Enhanced leukotriene C4 synthase activity in thioglycollate-elicited peritoneal macrophages

The utilization of LTA4 by peritoneal macrophages (MO) obtained from untreated rats (control) as well as by those elicited from rats was investigated at designated intervals (on days 3, 7, and 14) following the intraperitoneal injection of thioglycollate (TG). On day 7 following the injection the elicited MO converted LTA4 to LTC4 at the highest rate while the resident MO showed the lowest rate. The conversion of LTA4 to LTC4 and LTB4 was next examined by using each MO lysate. The apparent LTC4 synthase activity was significantly higher in the MO lysate both on day 3 and day 7, with the latter being the highest value obtained. The GSH S-transferase activity in each lysate using as the substrate, DNCB was significantly lower on day 3 but significantly higher on day 7 as compared to control values. However, this elevated activity was less variable than that observed with LTC4 synthase. The possible implication for these observations is discussed.

[Modification of spontaneous lung metastasis by local radiation combined with or without immunomodifier]

This study was carried out to determine the effect of local irradiation of the NFSa tumors on the incidence of lung metastases. The spontaneous lung metastases were found in those animals whose tumors had grown in size bigger than 10 mm in diameter. The incidence of metastases and the number of lung nodules were increased in those animals of irradiated group when compared to those of control group with the same size. This is probably because the irradiation of tumors resulted some retardation in their growth and thus, the irradiated tumors took a longer time to reach a given size than those unirradiated control tumors. The incidence of spontaneous lung metastases was significantly reduced by subcutaneous administration of OK-432 (2.5KE/mouse) locally into the surroundings of the tumor immediately after irradiation. The administration of OK-432 after the metastasis development was no longer effective. Both of intraperitoneal and subcutaneous administrations of OK-432 into opposite side of unirradiated thigh showed no suppression of metastasis. These results suggest that an appropriate immunostimulation combined with radiotherapy may be important for the suppression of tumor metastases.

[The significance of pleural fluid cytology in the differential diagnosis of pleurisy showing lymphocyte-predominant pleural effusion]

We examined the significance of pleural fluid cytology in differentiation between tuberculous and non-tuberculous pleurisy in patients with lymphocyte-predominant pleural effusion. We divided pleural fluid cytologic findings into two patterns, that is "tuberculous" and "non-tuberculous pattern", according to the report by Spieler, and compared the cytologic pattern with the final clinical diagnosis. Thirteen out of 19 cases (68.4%) with tuberculous pleurisy showed "tuberculous pattern" in the pleural fluid cytology, while four (pleurisy associated with collagen-vascular disease, asbestosis and carcinoma, and idiopathic pleurisy) out of 13 (30.8%) with non-tuberculous pleurisy revealed "tuberculous pattern". The pleural fluid cytology could be used as one of the additional means to differentiate between tuberculous and non-tuberculous pleurisy, though it is impossible to differentiate between them with the pleural fluid cytology alone.

[The effect of OK-432 on modifying a spontaneous lung metastasis from murine fibrosarcomas]

The authors have investigated the effect of OK-432 on the spontaneous metastasis from a murine fibrosarcoma, either an NFSA or a SANH, that had been transplanted into the right thigh of C3H mice. When the NFSA or the SANH tumors grew to 7 mm in diameter, they were irradiated with a single dose of 30 Gy and 20 Gy, respectively. A local administration of OK-432 (2.5 KE) around each of the tumors was initiated immediately after irradiation and continued twice a week. It was found that regrowth in both tumors was not modified by the OK-432, though the mean number of metastatic lung nodules per mouse from either tumor was significantly decreased. The incidence of a lung metastasis also was reduced by the OK-432 but not significantly. Further, mice that had received a SANH tumor transplant developed a lymph node metastasis in the abdominal cavity that was depressed by the OK-432.

Effects of azelastine on vagal neuroeffector transmission in canine and human airway smooth muscle

Azelastine is a newly developed antiallergic drug that is reported to antagonize histamine and leukotrienes in addition to its inhibitory action on release of chemical mediators. In the present study, the effects of azelastine on neuroeffector transmission in the airway smooth muscles with double sucrose gap and isometric tension-recording methods were evaluated. Azelastine (10(-8) to 10(-6) mol/L) markedly decreased the contractile response of human bronchial and dog tracheal muscle strips to electrical field stimulation (10 pulses at 20 V, 20 Hz, 800 microseconds) in a dose-dependent manner. In parallel with actions on twitch contractions, azelastine suppressed the amplitude of excitatory junction potentials of dog trachea without changing the resting membrane potential and input resistance of smooth muscle cells. However, azelastine did not alter acetylcholine sensitivity of the smooth muscle cells. These results indicate that azelastine possesses an inhibitory action on the release of acetylcholine by vagal nerve terminals. This inhibitory effect of azelastine may contribute to the treatment of asthma in addition to its antiallergic actions.

[Terminal pulmonary infections in autopsy cases that died of lung cancer]

To elucidate the predisposing factors of terminal pulmonary infection in patients with lung cancer, we reviewed the case record of 251 autopsy cases that died of lung cancer in Kyushu University Hospital from 1976 to 1987. The incidence of mycobacteriosis was significantly more frequent in cases treated with antineoplastic therapy and corticosteroid (Group III) than in those with antineoplastic therapy but without corticosteroid (Group II), while the incidence of common bacterial and nonbacterial infections was not significantly different between the two groups. In patients with lung cancer treated with antineoplastic therapy, corticosteroid administration of relatively short duration (less than a month) induced fatal mycobacteriosis. In cases with lymphocytopenia, the incidence of fatal mycobacteriosis was significantly more frequent in Group III than in Group II, whereas the incidence of fatal nonbacterial infection was not. In cases with monocytopenia, both fatal mycobacteriosis and nonbacterial infection were significantly more frequent in Group III than in Group II. In Group III, the incidence of mycobacterial and nonbacterial infections was not different significantly between cases with and without lymphocytopenia or monocytopenia. Thus, in patients with lung cancer, administration of corticosteroid has greater influence on the development and exacerbation of mycobacteriosis than lymphocytopenia or monocytopenia. On the other hand, the influence of corticosteroid on the development and exacerbation of nonbacterial infection was significantly different from that of lymphocytopenia. The administration of corticosteroid and antineoplastic therapy do not increase the incidence of terminal common bacterial infection in patients with lung cancer.

[The significance of subpleural mononuclear cell infiltration in the differential diagnosis of pleurisy showing nonspecific histological findings]

To determine whether or not patients who showed abundant lymphocytes in pleural effusion without any specific findings by pleural biopsy could be histopathologically differentiated between those with tuberculous and nontuberculous origin, we reexamined histology of pleural biopsies of all patients whose pleural effusion showed predominantly lymphocytes and did not contain malignant cells from January, 1984 to March, 1989. A total of 45 patients with a nonspecific histology of pleural biopsy were categorized based on their final diagnosis into three groups; tuberculous (n = 20), carcinomatous (n = 10) and nontuberculous, benign pleurisy (n = 15). Pleural biopsy of patients with nontuberculous, benign pleurisy frequently showed band-like infiltration of mononuclear cells in the subpleural adipose tissue (11 out of 15 patients), while the finding was significantly less frequent in those with tuberculous pleurisy (1 out of 20, p less than 0.01) and pleurisy associated with carcinoma (3 out of 10, p less than 0.05). Based on these findings, the presence of band-like infiltration of mononuclear cells in the subpleural adipose tissue in pleural biopsy of patients with abundant lymphocytes in pleural effusion strongly suggests that the pleurisy is nontuberculous origin.

A novel antifungal antibiotic, FR-900848. I. Production, isolation, physico-chemical and biological properties

Streptoverticillium fervens produced a new antibiotic, FR-900848, which has a high specific activity against filamentous fungi. Purified by solvent extraction and column chromatography, the compound appears as colorless crystals. Its structure is C32H43N3O6, which consists of 5'-amino-5'-deoxy-5,6-dihydrouridine with an unsaturated fatty acid having unprecedented four serial and one isolated cyclopropane rings.

Enhanced superoxide anion generation but reduced leukotriene B4 productivity in thioglycollate-elicited peritoneal macrophages

Lipoxygenase metabolism of arachidonic acid was compared between peritoneal macrophages from untreated rats and those from rats on day 7 after intraperitoneal injection of thioglycollate broth (TG). Resident macrophages (M phi) from untreated rats produced mainly LTB4 (303 +/- 25 pmol/5 x 10(6) cells) and 5-HETE (431 +/- 56 pmol/5 x 10(6) cells) when stimulated with 5 micrograms/ml calcium ionophore A23187 for 20 min at 37 degrees C. On the other hand, TG-elicited M phi generated less amounts of lipoxygenase metabolites (157 +/- 10 pmol LTB4 and 319 +/- 19 pmol 5-HETE/5 x 10(6) cells) with the same stimulus. Then, leukotriene productivity was examined by using subcellular fractions of each M phi lysate and an unstable epoxide intermediate, leukotriene A4. LTA4 hydrolase activity was mainly contained in soluble fractions from the both groups of M phi. The cytosol fraction from the resident M phi exhibited the following specific and total activity; 2.2 +/- 0.1 nmol LTB4/mg protein/5 min and 12.2 +/- 0.5 nmol LTB4/5 min per 10(8) cells. On the contrary, the cytosol fraction from the TG-elicited M phi showed 1.9 +/- 0.1 nmol LTB4/mg protein/5 min and 9.6 +/- 0.3 nmol LTB4/5 min per 10(8) cells. The resident M phi, however, generated 0.14 +/- 0.04 nmol O2-/min/4 x 10(5) cells whereas the TG-elicited M phi did 0.49 +/- 0.13 nmol O2-/min/4 x 10(5) cells when stimulated with wheat germ lectin. These results suggest that the TG-elicited macrophages show enhanced superoxide production but generate less lipoxygenase metabolites.(ABSTRACT TRUNCATED AT 250 WORDS)

FR112123, a new oligopeptide antibiotic from Streptomyces viridochromogenes. Taxonomy, fermentation, isolation, physico-chemical properties, structure and biological activity

FR112123 is a new oligopeptide antibiotic produced by Streptomyces viridochromogenes No. 7587. The structure of FR112123 is elucidated as N-(N6-(N2-glycyl-L-glutaminyl)-D-lysyl)-D-alanine (1) by spectroscopic and chemical evidence. It resembles a partial structure of peptidoglycan in bacteria. The compound has a superior activity against an Escherichia coli mutant sensitive to inhibitors of cell wall synthesis, although it has a weak activity against the parent strain. These suggest that FR112123 might act on the biosynthesis of bacterial cell wall.

Measurement of tuberculostearic acid in sputa, pleural effusions, and bronchial washings. A clinical evaluation for diagnosis of pulmonary tuberculosis

Gas chromatography/mass spectrometry combined with selected ion monitoring was used to measure tuberculostearic acid (TSA), in sputum, pleural effusion, and bronchial washing. The detection limit corresponded to the amount of TSA eluted from as low as 10(3) tubercle bacilli. Sputa were collected from 169 patients with active pulmonary tuberculosis, 35 clinically suspected to be active, 53 with obsolete pulmonary tuberculosis, and 160 with pulmonary diseases other than tuberculosis. TSA was positive in 90% of the patients with active pulmonary tuberculosis (152/169) and 71% of the clinically suspected cases (25/35), respectively. In contrast, less than 10% of the patients with obsolete tuberculosis or other pulmonary diseases had a positive TSA. Pleural effusions and bronchial washings were also collected from patients with active tuberculosis and from those with other diseases, as the controls. TSA in pleural effusions and bronchial washings was detected in 24 of 32 patients and 15 of 22 patients with active tuberculosis, respectively. In those with pulmonary diseases other than tuberculosis, only 8.7% of pleural effusion (4/46) and 4.3% of bronchial washing samples (3/69) showed a positive TSA. Therefore, the measurement of TSA is useful as a rapid and sensitive method for diagnosing pulmonary tuberculosis.

[Membranous and respiratory bronchiole disease in patients with normal air-flow and mild air-flow limitation]

In order to evaluate the role of membranous (MB) and respiratory bronchioles (RB) in patients with normal and mild airflow limitation, we quantitatively assessed the pathological change of MB, RB and alveoli in the pathological specimens of 42 patients who required surgery for removal of a solitary pulmonary nodule. We also measured the destructive index (DI), to evaluate the destruction of alveolar walls. High resolution CT scan and pulmonary function tests were performed within 1 month of resection. Results of the pulmonary function tests correlated with pathological changes of RB better than with MB. Significant correlation between the emphysema score of resected lung and the pathological change of MB and RB was observed. There was also significant correlations between the CT score or DI and RB changes. However, there was no significant correlation between the CT score or DI and the change of MB. There were significant differences between smokers and nonsmokers in the results of pulmonary function test, pathological changes of RB and severity of emphysema. We postulate that RB is responsible for subtle functional abnormalities in the early stages of chronic obstructive pulmonary disease.

[Contribution of the vagal nerve on histamine-induced bronchoconstriction in guinea-pigs]

Recently, it has been suggested that the peripheral vagal nerve might participate in the bronchoconstriction locally in addition to the concept of "vagal reflex". We investigated the contribution of the vagal nerve on the modulation of airway responses to histamine (8 micrograms/kg, iv) in anesthetized and mechanically ventilated guinea-pigs. Airway responses were assessed by measurement of pulmonary resistance (RL). To determine whether the vagal nerve mediates excitatory effects by "vagal reflex" in guinea-pigs, we investigated the effects of vagotomy or hexamethonium (2 mg/kg, iv). Increase in RL induced by histamine was significantly enhanced after the vagotomy or the treatment of hexamethonium. Histamine-induced bronchoconstriction was also enhanced by the vagotomy in the animals after the administration of propranolol (1 mg/kg, iv). To determine whether the peripheral vagal nerve may play any role in the vagotomized animals, we investigated the effect of atropine (1 mg/kg, iv). Atropine reduced histamine-induced bronchoconstriction significantly in the vagotomized guinea-pigs or in the animals treated with hexamethonium. We conclude that the vagal nerve mainly exerts on inhibitory role through the central nervous system, and that the peripheral vagal nerve distal to ganglion plays an excitatory effects by releasing acetylcholine from the terminals in histamine-induced bronchoconstriction in guinea-pigs.

Pulmonary alveolar proteinosis and disseminated atypical mycobacteriosis in a patient with busulfan lung

A 32-year-old Japanese man with chronic granulocytic leukemia died of respiratory failure. Autopsy revealed alveolar proteinosis and pulmonary fibrosis, complicated by disseminated atypical mycobacteriosis. Epithelial hyperplasia caused by busulfan therapy was probably responsible for the induction of excessive surfactant production, resulting in alveolar proteinosis, and the immunosuppressive state due to chronic granulocytic leukemia was probably related to the induction of disseminated atypical mycobacteriosis.

[Basic and clinical evaluation of rapid diagnosis of tuberculosis by detecting tuberculostearic acid]

Tuberculostearic acid (TSA) is known to be one of the characteristic lipid in the limited species of the order Actinomycetale, including Mycobacterium tuberculosis. We studied the significance of detecting TSA in the diagnosis of tuberculosis from clinical specimens collected from 791 patients with various respiratory diseases by using gas--chromatography/mass--spectrometry. By our method, the detectable limit of TSA was around 10(2)-10(3) bacilli of Mycobacterium tuberculosis, and our method is as sensitive as culture examination for tuberculosis. In sputa collected from patients with active pulmonary tuberculosis (n=169), TSA positively was around 90%, while less than 10% false positive ws also recognized. In pleural effusion (n=81) and bronchial washing (n=91) collected from patients with active tuberculosis, the positivity of TSA was around 70%. We could also detect TSA in about 30% of clinical specimens collected from patients suspected of tuberculosis. The diagnostic sensitivity of TSA for tuberculosis was similar to that of adenosine deaminase activity (ADA), while TSA was slightly superior to ADA in specificity. These findings indicate that detection of TSA from clinical specimens is useful to make rapid diagnosis of pulmonary tuberculosis.

The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores

Early and accurate diagnosis of emphysema is said to be invaluable for identification of clinically silent and mild emphysema. Recently, computed tomography (CT) has been much advocated for its efficacy in detailed diagnosis of emphysema, and the results have been compared with the pathology grade of emphysema in resected lung specimens. To assess the ability of high resolution CT scan in detecting and grading mild emphysema, we correlated the high resolution CT scan with the pathology grade of emphysema and the destructive index (DI) of lung specimens from 42 patients undergoing thoracotomy for a solitary pulmonary nodule. The high resolution CT scan and the cut surface of the lung, corresponding exactly to the same plane of the CT scan image, were assessed using the picture-grading system of Thurlbeck and coworkers on a scale of zero to 100. The CT scores for all patients ranged from 12 to 57, with a mean +/- SD of 22.1 +/- 9.6 using 1-mm collimation (n = 35), and from 7 to 46 with a mean +/- SD of 16.5 +/- 8.3 using 5-mm collimation (n = 33). The pathology scores ranged from 10 to 57, with a mean +/- SD of 23.2 +/- 9.8 (n = 42). The DI ranged from 15.4 to 67.1, with a mean +/- SD of 31.4 +/- 10.8 (n = 42). The CT scores using 1-mm and 5-mm collimation correlated significantly with the pathology scores (r = 0.68 and 0.76, respectively, p less than 0.001), and with the DI (r = 0.62 and 0.74, respectively, p less than 0.001). The pathology scores correlated significantly with the DI (r = 0.72, p less than 0.001). We therefore concluded that high resolution CT can help to identify the presence and grading of mild emphysema.

Effect of endogenous tachykinins on neuro-effector transmission of vagal nerve in guinea-pig tracheal tissue

To elucidate the effect of endogenous tachykinins on neuro-effector transmission of vagal nerves, we performed in vitro experiments using guinea-pig tracheal smooth muscle. The subthreshold dose (the highest dose which did not induce any smooth muscle contraction) of capsaicin (10(-8) to 10(-7) M) increased the amplitudes of contractions evoked by electrical field stimulation (EFS) significantly, but not those by acetylcholine (ACh). The inhibitor of neutral endopeptidase, phosphoramidon (10(-7) to 10(-6) M), increased the contractions evoked by EFS significantly. The inhibitor of cholinesterase, physostigmine (10(-6) to 10(-5) M), induced smooth muscle contractions, but such contractions were inhibited by atropine, suggesting the spontaneous release of ACh from the vagal nerve terminals. The subthreshold dose of substance P or capsaicin increased the contractions evoked by physostigmine. These results indicated that endogenous tachykinins increase the spontaneous ACh release as well as the ACh release in response to vagal stimulation from the nerve terminals. Furthermore, it is suggested that the excitatory effects of the tachykinins on the vagal neuro-effector transmission may be modulated by neutral endopeptidase in the guinea pig.

Measurement of lung density by computed tomography: implication for radiotherapy

In order to achieve practical application for the treatment planning of radiotherapy, lung density was assessed by means of CT. Cork phantoms were measured 360 times to test the reliability of CT densitometry. Densities were corrected by the CT value of pure water measured at the same time. The mean value of cork phantoms as measured by CT was 0.287 +/- 0.11 g/cm3, the true value of which was 0.320 g/cm3. These errors were within an allowable limit for radiotherapy. Lung density was studied in 50 patients with a mean age of 50 years, ranging from 46 to 76. The values obtained of the upper, middle, and lower lung were 0.123 +/- 0.46 g/cm3, 0.121 +/- 0.033, and 0.154 +/- 0.057 g/cm3 during inspiration and were 0.215 +/- 0.058 g/cm3, 0.228 +/- 0.066, and 0.260 +/- 0.078 g/cm3 during expiration, respectively. The dorsal, central, and ventral portions of the lung were measured simultaneously with a patient on supine position. In order to hold the variation of radiation dose within 2%, the variation must be kept within 30 HU of CT value. As for the upper lung, the difference of which between both subjects and sites was smallest during inspiration in this results, that was 20%; the difference of 60 HU CT value existed between the dorsal and ventral lungs. Variations in CT number between subjects were more than 60 HU in one third of this series. Before starting radiotherapy to the lung field, lung densitometry is warranted in order to irradiate the exact dose.

[Comparison of high resolution computed tomography and pulmonary function tests in diagnosis of mild emphysema]

To assess the ability of high resolution CT scan and pulmonary function tests in detecting and grading mild emphysema, we correlated the high resolution CT scan and pulmonary function tests with the pathologic grade of emphysema and the destructive index of lung specimens from 42 patients undergoing thoracotomy for solitary pulmonary nodules. Using the high resolution CT scan, we could identify the pathologic grade of mild and moderate emphysema. By measuring diffusing capacity per unit alveolar gas volume (DLco/VA), it seemed to be possible to detect the mildest degree of alveolar destruction assessed by the destructive index, which was not detected by high resolution CT scan. The reason for these results seemed to be that we assessed the severity of emphysema by detecting the air space enlargement on high resolution CT scan images caused by the destruction of alveolar walls, which were detectable by measuring DLco/VA. We conclude that it is possible to detect mild emphysema using the combination of high resolution CT scan and pulmonary function tests.

WS-9659 A and B, novel testosterone 5 alpha-reductase inhibitors isolated from a Streptomyces. II. Structural elucidation of WS-9659 A and B

On the basis of spectroscopic and chemical evidence, the structures of WS-9659 A and B isolated as inhibitors of testosterone 5 alpha-reductase from a Streptomyces have been established as 1 and 2, respectively. The reductase inhibitory activities of the derivatives 5 and 6, and degradation products 3 and 8 were considerably less active and substantially inactive, respectively.

[Membranous bronchiole diseases in patients without chronic air-flow limitation]

In order to investigate the relationship between pulmonary function and diseases involving membranous bronchioles (MB), we measured airway diameters and quantitated airway pathology scores in MB in 35 patients who required surgery for removal of a solitary nodule. The patients had FEV1 greater than 80% of the predicted value. Measurements of FEV1, nitrogen washout curve (delta N2/L), closing volume as a percentage of vital capacity (CV/VC%), and maximal flow rate at 50% of VC (V50) were made prior to the surgery. There were 21 smokers and 14 nonsmokers. There was 1.02 MB per cm2 of tissue. The mean internal diameter for MB cases was 0.55 +/- 0.05 mm. The total pathology scores for all MB cases were less than those found in North American populations. Inflammation scores were higher in patients with FEV1 less than 100% that of the predicted (p less than 0.05). FEV1 values correlated with goblet cell metaplasia (p less than 0.05). Tests specific for small airways did not correlate with the pathology scores in MB. We concluded. In 35 Japanese cases some diseases in MB were detected among cases whose average age was 59.5 years (42-78 yrs) and whose FEV1 was greater than 80% of the predicted value. The disease showed little effects of smoking and it was relatively minor in comparison with North American cases. This degree of abnormality is considered to be found in normal Japanese as well. It is supposed that an ordinary pulmonary function test would not reveal this abnormality in MB.

[Results of the treatment of Hodgkin's disease: the importance of establishing and executing a protocol]

A retrospective analysis was performed on 32 patients seen at Keio University Hospital and its affiliated hospitals from 1976 to 1987. Twenty-two patients were treated with our protocol, and the other 10 were not for several reasons. In this study, we compared the results of the treatment of these two groups. There were 20 males and 12 females. Age ranged from 13 to 72 years with a median value of 36 years. Histologically, six had lymphocytic predominance, 12 nodular sclerosis, 14 mixed cellularity. In the protocol group, seven were clinical stage I, 12 were CS II, two were CS III, and one was CS IV. Nine patients in the protocol group underwent staging laparotomy, and four CS II patients were upstaged to PS III. In the non-protocol group, five were CS I, four were CS II, one was CS III. According to the protocol, staging laparotomy was done excepting CS III.IV patients and some of CS I patients. In case of CS I without laparotomy, pathological stage(PS) I.II, or PS III1 with minimal splenic involvement, they were treated with radiation only. The rest of the patients were treated with chemotherapy and booster irradiation. Ten-year survival and 10-year relapse-free survival were 100%, 75%, respectively in the protocol group. In the non-protocol group, they were 31% and 32%, respectively. When picking up 17 patients treated by the authors through the whole process, 10-year survival and 10-year relapse-free survival were 100%, 92%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)