A duplicated PLP gene causing Pelizaeus-Merzbacher disease detected by comparative multiplex PCR

Pelizaeus-Merzbacher disease (PMD) is an X-linked dysmyelinating disorder caused by abnormalities in the proteolipid protein (PLP) gene, which is essential for oligodendrocyte differentiation and CNS myelin formation. Although linkage analysis has shown the homogeneity at the PLP locus in patients with PMD, exonic mutations in the PLP gene have been identified in only 10%-25% of all cases, which suggests the presence of other genetic aberrations, including gene duplication. In this study, we examined five families with PMD not carrying exonic mutations in PLP gene, using comparative multiplex PCR (CM-PCR) as a semiquantitative assay of gene dosage. PLP gene duplications were identified in four families by CM-PCR and confirmed in three families by densitometric RFLP analysis. Because a homologous myelin protein gene, PMP22, is duplicated in the majority of patients with Charcot-Marie-Tooth 1A, PLP gene overdosage may be a important genetic abnormality in PMD and affect myelin formation.

Effect of carnitine administration on glycine metabolism in patients with isovaleric acidemia: significance of acetylcarnitine determination to estimate the proper carnitine dose

In isovaleric acidemia (IVA), accumulated isovaleryl-CoA in the mitochondrion induces variable metabolic disturbances. To remove intramitochondrial isovaleryl groups, glycine therapy has been advocated primarily. On the other hand, secondary carnitine deficiency has been documented in this disorder and carnitine supplementation alone has been reported to be effective. In the present study, we administered carnitine and glycine to patients with IVA, and investigated serum carnitine and urinary excretion of total and free carnitine, acylcarnitine profile (i.e., isovalerylcarnitine and acetylcarnitine), and isovalerylglycine. By adding carnitine to glycine supplementation, more isovalerylglycine, not only isovalerylcarnitine, was excreted in the urine. Acetylcarnitine was detected in the urine only when sufficient carnitine was supplemented. We concluded that combined therapy of glycine and carnitine is more effective and safer to eliminate isovaleryl-CoA in IVA than conventional therapy using either glycine or carnitine. Urinary acetylcarnitine concentration might be a good marker indicating the optimal dose of L-carnitine supplementation.

Secondary carnitine palmitoyltransferase deficiency in chronic renal failure and secondary hyperparathyroidism

A 14-year-old girl, having mental and growth retardation with end stage renal disease, was affected by a stroke-like attack. The attack was associated with transient low density areas at both sides of the parietal portion on head CT. Lactic acidosis, hypertrophic cardiomyopathy, angina pectoris-like attacks, hypertension and hyperparathyroidism were also observed and they were supposedly due to mitochondrial cytopathy. No morphological or biochemical abnormalities were found on the mitochondrial respiratory chain. However, muscle carnitine palmitoyltransferase (CPT) activity was significantly low, which was restored to a normal level after hyperparathyroidism was controlled by alphacalcidol administration. Furthermore, we also found two more chronic renal failure patients with secondary hyperparathyroidism, as well as the primary hyperparathyroidism patient showing markedly low muscle CPT activity. These findings suggest the possible contribution of parathyroid hormone to lipid metabolism in skeletal muscle and to the myopathic manifestations often seen in hyperparathyroidism.

Biochemical bases in differentiation of a mouse cell line GSM06 to gastric surface cells

A mouse gastric surface cell line GSM06 established from a transgenic mouse harboring temperature-sensitive simian virus 40 large T-antigen gene was subjected to the lipid and glycoprotein analysis. When GSM06 cells were cultured for a long time after formation of a confluent monolayer, they differentiated to resemble foveolar epithelial cells morphologically. Biochemical changes during culture were studied in cells harvested just when a monolayer had formed (day 0), on day 7, and on day 21. Content of total phospholipids, cholesterol, cholesterol sulfate, total sugar and sialic acid increased about 1.5-fold from day 0 to 7 and remained elevated till day 21. The fatty acid composition of phospholipids revealed increased relative levels of oleic acid in phosphatidylcholine and phosphatidylethanolamine, and an increased level of plasmenylethanolamine from day 0 to 7. The level of dolichylphosphate continued to increase in a time-dependent manner. Glycosylation of various proteins, detected with lectins, was enhanced from day 7. In addition, greater resistance to taurodeoxycholate and acetylsalicylic acid was observed on days 7 and 21 than on day 0. Thus, enhanced glycosylation of proteins and an overall increase in the area of cellular membranes were the major changes in GSM06 cells during culture, and they were accompanied by an enhancement of cytoprotective potential.

Direct evidence of the production of IgA by tonsillar lymphocytes and the binding of IgA to the glomerular mesangium of IgA nephropathy patients

Tonsils were obtained by tonsillectomy from a 33-year-old woman with IgA nephropathy. Hetero-hybridoma cells of human tonsillar B-lymphocytes with mouse myeloma cells (NS-1) were made, and cultured in HAT medium supplemented with 10% fetus bovine serum and hybridoma cloning factor. The culture medium was analyzed by Western blot analysis using anti-human IgA antibody, and both IgA1 and IgA2 were demonstrated to be produced. The specimens of the biopsied kidney tissue of IgA nephropathy were washed with 0.02 M citrate buffer (pH 3.2) to remove deposited IgA from glomerulus. The specimens were then incubated with the culture media of hybridoma cells, and immuno-fluorescence analysis using FITC-conjugated anti-human IgA antibody was performed. IgA deposit was efficiently removed by washing with citrate buffer and was recovered after incubation with the culture medium of hybridoma cells. Direct evidence of binding of IgA produced by tonsillar B-lymphocytes to the glomerular mesangium of IgA nephropathy was demonstrated.

Biological characterization of gastric surface mucous cell line GSM06 from transgenic mice harboring temperature-sensitive simian virus 40 large T-antigen gene

We investigated the biological features of gastric surface mucous cell line GSM06, established from transgenic mice harboring the temperature-sensitive simian virus 40 large T-antigen gene. GSM06 cells grew until confluent monolayers were formed at the permissive temperature (33 degrees C), showing that the cessation of cell growth may be due to contact inhibition. Moreover, the cells did not grow in a soft agar gel. However, chromosome numbers of the cells were not normal. When GSM06 cells were cultured in Daigo's T medium supplemented with growth factors and 10% fetal bovine serum at 33 degrees C for 1, 3 or 9 days, the cells gradually grew to confluent monolayers (day 9). Morphological observations revealed that the cells time-dependently formed microvilli-like structures and yielded periodic acid-Schiff-positive glycoproteins on the cell surface with the growth of the structures. When GSM06 cells were cultured on a membrane filter for 1-9 days, elevated transepithelial resistance was noted in a culture period-dependent fashion. On day 9, junctional complexes such as tight junctions and desmosomes were observed between the cells. In addition, prostaglandin E2 production was evoked from the cells from day 1. In order to determine cell viability, GSM06 cells were labeled with the fluorescence dye 2',7'-bis(carboxyethyl)-carboxyfluorescein. Exposure of GSM06 cells to ethanol (7.5-17.5%) elicited cell injuries in a concentration-related manner on day 1, whereas these cytotoxic effects were attenuated on days 3 and 9, suggesting that this protection may be, at least in part, related to the increased glycoproteins and transepithelial resistance. GSM06 cells possessing these unique characteristics should be highly useful as an in vitro model of gastric epithelium.

Liquid chromatographic-atmospheric pressure chemical ionization mass spectrometric analysis of glycine conjugates and urinary isovalerylglycine in isovaleric acidemia

n-Acetylglycine, n-propionylglycine, n-butyrylglycine, isobutyrylglycine, n-valerylglycine, isovalerylglycine, heptanoylglycine, phenylacetylglycine and isovalerylglucuronide were identified based on their liquid chromatographic-atmospheric pressure chemical ionization mass spectra (LC-APCI-MS). We were able to detect the presence of urinary isovalerylglycine in two cases of isovaleric acidemia using LC-APCI-MS. Membrane-filtered urine samples were injected into the LC-APCI-MS system in the negative-ion mode without any further pretreatment, and large amounts of isovalerylglycine were detected as the [M-H]- ion. The urinary excretion of isovalerylglycine appeared to increase after L-carnitine therapy. This analytical method is quick and easy and it may be a useful tool in understanding dysfunctional conditions in isovaleric acidemia.

An electron microscopic study of the processes of nerve regeneration after lyophilized nerve homografting

The objective of the present study was to investigate the role of the Schwann cell basal lamina in nerve regeneration. To achieve this goal, we observed the process of axonal regeneration within a lyophilized nerve graft, in which only the basal lamina of the Schwann cell persisted. Sciatic nerves were removed from rats and lyophilized to kill the Schwann cells and other components. These grafts were transplanted to rat sciatic nerve defects. The rats were then killed after lapses of time. We observed the processes of axonal regeneration using a transmission electron microscope. Regeneration of axons along the inner surface of the Schwann cell basal lamina was clearly seen. These results suggest that, if tubular basal laminae persist, Schwann cells are not always necessary, and axonal regeneration can be induced in the direction toward the basal lamina.

An ultrastructural study of glomerular basement membrane in rheumatoid arthritis patients with urinary abnormalities

We measured the thickness of the glomerular basement membrane (GBM) in 48 rheumatoid arthritis (RA) patients with proteinuria and/or hematuria and studied its relationship to clinical features of RA. Ten cases with minor glomerular abnormalities, renal cancer, donor of renal transplantation, were studied as controls. Secondary glomerular diseases and hereditary thin basement membrane disease (TBMD) were excluded. Mean GBM thickness was 289 +/- 74 nm (mean +/- SD) in RA patients, which was significantly thinner than that of control group (342 +/- 38 nm) (p < 0.01). Mean GBM thickness were 276 +/- 72 nm and 336 +/- 68 nm in RA patients with and without gold sodium thiomalate (GST) treatment, respectively (p < 0.05). Mean GBM thickness of RA patients without GST and controls were not different statistically, but RA patients with GST had significantly thinner GBM, compared with controls (p < 0.01). The mean thickness of GBM were also 274 +/- 69 nm and 344 +/- 72 nm in RA patients with and without hematuria, respectively (p < 0.01). According to these results, we suspect that the thinning of GBM in RA patients may be related to GST treatment.

Two kinds of neutral serine proteinases in salted muscle of anchovy, Engraulis japonica

Two kinds of proteinases, type-I and type-II, were purified or partially purified from salted muscle of anchovy, Engraulis japonica. Mol. wts. of type-I and type-II proteinases were estimated to 25,000 and 37,000, respectively, on electrophoretic analysis. Both proteinases strongly hydrolyzed synthetic tri or tetrapeptide substrates specific to trypsin, alpha-thrombin, and an activated protein C, while they hardly hydrolyzed Arg-MCA and benzoyl Arg-MCA derivatives. The proteinases were inhibited by common trypsin inhibitors. Optimal pH for the proteinase activities were pH 6.8 (type-I) and pH 7.0 to 7.5 (type-II), and the proteinases showed the highest activities at 45 degrees C (type-I) and 50 degrees C (type-II). The N-terminal amino acid sequence of type-I proteinase, 1I-2V-3G-4G ... (29 residues were identified), was significantly similar to sequences of trypsins and tryptases. Based on these findings, both proteinases were presumed to be kinds of tryptases in E. japonica muscle.

Clinical evaluation of newly developed CRT viewing station: CT reading and observer's performance

The clinical performance of the new viewing station with six CRT monitors (17-inch, 1,024 x 1,280) was evaluated. In the primary interpretation of CT images, time measurements were carried out for eight radiologists. No significant differences in reading time existed between CRT and film in 3 of 4 readers in head CT series, and in 2 of 6 readers in body CT series. Compared with the previous system, the new prototype system achieved an approximately 30% decrease in reading time in both head and body CT studies and could reduce mental and eye fatigue.

MvaI polymorphism in the proteolipid protein (PLP) gene

We report a rare polymorphism in the human proteolipid protein (PLP) gene. A synonymous mutation, 168 A-->G, was detected in exon 2 of the PLP gene. Mutations in this gene have been reported in some cases of Pelizaeus-Merzbacher disease.

Atypical presentation of carnitine palmitoyltransferase (CPT) deficiency as status epilepticus

A 23-year-old Japanese man presented with status epilepticus unresponsive to medication, respiratory failure, rhabdomyolysis, myoglobinuria, and irreversible renal failure. Muscle biopsy revealed type 1 fiber atrophy and an increased type 2C fibers (7%). His carnitine palmitoyltransferase (CPT) I and II activities were 0.06 and 0.12 nmol/min/mg protein, as compared with a mean value of 0.22 +/- 0.14 and 0.27 +/- 0.07 nmol/min/mg protein, respectively, in control subjects. This appears to be the first report of this disorder presenting as status epilepticus. Metabolic encephalopathy due to CPT deficiency may have presented as status epilepticus. Seizures in the present case may have resulted from the functional disorder of brain due to CPT deficiency.

Assessment of auditory and vestibular functions after vestibular neurectomy for Menière's disease

Fourteen patients (12 Meniere's disease, one delayed endolymphatic hydrops and one labyrinthitis) suffering from intractable vertigo were treated with retrosigmoid vestibular neurectomy (RSVN) in our institute. Dizziness was controlled completely in all patients. Hearing was preserved in 91.7% of the cases with pure tone threshold deteriorating by more than 10 dB in one case, remained unchanged in 10 cases and improved in one case during long term observation. Substantial decrease of tinnitus was observed in 78.6%. Vestibular compensation was chronologically analyzed with a stabilometer, ENG and vestibular rotation test (0.01-0.64 Hz). Vestibular compensation under static conditions was accomplished within 2 weeks, except for spontaneous nystagmus measured in the dark. Asymmetry of vestibulo-ocular reflex was noted 2 weeks after the operation but had disappeared after 4 weeks. However, for over 2 years the VOR time constant remained lower (4.3-5.2 s) than the pre-operative value (8.2 s). Electro-cochleogram (ECoG) was recorded before and after RSVN. The -SP/AP ratio tended to increase after RSVN in the operated ear, though there was no change in the contralateral ear. The efferent olivo-cochlear bundle was thought to play a potential role in this increase of the -SP/AP ratio.

Ebselen, a seleno-organic compound, protects against ethanol-induced murine gastric mucosal injury in both in vivo and in vitro systems

The inhibitory effect of the seleno-organic compound ebselen on ethanol-induced murine gastric mucosal injury was examined. In an in vivo study, absolute ethanol (50 microliters/mouse, oral) produced marked gastric mucosal necrosis along with hemorrhage or edema and elevations in both lipid peroxide and peptidoleukotriene levels in the fundic mucosa. Pretreatment with ebselen (30 and 100 mg/kg, oral) significantly prevented this gastric mucosal injury and, further, remarkably decreased the elevated lipid peroxide and peptidoleukotriene levels. In an in vitro study using a murine gastric surface mucous cell line GSM06, exposure to ethanol concentration dependently elicited cell damage (7.5-17.5% ethanol) and an increase in lipid peroxides without alterations in peptidoleukotrienes (15% ethanol). Addition of ebselen (10 and 100 microM) to this system (15% ethanol) significantly inhibited the cell damage and completely prevented the increase in lipid peroxide level. These results indicate that ebselen protects against murine gastric mucosal injury both in vivo and in vitro, and that this protection may be related at least in part to its inhibitory action on lipid peroxides.

Alteration of ammonia and carnitine levels in short-term treatment with pivalic acid-containing prodrug

We investigated the influence on mitochondrial functions in carnitine deficiency caused by short-term treatment of cefteram-pivoxil (CFTM-PI) which is one of pivaloyloxymethyl-esterified antibiotics in adult volunteers and diseased children. Administration of CFTM-PI caused hypocarnitinemia in all cases, and we observed a significant elevation of blood ammonia levels compared with those after its withdrawal in diseased children. A significant negative correlation was found between the levels of serum free carnitine and blood ammonia, and a positive correlation was observed between serum carnitine and blood glutamine levels in all adult samples and samples during administration in diseased children. Our data suggest that these antibiotic medications affect the mitochondrial function even in a short-term treatment and that L-carnitine supplementation would be necessary for patients treated with CFTM-PI.

[A clinical and morphological study of thin basement membrane disease (TBMD)]

Among patients with minor glomerular abnormality detected by light microscopy, but without significant finding by immunofluorescent study, fifteen cases showing global thinning of the glomerular basement membrane (GBM) when examined by electron microscopy were investigated as thin basement membrane disease (TBMD). Fourteen cases with a normal GBM thickness were selected as the control group. In the TBMD group, the mean width of the GBM, the distance between the cell membranes of the epithelial and endothelial cells, was 225 +/- 20 nm, whereas it was 354 +/- 42 nm in the control group. Some cases in the control group revealed a thinner GBM than other cases, which suggested the existence of an intermediate type between the TBMD and normal groups. The mean thickness of GBM in the intermediate and other control cases were 299 +/- 6 nm and 388 +/- 9 nm, respectively. In addition to global thinning of the GBM, the characteristic lesions of TBMD, a lucent appearance of the mesangial area (6 cases), widening of the subendothelial space (8 cases), splitting of the GBM (2 cases) and rupture of the GBM (one case) were observed in the TBMD cases, although these changes were mild in degree. A lucent appearance of the mesangium and widening of the subendothelial space were noticed more frequently in the TBMD group, compared with the control group. A common urinary abnormality in the TBMD patients was microscopic hematuria, which was occasionally associated with mild to moderate proteinuria. The renal function remained within the normal range in thirteen cases. Five cases of the TBMD group had members with renal abnormality in their family, of whom two showed renal failure and were undergoing hemodialysis.

Preparation and taste of certain glycosides of flavanones and of dihydrochalcones

The 7-O-[2-O-(alpha-L-Rhamnopyranosyl)-beta-L-quinovoside] of naringenin and of hesperetin, and their dihydrochalcone (DHC) derivatives were synthesized by the method of Koenigs-Knorr (Ag2CO3 and quinoline). The reaction of TMS ethers of naringenin and of hesperetin with each of the alpha-acetofluoro derivatives of D-glucose, L-rhamnose, 2-O-(alpha-L-rhamnopyranosyl)-L-rhamnose, and 2-O-(alpha-L-rhamnopyranosyl)-D-glucose (neohesperidose), using boron trifluoride etherate as an activator, yielded coupling products which, after deprotection, gave naringenin 4'-O-beta-D-glucoside, naringenin 4'-O-alpha-L-rhamnoside, naringenin 4'-O-[2-O-(alpha-L-rhamnopyranosyl)-alpha-L-rhamnoside], hesperetin 3'-O-[2-O-(alpha-L-rhamnopyranosyl)-alpha-L-rhamnoside], and naringenin 4'-O-beta-neohesperidoside, respectively. Catalytic hydrogenation of these flavanones gave the corresponding DHC derivatives. Hesperetin DHC 4'-O-[2-O-(alpha-L-rhamnopyranosyl-beta-L-quinovoside] was 300 times sweeter than sucrose, while the other compounds were bitter or tasteless.