A novel metabolite of 3,4-methylenedioxyamphetamine (MDA): formation of 3-methyl-6,7-methylenedioxy-1,2,3,4-tetrahydroisoquinoline and its pharmacological effect

In 3,4-methylenedioxyamphetamine (MDA)-treated rat brain and urine, 3-methyl-6,7-methylenedioxy-1,2,3,4-tetrahydroisoquinoline (3Me6,7MDTIQ) was detected as a new metabolite. The content of 3Me6,7MDTIQ in (R)-MDA-treated rat was significantly higher than that in (S)-MDA-treated brain and urine. This result suggests that this metabolism of MDA contains stereoselective pathways. The pharmacological effects of 3Me6,7MDTIQ on behavior differed from those of MDA. The ambulation score of 3Me6,7MDTIQ was significantly decreased compared to the control, and the rearing score of 3Me6,7MDTIQ was moderately decreased compared to the control in an open-field test.

[An evaluation of prognostic factors in patients with esophageal carcinoma]

We evaluated the relationship between clinicopathological findings and the prognosis of 101 patients who underwent esophagectomy for primary esophageal cancers in our institution, from 1980 to 1991, and investigated the prognostic factors of esophageal carcinoma. There were significant relationships between the prognosis and the depth of cancer invasion (P < 0.05), lymph nodes involvement (P < 0.05), lymphatic invasion (P < 0.01), venous invasion (P < 0.05) and histological stages (P < 0.01). The stages were decided by the depth of invasion and the lymph nodes metastasis. There were also no positive relationships between the prognosis and lymphatic and venous invasion in the patients groups of both n (-) and n3 + 4. Therefore, we concluded that the most important prognostic factors were the depth of cancer invasion (invasion into the neighboring structures) and lymph nodes involvement. We suggest that lymphatic and venous invasion may play an important part in the prognosis of the patients in the n1 + 2 positive group.

An occurrence of equine transport pneumonia caused by mixed infection with Pasteurella caballi, Streptococcus suis and Streptococcus zooepidemicus

An acute death occurred in a racehorse with pneumonia after long-distance transportation in December, 1990. Pasteurella caballi, Streptococcus suis and Streptococcus zooepidemicus were isolated from the lung at high rate. Specific antigens of these bacteria were also demonstrated immunohistologically in the pneumonic lesion. These findings indicated that the disease is equine transport pneumonia caused by a mixed infection of the three bacterial species. This is the first report on the isolation of P. caballi and S. suis from a racehorse in Japan.

Detection of focal nodular hyperplasia of the liver with color Doppler ultrasonography

A 3-cm lesion indicative of focal nodular hyperplasia (FNH) of the liver was coincidentally detected in a 21-year-old female. Ultrasonography (US), computed tomography (CT), magnetic resonance (MR) imaging and liver scintigraphy all proved nonspecific. However, color Doppler US demonstrated characteristic vascular patterns of FNH of the liver, including (a) hypervascularity of the mass, (b) an enlarged afferent blood vessel in the tumor with blood flow toward the center of the tumor, and (c) arterial pulse waves in all the vessels in the lesion, detected by means of the fast Fourier transformation (FFT). With selective hepatic angiography, a "spoke-wheel" pattern was revealed. The angiographic pattern corresponded well to that shown by color Doppler US. On the basis of the findings from these two modalities, the diagnosis of FNH was made. This report examines the effectiveness of color Doppler US in the differential diagnosis of FNH, compared with other imaging modalities.

Serotype-specific amplification of Rickettsia tsutsugamushi DNA by nested polymerase chain reaction

Polymerase chain reaction (PCR) with nested primer pairs was used to diagnose scrub typhus and identify the Rickettsia tsutsugamushi serotype. The primer pairs used for PCR were designed on the basis of the nucleotide sequence of the gene that encodes the 56-kDa antigen. Serotype-specific primers were used in the second PCR amplification. Five serovariants, the Gilliam, Karp, Kato, Kawasaki, and Kuroki strains of R. tsutsugamushi, were identified by nested PCR. In addition, the serotype identified by PCR with DNA from blood clots was the same as that of the strain isolated from five patients with scrub typhus. These findings indicate that this method is useful for diagnosis and identification of the rickettsial serotype in infected patients.

Granulomatous angiitis of the central nervous system--case report

A 22-year-old male presented with granulomatous angiitis manifesting as headache. Computed tomography (CT) demonstrated a low-density area and ring-like enhancement in the right frontoparietal region. Steroid therapy caused rapid improvement in the signs and symptoms. Withdrawal of steroid was followed by recurrence of the headache and low-density area. The steroid treatment was resumed until he became asymptomatic 3 months after admission. He was followed up as an outpatient once every 2 weeks. One month after discharge, he complained of mild headache, and CT again demonstrated a mild increase in the low-density area. He was followed up continuously without steroid treatment. Two months after discharge, he suddenly lost consciousness, and CT demonstrated multiple intracerebral hematomas in the bilateral parietal regions. Removal of an intracerebral hematoma in the right parietal region and external decompression were carried out, but he died 3 days later. Histological examination of tissues from the right parietal cortex and leptomeninges demonstrated granulomatous inflammation with several giant cells in the vessels of the cerebral cortex and leptomeninges.

Cleavage of potato virus Y polyprotein in Escherichia coli depending on the proteolytic activity of viral protease

We have cloned a 5-kb cDNA corresponding to the 3'-half of genomic RNA of potato virus Y (PVY), the type member of plant potyvirus. Based on its nucleotide sequence, the cDNA was presumed to encode PVY protease responsible for the self-processing of polyprotein precursor expressed from PVY genome. To test its proteolytic activity, the cDNA was modified so as to express the protease-polymerase-coat protein (CP) portion of PVY polyprotein in Escherichia coli. By Western blotting analysis of the cell extract of E. coli expressing the polyprotein, mature CP was detected. A large deletion in the polymerase-coding region did not affect the emergence of mature CP, but a small deletion in the putative protease region resulted in disappearance of mature CP and appearance of the intact polyprotein. These results indicated that the polyprotein expressed in E. coli was cleaved depending on the proteolytic activity of PVY protease.

Effects of tamoxifen and the derivative (TAT) on cell cycle of MCF-7 in vitro

The growth inhibitory activity and influences on cell-cycle progression of tamoxifen (TAM) and its derivatives [toremifene(NK), droloxifene (FK) and TAT-59 (TAT) against MCF-7, cells, an estrogen respondent human breast cancer cell line were investigated. TAM and its derivatives exhibited a dose-dependent growth inhibitory activity against MCF-7 cells in the order of TAT > FK > TAM > NK at 48 and 120 hours in vitro. 10(-6) M TAT reduced growth of MCF-7 to 25% of that of control after 120 hours incubation in the presence of 10(-8) M estradiol; however, in the case of TAM the growth of MCF-7 was 73%. FACS analysis showed that 82.7% of the cells were accumulated at G0/1 phase after 120 hours incubation with TAT and its accumulative activity was higher than that of TAM. Moreover, when TAT was used in combination with 5-FU, the accumulative effect was significantly increased. Thus it is suggested that TAT or TAT in combination with 5-FU may be a useful adjuvant treatment against breast cancer.

Ganglions and ganglionic neurons in the cat's larynx

Localization, projections and role of ganglia and ganglionic neurons in the laryngeal framework were demonstrated in cats. Six to 8 large size ganglia containing 50 to 80 ganglionic neurons per ganglion in the paraglottic space, 4 to 6 small ganglia involving 5 to 25 cells in each ganglion dorsal to the posterior cricoarytenoid muscle, and 1 to 3 small ganglia including 15 to 25 perikarya per ganglion around the inferior laryngeal nerve were observed. Each ganglion showed spindle shaped covering fibrous capsule. Ganglionic neurons totaling 600 to 800 were oval shaped with an average diameter of 25 microns. Projections of the ganglionic neurons to the superior cervical ganglion (SCG) and nodose ganglion (NG) through the ipsilateral internal branch of the superior laryngeal nerve and to periphery were detected. From the dorsal motor nucleus of vagus, SCG and NG, the ganglionic cells received projections ipsilaterally. On immunocytochemistry many vasoactive intestinal polypeptide (VIP)-immunoreactive (ir) neurons, some neuropeptide Y (NPY)- and tyrosine hydroxylase (TH)-ir neurons and a few substance P (SP)-ir cells were recognized in ganglions. VIP-, NPY-, TH-, SP-, and calcitonin gene-related peptide (CGRP)-ir fibers were also observed in and around vessels and glands. Following denervation, VIP-, NPY- and TH-ir neurons and fibers did not change. These results prove that laryngeal ganglionic neurons have endogenic autonomic, especially cholinergic nature and innervate vessels and glands.

Negative feedback regulation of acid secretion: linkage of acid secretion and mucosal defense

To regulate inappropriate or excessive acid secretion that may be harmful not only to surrounding mucosal cells but also parietal cells themselves, versatile mechanisms operate to control acid secretion. In this article elaborate mechanisms that participate in the control of acid secretion are described with our data and a review of relevant findings in the literature concerning the action or secretion of key regulatory molecules. The analysis of the regulatory mechanisms revealed that appropriate secretory control can be achieved by multiple feedback regulations, which are closely coordinated with mucosal defense. In the feedback circuits, the regulatory factors cannot be simply categorized into either aggressive or defensive factors. Therefore we propose that the mucosal integrity and tissue homeostasis would be better understood by a feedback loop model rather than by a dualistic balance model.

Endoscopic ultrasonographic (EUS) evaluation of the quality of gastric ulcer healing

EUS provides cardinal tomographic findings of gastric ulcer such as low echo mass (ulcer echo), thickening of the wall, a symmetrical or asymmetrical convergence of the submucosal layer, and a sharp (pin-point) or blunt (broad-surface) convergence, variously expressed in accordance with the depth or width, and also with the history of recurrence of ulcer. A low echo mass, or an ulcer echo histopathologically consists of fibrosis and granulation, sonographically correlating well with the thickening of the wall. Seventy nine cases of ulcer scar, 52 of which were evaluated endoscopically as S1 (red scar) and 27 as S2 (white scar), were scanned by EUS. The incidence of high quality healing recognized on EUS with complete disappearance of a low echo mass and subsidence of the wall thickness was 21.2% (11 of 52 ulcer scars) in the S1 stage group, which remarkably increased up to 70.4% (19 of 27) in the S2 group (P < 0.01). The results indicate a definite correlation between endoscopic and EUS assessment of an ulcer scar state. The cumulative relapse rate at 12 months during maintenance therapy with half doses of H2 blocker was found to be 4.5% (1 of 22 cases) in the group with high quality healing on EUS, 40.9% (9 of 22) in the group with fair quality healing, and 75.0% (12 of 16) in the group with poor quality healing. The results of the present study suggest that EUS assessment may be a reliable and objective predictor of susceptibility to ulcer recurrence, accurately evaluating the quality of gastric ulcer healing.

Photodegradation products of levofloxacin in aqueous solution

The photodegradation of levofloxacin (DR-3355, CAS 100986-85-4), the S-(-)-isomer of ofloxacin, was investigated. Levofloxacin in aqueous solution was exposed to near ultraviolet light (peak wavelength 352 nm) for 16 h at room temperature. Nine degradation products (P-2-P-10) were isolated from the reaction mixture by preparative high performance liquid chromatography. The structures of these compounds were deduced from their NMR, MS, UV and IR spectra and optical rotations. The elucidated structures showed that all of these degradation products were analogues altered at the N-methylpiperazine moiety of levofloxacin.

[Clinical application of retinoic acid and vitamin D3 derivatives to the treatment of refractory anemias]

Refractory anemias and the myelodysplastic syndromes are a group of hematopoietic stem cell disorders characterized by ineffective and dysplastic hematopoiesis, leading to persistent peripheral cytopenias. Patients also have an increased risk of transformation to acute myelogenous leukemia. Since defective cellular maturation is the central pathogenetic feature, improved differentiation may result in correction of neutropenia and thrombocytopenia. Clinical trials using retinoic acid and vitamin D3 analogues are not satisfactory and only small numbers of patients may benefit from receiving them. In view of the absence of other effective treatment, future studies should be directed to the combined use of differentiating agents with hematopoietic growth factors and to the identification of new compounds with greater differentiating ability and less toxicity.

Myelodysplastic syndromes: from morphology to molecular biology. Part I. Classification, natural history and cell biology of myelodysplasia

The myelodysplastic syndromes are a heterogeneous group of clonal hematopoietic disorders predominantly affecting the elderly. Patients frequently develop acute leukemia, but the majority suffer from the consequences of bone marrow failure. The underlying acquired genetic abnormality is the inadequate production of dysplastic and poorly functional cells resulting from defective differentiation and premature cell death of the abnormal hematopoietic clone. Although the pathogenesis is unknown, recent evidence suggests that a sequence of DNA lesions leads to alteration of the cellular function, emergence and consequent evolution of the premalignant clone.

Serial changes in endogenous erythropoietin levels in patients with myelodysplastic syndromes and aplastic anemia undergoing erythropoietin treatment

Recombinant human erythropoietin (rhEpo) was administered to 14 patients with myelodysplastic syndrome (MDS) and seven patients with aplastic anemia (AA). In 19 patients, doses of 6000 units were given intravenously three times a week (t.i.w.) with the dose being doubled up to 24,000 units every 8 weeks until a response was obtained. RhEpo was given subcutaneously in two patients. Seven patients, four with MDS and three with AA, showed a significant response with an increase of hemoglobin concentration during therapy. The response occurred at doses of 12,000 units in five and 24,000 units in two patients. Responding patients with both MDS and AA had a relatively low serum Epo (s-Epo) level prior to Epo therapy. MDS responders had either refractory anemia (RA) or RA with ring sideroblasts (RARS), while two of the Epo responders in AA had a severe form of the disease. However, since some of the Epo responders had a high initial s-Epo concentration, a high s-Epo level does not preclude the use of rhEpo. Serial determination of s-Epo levels showed a progressive decline in six of the seven responders even when they were on rhEpo therapy, while the s-Epo levels remained elevated or further increased with time in most nonresponders. RhEpo was well tolerated by all patients. The results suggest that rhEpo is a safe and effective treatment for a certain proportion of patients with MDS and AA. Moreover, serial determination of s-Epo during therapy may be useful in monitoring and predicting the therapeutic effect of rhEpo.

Clinical implications of chromosomal abnormalities in 401 patients with myelodysplastic syndromes: a multicentric study in Japan

It is well known that cytogenetic analysis in patients with myelodysplastic syndrome (MDS) provides information useful in determining their prognosis. Based on the chromosomal results obtained from 401 MDS patients by a multicentric study in Japan, we studied correlations between chromosomal findings and prognosis or leukemic transformation in MDS patients. Patients with complex aberrations (cytogenetic abnormalities at more than three chromosomes), of any subtype, had a poor prognosis; for example, > 60% of patients with refractory anemia (RA) showing complex aberrations died within one year, but only 11% of them developed leukemia. In patients with RA with ringed sideroblasts (RARS), > 70% of those with complex aberrations evolved into the leukemic phase and survived for less than one year, suggesting a biologic heterogeneity in RARS patients. By contrast, about 5% of patients with RA or RARS exhibiting chromosomal findings other than -7/7q-, +8, two aberrations, and complex aberrations, developed leukemia and had a favorable prognosis. Therefore, the presence of chromosome abnormalities alone in patients with RA or RARS is not a factor in predicting leukemic transformation or poor prognosis. In patients with refractory anemia with an excess of blasts (RAEB), the presence of chromosome aberrations at MDS diagnosis affected the occurrence of leukemic transformation (24% versus 43%), however, no particular difference was noted in patients with RAEB in transformation with regard to whether they had chromosome changes or not, and about 60% of them evolved into leukemia. The poor prognosis related to complex aberrations was consistently noted in all MDS subtypes or age-matched groups, indicating that this cytogenetic anomaly is an independent risk factor for a poor prognosis in MDS patients. The duration between MDS diagnosis and development of the leukemic phase and that between the latter and death were significantly shorter in patients with complex aberrations than those without this change. Although the clinical significance of certain chromosomal abnormalities differs among subtypes of MDS, a new scoring system for predicting prognosis by cytogenetic changes, in combination with hematologic parameters, was proposed.

[Assay of erythropoietin in serum with short term enzyme linked immunosorbent assay method--the clinical significance: Part 2--:Relation to serum iron, UIBC and ferritin in renal failure and hematological disorders]

With a newly developed short term enzyme linked immunosorbent assay kit (TOYOBO Co.), in which 2 kinds of anti-EPO monoclonal antibodies were used, we assayed EPO concentration in sera from patients with renal failure and hematological disorders. In this report, the EPO data were analysed in relation to serum iron concentrations, with ferritin and UIBC. In the patients with renal failure, there was no significant correlation between EPO concentration and serum iron, ferritin, nor UIBC concentration. On the other hand, in the patients with hematological disorders, there were two types. One was in patients with iron deficiency anemia, whose serum EPO was negatively correlated to serum iron (r = -0.64) and ferritin (r = -0.59), but positively related to UIBC (r = 0.27). The another was the pattern in patients with aplastic anemia, leukemia and MDS, whose serum EPO positively correlated to iron and ferritin but negatively correlated to UIBC. In the patients with aplastic anemia serum EPO had good correlation to serum iron (r = 0.62), ferritin (r = 0.60) and UIBC (r = -0.46). The relationship of EPO to iron in the patients with leukemia (r = 0.54), and EPO to ferritin in the patients with MDS (r = 0.42) show significantly positive correlation coefficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Exercise coronary flow reserve of bilateral internal thoracic artery bypass grafts

We attempted to quantify the exercise coronary flow reserve in 20 patients with bilateral internal thoracic artery grafts to the left coronary arteries (group I) who had complete revascularization. The coronary sinus blood flow was measured by the continuous thermodilution method both at rest and during exercise (50 W for 8 to 9 minutes) approximately 1 month after the operation. These results were compared with 30 patients treated with an internal thoracic artery and saphenous vein grafts to the left coronary arteries (group II) and 9 patients with saphenous vein grafts alone to the left coronary arteries (group III). There were no differences among the three groups in age, sex, number of vessels involved, heart rate, double products, left ventricular (LV) end-diastolic pressure, LV ejection fraction, LV end-diastolic volume, or LV mass at the time of study. None of the 59 patients in the study had abnormally enlarged LV end-diastolic volume or increased LV mass. The postoperative coronary sinus blood flow per 100 grams of LV mass at rest was similar among the three groups (73.0 +/- 28.4 mL/min per 100 g LV mass in group I, 73.4 +/- 31.1 mL/min per 100 g LV mass in group II, and 75.9 +/- 28.5 mL/min per 100 g LV mass in group III [not significant]) and significantly (p < 0.01) increased by exercise, although the differences between groups during exercise were not significant (158.9 +/- 45.9, 153.5 +/- 72.1, and 148.3 +/- 60.0 mL/min per 100 g LV mass, respectively [not significant]).(ABSTRACT TRUNCATED AT 250 WORDS)

Myelodysplastic syndromes: from morphology to molecular biology. Part II. The molecular genetics of myelodysplasia

Most studies of the clonal origin of the underlying lesion(s) and all investigations using X-inactivation, have concluded that the myelodysplastic syndromes arise from a multipotent stem cell. Non-random chromosomal abnormalities, particularly deletions of 5q and 7q, are common, most notably in therapy related MDS. Progression to AML is also frequently accompanied by increased genomic instability as evidenced by the emergence of multiple karyotypic abnormalities. While some evidence hints at the presence of tumour suppressor genes on chromosomes 5, 7, 20 and 12, no such genes have yet been identified. The search for point mutations in known oncogenes has concentrated on two oncogenes RAS and c-FMS. Point mutation frequency generating active forms of RAS oncogenes is approximately 40% in MDS overall, up to 80% in studies of CMML. 60% of all MDS RAS mutation involves a G to A transition, producing a substitution of aspartate for glycine at a frequency of 50% (of total ras mutants). RAS mutation is associated with progression to AML, although the presence of a RAS point mutation alone is neither necessary nor sufficient for leukaemic transformation. Mutation of c-FMS is also more common in CMML in comparison to other MDS subtypes and, as yet, point mutation potentiating the response of the receptor to CSF-1 (codon 969) has been found more frequently than point mutation resulting in permanently activated receptor (codon 301). However, recent work has identified additional mutations which produce transforming proteins, and mutation rates at these sites may be relevant in MDS.

Chemical analysis of lipopolysaccharides of Shigella sonnei form II strains expressed by cloned form I antigen genes

A compositional sugar analysis was carried out on lipopolysaccharide (LPS) from Shigella sonnei form II in which a plasmid with cloned form I antigen genes had been introduced. The recipient form II strains contained galactose, glucose, heptose, glucosamine, and 2-keto-3-deoxyoctonic acid (KDO) (2: 3: 1: 2: 2) in its LPS, while the transformant form I LPS contained, besides these sugars, N-acetyl-L-altrosaminouronic acid as an additional sugar constituent, which is known to be one of the antigenic determinants of form I antigen.

[Determination of the standard level of serum erythropoietin in relation to hemoglobin concentration]

Serum erythropoietin (EP) concentration was measured by the recombinant EP-based radioimmunoassay and was examined to standardize the hemoglobin (Hb) related level of 144 normal control and 56 patients with iron deficiency anemia and hemolytic anemia excluding paroxysmal nocturnal hemoglobinuria. The standardization was achieved by logarithmic regression of the EP titier on Hb either by the two-phase linear form or by the third degree sigmoid form at a 95% confidence limit for each regression. The third degree regression was found to be preferable from the view point of both statistics and the negative feedback mechanism. The average and scattering of the deviation from the standard level thus determined of the disease groups indicated that the EP level is: (1) 12 fold higher than the standard level in 42 aplastic anemias (the most in excess and a few in standard). (2) three fold higher than that in 27 myelodysplastic syndromes (relatively higher dispersed state). (3) 29% of the standard level in 33 anemias associated with chronic renal failure (deficient state). (4) 105% of the extrapolated standard level in 22 polycythemia veras (standard state). The standardization of Hb-related Ep titer may provide new pathophysiological approaches in a variety of hematopoietic disorders.

Archaebacterial lipids: highly proton-impermeable membranes from 1,2-diphytanyl-sn-glycero-3-phosphocholine

Unlike ordinary glycero-lipids such as egg-yolk lecithin, 1,2-diphytanyl-sn-glycero-3-phosphocholine, which was employed as a model lipid of archaebacterial acidophiles, gave liposomal membranes which were highly resistant to proton permeation in a wide temperature range (about 10-50 degrees C); the permeability coefficient and activation energy of the flux were 0.7 x 10(-5) cm/s at 20 degrees C and 24.5 kcal/mol, respectively. The high resistance to proton flow was attributed to a fluid and bulky isoprenoid chain-layer of the membrane.

Nonpharmacologic treatment of common atrial flutter guided by transient entrainment

We attempted nonpharmacologic treatment for common atrial flutter in 7 patients, with direct current catheter ablation (CA) in 5 cases and cryoablation in 2 cases under the guidance of transient entrainment. Transient entrainment during common atrial flutter by pacing from the mid or low lateral right atrium (LLRA) revealed a long conduction time between the LLRA and the orifice of the coronary sinus (CSo) (73% to 121% of flutter cycle length). In 2 cases, fragmented electrograms were recorded at the low right atrial septum with durations of 150 msec and 155 msec, respectively. Because these fragmented electrograms were transiently entrained by rapid atrial pacing in the same manner as other atrial electrograms and were recorded in an area of long conduction, we believe that fragmented electrograms represent critical slow conduction. In 5 cases, CA was directed at this area. Three cases were successfully treated with 3 to 4 DC shocks of 100 J (follow up periods of 11.3, 4.5 and 3 months). Two cases which received 1 to 2 DC shocks of 100 J had recurrence of atrial flutter 6 and 4.7 months later, respectively. Two cases which showed atrial septal defect received surgical treatment. They were successfully treated with extended cryoablation in this same area (follow up periods of 26 and 9.2 months). In conclusion, extended ablation of an area of fragmented electrograms using transient entrainment may be an effective treatment for common atrial flutter.