[Polyangiitis overlap syndrome with multiple pulmonary aneurysms and renal vascular hypertension]

A 37-year-old man with multiple nodules on a chest X-ray film, hypertension, and proteinuria was admitted to our hospital in September, 1993. Thirteen years earlier, he had been admitted to another hospital because of bloody sputum, fever, and dyspnea. He also had slight oral aphthae and slight iridocyclitis. A chest X-ray film at that time showed bilateral diffuse reticular shadows, and his illness was diagnosed as acute interstitial pneumonitis. Since that time, he had been continuously receiving tapering doses of prednisolone. His chest symptoms were relieved, and the findings on the chest X-ray film resolved with that treatment. In 1993, he also had positive tests for HBs antigen and for HLA-B51, and he was found to have renal vascular hypertension. Chest CT films and a pulmonary angiogram showed multiple aneurysms and occlusions of pulmonary arteries. A renal angiogram showed multiple intraparenchymal aneurysms of renal arteries. A specimen taken by open-lung biopsy showed healed endoarteritis obliterans of muscular arteries and no alveolitis. His illness was diagnosed as polyangiitis overlap syndrome, because of the unclassified systemic necrotizing vasculitis.

Prediction of maximal oxygen uptake by squat test in men and women

To examine the reproducibility of simple tests including step, squat and double quick tests, the respective tests were performed twice in 242 college women. The step test for 1, 2 or 3 min and the squat test for 1 or 1.5 min were adopted as simple endurance tests with superior reproducibility. Then 30 men (18-26 yr) and 32 women (18-34 yr) participated in a maximal O2 uptake (VO2max) test and the simple endurance tests. The scores (the sum of heart beats for 30-60, 90-120, 150-180 seconds in a sitting posture following the exercise) in the respective simple endurance tests were significantly correlated (P < 0.001) with VO2max per kilogram body weight in the men and women. For example, the equation relating VO2max to the score (X) of the squat test for 1.5 min in men was: VO2max (ml. kg-1. min-1) = -0.261X + 85.19 (r = -0.820, P < 0.001). The discrepancies between VO2max predicted by using the respective estimation equations and that determined by the direct method were 6.3% (by the step test for 3 min) approximately 8.1% (by the squat test for 1 min) in men and 4.7% (by the step test for 2 min) approximately 6.1% (by the squat test for 1 min) in women. Significant correlations were observed between the respective scores in the simple endurance tests (P < 0.001) and between % body fat and the scores (P < 0.01) in both men and women, but not for height vs. the scores. These results suggest that VO2max can be estimated not only by the step test for 1, 2 or 3 min but also the squat test for 1 or 1.5 min.

Two-dimensional crystallization and cryo-electron microscopy of photosystem II

Two dimensional (2D) crystals of photosystem II (PSII) were obtained from n-heptyl-beta-D-thioglucoside-solubilized monomers of spinach PSII complex by conventional detergent dialysis. The 2D crystals were either large cylindrical vesicles (1 to 2 micrometer by 4 to 6 micrometer as flattened vesicles) or large monolayer sheets (ca. 1 micrometer X 1 micrometer), both suitable for cryo-electron microscopy. Images of unstained crystals embedded in ice were recorded using low-dose microscopy and analyzed by digital image processing. Both types of crystals had the same unit cell size and the same packing arrangement of PSII particles. The plane group was p22(1)2(1) and the unit cell was rectangular with dimensions of 16.7 nm X 15.3 nm containing four monomers (two face-up and two face-down). SDS-PAGE and immunoblot analyses of the 2D crystal indicated that the constituent subunits of particles in the 2D were CP47, D1, D2, cytochrome b-559 and psbI protein. A projection map of 20 A resolution revealed that each monomer has asymmetrical shape with a length of 8.1 nm and a maximal width of 7.5 nm consisting of four areas of density. Two high-density areas with similar sizes were located close to each other to form a roughly rectangular core of 4.0 nm X 6.5 nm. From its size similarity to the size of the L/M heterodimer of the bacterial reaction center, this high density core area was tentatively assigned to the D1/D2 heterodimer. The remaining large and small areas were also tentatively assigned to CP47 and cytochrome b-559 plus psbI protein respectively.

Synthesis and hypolipidemic activities of novel 2-[4-[diethoxyphosphoryl)methyl]phenyl]quinazolines and 4(3H)-quinazolinones

The novel compound NO-1886, 4-[(diethoxyphosphoryl)methyl]-N-(4-bromo-2-cyanophenyl)-ben zamide, is a hypolipidemic agent, which appears to increase lipoprotein lipase activity in rats. Various analogs of NO-1886 were synthesized to study the structure-activity relationship of this hypolipidemic drug. A novel series of quinazolines and 4(3H)-quinazolinones were prepared by cyclization of NO-1886 derivatives. Derivatives bearing a 4-[(diethoxyphosphoryl)-methyl]phenyl] group at the 2-position were found to lower triglyceride and total cholesterol levels. In accord with the decrease in log P*, quinazolines and 4(3H)-quinazolinones showed good absorption and hypolipidemic activity. When the quinazolinone ring system is substituted at positions 6 and 7 with methoxy groups, increased hypolipidemic activity was observed. The highest hypolipidemic activity was observed when the 3-position was substituted by a methyl or benzyl group.

The occurrence of novel 9-O-sulfated N-glycolylneuraminic acid-capped alpha2-->5-Oglycolyl-linked oligo/polyNeu5Gc chains in sea urchin egg cell surface glycoprotein. Identification of a new chain termination signal for polysialyltransferase

We report the isolation and structural characterization of an oligo/polysialic acid-containing glycopeptide fraction (designated ESP-Sia) prepared from the egg cell surface complex of the sea urchin, Hemicentrotus pulcherrimus, by exhaustive pronase treatment. The carbohydrate chains isolated from ESP-Sia were shown to consist of O-linked oligo/polysialic acid-containing glycan units and N-linked carbohydrate chains. The present studies have revealed that the O-linked oligo/polysialic acid-containing glycan chains derived from the ESP-Sia were similar to those present in egg jelly coat polysialylated glycoprotein in being composed of tandem repeats of N-glycolylneuraminic acid (Neu5Gc) glycosidically linked in a novel fashion through the glycolyl group, (-->5-OglycolylNeu5Gcalpha2-->)n. However, they differ from the egg jelly coat in two key respects. First, the average degree of polymerization of the oligo/polysialic acid chains of ESP-Sia is only 3; a value far lower than that found in the jelly coat glycoprotein (average degree of polymerization was about 20). Second, ESP-Sia is uniquely characterized by the presence of 9-O-sulfated N-glycolylneuraminic acid (Neu5Gc9HSO3) residues at the nonreducing termini of the (-->5-OglycolylNeu5Gcalpha 2-->)n chains. The terminal sialyl residues in the Neu5Gc9HSO3 alpha2-->(-->5-OglycolylNeu5Gcalpha2-->)n chains were totally resistant to exosialidases. The discovery of Neu5Gc9HSO3 as the nonreducing terminal residue of oligo/poly(-->5-OglycolylNeu5Gcalpha 2-->) group is especially noteworthy in that Neu5Gc9HSO3 appears to be of limited distribution among glycoconjugates. Following the earlier discovery of oligo/polysialic acid chains capped with KDN, i.e. KDN alpha2-->(-->8Neu5Gcalpha2-->)n, found in rainbow trout egg polysialoglycoproteins, it now appears that the sulfated Neu5Gc can serve a similar capping function.

Substrate specificity of rainbow trout testis CMP-3-deoxy-D-glycero-D-galacto-nonulosonic acid (CMP-Kdn) synthetase: kinetic studies of the reaction of natural and synthetic analogues of nonulosonic acid catalyzed by CMP-Kdn synthetase

In this report we present kinetic data of the activation reaction of several synthetic 3-deoxy-D-glycero-D-galacto-nonulosonic acid (Kdn) and N-acetylneuraminic acid (Neu5Ac) analogues catalyzed by the rainbow trout testis CMP-Kdn synthetase. This enzyme showed broad substrate specificity in terms of substitutions at C4 or C5 position of Kdn and Neu5Ac. In contrast, calf brain CMP-N-acylneuraminic acid synthetase had narrow substrate specificity, being active only on various N-acyl analogues of Neu5Ac and only slightly active on Kdn derivatives. Usefulness of the trout testis enzyme for synthesis of various CMP-sialate analogues, which could be donor substrates for sialyltransferases, was demonstrated.

Studies on selectin blocker. 1. Structure-activity relationships of sialyl Lewis X analogs

As part of our studies of selectin blockers, we prepared 1-deoxy-3'-O-sulfo LeX analogs (1-3), 1-deoxy-3'-O-phosphono LeX analogs (4), and 1-deoxy sLeX analogs (5-7), and examined their inhibitory activities against natural ligand (sLeX) binding to E-selectin, P-selectin, and L-selectin. The 1-deoxy sLeX 5 was up to 20 times more potent an inhibitor than the sLeX tetrasaccharide toward P- and L-selectin binding. This indicates that the modification of the 1 or 2 position of sLeX is useful in the design of a more potent selectin blocker.

Lesser sac hernia through the gastrocolic ligament: CT diagnosis

We present a case of a lesser sac hernia of the ileum through a defect in the gastrocolic ligament with reemergence through a defect in the gastrohepatic ligament. Computed tomography (CT) revealed the herniated bowel surrounded by the liver, the stomach and the pancreas, and demonstrated the defect in the gastrocolic ligament between the stomach and the transverse colon.

Electrocochleography during experimental cochlear ischemia of the guinea pig

It has been postulated that impairment of cochlear blood flow (CoBF) is one of the most important causes of hearing loss occurring during acoustic neuroma (AN) surgery. However, it remains unclear how the degree of cochlear ischemia influences the evoked responses in electrocochleography. (ECochG) which has been used for monitoring cochlear functions. In the present study, we investigated alterations in ECochG during cochlear ischemia of varying degree in the guinea pig. In order to induce cochlear ischemia, the anterior inferior cerebellar artery (AICA) was mechanically compressed via the transclival approach. The compression of AICA resulted in the reduction of CoBF in 55 out of 70 guinea pigs. A constant reduction of CoBF was maintained during the compression of AICA in 44 (63%) guinea pigs. CoBF abruptly decreased upon compressing AICA, and promptly recovered after releasing the compression. N1 and N2 in ECochG were also altered by compression. During 3-min ischemia, N1 and N2 disappeared in 36% and 41% of the cases, respectively. The residual CoBF in cases whose N1 and N2 disappeared was significantly lower than that in other cases whose N1 and N2 were sustained during 3-min ischemia. In addition, there was a tendency that the lower the residual CoBF was, the shorter the survival time of N1 and N2. In cases whose N1 and N2 did not disappear, the prolongation of N1 and N2 latencies after 3-min ischemia was positively correlated to the residual CoBF. On the basis of these results, we discuss the mechanisms underlying the changes in CoBF and ECochG during cochlear ischemia, and conclude that the degree of cochlear ischemia during AN surgery can be estimated with ECochG.

[Dip-shaped hearing loss of Békésy audiogram in high school students]

Small dip-shaped hearing loss may be frequently observed on Bekesy audiograms in ears without any hearing loss on pure tone audiograms. Hearing tests and otoacoustic emission measurements were performed in club member of 2 senior high schools (K-D School and S-D School), in order to determine any relationship between inner ear impairments and the small dips on Bekesy audiograms. In the kendo, soccer, tennis and orchestral music clubs of K-D School micro-dips in depth over 10 dB were found to have incidences between 40% and 53%, and the micro-dips were distributed in frequencies above 5 kHz. In the of kendo, tennis, brass band and tea ceremony clubs of S-D School the incidences of micro-dips ears were between 30% and 48%, and the micro-dips tended to be distributed in higher frequencies except in the tea ceremony club. The micro-dips in the ears of the tea ceremony club members were distributed over all the frequencies examined, but most of them disappeared when counted for dip size above 15 dB remaining an ear at 7.5 kHz. Incidences of earphone or headphone users as a hobby were in the range of 30 to 70% in members of all clubs. There were no characteristic findings of clubs in the incidences of the earphone or headphone users. The degree of association between the micro-dip ears and the use of earphone or headphone was low. C-EOAEs which had a 6 ms or longer duration of evoked otoacoustic emissions were detected with an incidence of 40 to 65% and there was a significant association between the micro-dip ears and the C-EOAE ears. Incidences of spontaneous otoacoustic emissions were between 26% and 28% in all clubs and there were differences in the incidences between sexes. The frequency distribution of the spontaneous otoacoustic emissions were remarkably different to that of the micro-dips. To determine whether the C-EOAEs express a predisposition to inner ear susceptibility to noise-induced hearing loss and to ascertain that the micro-dip is a precursor notice to noise-induced hearing loss, further follow-up surveys are needed.

Recommendation of early surgery from the viewpoint of daily quality of life

We surveyed pre- and postoperative levels of satisfaction with a range of the daily quality-of-life (QOL) domains in 132 sets of epilepsy surgery patients and their families. All patients underwent resective surgery for temporal lobe epilepsy and were monitored for > 2 years. Patient and family assessments showed patients' overall QOL markedly improves after surgery, depending on freedom from seizures. However, factors such as social contacts, family relations, or financial status improved little. Some families and patients were not satisfied with the postsurgical status, despite freedom from seizures. Patients who had surgery at a later age were not so satisfied with their postsurgical status as were patients who had surgery at a younger age, particularly on the QOL domains of role activities, memory function, leisure activities, or emotional well-being. This lower satisfaction level in older patients likely results from a variety of problems affecting patients during the long-lasting epileptic process; social handicaps, psychologic conflicts, and deterioration of cognitive/behavioral functions. Based on each case, we recommend that investigations start at an early stage of the illness, so that surgical intervention may be considered as early as possible.

[Intermittent intra-arterial chemotherapy for the treatment of patients with bladder cancer or prostate cancer using implantable injection pump]

BACKGROUND

The objective of this study is to evaluate the usefulness of intra-arterial chemotherapy using an implantable injection system for the treatment of bladder or prostate cancer.

METHODS

Twenty-four patients with bladder cancer and 13 with prostate cancer were treated with intermittent intra-arterial chemotherapy using a totally implantable injection pump. A heparinized catheter was percutaneously fixed through the femoral artery with the tip 2 or 3 cm above the bifurcation of the common iliac artery, and the pump was placed in a subcutaneous pocket.

RESULTS

The total number of infusion sessions for bladder cancer ranged from 4 to 38 times (mean 20.8), and 15 of the 24 patients were injected from 2 to 19 sessions (mean 8.5) as outpatients. The tumor response for 15 patients with newly diagnosis muscle-invasive bladder cancer were 12 patients in CR, 1 in PR, and 2 in NC, and 9 patients with recurrent bladder cancer were 6 patients in CR, 1 in PR, and 2 in NC. The total number of infusions for prostate cancer ranged from 6 to 35 times (mean 20.2), and 10 of the 13 patients were injected from 1 to 11 times (mean 6.3) as outpatients. All 13 patients with prostate cancer were treated with hormone therapy and irradiation, and achieved PR. Complications of this drug delivery system were obstruction of the catheter or pump observed in 7 patients, dislocation of the catheter in 2, and obstruction of right external iliac artery in 1.

CONCLUSION

These findings suggest that favorable therapeutic efficacies and an improved quality of life for patients can be obtained by intra-arterial chemotherapy using an implantable injection pump.

[Pulmonary lymphangiomyomatosis with tuberous sclerosis and endolymphatic stromal myosis of the uterus]

Pulmonary lymphangiomyomatosis is a rare disorder that affects only women of reproductive age. The lung shows numerous cystic changes and striking proliferation of smooth muscle around the airways, blood vessels, and lymphatic channels. We encountered a patient with pulmonary lymphangiomyomatosis who had repeated pneumothorax and bloody sputum over 10 years. The patient also had other lesions, including intracranial calcification, renal angiomyolipoma and endolymphatic stromal myosis of the uterus. The first two findings are known as tuberous sclerosis, and lymphangiomyomatosis is considered to be a form fruste of tuberous sclerosis. However, we know of no previous reports of uterine lesions in this disease. Lymphangiomyomatosis may be a systemic disorder of smooth muscle.

Identification and mapping of functional domains on human T-cell lymphotropic virus type 1 envelope proteins by using synthetic peptides

To identify the regions that are important in human T-cell leukemia virus type 1 (HTLV-1) envelope function, we synthesized 23 kinds of peptides covering the envelope proteins and examined the inhibitory effect of each peptide on syncytium formation induced by HTLV-1-bearing cells. Of the 23 synthetic peptides, 2, corresponding to amino acids 197 to 216 on gp46 and 400 to 429 on gp21, inhibited syncytium formation induced by HTLV-1-bearing cells but did not affect syncytium formation induced by human immunodeficiency virus type 1-producing cells. The peptide concentrations giving 50% inhibition of syncytium formation for gp46 197 to 216 and gp21 400 to 429 were 14.9 and 6.0 microM, respectively. A syncytium formation assay with overlapping synthetic peptides containing amino acids 175 to 236 and 391 to 448 of the envelope proteins showed that syncytium formation was inhibited by peptides that contained the amino acid sequences 197 to 205 (Asp-His-Ile-Leu-Glu-Pro-Ser-Ile-Pro) and 397 to 406 (Gln-Glu-Gln-Cys-Arg-Phe- Pro-Asn-Ile-Thr). These observations suggest that the two regions corresponding to amino acids 197 to 216 and 400 to 429 are involved] in HTLV-1 envelope function.

Modified antigen-binding of human antibodies with glycosylation variations of the light chains produced in sugar-limited human hybridoma cultures

We have characterized the effects of serum and N-acetylglucosamine in a glucose-deprived condition on the glycosylation of antibody light chains, as well as the resulting biological properties of those antibodies. We have chosen for our investigation the human hybridoma lines producing monoclonal antibodies reactive to lung adenocarcinoma. Each antibody possess a N-glycosylated carbohydrate chain in the hypervariable region of the light chains. When the cell lines were grown in the absence of glucose, variant light chains with varying molecular masses were found to be secreted. Analysis of these light chains produced in a glucose-deprived condition revealed that the changed molecular-mass of the variant light chains is due to different glycosylation. Addition of N-acetylglucosamine or fetal calf serum to the glucose-free medium led to the creation of other light chains that exhibit increased antigen binding activity.

AL0671, a new potassium channel opener, inhibits nonenzymatic glycation of protein and LDL oxidation

1. The effects of AL0671, a novel potassium channel opener, on protein glycation and low-density lipoprotein (LDL) oxidation were tested. 2. AL0671 dose-dependently inhibited both fluorescence development of bovine serum albumin and cross-linking of lysozyme. These inhibitory effects for glycation were no less potent than aminoguanidine. 3. AL0671 dose-dependently inhibited both increase in negative charge and apo B-100 fragmentation during incubation of LDL with Cu2+. In addition, AL0671 significantly decreased the LDL degradation in rat peritoneal macrophages. 4. Neither pinacidil nor levcromakalim inhibited protein glycation and LDL oxidation. 5. Antioxidant properties of AL0671 might be due to its potent electron-donating ability, and this agent is expected to be useful for hypertensive diabetes.

Dynamic changes in expression of glutamate transporter mRNAs in developing brain

Developmental changes in gene expression for three glutamate transporter subtypes in the mouse brain were analysed by in situ hybridization. During embryonic stages, GluT-1 and GLT-1 mRNAs were expressed at high levels in the ventricular zone, whereas EAAC1 mRNA was not detected in the zone. In the mantle zone, transcription levels of three transporter mRNAs were low during embryonic stages, and these levels, especially those of the GluT-1 and GLT-1 mRNAs, displayed remarkable increases postnatally to reach maximal levels at 14 days of age. These dynamic developmental regulations suggest that the glutamate transporter not only regulates the excitatory synaptic transmission at mature stages, but might also be intimately involved in the brain development.

Cloning of the cDNA encoding the mouse ATBF1 transcription factor

We have isolated a mouse ATBF1 cDNA which is 12-kb long and capable of encoding a 406-kDa protein containing four homeodomains and 23 zinc-finger motifs. Mouse ATBF1 is 94% homologous to the human ATBF1-A transcription factor. Northern blot and RNase protection analysis showed that levels of ATBF1 transcripts were low in adult mouse tissues, but high in developing brain, consistent with a role for ATBF1 in neuronal differentiation.

Induction, localization, and purification of a novel sialidase, deaminoneuraminidase (KDNase), from Sphingobacterium multivorum

Recently, we reported the discovery of a new type of sialidase, KDNase, which specifically hydrolyzes the ketosidic linkages of 2-keto-3-deoxy-D-glycero-D-galacto-nononic acid (KDN), but not N-acylneuraminyl linkages. We now report that this enzyme, designated KDNase SM, is an inducible enzyme that is localized in the periplasm of Sphingobacterium multivorum. Growth of S. multivorum in the presence of KDN-containing oligosaccharide alditols, KDNalpha2-->3Galbeta1-->3GalNAc alpha1-->3[KDNalpha2--> (8KDN alpha2-->)n-->6]GalNAcol, as a sole carbon source induced KDNase SM activity 15 40-fold, compared with growth in the absence of inducer. KDN, Neu5Ac, or Neu5Ac oligomers were ineffective as inducers. The enzyme was released from the periplasm of induced cells by cold osmotic shock and purified 700-fold to homogeneity. The specific activity of the pure enzyme was 82,100 units/mg of protein. KDNase SM activity resided in a single polypeptide chain with an estimated molecular weight of approximately 47,500. Enzyme activity was maximal at near neutral pH. The availability of pure KDNase will now make it possible to study the structure and functional role of KDN-glycoconjugates and to determine the molecular mechanism whereby the enzyme can discriminate between KDN and N-acylneuraminic acid.

Interleukin 11 levels in patients with disseminated intravascular coagulation

We assessed the blood interleukin 11 (IL-11) levels in patients with disseminated intravascular coagulation (DIC). The IL-11 level exceeded the detection limit, i.e., IL-11 was positive, in 14 of the 21 patients in the group with DIC complicated by sepsis, with a mean value of 20.4 pg/ml. In the group with DIC uncomplicated by infection, IL-11 levels were above the detection limit in 8 of the 17 patients, and the average level was 10.6 pg/ml. The difference between the IL-11-positive rate in the two groups was not significant. Although IL-11 levels tended to be higher in the group with sepsis as a complication, the difference was not significant. The elevated IL-11 levels observed in patients with DIC, with or without complication by infection, seem quite appropriate as a biological response to increased platelets.

Captopril, an angiotensin-converting enzyme inhibitor, induced pulmonary infiltration with eosinophilia

In this study, we investigated the association between the drug-induced pulmonary infiltration with eosinophilia (PIE) syndrome in a patient with hypertension and the angiotensin-converting enzyme inhibitor (ACE-I) captopril. Although the patient developed diffuse lung field infiltrates accompanied by productive cough and striking peripheral eosinophilia, these symptoms disappeared after termination of the administration of captopril, pronase and cephalexine. Furthermore, the results of the peripheral lymphocyte stimulation test, skin patch test and provocation test under informed consent showed a positive reaction only for captopril. Therefore, this patient was diagnosed as captopril-induced PIE syndrome.

Impairment of suckling response, trigeminal neuronal pattern formation, and hippocampal LTD in NMDA receptor epsilon 2 subunit mutant mice

Multiple epsilon subunits are major determinants of the NMDA receptor channel diversity. Based on their functional properties in vitro and distributions, we have proposed that the epsilon 1 and epsilon 2 subunits play a role in synaptic plasticity. To investigate the physiological significance of the NMDA receptor channel diversity, we generated mutant mice defective in the epsilon 2 subunit. These mice showed no suckling response and died shortly after birth but could survive by hand feeding. The mutation hindered the formation of the whisker-related neuronal barrelette structure and the clustering of primary sensory afferent terminals in the brainstem trigeminal nucleus. In the hippocampus of the mutant mice, synaptic NMDA responses and longterm depression were abolished. These results suggest that the epsilon 2 subunit plays an essential role in both neuronal pattern formation and synaptic plasticity.

Correlation of the OSR/ZRCI gene product and the intracellular glutathione levels in Saccharomyces cerevisiae

The OSR (oxidative-stress-resistance) gene was cloned as the gene which enhances resistance against oxidative stress caused by lipid hydroperoxide in Saccharomyces cerevisiae. The nucleotide sequence of the gene was determined and found to be identical with the zinc-resistance-conferring (ZRCI) gene, which was cloned as the gene enhancing the resistance against zinc and cadmium. A knockout mutant of the OSR gene showed increased sensitivity to lipid hydroperoxide. The intracellular glutathione content in the knockout mutant decreased approx. 40% compared with that of wild-type cells, whereas it increased 3-fold in yeast overexpressing the OSR gene. Therefore the OSR/ZRCI gene product seems to regulate the intracellular glutathione content.