Histiocyte reaction in rabbit femurs to UHMWPE, metal, and ceramic particles in different sizes

To assess the histologic reaction caused by biomaterial particles in different sizes around the bone-implant interface, we examined ultra-high molecular weight polyethylene (UHMWPE, average diameter of 11 microm), UHMWPE (99 microm), cobalt-chromium alloy (Co-Cr, 3.9 microm), stainless steel (SUS316L, 3.9 microm), alumina ceramics (3.9 microm), titanium alloy (Ti, 3.5 microm), Co-Cr (0.03 microm), and Ti (0.03 microm). After the longitudinal groove on a polymethylmethacrylate plug was filled with one type of the particles, the plug was inserted into the medullar canal of the distal end of rabbit femurs, and tissue block was resected 4 and 12 weeks after the insertion. Histiocytes were markedly accumulated around the particles of UHMWPE (11 microm), Co-Cr (3.9 microm), SUS316L (3.9 microm), Co-Cr (0.03 microm), and titanium alloy (0.03 microm). Around the UHMWPE particles (99 microm), a slight histiocytic reaction and bone formation were observed. Particles of alumina ceramics (3.9 microm) and titanium alloy (3.5 microm) which were in phagocytosable sizes also had few histiocytic reactions. Statistically, the material difference was more strongly related to the histiocyte reaction than to the particle size and calculated total surface area of particles. Our findings demonstrate that particles of different biomaterials and in different sizes induce different foreign-body histological reactions.

Gene organization of the quail major histocompatibility complex (MhcCoja) class I gene region

Class I genomic clones of the quail (Coturnix japonica) major histocompatibility complex (MhcCoja) were isolated and characterized. Two clusters spanning the 90.8 kilobase (kb) and 78.2 kb class I gene regions were defined by overlapping cosmid clones and found to contain at least twelve class I loci. However, unlike in the chicken Mhc, no evidence for the existence of any Coja class II gene was obtained in these two clusters. Based on comparative analysis of the genomic sequences with those of the cDNA clones, Coja-A, Coja-B, Coja-C, and Coja-D (Shiina et al. 1999), these twelve loci were assigned to represent one Coja-A gene, two Coja-B genes (Coja-B1 and -B2), four Coja-C genes (Coja-C1-C4), four Coja-D genes (Coja-D1-D4), and one new Coja-E gene. A class I gene-rich segment of 24.6 kb in which five of these genes (Coja-B1, -B2, -D1, -D2 and -E) are densely packed were sequenced by the shotgun strategy. All of these five class I genes are very compact in size [2089 base pairs (bp)-2732 bp] and contain no apparent genetic defect for functional expression. A transporter associated with the antigen processing (TAP) gene was identified in this class I gene-rich segment. These results suggest that the quail class I region is physically separated from the class II region and characterized by a large number of the expressible class I loci (at least seven) in contrast to the chicken Mhc, where the class I and class II regions are not clearly differentiated and only at most three expressed class I loci so far have been recognized.

A rare case of acromegaly associated with pachydermoperiostosis

Pachydermoperiostosis (PDP) is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified and few endocrine abnormalities were apparent. We report here a 58-year-old man with acromegaly associated with PDP, the features of clubbed fingers, coarse skin, and cutis verticis gyrata. Acromegaly due to GH-producing pituitary adenoma was confirmed in endocrinological and pathological studies.

Pantropic retroviral vectors mediate gene transfer and expression in Entamoeba histolytica

Transformation of Entamoeba histolytica has been previously reported, but the foreign genes have all been replicated episomally. Pantropic retroviral vectors based on the Moloney murine leukemia virus with the envelope glycoprotein of vesicular stomatitis virus (VSV-G) have an extremely broad host range and can be concentrated to high titer. To investigate whether these pseudotyped, pantropic vectors can mediate gene transfer and expression in E. histolytica, we constructed a retroviral vector, in which a hygromycin phosphotransferase is expressed from the E. histolytica actin promoter. Data confirm the infection, integration, and expression of a foreign gene mediated by the provirus. To our knowledge, this is the most evolutionarily distant example of successful integration and expression of a mammalian retrovirus. Pantropic retroviral vectors may thus facilitate genetic analysis in species lacking transformation systems.

Serum samples of patients with rheumatoid arthritis contain a specific autoantibody to "denatured" aldolase A in the osteoblast-like cell line, MG-63

OBJECTIVE

To identify rheumatoid arthritis (RA) specific autoantibody and its antigen in the human osteoblast-like cell line, MG-63.

METHODS

MG-63 cell extract was subjected to western blotting by using RA and normal serum samples as probes. The autoantigen was purified and its N-terminal sequence was determined by automated Edman degradation. The reactivity of denatured aldolase A was evaluated by immunoblotting. Screening by enzyme linked immunosorbent assay (ELISA) using the autoantibody was performed.

RESULTS

40 kDa protein was found only in the RA serum samples and it was identified as aldolase A. A polyclonal antibody for rabbit muscle aldolase A bound to the 40 kDa protein and reacted in preference with the denatured enzyme. Using ELISA for denatured rabbit aldolase A, the autoantibody was found in approximately 10% of RA patients, whereas it was not found in the other arthropathy and healthy adults.

CONCLUSION

This 40 kDa anti-aldolase A autoantibody, which was identified only in serum samples of RA patients with severe bone erosion, could be related to a certain event that induces RA specific joint destructions.

T cell antigen receptor-mediated activation of the Ras/mitogen-activated protein kinase pathway controls interleukin 4 receptor function and type-2 helper T cell differentiation

The central role of type-2 helper T (Th2) cells in the development of allergic responses and immune responses against helminthic parasites is well documented. The differentiation of Th2 cells from naive T cells requires both the recognition of antigen by T cell antigen receptors (TCR) and the activation of downstream signal-transduction molecules of the interleukin 4 receptor (IL-4R) pathway, including Jak1, Jak3, and STAT6. Little is known, however, about how these two distinct pathways cooperate with each other to induce Th2 cells. Here, we use a T cell-specific H-Ras-dominant-negative transgenic mouse to show that TCR-mediated activation of the Ras/mitogen-activated protein kinase pathway alters IL-4R function and is required for Th2 cell differentiation. The enhancement of IL-4R signaling seems to be a consequence of both direct "crosstalk" with the TCR signaling pathway and increased protein expression of downstream signaling molecules of the IL-4R pathway. Therefore, successful Th2 differentiation depends on the effectiveness of the TCR-mediated activation of the Ras/mitogen-activated protein kinase pathway in modifying the IL-4R-mediated signaling pathway.

[A consideration in the care of elderly patients receiving home hospice care: administration of parenteral nutrition at home]

Due to the recent increase in the elderly population in Japan, the number of elderly patients with gastric cancer has also increased. As a result, not only the need for care of these patients has increased but also the care system has become diverse. In our hospital, more than 30% of patients who received home hospice care were over 70 years old and home hospice care of elderly patients with terminal cancer has become an important activity of our hospital. Whether home parenteral nutrition (HPN) procedures should be administered in the home for these patients is controversial. Our hospital has decided to inform patients with malignant disease of their true diagnosis under the doctrine of informed consent. In 1997, 94.1% of patients above 70 years, of age were informed of the actual nature of their disease. As a result, they were allowed to make a choice regarding home hospice care. An 81-year-old patient with terminal gastric cancer chose home hospice care and successfully managed the treatment procedures, including the use of a pump for intravenous alimentation. Through this case, we report here an ideal model of home hospice care of elderly patients under the concept of informed consent.

Infection of lepidoptera with a pseudotyped retroviral vector

Studies requiring the introduction and expression of manipulated gene constructs have been technically difficult in non-drosophilid insects. Retroviruses can be engineered to be replication defective and to serve as vectors for gene constructs of interest. In this study, pseudotyped MoMLV(VSV-G) retroviral vectors are shown to successfully infect lepidopteran cells in vitro and in vivo. In Spodoptera frugiperda cells in vitro and in Manduca sexta in vivo, infection and conversion to proviral DNA were confirmed by PCR amplification and Southern blot hybridization of vector-specific sequences. Gene expression and integration of proviral DNA were also documented in vitro. This is the first report of retroviral infection in lepidoptera and suggests that pseudotyped retroviral vectors could be powerful tools in gene manipulation studies of non-drosophilid insects.

[New curriculum of behavioral dentistry]

Faculty of Dentistry, Tokyo Medical and Dental University first introduced New Curriculum of Behavioral Dentistry in Japan. This curriculum has been established in consideration of the current social environments and dental clinical practice in our country, in addition to reference to Curriculum Guidelines in the USA. When students' impressions and assessments on the courses were researched and analyzed, the majority were found to be satisfied with this curriculum although several problems to be solved were also presented at the same time, such as timing of derivering lectures.

[Medical interview with simulated patients at behavioral science in dentistry]

The purpose of this paper is to present an outline of student's practice of interviewing simulated patients at behavioral science in dentistry. This practice was initiated as part of a newly introduced behavioral science course at our school of dentistry, to enable students to acquire communication skills, comprehensive understanding, and a proper attitude vis-à-vis patients. Students as well as instructors involved in the practice evaluated it as highly relevant for clinical education. It is concluded that the development of such practices in dental education is a prerequisite for training students to dentists oriented toward patient-centered dental practice.

Histomorphometric and biochemical effect of various hyaluronans on early osteoarthritis

OBJECTIVE

To evaluate, histomorphometrically and biochemically, different protective effects of clinically used hyaluronans (HA).

METHODS

An experimental osteoarthritis (OA) model was applied to 132 mature NZW rabbits by resecting the unilateral anterior cruciate ligament (ACL). The other knee, where ACL remained intact, served as the control. We used native HA with different molecular weights, HA-50 (MW 5-7.3 x 10(5)), HA-80 (MW 8 x 10(5)), HA-360 (MW 3.6 x 10(6)), and crosslinked HA (HA-CL). HA were injected into the joint once a week for 5 weeks (HA-50, HA-80, HA-360) or 3 weeks (HA-CL) beginning 4 weeks after ACL transection. Histomorphometric and biochemical assessment was performed 9 weeks post-transection for both the HA treated and nontreated groups.

RESULTS

In gross morphological observation, cartilage degeneration was suppressed in HA treated groups, and this effect was superior in the groups receiving either HA-80 or HA-CL. Histomorphometric and biochemical analyses of the articular cartilage revealed similar results: the HA-80 and HA-CL groups showed no significant differences between the ACL transection and the control knees by histomorphometric variables, while the nontreated groups revealed significant degeneration. These evaluations were done in unblinded fashion. Biochemical analyses, including DNA synthesis in the synovium, also showed that articular cartilage and synovium in the HA-80 and HA-CL groups did not present significant changes compared to controls.

CONCLUSION

In quantitative evaluation of this short term study using the OA model, native HA-80 and HA-CL presented a superior cartilage protective effect compared to the other native HA.

A novel immunosuppressant, FTY720, increases the efficiency of a superantigen-induced peripheral T-cell deletion whilst inhibiting negative selection in the thymus

A novel immunosuppressant, FTY720, was generated by chemical modification of ISP-I, an immunosuppressive compound purified from culture filtrates of Isaria sinclairii. FTY720 directly induces apoptotic cell death in lymphocytes, which is believed to be the mechanism by which this drug exerts its immunosuppressive effect. We examined the effect of FTY720 treatment on antigen-induced apoptotic cell death in peripheral T cells and thymocytes. A superantigen, staphylococcus enterotoxin B (SEB), induces T-cell antigen receptor (TCR) Vbeta-specific apoptotic cell death in mature T cells in vivo. In this well-documented experimental system, FTY720 administration significantly enhanced the efficiency of superantigen-induced T-cell deletion. We also determined that apoptotic cell death with DNA fragmentation induced in T-hybridoma cells after stimulation in vitro with anti-TCR antibodies was enhanced in the presence of non-cytolytic doses of FTY720. In sharp contrast, negative selection of T cells in the thymus, another example of antigen-induced apoptosis, was found to be inhibited by FTY720 treatment. A rescue effect was observed on clonal deletion in the H-Y-specific TCRalpha beta transgenic male thymus. In a chicken egg albumin (OVA)-specific TCRalphabeta transgenic system, OVA-induced apoptotic cell death of CD4+CD8+ thymocytes was also inhibited by FTY720 injection. Thus, FTY720 increased the susceptibility of mature T cells to TCR-mediated apoptosis but decreased that of immature thymocytes. The results in this report suggest that the potent immunosuppressive effect of FTY720 is, in part, a result of the augmentation of effects on antigen-induced apoptosis in mature T cells, and that two distinct apoptotic cell death pathways are operating in mature and immature T cells.

Giant cell granulamatous hypophysitis with remarkable uptake on Gallium-67 scintigraphy

We treated a man with giant cell granulomatous hypophysitis with pituitary enlargement, as seen on magnetic resonance imaging. Endocrinological examination revealed panhypopituitarism and diabetes insipidus. Microscopic examination of the specimen obtained by transsphenoidal pituitary biopsy revealed a granulomatous lesion, composed of epitheliod cells, Langhans' multinucleated giant cells, lymphocytes and other chronic inflammatory cells. On whole body gallium-67 scintigraphy, there was extensive uptake in the pituitary gland. Gallium-67 scintigraphy may greatly aid in the diagnosis of granulomatous hypophysitis.

[Intra-arterial injection therapy of mitoxantrone for locally advanced breast cancer]

Mitoxantrone (MIT) is a new anthraquinone anticancer agent. We treated 14 patients with locally advanced breast cancer, 3 of which were inflammatory breast cancers, by pre-operative arterial injection of MIT. The treatment protocol was MIT 12 mg/m2 injected into both the internal mammary and the subclavian arteries with oral administration of 5'-DFUR 1,200 mg/day for 20 days. After 2 courses, all tumors were decreased over 50% in size. Down-staging was obtained in all of 8 cases. Mastectomy could be carried out on all patients, without microscopically residual tumor cells. Preoperative arterial injection of MIT might be the treatment of choice for locally advanced breast cancer to perform down-staging, however the survival benefit has remained equivocal. These preliminary results are encouraging to further studies.

Characterization of recombinant and brain neuropsin, a plasticity-related serine protease

Activity-dependent changes in neuropsin gene expression in the hippocampus implies an involvement of neuropsin in neural plasticity. Since the deduced amino acid sequence of the gene contained the complete triplet (His-Asp-Ser) of the serine protease domain, the protein was postulated to have proteolytic activity. Recombinant full-length neuropsin produced in the baculovirus/insect cell system was enzymatically inactive but was readily converted to active enzyme by endoprotease processing. The activational processing of prototype neuropsin involved the specific cleavage of the Lys32-Ile33 bond near its N terminus. Native neuropsin that was purified with a purity of 1,100-fold from mouse brain had enzymatic characteristics identical to those of active-type recombinant neuropsin. Both brain and recombinant neuropsin had amidolytic activities cleaving Arg-X and Lys-X bonds in the synthetic chromogenic substrates, and the highest specific activity was found against Boc-Val-Pro-Arg-4-methylcoumaryl-7-amide. The active-type recombinant neuropsin effectively cleaved fibronectin, an extracellular matrix protein. Taken together, these results indicate that this protease, which is enzymatically novel, has significant limbic effects by changing the extracellular matrix environment.

Axonal transports of Boc-Gly-Arg-Arg-MCA hydrolysing enzyme in rat sciatic nerves

Study on neural axon transport is a very useful method to find a neuron-specific protease. In the present study, the enzyme activity (release of 7-amino-4-methyl-coumarin from t-butyloxycarbonyl-glycyl-L-arginyl-L-arginine-4-methylcoumaryl-7-amide) was measured in the proximal, middle, and distal segments between 12 and 120 h after double ligations of rat sciatic nerves to find precursor processing enzyme specific for pair of basic amino acid residue. The enzyme activity was significantly increased not only in the proximal but also in the distal segments 12-120 h after the ligation, and the maximal enzyme activity was found in both segments at 72 h. The enzyme activity eluted by anion exchange chromatography of the proximal segment showed at least three peaks, and was slightly higher than the activity of the distal one. The activity in the middle segment was very low in comparison with the activity in the proximal and distal segments. These data indicate that some of the enzymes specific for pair of basic amino acid residue are transported by both anterograde and retrograde axonal flow, and may undergo a neuron-specific processing.

Long-term effects of hyaluronan on experimental osteoarthritis in the rabbit knee

OBJECTIVE

Long-term assessment of the effect of hyaluronan (HA) on the articular cartilage and synovium in an animal knee joint during the development of osteoarthritis (OA).

DESIGN

Sixty mature New Zealand white rabbits underwent unilateral anterior cruciate ligament transection (ACLT) and were divided into two groups. Group 1 (SA) received intra-articular injections of 0.3 ml hyaluronan (HA) (i.e., ARTZ, MW: 8 x 10(5)) beginning 4 weeks after ACLT, once a week for 5 weeks. Group 2 (SV) received injections of the vehicle (phosphate buffered saline) in the same fashion as with the SA group. The contralateral nonoperated knee served as control. All animals were killed 21 weeks after surgery and their knee joints evaluated by gross morphologic, histologic, histomorphometric and biochemical analyses.

RESULTS

Gross morphological inspection indicated that the femoral condyles from the knees injected with vehicle suffered more severe cartilage damage than cartilage from the knees injected with HA. Furthermore, two out of three histomorphometric parameters measured in the HA-treated cartilage (i.e., cartilage thickness and cartilage area which were not statistically different than control) provided evidence showing a protective effect of HA on the femoral condyles following ACLT. Biochemical analysis showed articular cartilage remaining on the femoral condyles following ACLT to have similar characteristics to contralateral controls. However, DNA concentration in the synovium from the ACLT knees of the vehicle-treated animals was greater than contralateral control, while this parameter was not statistically different than contralateral control in the HA treated animals.

CONCLUSIONS

These results demonstrate a protective effect of HA on preservation of the articulating surface of the femoral condyle following ACLT up to 21 weeks post-surgery.

CD4 regulates the efficiency of an endogenous superantigen-induced clonal deletion of TCRV beta 11+ cells in the periphery

Peripheral T-cell antigen receptor V beta (TCRV beta) repertoire is influenced by clonal deletion both in the thymus and periphery. Developing thymocytes expressing certain TCRV beta are deleted by endogenous superantigens presented on major histocompatibility complex (MHC) molecules in the thymus. Likewise, mature T cells bearing particular TCRV beta chains can be clonally deleted by superantigens in the periphery. The efficiency with which T cells expressing particular V beta subunits are deleted differs depending upon which coreceptor is expressed. Indeed, while deletion of V beta 11+ splenic T cells in CBA/J (Mls-1, a I-E, + MTV 9+) mice is quite efficient for CD4+ spleen T cells, it is much less efficient for CD8+ splenic T cells. If the difference in the efficiency of deletion is due solely to the coreceptor expressed, then a transgene encoding CD4 should increase the efficiency with which CD8+ cells are deleted. To address this question, we have produced CD4 transgenic (TG) mice that express physiologic levels of CD4 on all thymocytes and peripheral CD8 T cells. CD4 molecules expressed on CD8+ splenic T cells were associated with P56lck tyrosine kinase, and were functional as evidenced by their ability to facilitate class II alloreactivity. Furthermore, we found that ectopic expression of TG CD4 molecules on CD8+ cells was able to affect the efficiency of deletion in response to superantigen stimulation. In particular, deletion of TCRV beta 11+ T cells was much less efficient for CD8+ than for CD4+ T-cell subpopulations in (CBA/J x B6) F1 mice. However, expression of the CD4 transgene on CD8+ splenic T cells from these mice increased the efficiency of deletion in the CD8+ V beta 11 T cells. Interestingly, this effect was not observed in a mature CD8+ thymocyte subpopulation. The results in this report demonstrate that CD4 molecules are involved in peripheral deletion of TCRV beta 11+ T cells in (CBA/J x B6) F1 mice, and that the TCRV beta repertoire can be altered by ectopic expression of CD4 on all T-lineage cells.

Genetic analysis of a Japanese patient with butyrylcholinesterase deficiency

A patient (64-year-old, male) with familial cholinesterasemia caused by BChE deficiency was studied. DNA sequence analysis of all exons identified a point mutation, an A-->G transition at codon 128, resulting in a Tyr-->Cys substitution. The propositus showed extremely low BChE activity, but his other family members (three individuals) showed from intermediate to normal BChE activity. An immunological method revealed the absence of BChE protein in serum of the propositus. Both PCR primer introduced restriction analysis (PCR-PIRA) and sequence analysis revealed all three family members to be heterozygotes for this mutation.

A novel missense mutation in codon 218 of the albumin gene in a distinct phenotype of familial dysalbuminemic hyperthyroxinemia in a Japanese kindred

Familial dysalbuminemic hyperthyroxinemia (FDH) is the most common cause of inherited euthyroid hyperthyroxinemia in Caucasians. To our knowledge, no such documentation on Asians exists. Six of 8 members of a 3-generation Japanese family were found by us to carry the FDH phenotype. Serum total T4 levels ranged from 1763.2-2741.3 nmol/L (normal range, 65.6-164.7), serum total T3 levels ranged from 2.73-5.62 nmol/L (normal range, 1.47-2.95), and rT3 levels ranged from 1.08-2.52 nmol/L (normal range, 0.22-0.60). In the proband, the majority of [125I]T4 in serum T4-binding proteins was distributed in albumin fractions, and the isolated albumin had an increased affinity for T4. A guanine to cytosine transition in the second nucleotide of codon 218, resulting in replacement of normal arginine with proline, was detected in 1 of 2 alleles in all 5 subjects of the family with FDH. In all FDH-affected Caucasian subjects from 10 unrelated families with a moderate increase in serum T4, the guanine to adenine transition was demonstrated at the same position of the albumin gene as noted in our patients, but histidine, the replacement amino acid, differed from proline noted in our FDH Japanese subjects. It would thus appear that FDH has ethnic variations.

Method of histomorphometric assessment of glycosaminoglycans in articular cartilage

A method of image analysis has been developed for use in the semiquantitative histomorphometric assessment of glycosaminoglycans in articular cartilage stained with safranin O. The reliability of the methodology is reported along with its application to the assessment of articular cartilage in a model of osteoarthritis, i.e., transection of the anterior cruciate ligament in rabbits. With this system, specimens of normal and osteoarthritic articular cartilage were assessed histomorphometrically for the following parameters: total cartilage area, percentage of safranin O stained area, mean gray scale (average stain intensity), and gray scale index (the relative total amount of glycosaminoglycans). Reproducibility was established for 12 specimens of normal cartilage and found to have a SD of less than 8% of the mean for each parameter that was measured. Image analysis of osteoarthritic cartilage revealed each of the parameters, except for average stain intensity, to be significantly lower than that in control cartilage.

The effects of hyaluronan during the development of osteoarthritis

Ninety-nine mature New Zealand White (NZW) rabbits underwent unilateral anterior cruciate ligament transection (ACLT) and were divided into three groups. The contralateral non-operated knees served as controls. The first group (SA) received intra-articular injections of 0.3 ml hyaluronan (HA: MW; 8 x 10(5)) beginning 4 weeks after ACLT, once a week for 5 weeks. The second group (SV) was injected with vehicle (carrier of HA) in the same fashion as the SA group. The third group (SN) served as a nontreatment group post ACLT. All animals were killed 9 weeks post-surgery and were assessed by gross morphology, histomorphometry and biochemical analysis. Gross morphologic changes on the femoral cartilage in the SA group were less severe than those in the SV and SN groups. Cartilage thickness, cartilage area, and thickness of synovial lining cell layer histomorphometric parameters were measured, showing a positive effect of HA on the preservation of articular cartilage and synovial tissue. Similarly, the cartilage and synovial tissues from knees injected with HA did not demonstrate significant alterations from contralateral controls as measured by biochemical analysis [i.e., water content, pyridinoline concentration, glycosaminoglycan (GAG) content for the cartilage, and DNA concentration for the synovial tissue].

[4-year clinico-statistical observation of outpatients]

Clinico-statistical observations were made on the outpatients visiting the Department of Initial Diagnosis and Emergency, Faculty of Dentistry Hospital, Tokyo Medical and Dental University in 1986, 1987, 1989 and 1990. The following findings were obtained according to sex, age group, and chief complaints of new outpatients. Approximately 60% of the outpatients were female during the year examined. The number of outpatients tended to increase in March and to decrease during the winter. The largest number of new outpatients visiting the hospital was in the 20-24-year-old group in both males and females. In the female patients, the 50-54-year-old group had a relatively higher peak. The greatest chief complaint was tooth pain. Further, the chief complaint involving oral soft tissues was due to inflammation. The main disease diagnosed due to chief complaints was caries in the 20-29-year-old group, marginal periodontitis in the 50-59, pericoronitis of wisdom tooth in the 20-29, temporomandibular joint problem in the < or = 19 and masticatory disturbance in the 60 < or = -year-old groups.

Genomic organization of the mouse adrenocorticotropin receptor

As a step toward understanding the transcriptional regulation of the adrenocorticotropin receptor (ACTH-R) gene, we examined the full length cDNA sequence of the mouse ACTH-R by rapid amplification of cDNA ends, and the organization of the gene. Mouse ACTH-R mRNA consists of 374 bp in the 5'-untranslated region (UTR), 888 bp in the coding sequence, and 445 bp in the 3'-UTR, the 1707 bp being fairly compatible with the 1.8-kb adrenal mRNA detected by Northern analysis. The mouse ACTH-R gene consists of at least four exons; the first three exons encode 5'-UTR and the fourth exon encodes part of 5'-UTR, the entire coding region, and the whole of 3'-UTR. We also defined two mRNA species, one with and one without the 57-bp exon 2, produced by alternative splicing.

Genetic mapping of four mouse bHLH genes related to Drosophila proneural gene atonal

It has been shown that mammalian neurogenesis is partly controlled by multiple basic helix-loop-helix (bHLH) genes, as in Drosophila. Recently, mouse homologs of Drosophila atonal, a proneural gene encoding a bHLH protein required for chordotonal organ and photoreceptor development, have been characterized to obtain further insights into the molecular nature of mammalian neurogenesis. Here, to assess their potential involvement in genetic neural disorders, we have determined genetic map positions for four mouse atonal-related genes, Atoh1, Atoh2, Atoh3, and Ndrf, which encode MATH-1, MATH-2, MATH-3, and NDRF, respectively. Interspecific backcross analysis indicated that Atoh1 and Atoh2 were located in separate positions of Chr 6 and that Atoh3 and Ndrf were mapped to Chr 10 and Chr 11, respectively. Thus, these structurally related genes are located separately on multiple chromosomes.

Acute anterior uveitis in a child with HLA-B60 after Salmonella enteritis associated with the transient appearance of auto-antibody

A Japanese girl with HLA-B60, but not B27, who developed acute anterior uveitis after Salmonella enteritis is described. There was no evidence of arthritis or urethritis during this episode. This is the first report that acute anterior uveitis after Salmonella enteritis was associated with the transient appearance of auto-antibody in the serum at an early period.

Retrovirol gene transfer in Xenopus cell lines and embryos

A new class of retroviral vector pseudotypes have an expanded host species range and can be concentrated to high titers by ultracentrifugation. These pantropic vectors contain the genome of the murine leukemia virus-based vectors and the envelope protein of vesicular stomatitis virus substituted for the amphotropic envelope protein. We tested (a) the ability of pseudotyped (pantropic) and unmodified (amphotropic) vectors to stably infect three different Xenopus laevis cell lines, including one derived from the embryonic retina; and (b) the ability of the concentrated pseudotyped virus to infect embryos and to mediate foreign gene expression in the embryonic CNS. Expression of the neomycin phosphotransferase gene and single copy integration of the provirus into the genome of the cell lines was demonstrated. Surprisingly, the amphotropic and pantropic vectors generated neomycin-resistant clones with similar efficiency. PCR amplification of genomic DNA from single stage 10, 20, and 25 embryos microinjected in the blastocoel or neural tube cavities with concentrated pantropic vector (10(8) cfu/ml) revealed proviral DNA. Microinjection of a concentrated pantropic vector containing the coding sequence for the beta-galactosidase gene into the neural tube lumen of 24-h embryos yielded beta-galactosidase expressing cells in the brain. Thus, retroviral vectors provide an additional approach to existing strategies for gene transfer in Xenopus embryos and cell lines.

Serial magnetic resonance imaging in post-infectious focal encephalitis due to influenza virus

Two cases of a 13-year-old girl and a 14-year-old boy with postinfectious focal encephalitis due to influenza are reported. The clinical and magnetic resonance imaging (MRI) findings included: (1) partial motor seizures as the initial central nervous system manifestation, appearing more than 20 days after the influenzal infection, (2) no change in the level of consciousness although a boy demonstrated apraxia, and (3) high signal intensity lesions noticed with T2-weighted MRI located mainly in the cortex. The girl's lesion appeared to resolve within 10 days on MRI, while that of the boy (demonstrated in the thalamus on a third MRI) resolved within 1 week. However, a new lesion appeared in the cortex approximately 1 month later, that was visualized on a fourth MRI. Small gadolinium-enhanced lesions also were noticed during earlier stages in both patients. The pathogenesis of these MRI lesions is unknown, but the coexistence of small enhancing lesions, rapidly resolving lesions, and the elevated thrombin anti-thrombin III complexes, may indicate the presence of an angiopathy. Serial MRI examinations in patients with postinfectious encephalitis may lead to a better understanding of the pathogenesis of this disorder.

Molecular identification of viruses in sudden infant death associated with myocarditis and pericarditis

A subset of infants dying suddenly and unexpectedly have myocarditis with or without pericarditis found at autopsy. To address whether viruses known to cause infantile myocarditis and pericarditis might be present in such infants, we examined myocardium, liver and skeletal muscle for the presence of genomic sequences from adenovirus, cytomegalovirus, enterovirus and echovirus 22/23 in infants enrolled in a comprehensive evaluation protocol. We studied eight infants who died suddenly and unexpectedly with histologic evidence of myocarditis and/or pericarditis detected at postmortem examination. One infant with myocarditis and pericarditis had adenovirus genome detected in the myocardium. In an additional infant with severe pericarditis alone, enterovirus genome was detected in the liver. Although echovirus 22/23 has been associated with myopericarditis in young infants, no previous studies have used molecular methods to search for the genomic sequences of these viruses in clinical samples. No echovirus 22/23 genome was detected in the patients reported here. The significance of enterovirus and adenovirus genome in the tissues of two patients dying suddenly and unexpectedly remains speculative but raises the possibility that pathogenic viruses may cause little or no clinical symptoms and yet be contributory to sudden death in young infants.

[The efficacy of intravenous lidocaine on various types of neuropathic pain]

We examined the efficacy of systemic local anesthetics on various types of neuropathic pain in 89 patients. Lidocaine 1.5 mg.kg-1 was infused intravenously for one minute. Pain score (PS) by visual analogue scale (VAS, 0-10) was measured 1, 5, 15 and 35 min after the infusion. The efficacy of intravenous lidocaine was evaluated by PS which was lowest after infusion. PS decreased to less than 50 percent of pre-infusion value in more than 75 percent of cases of cancer pain, postherpetic neuralgia, trigeminal neuralgia, low back pain with signs of root pain or spinal canal stenosis, peripheral nerve injury and thalamic pain, in 50-75 percent of cases of herpetic neuralgia, and in less than 50 percent of cases of cervical spondylosis, spinal cord injury, reflex sympathetic dystrophy, causalgia and psychogenic pain. This study suggests that systemic local anesthetics is effective in neuropathy due to cancer pain, postherpetic neuralgia, trigeminal neuralgia, low back pain with signs of root pain or spinal canal stenosis, peripheral nerve injury and thalamic pain.

A mammalian helix-loop-helix factor structurally related to the product of Drosophila proneural gene atonal is a positive transcriptional regulator expressed in the developing nervous system

We report the molecular characterization of a mouse basic helix-loop-helix factor, designated MATH-1, structurally related to the product of the Drosophila proneural gene atonal. MATH-1 mRNA is first detected in the cranial ganglions and the dorsal part of the central nervous system on embryonic day 9.5 (E9.5). From E10.5 onward, prominent expression of MATH-1 continues in the dorsal part of the central nervous system but becomes restricted to the external granular layer of the cerebellum by E18 and is undetectable in the adult nervous system. MATH-1 activates E box-dependent transcription in collaboration with E47, but the activity is completely antagonized by the negative regulator of neurogenesis HES-1. These results suggest that MATH-1 may be a target of HES-1 and play a role in the differentiation of subsets of neural cells by activating E box-dependent transcription.

[Diltiazem potentiates the neuromuscular blockade by vecuronium in humans]

We investigated interaction of diltiazem with vecuronium using constant infusion technique in 24 ASA class I or II elective surgical patients with no preoperative administration of Ca antagonists. Neuromuscular blockade was evaluated with accelerometry, which measured single twitch height of adductor pollicis muscle. After tracheal intubation under isoflurane anesthesia, patients received either no diltiazem (control group, n = 8)m, 5 mg (bolus) + 2 mcg.kg-1.min-1 constant infusion (2 mcg group, n = 8) or 5 mg (bolus) + 4 mcg.kg-1.min-1 constant infusion (4 mcg group, n = 8). When single twitch height returned to 10% of control value, infusion of vecuronium was started and the infusion rate was adjusted to maintain twitch height at 10% of the control value. After 30 minutes of stable twitch height, the vecuronium infusion rate and plasma diltiazem concentrations were measured. Diltiazem infusion of 4 mcg.kg-1.min-1 decreased the vecuronium infusion rate by 45% compared with 2 other groups. Plasma diltiazem concentrations in patients receiving 4 mcg.kg-1.min-1 were significantly higher than those receiving 2 mcg.kg-1.min-1. In conclusion diltiazem 4 mcg.kg-1.min-1 potentiates the neuromuscular blockade of vecuronium and it relates with the plasma diltiazem concentration.

MATH-2, a mammalian helix-loop-helix factor structurally related to the product of Drosophila proneural gene atonal, is specifically expressed in the nervous system

In Drosophila, multiple helix-loop-helix (HLH) factors play an essential role in neural development. Mammalian homologues of such Drosophila HLH factors have been recently characterized and provide useful information for the analysis of the mechanisms of mammalian neurogenesis. We report here the molecular characterization of a novel mouse HLH factor, designated MATH-2, that has a structural homology to the product of Drosophila proneural gene atonal. MATH-2 consists of 337 amino acid residues and contains an atonal-related basic HLH domain. However, outside of this domain, there is no significant sequence similarity between MATH-2 and Atonal. MATH-2 expression occurs by embryonic day 11.5 (E11.5), and is first detected in the wall of brain vesicles as well as in the spinal cord. It is expressed in the cortical plate and the mantle layer throughout the developing central nervous system but not in the ventricular zone. By E13.5, the expression becomes more prominent in the cortical plate of the cerebrum but decreases in the other regions. In the adult, the cerebrum produces a high level of MATH-2 RNA but other neural tissues produce only low levels. MATH-2 RNA is not detected in non-neural tissues, indicating that MATH-2 expression is specific to the nervous system. The gel mobility-shift analysis shows that MATH-2 can interact with several E-box sequences in collaboration with E47, a ubiquitously expressed HLH factor. These results raise the possibility that MATH-2 may be a trans-acting factor involved in the development and maintenance of the mammalian nervous system.

[A case of juvenile dermatomyositis with calcinosis universalis--remarkable improvement with aluminum hydroxide therapy]

Juvenile dermatomyositis (JDM) is a multisystem disease characterized by acute and chronic nonsuppurative inflammation of striated muscle and skin. JDM is classified into an independent entity in the classification of dermatomyositis, and it is marked by the development of calcinosis late in the course of the disease. Since an appropriate steroid therapy for the disease was established, the prognosis of the JDM has been improved except for a fulminant case. Frequency of calcinosis in JDM also has been decreasing because of the adequate steroid therapy. However, once calcinosis universalis occurs, this is the most troublesome and debilitating complication in JDM. Treatment of calcinosis universalis in JDM, so far, remains unsatisfactory. We report here a case of JDM, who suffered from at the age of 3 years, with calcinosis universalis that showed remarkable improvement to orally administrated aluminum hydroxide.

Acute leucoencephalopathy during cyclosporin A therapy in a patient with nephrotic syndrome

A 13-year-old girl with nephrotic syndrome (NS) developed acute leucoencephalopathy during combination therapy with cyclosporin A (CyA) and prednisolone (PSL). The patient had a generalized motor seizure followed by coma at 19 days after CyA administration. Magnetic resonance scanning performed on the 1st hospital day revealed white matter lesions in the subcortices of the parietal and occipital lobes, brain stem and cerebellum. These lesions had completely resolved on the 10th hospital day. This episode might be caused by CyA because the clinical course and laboratory data revealed neither inflammation nor other causative factors. To our knowledge, this is the first report of acute leucoencephalopathy during combination therapy with CyA and PSL in a patient with NS.

One-step determination of herpes simplex virus types I and II by polymerase chain reaction

A rapid and sensitive one-step polymerase chain reaction (PCR) assay was developed for use in identifying type I and type II herpes simplex virus (HSV). Although the nucleotide sequences of the two HSV subtypes are quite similar, common and type-specific sequences 20 nucleotides in length could be deduced in the thymidine kinase gene. Oligonucleotide primers targeted to the type-specific regions generated products of different sizes that served to distinguish two HSV types. Type-specific PCR amplification products were verified by restriction enzyme digestion. Specificity of the HSV PCR was established by the lack of amplification of other herpes-group viruses including cytomegalovirus, Epstein-Barr virus, and varicella zoster virus. Extraction of DNA from clinical materials (throat swabs, vesicular swabs, cerebrospinal fluid and eye discharge) yielded an amplification product of the predicted size for each HSV type. Thus, this PCR system provides a rapid, sensitive and specific assay that can supplement the currently available modalities for detecting and typing HSV.

Detection of novel RNA viruses: morbilliviruses as a model system

Recent advances in molecular detection of viral-specific nucleic acid sequences have facilitated the search for pathogenic viruses in clinical samples. Primers for the polymerase chain reaction can be targeted to unique or conserved regions of the viral genome. While the design of primers must be based on known sequences, it has been demonstrated in bacteria that amplification with primers which hybridize to highly-conserved regions of the genome can be exploited to detect new agents. By taking advantage of sequence conservation among diverse members of a viral genus, we designed PCR primers capable of hybridizing to three different members of the genus Morbillivirus for which sequence information is available. Simultaneous amplification with primers for the porphobilinogen deaminase gene, a constitutively expressed gene in all cells, confirmed the presence of amplifiable RNA. Sequence alignments for the matrix and nucleoprotein genes suggested a highly conserved region of the nucleoprotein gene as a likely target for gene amplification. Morbillivirus primer pairs were chosen from the nucleoprotein gene, which successfully amplified measles virus, canine distemper virus, and phocine distemper virus. In a single reaction which combines cDNA synthesis by reverse transcription of the RNA genome with the polymerase chain reaction (RT PCR reaction), amplification with these primers detected as little as 0.1 pfu (plaque forming unit) of measles virus and 1 TCID50 of canine distemper virus. These Morbillivirus primers can be used to search for novel members of the genus which are likely to share sequence similarity in these highly conserved regions.(ABSTRACT TRUNCATED AT 250 WORDS)

Substituted 1,8-naphthyridin-2(1H)-ones as selective phosphodiesterase IV inhibitors

New substituted 1,8-naphthyridin-2(1H)-ones have been found to exhibit highly selective phosphodiesterase (PDE) IV inhibition. These compounds inhibited polymorphonuclear leukocyte activation induced by N-formylmethionyl-leucyl-phenylalanine and caused relaxation of isolated guinea pig trachea precontracted by histamine or leukotriene D4. In anesthetized guinea pigs, presensitized with the antigen, these compounds also alleviated airway constriction induced by the antigen. Since these compounds differ in their chemical structure compared with theophylline and other PDE IV inhibitors so far reported and some of them have been shown to be well tolerated in acute toxicity studies, they will provide a new tool for investigating the possible relationship between PDE IV inhibition and anti-asthmatic activity.

[Behçet's disease in childhood--case reports and review of literature]

Two childhood with Behcet's disease were reported. To evaluate the clinical features of Behcet's disease in childhood, fifty eight case studies (domestic; 19 cases, world-wide; 39 cases) were examined from the literature including two cases in our clinics. Oral ulcers (100%), genital ulcers (82.8%), skin manifestations (77.6%), and articular involvement (51.7%) were frequently found as seen in adult cases. Gastrointestinal manifestations were more common in childhood than in adults (50.0% vs. 29.3%). However, ocular inflammatory disease was less frequently seen in pediatric patients as opposed to adults. Three fourth of children with Behçet's disease was effectively treated with oral or intravenous prednisolone. These findings suggested that the criteria for childhood Behçet's disease will be necessary for early and proper diagnosis.

[Effects of combined administration of prednisolone and mizoribine in the course of remission for SLE children with nephritis]

Since oral steroid therapy was introduced for SLE, the long-term prognosis of the patients has been significantly improved. Adverse effects of the drug, however, are inevitable for these patients. The characteristic of the adverse effects especially for the child case is the suppression of linear growth. In order to prevent these undesirable effects and to improve their quality of life (QOL), we had introduced the methylprednisolone pulse therapy for SLE in children as both an initial and a relapse therapy. Although this therapy improved QOL of the patients significantly, there was little benefit for the growth disturbance. Then, we have introduced Mizoribine in addition to prednisolone (PSL) therapy for more than 18 months in three SLE children with lupus nephritis. In this trial, the combination therapy was effective for the decrease of urinary protein in one case, and for the reduction of a dosage of oral PSL in one case. In other case, MZR showed only partial immunosuppression. Thus, we concluded that there was a limitation with this combination therapy, however, it is one of the worthy therapy to be tried in SLE children with nephritis.

[Therapeutic efficacy of cefodizime in combination with minocycline against systemic infection caused by methicillin-resistant Staphylococcus aureus in immunocompromised tumour bearing mice]

The in vivo synergistic effect of cefodizime (CDZM) in combination with minocycline (MINO) against methicillin-resistant Staphylococcus aureus (MRSA) was investigated. A study of fractional effective dose (FED) index showed that either synergistic or additive effect was observed between CDZM and MINO. The postantibiotic effect (PAE) of MINO was not altered by the addition of CDZM. However, a strong synergistic bactericidal effect of CDZM and MINO against MRSA CT-18 was observed for more than 14 hours in the presence of immunocompromised tumour bearing murine polymorphonuclear leukocytes (PMN). These results suggest that the strong therapeutic efficacy of CDZM in combination with MINO was caused by synergistic bactericidal effect of the 2 drugs in the presence of PMN.

Increased hypothalamic somatostatin mRNA following dexamethasone administration in rats

There is increasing evidence to suggest that supraphysiological doses of glucocorticoids suppress growth hormone secretion in vivo by augmenting somatostatin release from the hypothalamus; previously, we reported an increase in hypothalamic somatostatin content in dexamethasone-treated rats. To further examine whether the production of somatostatin really is augmented, hypothalamic somatostatin mRNA levels were determined by the Northern blot technique in female rats receiving 330 micrograms of dexamethasone daily for three days. In two series of experiments, hypothalamic somatostatin mRNA levels in dexamethasone-treated rats were significantly (p < 0.05) increased to 133 +/- 19 (mean +/- SD)% and 153 +/- 38% of the controls. In the dexamethasone-treated rats, plasma growth hormone levels were markedly suppressed compared with those of the controls. These results further support the hypothesis that pharmacological doses of glucocorticoids increase the production and release of somatostatin from the hypothalamus and thus inhibit growth hormone secretion, overriding the direct stimulatory effect of glucocorticoids on growth hormone production at the pituitary level.