[Aortic and mitral valve aneurysms complicated with infective endocarditis: a case report]

A rare case of aortic and mitral valve aneurysms complicated with infective endocarditis was accurately diagnosed by transesophageal echocardiography. A 57-year-old man with severe aortic regurgitation due to infective endocarditis was admitted to our hospital. Transthoracic echocardiography showed an aortic valve aneurysm on the right coronary cusp and perforations on the other cusps. Transesophageal echocardiography demonstrated a small aneurysm on the anterior leaflet of the mitral valve which was not clearly visualized by transthoracic echocardiography. Color Doppler echocardiography revealed severe aortic regurgitation and mild mitral regurgitation without perforation of the mitral valve aneurysm. Aortic valve replacement and mitral valvuloplasty of the anterior mitral leaflet were performed. The right coronary cusp of the aortic valve showed marked thinning with infiltration of inflammatory cells. The postoperative clinical course was uneventful.

Expression of decay accelerating factor mRNA and complement C3 mRNA in human diseased kidney

BACKGROUND

Decay accelerating factor (DAF), a product of mesangial cells in vitro, is expressed on the surface of cells and is a candidate for the focal suppression of complement activation. It is not clear at present whether the levels of expression of DAF and intrarenal C3 synthesis correlate with the level of tissue injury.

METHODS

Immunohistochemistry for DAF and C3 and nonradioactive in situ hybridization with digoxigenin-labeled oligonucleotide probe for DAF and C3 mRNA were performed in 22 tissue samples of kidneys from patients with IgA nephropathy (IgAN), 6 with membranous nephropathy (MN), 6 with lupus nephritis (LN), and five normal kidneys.

RESULTS

In the normal kidney, DAF was confined to the juxtaglomerular apparatus and little or no C3 was detected; however, a few glomerular cells were positive for DAF mRNA but no C3 mRNA positive cells were detected. In diseased kidneys, DAF and C3 as well as their mRNAs were detected in mesangial cells, tubular cells and infiltrating cells. Glomerular epithelial cells and Bowman's capsule cells contained little or no DAF and C3 but were positive for their mRNAs. The mean percentages of mesangial cells positive for DAF and C3 mRNAs were 49.3 +/- 11.5% and 50.7 +/- 10.3% in IgAN, and 17.0 +/- 6.3% and 19.4 +/- 9.0% in MN, respectively. The percentage of mesangial cells positive for DAF and C3 mRNAs among intraglomerular cells correlated positively with the degree of mesangial proliferation and glomerular sclerosis in IgAN. In contrast, in LN the percentage of glomerular cells positive for DAF mRNA correlated negatively with the degree of glomerular injury, while the percentage of cells positive for C3 mRNA did not change with the progression of the disease. The ratio of C3 mRNA/DAF mRNA of glomerular cells correlated with the degree of glomerular injury in both IgAN and LN. In the tubulointerstitium, the percentage of cells expressing mRNA, and C3 mRNA/DAF mRNA radio correlated with the degree of tubular atrophy and interstitial broadening in both IgAN and LN.

CONCLUSIONS

We conclude that DAF and C3 mRNAs are synthesized in human diseased kidneys, and that a balance between locally synthesized DAF and C3 may be important in the progression of glomerulonephritis.

Insulin-like growth factor I stimulates proliferation and Fas-mediated apoptosis of human osteoblasts

In vitro studies have shown that insulin-like growth factor I (IGF-I) is a potent growth factor for osteoblasts, although both bone formation and resorption are upregulated by IGF-I in vivo. To understand the difference in the action of IGF-I observed in vitro and in vivo experiments, we examined the effect of IGF-I on the proliferation and Fas-mediated apoptosis of human osteoblasts in vitro. Human osteoblastic cell line MG63 and human primary osteoblast-like cells obtained from biopsy specimens were used as human osteoblasts. Cells were cultured with or without various concentrations of IGF-I followed by determination of the proliferative response and Fas-mediated apoptosis. IGF-I dose dependently stimulated the proliferation of cultured human osteoblasts. Both Fas expression and the degree of anti-Fas IgM-induced apoptosis of human osteoblasts was also augmented by IGF-I. Furthermore, the cytotoxicity of Fas ligand (FasL) cDNA transformants against human osteoblasts was increased when IGF-I-stimulated osteoblasts were used as target cells, indicating that stimulation of IGF-I increased functional Fas expression on human osteoblasts as well as their proliferation. The addition of DEVD-CHO, a specific inhibitor of CPP32, to the culture resulted in a significant inhibition of Fas-mediated apoptosis of both unstimulated and IGF-I-stimulated osteoblasts, although it did not affect the proliferative response or Fas expression. Our data suggest that activation of CPP32 is necessary for Fas-mediated apoptosis of human osteoblasts, and treatment of IGF-I increased this signaling pathway. In contrast, regulation of proliferation and Fas expression of the cells were probably not affected by CPP32 activation. Our results suggest that IGF-I acts on cultured human osteoblasts by increasing their proliferation and induction of Fas-mediated apoptosis by neighbouring FasL+ cells such as osteoclasts, thus probably functioning as a local coupling factor in the bone in vivo, stimulating both bone formation and resorption.

[A case of systemic lupus erythematosus developed with intestinal perforation]

A case of intestinal perforation associated with SLE is presented. A 54-year-old woman was diagnosed as having SLE twenty-five years ago when she had facial erythema, photosensitivity, oral aphtha, polyarthraliga, leukopenia, positive LE cell and positive antinuclear antibody. She had been treated with prednisolone and admitted to Kushiro City General Hospital because of one month history of fever and anorexia in February 1996. Laboratory findings did not reveal activity of SLE, and a diagnosis of urinary tract infection was made based on the findings of urinalysis. After severe diarrhea, disseminated intravascular coagulation (DIC) developed. A rectal perforation was revealed by endoscopic and radiological examination. An emergency laparotomy revealed necrosis of the rectum and sigmoidostomy was performed. The biopsied specimen of the rectum were diagnosed as gangrene of ischemic colitis histologically. Because of a penetration to the urinary bladder, an ureterocutaneostomy was performed. She died of sepsis and DIC on the 127th day of admission. Only 11 cases of intestinal perforation associated with SLE have been reported in Japan, and the association of vasculitis has been considered. In the present case, the prolonged use of prednisolone might cause the necrotizing ischemic colitis.

Effects of local administration of osteocalcin on experimental tooth movement

The purpose of this study was to evaluate the effects of local administration of osteocalcin, a major noncollagenous bone matrix protein, on experimental tooth movement in rats. An orthodontic elastic band was inserted between the upper first and second molars, and the first molar was moved mesially. Purified osteocalcin (0 to 10 micrograms) in 20 microliters of phosphate-buffered saline was injected into the region of the root bifurcation of the first molar daily for 4 days. Tooth movement increased significantly following the injections. Histological studies revealed that the injections markedly stimulated the appearance of osteoclasts on the pressured side of the alveolar bone surface. The results suggest that osteocalcin has an additive effect on the rate of orthodontic tooth movement through the enhancement of osteoclastogenesis on the pressured side.

Expression of endothelial and inducible nitric oxide synthase in human glomerulonephritis

The presence of nitric oxide (NO) in the kidney has been implicated in the pathogenesis of human glomerulonephritis. However, the exact type of glomerular cells that express NO synthase (NOS) and the NOS isoform involved in the local production of NO has not been identified in the human diseased kidney. We examined the expression of three isoforms of NOS, inducible NOS (iNOS), endothelial NOS (eNOS) and brain NOS (bNOS) in the renal tissue of patients with IgA nephropathy (IgAN, N = 10), lupus nephritis (LN, N = 5), membranous nephropathy (MN, N = 5) and minimal change nephrotic syndrome (MCNS, N = 5). Sections were immunostained and the correlation between the expression of each NOS and the degree of glomerular injury in that section was also examined. Normal portions of surgically resected kidneys served as controls. eNOS was present in glomerular endothelial cells and endothelium of cortical vessels in the control and diseased kidneys. iNOS was localized in mesangial cells, glomerular epithelial cells and infiltrating cells in the diseased glomeruli, whereas immunostaining for iNOS was hardly detected in control kidneys. In addition, the expression pattern of eNOS in each glomerulus was the reverse of that of iNOS. In IgAN and LN, the extent of staining for eNOS correlated negatively with the degree of glomerular injury, while the extent of staining for iNOS correlated positively with the degree of glomerular injury in the same tissues. bNOS was not detected in normal or nephritic glomeruli. Our results indicate the presence of a NO pathway in human diseased kidney, and suggest that NO derived from eNOS and iNOS may be involved in the progression of renal diseases and that NO derived from each NOS may play an important role in different way in human inflamed glomeruli.

Comparison of three treatment regimens of inhaled sodium cromoglycate in the management of adult patients with severe, steroid-dependent asthma

BACKGROUND

Asthmatic patients whose asthma remains poorly controlled despite treatment with high doses of inhaled corticosteroids and co-administration of oral corticosteroids are a difficult problem in therapeutics.

OBJECTIVE

To investigate the relative efficacy of three treatment regimens of inhaled sodium cromoglycate in the treatment of adult, severe, corticosteroid-dependent patients as determined by the reduction in the dose of oral corticosteroids and change in lung function.

METHODS

Open, randomized, group comparative trial of 12 weeks duration in asthmatic patients attending a hospital outpatient department. Patients whose asthma is (1) severe according to the classification of the Japanese Society of Allergology, (2) stable, and (3) needing treatment with at least 1600 microg of inhaled beclomethasone dipropionate and 5 mg or greater of oral prednisolone per day. The three treatment regimens of inhaled sodium cromoglycate were group A received sodium cromoglycate powder at a dose of 16 mg/day administered by a metered dose inhaler. Group N received sodium cromoglycate aqueous solution at a dose of 80 mg/day administered by a nebulizer. Group C received sodium cromoglycate aqueous solution (80 mg/day) combined with salbutamol (3 mg/day) administered by a nebulizer. The main outcome measures were a change in the daily dose of oral corticosteroids and in lung function with twice daily measurements of peak expiratory flow (PEF) recorded in the morning (PEF AM) and in the evening (PEF PM).

RESULTS

Mean reduction in oral corticosteroid dose/day was group A, 3.68 mg (95% CI 1.35,5.95); group N, 3.59 mg (95% CI 0.73,6.45); and group C, 3.97 mg (95% CI 1.81,6.13). The dosage reductions are all significant but with no differences between the groups. The mean increase in PEF over the last 4 weeks of treatment compared with baseline values was significant in all groups. The increases in group C are significantly greater than those in the other groups. These changes are all significant and the increases in group C are significantly greater than those in the other groups.

CONCLUSIONS

Inhaled sodium cromoglycate may be a useful additional treatment in the management of adult patients with severe, oral steroid-dependent asthma. Of the three methods of administration compared in this trial the most useful immediate results were obtained when the drug was administered as an aqueous solution mixed with salbutamol and delivered by a powered nebulizer.

An elevation of stem cell factor in patients with hyperthyroid Graves' disease

Graves' disease is an autoimmune disorder characterized by the presence of antibodies against thyrotropin receptor (TRAb). Stem cell factor (SCF), derived from bone marrow, is known to promote lymphohematopoiesis. To investigate the relation between the alteration in plasma levels of SCF, thyroid hormone status, and TRAb measured by thyrotropin binding inhibition (TBI), 13 untreated, 21 treated, and 4 relapsed hyperthyroid Graves' disease patients, 21 patients with Hashimoto's thyroiditis, 6 patients with subacute thyroiditis, and 11 control subjects were examined. In untreated hyperthyroid Graves' disease patients, serum levels of thyroxine (T4) and triiodothyronine decreased rapidly by methimazole treatment, and TBI decreased progressively, but variably. Simultaneously, the elevated plasma levels of SCF decreased gradually and progressively. The plasma levels of SCF correlated curvilinearly with the serum levels of T4. In 4 patients with relapsed hyperthyroid Graves' disease, TBI was marginally positive in 3 patients and negative in 1, but plasma levels of SCF were elevated significantly in all 4 patients. In patients with subacute thyroiditis and Hashimoto's thyroiditis with or without T4 replacement, plasma levels of SCF did not differ from that of controls. These findings indicate that the elevation of plasma levels of SCF relates to the longstanding thyrotoxic state and that short-term thyrotoxicosis does not significantly affect plasma levels of SCF. It remains to be determined whether the elevation in plasma levels of SCF is induced by excess thyroid hormone, reflecting the hypermetabolic state, or whether the elevation of plasma levels of SCF contributes to stimulation of lymphocytes producing TRAb.

Effect of local application of basic fibroblast growth factor on ligament healing in rabbits

OBJECTIVE

The effect of basic fibroblast growth factor (bFGF) on healing of a 4-mm defect in the medial collateral ligament of rabbits was studied.

METHODS

Fibrin gel containing 0 (vehicle only), 0.1, 1, or 10 micrograms of recombinant human bFGF was applied to the defect during the surgical procedure. Controls did not receive fibrin gel. Four rabbits in each group were sacrificed 1, 2, 3, and 6 weeks after surgery. Repair tissues were subjected to gross and histologic examinations, and expression of type I procollagen messenger RNA was evaluated using in situ hybridization after 2 and 3 weeks.

RESULTS

bFGF promoted formation of repair tissue and was associated with early filling of the ligament defect. Tissue maturation was significantly delayed after 3 and 6 weeks in the high-dose bFGF groups. In the low dose group, in contrast, tissue maturation was similar to that in controls at all time points, by both gross and histologic examination. In situ hybridization studies showed that type I procollagen mRNA expression was reduced in all bFGF groups.

CONCLUSION

Our data demonstrate that a single local application of bFGF promoted early formation of repair tissue in injured medial collateral ligaments. High doses of bFGF reduced repair tissue maturation, suggesting that in clinical uses the dose may play a significant role.

Synthesis of guanosine 5'-triphosphate analogues and their effect on microtubule assembly

More than 20 base-modified analogues of guanosine 5'-triphosphate including 2'-deoxyguanosine derivatives were synthesized and examined their effect on tubulin polymerization into microtubules (Mts). Among those, 2,6-diamino-8-oxopurineriboside 5'-triphosphate (1d), 2,6-diamino-2'-deoxypurineriboside 5'-tri phosphate (1b) and 8-bromoguanosine 5'-tri phosphate (1g) were shown to have remarkable effect to promote microtubule assembly.

Polymorphism in the Ialpha1 germ-line transcript regulatory region and IgA productivity in patients with IgA nephropathy

Enhanced in vivo and in vitro production of IgA has been reported in patients with IgA nephropathy (IgAN) and their family members. It is generally considered that IgA1 is a prominent subclass of IgA in IgAN. Although genetic mechanisms of IgA class switch recombination in IgAN have been studied enthusiastically, the critical factors that induce IgA1-specific class switching in IgAN have yet to be elucidated. A large body of data indicates that the germ-line transcript of Ig constant region (C(H)) genes that precedes actual class switching has regulatory effects on class switch recombination. To analyze structural abnormalities in the Ialpha1 germ-line transcript regulatory gene, a region about 1000 bp long located upstream of Ialpha1 exons was surveyed by the PCR-single strand conformation polymorphism method, and the polymorphism detected was confirmed by subsequent DNA sequencing. Three hot spots for point mutation were detected upstream of the promoter region of the Ialpha1 germ-line transcript, and the mutations were observed more frequently in patients than in controls. Patients with the mutations showed higher levels of serum IgA and higher in vitro IgA synthesis. In the luciferase assay, the regulatory gene with the mutations showed a potent effect for induction of the Ialpha1 germ-line transcript. The polymorphism in the Ialpha1 regulatory region possibly causes enhanced IgA production in some patients with IgAN.

ETR2 is an ETR1-like gene involved in ethylene signaling in Arabidopsis

The plant hormone ethylene regulates a variety of processes of growth and development. To identify components in the ethylene signal transduction pathway, we screened for ethylene-insensitive mutants in Arabidopsis thaliana and isolated a dominant etr2-1 mutant. The etr2-1 mutation confers ethylene insensitivity in several processes, including etiolated seedling elongation, leaf expansion, and leaf senescence. Double mutant analysis indicates that ETR2 acts upstream of CTR1, which codes for a Raf-related protein kinase. We cloned the ETR2 gene on the basis of its map position, and we found that it exhibits sequence homology to the ethylene receptor gene ETR1 and the ETR1-like ERS gene. ETR2 may thus encode a third ethylene receptor in Arabidopsis, transducing the hormonal signal through its "two-component" structure. Expression studies show that ETR2 is ubiquitously expressed and has a higher expression in some tissues, including inflorescence and floral meristems, petals, and ovules.

Subtalar instability following lateral ligament injuries of the ankle

A stress radiograph of the subtalar joint was taken using Telos equipment, while the X-ray beam was directed onto the posterior subtalar joint at angles of 30 degrees latero-medially and 40 degrees caudocranially. From this radiograph the subtalar tilt angle was measured as an index of stability of the subtalar joint. Intra-and interobserver evaluations of measurement of this angle were performed on 20 unstable ankles. The errors at a 95 per cent confidence level were 1.9 degrees for intraobserver A, 1.4 degrees for intraobserver B and 2 degrees in interobservation. Stability of the subtalar joint was evaluated on 46 lateral ligament injuries of the ankle (23 acute injuries and 23 chronic injuries) and 80 normal ankles. The subtalar tilt angle was 9.7 degrees +/ 3.2 degrees in acute injuries 10.3 degrees #/ 2.9 degrees in chronic injuries, and 5/2 degrees +/ 2/6 degrees in normal ankles. There were significant differences between the acute or chronic injury and the normal ankles. These results suggested that stability of the subtalar joint was disturbed following acute and chronic lateral ligament injuries of the ankle.

Identification of cellular compartments involved in processing of cathepsin E in primary cultures of rat microglia

Cathepsin E is a major nonlysosomal, intracellular aspartic proteinase that localizes in various cellular compartments such as the plasma membrane, endosome-like organelles, and the endoplasmic reticulum (ER). To learn the segregation mechanisms of cathepsin E into its appropriate cellular destinations, the present studies were initiated to define the biosynthesis, processing, and intracellular localization as well as the site of proteolytic maturation of the enzyme in primary cultures of rat brain microglia. Immunohistochemical and immunoblot analyses revealed that cathepsin E was the most abundant in microglia among various brain cell types, where the enzyme existed predominantly as the mature enzyme. Immunoelectron microscopy studies showed the presence of the enzyme predominantly in the endosome-like vacuoles and partly in the vesicles located in the trans-Golgi area and the lumen of ER. In the primary cultured microglial cells labeled with [35S]methionine, >95% of labeled cathepsin E were represented by a 46-kDa polypeptide (reduced form) after a 30-min pulse. Most of it was proteolytically processed via a 44-kDa intermediate to a 42-kDa mature form within 4 h of chase. This processing was completely inhibited by bafilomycin A1, a specific inhibitor of vacuolar-type H+-ATPase. Brefeldin A, a blocker for the traffic of secretory proteins from the ER to the Golgi complex, also inhibited the processing of procathepsin E and enhanced its degradation. Procathepsin E, after pulse-labeling, showed complete susceptibility to endoglycosidase H, whereas the mature enzyme almost acquired resistance to endoglycosidases H as well as F. The present studies provide the first evidence that cathepsin E in microglia is first synthesized as the inactive precursor bearing high-mannose oligosaccharides and processed to the active mature enzyme with complex-type oligosaccharides via the intermediate form and that the final proteolytic maturation step occurs in endosome-like acidic compartments.

Expression and localization of ferritin mRNA in ameloblasts of rat incisor

At the maturation stage, the ameloblasts of the rat incisor incorporate iron, supplied through the bloodstream, and deposit it into the surface layer of the enamel. In this unique iron transport system, ferritin functions as a transient iron reservoir in the cells. Here the expression of ferritin mRNA and its localization in the rat enamel organ was examined. Among various tissues, the enamel organ showed the highest expression for both ferritin H- and L-chain mRNA, as quantified by reverse transcription-polymerase chain reaction. In situ hybridization using digoxigenin-labelled cRNA probes for each chain demonstrated that both ferritin H- and L-chain mRNA were abundantly expressed in presecretory and secretory ameloblasts. The intensity of the positive hybridization signal gradually decreased toward the incisal direction. Differing from the mRNA localization, ferritin protein was immunologically undetectable in presecretory or secretory ameloblasts but was found in ameloblasts at the maturation stage, into which iron is known to be incorporated from the bloodstream. Thus, the expression of ferritin mRNA precedes the protein expression in the developmental stages of rat incisor ameloblasts, and the translation of ferritin and its half-life are probably controlled by the iron entry, as has been reported for other cell types.

A cross-validation of the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30) for Japanese with lung cancer

The EORTC QLQ-C30 was developed in English-speaking cultures. To determine if this instrument could cross a broad cultural divide and be used in Japan, the cross-cultural validity of its Japanese version was estimated. In evaluating psychometric testing, internal consistency by Cronbach's alpha, item-discrimination by multitrait scaling analysis, and validity analysis with ECOG performance score (PS) and Karnofsky Performance Status Scale (KPS) were performed. The QLQ-C30 (version 1.0) was given to 105 patients with lung cancer. Although the response rate was low in patients with PS 4, the questionnaire was well accepted by patients with PS 0-3. The Japanese QLQ-C30 has a weak scale of role functioning in terms of item discriminative validity. It also has a weak scale of cognitive functioning in items of discriminative validity and internal consistency. However, known-groups comparison showed the expected clinical validity with PS for all the scales except for financial impact, and longitudinally clinical validity with KPS was shown in scales of cognitive functioning, fatigue, and nausea and vomiting. Multitrait scaling analysis showed that the predicted scales constituting quality of life (QOL) in the English-speaking culture were extracted from the Japanese QLQ-C30, and found to be valid in Japan, indicating its possible usefulness as an instrument that is universally applicable across cultures.

Cellular expression of beta-microseminoprotein (beta-MSP) mRNA and its protein in untreated prostate cancer

BACKGROUND

Previous studies have shown that beta-microseminoprotein (beta-MSP) may be used as a diagnostic marker for prostate cancer. However, the level of expression of beta-MSP in prostate cancer detected by immunohistochemistry (IHC) has varied from one study to another.

METHODS

We analyzed the expression of both beta-MSP mRNA and its protein in a large sample of prostate tumors from 104 patients with untreated prostate cancer, using both nonradioactive in situ hybridization (ISH) and IHC.

RESULTS

Our results showed that 72 and 96 of 104 specimens were negative for beta-MSP mRNA (69.2%) and beta-MSP (92.3%), respectively. Furthermore, a reduced expression of both beta-MSP mRNA and its protein was detected in all malignant epithelial tissues compared with benign epithelia. Not all malignant tissue samples negative for beta-MSP mRNA were negative for beta-MSP (6.7%), and vice versa (29.8%). Other tissue samples were either negative for both (62.5%) or positive for both (1.0%).

CONCLUSIONS

Our results showed a lower level of expression of beta-MSP in prostate cancer tissue, compared with benign prostate tissue. This phenomenon may be mainly due to the presence of reduced levels of beta-MSP mRNA.

Coproantigen detection in a survey of Echinococcus multilocularis infection among red foxes, Vulpes vulpes schrencki, in Hokkaido, Japan

Detection of Echinococcus coproantigen using sandwich enzyme-linked immunosorbent assay (sELISA) was performed on fecal samples of red foxes in Hokkaido, Japan. Fecal samples were collected around fox dens in 1990 and 1992. The antibodies used for sELISA recognize heat-resistant antigens, thus all fecal samples were heated to render it safe for handling before examination. Detection of taeniid egg in fox feces collected was considered as an indication of E. multilocularis infection. In fecal samples collected in 1990 and 1992, coproantigen positive results out of taeniid-egg positive cases were 38/40 (95.0%) and 95/97 (97.9%), respectively. In addition, coproantigen was detected regardless of fecal condition when collected from the field, suggesting that the antigens detected by this method are quite stable. These results suggest that detection of coproantigen is useful for field surveys of foxes naturally infected with E. multilocularis.

Amplification of JC virus regulatory DNA sequences from cerebrospinal fluid: diagnostic value for progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease in the central nervous system caused by a ubiquitous human polyomavirus designated as JC virus (JCV). PML affects individuals with decreased immune competence and is now one of the common opportunistic infections in patients with AIDS. JCV DNAs in the brain of PML patients contain various PML-type regulatory regions that were generated from the archetypal regulatory region during persistence. Recently, many studies have suggested that detection of JCV DNA from the cerebrospinal fluid (CSF) may offer a tool for diagnosing PML. However, in all of these studies, coding sequences within the T antigen or capsid protein gene have been targeted for amplification. To amplify the JCV regulatory region, we established a nested PCR that could efficiently amplify the regulatory region from most JCV subtypes prevalent in the world. Using this PCR, we amplified JCV regulatory regions from the CSF samples from 4 patients strongly suspected of PML, whereas amplification was negative from 80 CSF samples from patients without PML. Sequencing of the amplified fragments revealed that they had unique deletions and/or duplications. Furthermore, in 3 PML patients, we analyzed the structures of regulatory regions derived from the brain as well as CSF. In each of these cases, the major regulatory sequence of both origins were identical. This finding indicates that JCV DNA in brain lesions is excreted in the CSF. Since the structures of PML-type JCV regulatory regions are unique to individual patients, the current PCR, if the amplified fragments are sequenced, can eliminate false positives that may arise from contaminations.

Implication of altered redox regulation by antioxidant enzymes in the increased plasma pentosidine, an advanced glycation end product, in uremia

Pentosidine is an advanced glycation end product (AGE) formed during Maillard or browning reaction by non-enzymatic glycation and oxidation (glycoxidation). Recent studies demonstrated the increased plasma pentosidine levels not only in diabetic patients with hyperglycemia but also in normoglycemic uremic patients. The mechanism of increased glycoxidation reaction in uremia, however, remains unknown. As superoxide dismutases (SODs) and glutathione peroxidase (GPx) are antioxidant enzymes involved in the metabolism of H2O2 which accelerates the glycoxidation reaction, we measured their activities by enzymatic assays in the plasma of normal and non-diabetic hemodialysis patients and examined a link between redox regulation by antioxidant enzymes and glycoxidation reaction. The activities of GPx were significantly lower in the plasma of hemodialysis patients than in normal subjects, whereas those of SODs were higher in the former than in the latter. As plasma SODs comprise three isozymes, i.e., Cu/Zn-SOD, Mn-SOD, and extracellular (EC)-SOD, we determined the levels of each SOD isozyme by ELISAs. The plasma concentrations of Cu/Zn-SOD and EC-SOD were significantly higher in hemodialysis patients than in normal subjects, whereas those of Mn-SOD did not differ between the two groups. It is of note that GPx activities correlated inversely with pentosidine in the plasma of hemodialysis patients (r2 = 0.262, P < 0.01). There was no significant correlation between total SOD activities and pentosidine levels in the plasma of hemodialysis patients, but, among the three SOD isozymes, the plasma EC-SOD levels correlated with the levels of pentosidine in hemodialysis patients (r2 = 0.286, P < 0.05). As decreased GPx and increased SOD activities result in the increased H2O2 generation, which accelerates the glycoxidation of protein, these data suggest a link of altered redox regulation by antioxidant enzymes to increased glycoxidation reaction in the uremic plasma. This paper provides the first time evidence for the possible involvement of enzymatic redox regulation in the non-enzymatic glycoxidation reaction in vivo.

Molecular cloning and chromosome mapping of rat phospholipase D genes, Pld1a, Pld1b and Pld2

We have previously obtained three partial rat phospholipase D (PLD) cDNA fragments by a reverse transcriptase-polymerase chain reaction (RT-PCR) method using degenerate primers based on two conserved amino acid sequences in PLDs of human and yeast. The entire coding regions of these genes were isolated and sequenced. The longest clone, Pld1a encodes a 1075 amino acid (aa) protein that was highly similar (89% identity) to human PLD1a, especially in four conserved regions present in other PLDs. The nucleotide sequence of the second clone was identical to that of Pld1a except that the clone lacked 114 nucleotides corresponding to 38 aa in the middle. A shorter alternatively spliced form of human PLD1 (PLD1b) lacking the corresponding 38 aa was also identified. Therefore, the second clone (Pld1b) was considered to correspond to the rat counterpart of human PLD1b. The third clone, Pld2 encoding 933 aa was smaller than that of Pld1 and its aa identity to rat Pld1 was 56%. However, it contains four conserved regions and aa sequences of these regions are homologous to those of rat Pld1 and human PLD1. Its entire aa sequence was very similar (96% identity) to the recently cloned mouse PLD, Pld2. Chromosome locations of the Pld1a, Pld1b and Pld2 genes were determined in the rat and mouse by fluorescent in situ hybridization. As expected, both Pld1a and Pld1b clones were hybridized to the same chromosome regions. The Pld1 and Pld2 genes were localized to rat chromosome 2q23.3-->q24 proximal end and the proximal region of mouse Chromosome 3B, and rat chromosome 10q23.3-->q24 proximal end and mouse Chromosome 11B3, respectively. They were mapped in regions where conserved linkage homology has been identified between the two species.