. A 72-year-old woman was admitted to our hospital with a postoperative rectal anastomotic stenosis. Twenty months prior to admission, the patient underwent a low anterior resection for the treatment of the rectal cancer using an EEA stapling device. A barium enema and colonoscopy revealed a rectal stenosis, 0.8-cm diameter. This stenosis was at the anastomotic site, approximately 4.0 from the dental line. An endoscopic treatment was performed transanally using the contact Nd:YAG laser. The stenotic rectal wall was fulgurated or vaporized completely. There were no intraoperative or postoperative complications. We concluded that TEM appears to be a safe and minimally invasive procedure. Furthermore, the contact Nd:YAG laser is very effective in treating the gastrointestinal stenotic area. To our knowledge, this is the first successful report of this novel procedure.

[Mothers attending hospitalized children: using Leininger's ethnonursing method]

The purpose of this study was to discover the views of mothers with hospitalized children. Leininger's mini-ethnonursing method was used to explore and describe the views of Japanese mothers. A children's unit of a general hospital in Kanto in Japan was used for the field research. Six mothers who were with their hospitalized children were selected as the key informants. And 14 staff members on the unit including nurses, physicians, and nurse aides, were selected as the general informants. From nearly 140 days of observation-participation and reflection (Leininger enabler), the following themes were discovered; Theme 1: The mothers wanted to be close to their children (like tied to their navel string) and to be the only persons who could stay continually with their hospitalized child. Theme 2: The mothers tried to do everything by themselves, because they thought nurses were too busy and, therefore, they could not leave their children alone. They still wanted the nurses to help the child when they needed a long-term care at the hospital. Theme 3: The mothers expected an assurance of the life of their child and wanted an effective treatment from physicians, but held there was no one to consult fully with about their children's illness. Theme 4: Mothers searched companions who had the similar feelings and views, but didn't ask about their children's diagnosis. Theme 5: The mothers believed they had limited knowledge about prevention of an infection, but they tried to prevent by infection. Theme 6: The mothers were unaware of their fatigue and neglected to rest, sleep, and eat properly while child was hospitalized. Theme 7: The mothers did not expect their husbands to stay with their children, but expected their own mothers to help them. Theme 8: The mothers believed that nobody could explain and advise them about their daily life at the hospital, the medical systems and to reassure them. A recurrent theme was that "mothers took for granted that they must stay with" or "hold out" for their hospitalized child.