[Contamination of hot water supply in office buildings by Legionella pneumophila and some countermeasures]

An assessment of the contamination by Legionella species of hot water supplied to office buildings was made based on 80 samples of water from 3 types of systems as follows: 20 samples supplied from instantaneous heaters, 20 samples from hot water storage type systems, and 40 samples from circulation type systems. Legionella spp. were detected in two samples (10.0%) from hot water storage systems and five samples (12.5%) of the circulation type. The number of Legionella spp. was 2.0 x 10-8.4 x 10(2) CFU/500 ml. All isolated strains were identified as Legionella pneumophila. All hot water samples with Legionella spp. showed a temperature range from 41-55 degrees C. Contamination may easily occur in hot water storage and circulation type systems, due to their presence for prolonged periods. Hot water may be therefor be a source of Legionnaires' disease. It is clear from the present study that Legionella spp. survived over long periods and proliferated considerably. Elimination of this organism requires careful cleaning of hot water storage tanks but this alone may not be sufficient. Heat treatment for 20 hours at 70 degrees C was found to be adequate for complete elimination. Experimentally, complete sterilization from Legionella spp. within 5 minutes was demonstrated by heating at 60 degrees C. As a countermeasure temperature of hot water should be maintained at more than 55 degrees C, as the best means for elimination while also giving consideration to the prevention of scalding.

Role of protein kinase C-mediated pathway in the pathogenesis of coronary artery spasm in a swine model

BACKGROUND

The intracellular mechanism of coronary artery spasm is still unknown. The pathway mediated by protein kinase C (PKC) is an important intracellular process of various cellular responses, including vascular smooth muscle contraction. Thus, we examined the role of the PKC-mediated pathway in the pathogenesis of coronary artery spasm in our in vivo swine model.

METHODS AND RESULTS

Seven Göttingen miniature pigs underwent coronary balloon injury and x-ray irradiation to induce atherosclerotic lesion. After 6 to 18 months, intracoronary serotonin (3 micrograms/kg) or histamine (3 micrograms/kg) repeatedly induced coronary artery spasm at the atherosclerotic site. At the spastic site, intracoronary administration of phorbol-12,13-dibutyrate (PDBu) (10(-9) mol/kg), a PKC-activating phorbol ester, also induced coronary artery spasm, which was completely blocked by pretreatment with intracoronary staurosporine (10 micrograms/kg), a PKC inhibitor. Intracoronary administration of an inactive phorbol ester, phorbol-12,13-didecanoate (10(-9) mol/kg), did not induce coronary vasoconstriction. Coronary artery spasm induced by the autacoids was significantly augmented by pretreatment with intracoronary PDBu and partially inhibited by staurosporine. Intracoronary administration of Bay K 8644 (10 micrograms/kg), a dihydropyridine-sensitive L-type calcium channel agonist, also induced coronary artery spasm at the spastic site, which was significantly inhibited by pretreatment with intracoronary staurosporine or nifedipine (0.1 mg/kg).

CONCLUSIONS

These results suggest (1) the PKC-mediated pathway is importantly involved in the pathogenesis of coronary artery spasm, (2) activation of the PKC-mediated pathway partially accounts for serotonin- and histamine-induced coronary artery spasm, and (3) at the spastic site, calcium influx through dihydropyridine-sensitive L-type calcium channel and/or calcium sensitivity of the contractile proteins may be augmented by the PKC-mediated pathway.

Synthesis of N-acetylglucosamine-modified ara-C and its effect on ovarian cancer cells

1-beta-D-Arabinofuranosylcytosine (ara-C) was modified by reaction of tetra-N-acetylchitotetraose ((GlcNAc)4) using the transglycosylation activity of thermostable chitinase (EC 3.2.1.14) from Bacillus licheniformis X-7u. The structure of the modified ara-C was determined to be either beta 1-3'- or beta 1-5'-linked GlcNAc-ara-C or (GlcNAc)2-ara-C. The total yield of these glycosylated ara-Cs was about 10%. GlcNAc-ara-C and (GlcNAc)2-ara-C depressed the growth of G-401 cancer cells, while 5-O-beta-D-galactopyranosyl-beta-D-arabinofuranosylcytosine (Gal-ara-C) had no effect on G-401 cells.

Sweat function in Parkinson's disease

Sweat function was studied in patients with Parkinson's disease and in normal adults by sympathetic skin response, the bromphenol blue printing method and the silicone mould method. In patients with Parkinson's disease, dysfunction of sweating was classified into two types: one type involved the postganglionic fibres and the other involved the preganglionic fibres or the central nervous system. The latter was observed in patients with milder disease and the former was observed in patients with severe disease. The progressive involvement of sweat function in Parkinson's disease may reflect spread from the central nervous system or preganglionic fibres to postganglionic fibres. In a few patients the results of sweat tests were normal. Ceruletide increased sweating in Parkinson's disease patients, and decreased the prolonged latency of the sympathetic skin response. It is hypothesized that ceruletide facilitates the preserved somatosympathetic reflex of sweating.

Association of vascular endothelial growth factor expression with tumor angiogenesis and with early relapse in primary breast cancer

Angiogenesis is an independent prognostic indicator in breast cancer. In this report, the relationship between expression of vascular endothelial growth factor (VEGF; a selective mitogen for endothelial cells) and the microvessel density was examined in 103 primary breast cancers. The expression of VEGF was evaluated by immunocytochemical staining using anti-VEGF antibody. The microvessel density, which was determined by immunostaining for factor VIII antigen, in VEGF-rich tumors was clearly higher than that in VEGF-poor tumors (P < 0.01). There was a good correlation between VEGF expression and the increment of microvessel density. Furthermore, postoperative survey demonstrated that the relapse-free survival rate of VEGF-rich tumors was significantly worse than that of VEGF-poor tumors. It was suggested that the expression of VEGF is closely associated with the promotion of angiogenesis and with early relapse in primary breast cancer.

Spinocerebellar degenerations in Japan: a nationwide epidemiological and clinical study

A nationwide survey of patients in Japan with spinocerebellar degenerations (SCD), including SDS and SND, was conducted from 1988 to 1989. The survey consisted of two parts. The first revealed that the estimated total number of patients with SCD in Japan was 5,050 (range: 4,100-6,000) with an estimated prevalence of 4.53 per 100,000 in 1987. The second part investigated the neurological and functional status of patients with SCD. The percentages of those belonging to each subtype of SCD were: OPCA; 34.4%, LCCA; 15.2%, MHCA; 12.6%, HHCA; 7.5%, SDS; 7.0%, HSP; 3.9%, DRPLA; 2.5%, FA; 2.4%, MJD; 2.0% and SND; 1.5%. Compared with European epidemiological studies Japan had a higher proportion of non-hereditary types of SCD. Various clinical features of SCD subtypes were compared grouped by pathological lesion and heredity. HHCA and LCCA: cerebellar ataxia predominated in all stages, and neurological signs other than cerebellar ataxia were rare. MHCA, DRPLA and MJD: in the early phase ataxia was the most common symptom in MHCA, the AC form of DRPLA and MJD, but ataxia was less common and chorea or epilepsy were often observed in ME and PH forms of DRPLA. Other frequently observed clinical features were parkinsonian rigidity in MHCA, abnormal movements and posture in DRPLA and MJD, and disturbances of eye movements in MHCA, the AC form of DRPLA and MJD. OPCA, SDS and SND: dominant clinical features were cerebellar ataxia in OPCA, autonomic disturbance in SDS, and parkinsonian rigidity in SND. FA and HSP: both were rare in Japan. Clinical features related to supra-supinal lesions were frequently observed in FA. Functional status of SCD: the severity of illness was significantly associated with the level of independence in each item of ADL. Activities not requiring dynamic balance were performed independently for a longer period than those requiring dynamic balance. Among SCD subtypes, functional prognosis was poorest in non-hereditary, multi-systemic types (OPCA, SDS and SND) followed by hereditary multi-systemic types (MHCA, DRPLA and MJD), and better in spinal types (FA and HSP) and cerebellar types (HHCA and LCCA).

Novel structures of N-linked high-mannose type oligosaccharides containing alpha-D-galactofuranosyl linkages in Aspergillus niger alpha-D-glucosidase

Seven oligosaccharides were isolated from alpha-D-glucosidase (EC 3.2.1.20) from Aspergillus niger, and the structures of these oligosaccharides were studied by 1H NMR spectroscopy. After treatment of the alpha-D-glucosidase with N-glycosidase F, seven major oligosaccharide peaks were detected by Dionex anion-exchange HPLC. The structures corresponding to the three peaks OS-1, OS-2, and OS-4 were determined to be Man8GlcNAc2, Man9GlcNAc2, and GlcMan9GlcNAc2, respectively, from 1H NMR spectra of the isolated fractions. Each of the four oligosaccharides OS-5, OS-6, OS-7-1, and OS-7-2 contained an alpha-D-galactofuranosyl residue (Galf) linked to Man(A) via an alpha-(1-->2)-linkage. OS-7 was found to consist of two oligosaccharides. The structures of these four oligosaccharides were determined to be GalfMan5GlcNAc2, GalfMan6GlcNAc2, GalfMan7GlcNAc2, and GalfMan8GlcNAc2 by 1H NMR spectroscopy and compositional analysis. The Galf structure of GalfMan5GlcNAc2 was found to be identical to that of an oligosaccharide previously isolated from the alpha-D-galactosidase of the same strain. The structure of OS-3 remains undetermined.

Inhibition of vascular endothelial growth-factor induced cell-growth by an angiogenesis inhibitor agm-1470 in capillary endothelial-cells

It is known that an anti-angiogenic compound AGM-1470 inhibits cells in vitro and in vivo, on mitogen-induced cell growth in capillary endothelial cells. In monolayer cultures, 1 ng/ml AGM-1470 completely inhibited both basic fibroblast growth factor (bFGF) induced cell growth and vascular endothelial growth factor (VEGF) induced cell growth in a cytostatic manner. IC50 was 85 pg/ml and 55 pg/ml for bFGF and VEGF induced cell growth, respectively. Moreover, in collagen gels, AGM-1470 suppressed the colony formation induced by bFGF and by VEGF in a dose dependent manner. Few colonies appeared 25 days after co-culuture with I ng/ml AGM-1470 and either 1 ng/ml bFGF or 5 ng/ml VEGF. It is suggested that a potent; inhibition of growth signals of more than one growth factor for endothelial cells might be involved in anti-angiogenic activity of AGM-1470.

[Distribution of androgen receptors in bulbo-spinal muscular atrophy]

Immunohistochemical staining with anti-androgen receptor (AR) antibody was performed in skeletal muscle specimens obtained from 3 cases with bulbo-spinal muscular atrophy (BSMA) and 12 cases with other neuromuscular disease. Anti-AR antibody staining was found exclusively in the muscle nuclei of Type 2A fibers in all of the 3 cases. But there was no positive staining in the muscle nuclei of other disease. As above mentioned, very specific immuno-staining of AR in skeletal muscle would be of benefit to diagnosis of BSMA in addition to identification of a mutation of AR gene.

Pulsed magnetic stimulation and F waves in Parkinson's disease

Twenty-two patients with Parkinson's disease with predominantly unilateral signs in the upper extremities were studied by means of transcranial magnetic stimulation. The mean central motor conduction time (CMCT) on the clinically affected side determined by F wave technique was significantly shorter (p < .01) than that of the other side at rest. However, the mean CMCT during slight voluntary contraction was not significantly different in the two sides. Amplitudes of motor evoked potentials and F waves tended to be higher on the clinically affected side than on the other side. We conclude that reduced CMCT and high F wave amplitudes reflect hyperexcitability of the anterior horn cells in patients with Parkinson's disease.

An outbreak of group B streptococcus infection in a neonatal nursery and subsequent trial for prophylaxis of nosocomial transmission

An outbreak of sepsis and meningitis caused by group B streptococcus occurred in three very low birthweight infants. To prevent further nosocomial transmission, immune globulin and ampicillin sodium were administered intravenously to other very low birthweight infants. After this prophylaxis, no other infants were involved in this outbreak. Immuno- and chemoprophylaxis may be considered as procedures to prevent nosocomial infection for very low birthweight infants.

[A refined evaluation of cerebellar ataxia and its application to treatment of spinocerebellar degeneration]

A two-dimensional analysis of cerebellar ataxia was performed by using video-computer motion measurement system, PEAK, which has been developed and produced by U.S.-Japan-Chatanuuga Co., Ltd. The analyses of gait, heel-knee tapping test, finger-nose test and heel-knee test were made on 23 cases of spinocerebellar degeneration (SCD) as compared with the 9 healthy. The cases of SCD included olivopontocerebellar atrophy (OPCA), hereditary OPCA, late cortical cerebellar atrophy (LCCA), hereditary LCCA, Joseph disease and dentatorubropallidoluysian atrophy. The results of analyses by the computer demonstrated slow movement of gait, decrease of flexion angle at knee joint at the swing phase of the gait. Heel-knee test revealed irregular, dysrhythmic movements of heel. The interval of the tapping showed great variance and its standard deviation of the average was found to be increased. And the average values were so increased as to implement slow movements of the heel. These above-mentioned findings were also observed in the tests of finger-nose and heel-knee as well. Oral intake of TA0910, TRH derivative, which was synthesized and produced by Tanabe pharmaceutical Co. Ltd. in Japan improved slow movements of the tests. Disorders of range, direction, and rate of the movements, as usually observed in the patient of ataxia, could be well recognized to be alleviated following the administration and the effects were statistically significant. Application of the computerized instrument to analysis of ataxia would be very beneficial in the neurological bed-side clinical examination.

A clinicophysiologic study of central and peripheral motor conduction in hereditary demyelinating motor and sensory neuropathy

Central and peripheral motor nerve conduction were analyzed in 13 patients with hereditary demyelinating motor and sensory neuropathy using central magnetic stimulation and peripheral electrodiagnostic techniques. All patients showed a marked decrease in peripheral nerve conduction velocity. In 11 patients, the central motor conduction time was slightly prolonged but in 2 it was markedly prolonged suggesting dysfunction of the corticospinal tract. These two patients exhibited marked weakness and atrophy of distal muscles without clinical signs of upper motor neuron dysfunction, which was considered to be masked by the lower motor neuron disorder. This study suggests that in some patients with hereditary demyelinating polyneuropathy central as well as peripheral nerve fibers may be affected.

Ceruletide therapy in action tremor following thalamic hemorrhage

Two men, aged 63 and 71 years, developed a gross action tremor and dysesthesias several months after an intracerebral hemorrhage. CT and MRI showed a small hemorrhage in the posterior region of the lateral nucleus of the thalamus in each patient. The tremor occurred on movement, had frequencies of 2.5-4.5 Hz and the amplitude varied depending on the joint position of the limb. Ceruletide (a cholecystokinin analog) 0.8 micrograms/kg i.m. produced a marked reduction in the action tremor and improved motor function. This effect appeared 10-15 min after the injection, and lasted for up to 4 weeks. It is suggested that ceruletide may be of value in the treatment of action tremors following a thalamic lesion.

Inhibition of IgM antibody-mediated aggregation of Trypanosoma gambiense in the presence of complement

This paper deals with the immune reaction between Trypanosoma gambiense and monoclonal IgM mouse antibody at equivalence with or without rabbit complement. Antibody-mediated trypanosome clumps formed in the absence of complement, and were readily dissociated by complement to become free. In the presence of complement, on the other hand, T. gambiense were not aggregated by the antibody. Free parasites adhered readily to cultured peritoneal macrophages. Complement-mediated dissociation of the clumped trypanosomes in the equivalence area released a large number of previously bound surface antigens. These antigens were capable of binding again to fresh IgM antibody. Experimental results further indicated that the complement system caused a functional alteration, changing the multivalent nature of the IgM antibody in the immune complex into a univalent one. This phenomenon is of great advantage to the infected host in clearing pathogens in vivo, as it allows more antibodies to attach to trypanosomes and subsequently initiate complement activity.

Novel N-linked oligo-mannose type oligosaccharides containing an alpha-D-galactofuranosyl linkage found in alpha-D-galactosidase from Aspergillus niger

Structures of oligosaccharides from Aspergillus niger alpha-D-galactosidase [EC 3.2.1.22] were studied. Purified alpha-D-galactosidase was treated with N-glycosidase F, and six kinds of oligosaccharides were isolated by gel chromatography and anion-exchange chromatography. The structures of the oligosaccharides were determined by 1H-NMR and compositional analysis to be Man5GlcNAc2, Man6GlcNAc2, Man9GlcNAc2, GlcMan9GlcNAc2, GalMan4GlcNAc2 and GalMan5GlcNAc2. From mild acid hydrolysis, methylation analysis and ROESY spectral analysis, it was ascertained that the galactosyl residue in two oligosaccharides was in the furanose form and was bound to mannose at the nonreducing end with an alpha 1-2 linkage (GalfMan4GlcNAc2 and GalfMan5GlcNAc2).

[X-ray computed tomographic scans of lower limb and trunk muscles in facioscapulohumeral muscular dystrophy]

X-rays computed tomographic (CT) scans of muscles of the lower limbs and the trunk in 14 patients with facioscapulohumeral muscular dystrophy (FSH) were studied. The CT scans showed that the affected muscles were decreased in density and size. The laterality of muscular involvement was sometimes observed. The muscular lesions in the lower limbs showed proximal distribution. In the thigh, the hamstrings were affected first, the adductor muscles second, and then the muscular involvement progressed to the quadriceps femoris muscle. In the lower leg, the gastrocnemius and soleus muscles were relatively spared as compared with the tibialis anterior muscle. In the lumbar girdle, the abdominal muscles were involved first, the gluteal muscles second, the back muscles third, and the psoas major muscle were relatively spared. The muscular weakness of this distribution exacerbated lumbar lordosis. The neck muscles were less affected than those of the lumbar girdle. The CT scans in FSH demonstrated the characteristic pattern of muscular involvement, which differed from the inherited muscular diseases such as Duchenne muscular dystrophy, myotonic dystrophy, and others.

[Aggravation of hypoxemia in supine position in myotonic dystrophy]

Myotonic dystrophy (MyD) involves a variety of systems. Respiratory disorders are common, namely elevation of diaphragm, alveolar hypoventilation, aspiration pneumonia and sleep apnea. We evaluated respiratory involvement. The subjects were 11 patients with MyD. Also 6 patients with limb girdle muscular dystrophy (LG) were examined to be compared with MyD. Both groups had the similar activities of daily living. All of them never complained of dyspnea. Arterial blood gas studies were performed in supine position and standing position. A new evidence was found that hypoxemia was aggravated and alveolar-arterial oxygen pressure difference was increased in supine position in MyD. Next, pulmonary function tests were done in supine position and sitting position. Functional residual capacity (FRC) were more reduced in supine position in MyD compared with LG. The value to subtract closing capacity from FRC was negative in supine position in MyD, showing closing phenomenon. We propose the mechanism of the aggravation of hypoxemia may be the following. The reduction of FRC caused by respiratory muscle involvement brings out the closing phenomenon. Abnormal uneven distribution of ventilation-perfusion ratio happens and then hypoxemia is worsened in supine position in MyD.

[Mechanism to induce scoliosis in Duchenne muscular dystrophy--a study of paraspinal muscle by X-ray computed tomography]

We studied mechanism to induce scoliosis in Duchenne muscular dystrophy (DMD) by use of X-ray computed tomography (CT) of paraspinal muscles. CT examination of paraspinal muscles was performed on 15 DMD patients at the following six levels; 1. Th3 vertebrae (upper thoracic spine level) 2. Th6 vertebrate (middle thoracic spine level) 3. Th10 vertebrae (lower thoracic spine level) 4. L1 vertebrae (upper lumbar spine level) 5. L3 vertebrae (middle lumbar spine level) 6. L5 vertebrae (lower lumbar spine level). We evaluated the degeneration of paraspinal muscle by a decrease in radio-density of the muscle which indicates infiltration of fatty tissue. The degeneration of the lateral portion of paraspinal muscle was more marked than that of the medial portion. The muscle was most severely affected at the middle lumbar spine level, showing a tendency to increase degeneration at the lower level of the spine. In cases showing laterality of the degeneration of paraspinal muscle, the less affected muscle on CT was located at the convex site of scoliosis. We speculate that the scoliosis occurs when DMD patients have asymmetrical paraspinal muscle degeneration, leading them to take compensatory posture.

Central motor conductivity in aged people

The conductivity of motor neurons in 26 aged females (mean age 79 years) was analyzed by the conventional conduction method and by pulsed magnetic stimulation and compared with that in 14 younger controls. In aged people, slow motor conduction velocities were found in peripheral nerves. Central motor conduction time (CMCT) in relaxed muscle was shorter in the aged people, although CMCT was normal in mildly contracted muscle. These findings coincide with the results studied in Parkinson's disease, although these subjects were not diagnosed as having Parkinson's disease. Aged people generally have an anteflexed posture, slow movements, and poor postural reflexes, and have been reported to have a decrease in the dopamine level which is relatively earlier than that of other transmitters in the basal ganglia. This may account for the present finding that aged people have neurophysiological abnormalities in CNS which are similar to those in Parkinson's disease.

[Multivariate analysis of the clinical signs in late cortical cerebellar atrophy (LCCA) in Japan--compared with olivo-ponto-cerebellar atrophy (OPCA) and hereditary cortical cerebellar atrophy (HCCA)]

We investigated the clinical features of 179 patients with late cortical cerebellar atrophy (LCCA) comparing with 382 patients with olivo-ponto-cerebellar atrophy (OPCA) and 91 patients with hereditary cortical cerebellar atrophy (HCCA) using multivariate analysis. They had no significant difference in durations from onset. Disorders of finger-nose test were of more severity and disorders of heel-knee test were less involved in LCCA than in HCCA. Eye movements tended to be normal in LCCA. LCCA showed more depressive and euphoric character than OPCA and HCCA. Analysis of LCCA and OPCA demonstrated that LCCA revealed hypotonia in muscles, normal or weak reactions of muscle stretch reflexes. There existed 21.4 percent of cases which could not be discriminated by multivariate analysis using clinical signs in LCCA and OPCA. Multivariate analysis of LCCA and HCCA, which are very similar in clinical signs, showed 66.3 percent of discriminatory rate. Thus, we could diagnose them to a certain extent only by clinical signs.