Recurrent Pregnancy Loss: Etiology of Thrombophilia

Congenital and acquired thrombophilia are associated with an increased risk of pregnancy-associated venous thrombosis and fetal loss. Two hundred eighty-nine patients with a history of recurrent spontaneous abortion were subjected to screening examinations for the etiology of these abortions. Endocrine abnormality (28.0%), uterine abnormality (10.4%), autoimmune diseases (1.4%), antiphospholipid antibody syndrome (4.5%), and balanced type chromosome translocation (4.2%) were found as underlying causes of recurrent abortions, and the remaining 55.0% of the 289 patients were classified as having an unexplained etiology. Congenital thrombophilia such as protein C (PC) deficiency, protein S (PS) deficiency, antithrombin deficiency, and factor V Leiden mutation was not frequently detected; only one patient had PS deficiency. A reduced factor XII activity was found at a frequency of 4.2%. The frequency of methylene tetrahydrofolate reductase gene C677T mutation in recurrent aborters (0.38) was the same as that found in a fertile control group. Although the prevalence of anti-beta2-glycoprotein I antibody (abeta2-GPI) syndrome was very low (1.7%), patients with a high titer of immunoglobulin G (IgG) class abeta2-GPI, despite anticoagulation therapy, experienced severe fetomaternal complications in subsequent pregnancies. The rate (13.8%) of positive tests for serum IgA class abeta2-GPI in patients with unexplained etiology was higher than that in the controls (0%) (P < .05). We conclude that congenital thrombophilia is rare in Japanese patients who had experienced consecutive spontaneous abortions.

Suppression of lens stalk cell apoptosis by hyaluronic acid leads to faulty separation of the lens vesicle

How the lens vesicle separates normally from the surface ectoderm has not been adequately explained. Apoptosis is an important mechanism that induces tissue development and morphogenesis by physiological cell death during normal development, and hyaluronic acid has been shown to regulate the apoptotic process in various tissues. To elucidate the normal and abnormal processes of lens vesicle separation, we investigated the distribution of apoptotic cells and hyaluronic acid in normal and abnormal lens vesicle development. The offspring from pregnant C57BL/6NJcl mice were removed by laparotomy on days 9, 10, 11, 12, 13, 14, 15, 16 or 18 of gestation. Tissue blocks of the eyes were fixed in 4% paraformaldehyde solution and embedded in paraffin wax. Serial sections of the eye were cut, and sections containing normal lens tissues and spontaneously occurring faulty separation of the lens vesicle were chosen for subsequent procedures. These sections were stained either with TUNEL method for detection of apoptosis or with biotinylated hyaluronic acid binding protein (HABP) for hyaluronic acid. Then TUNEL-positive and HABP-positive reactions in the lens tissues were examined by light microscopy. In normal eye development, the lens stalk connecting the surface ectoderm with the lens vesicle was observed from day 11 through day 12 of gestation, and the lens stalk completely disappeared on day 13 of gestation in this strain. In normally regressive lens stalk, several TUNEL-positive cells were identified, and no positive staining for HABP was seen. However, in spontaneously occurring persistent lens stalk tissues on days 14, 15, 16 and 18 of gestation, no TUNEL-positive cells were detectable, and evident HABP-positive reactions were seen. In eyes on day 12 of gestation with possibly presumed faulty separation of the lens vesicle, no TUNEL-positive cells were detectable and evident HABP-positive reactions were seen in the lens stalk areas. The results indicated that cell death by apoptosis is anatomically closely associated with, appears to be essential for normal regression of the lens stalk, and its failure to occur leads to faulty separation of the lens vesicle. In addition, excessive hyaluronic acid in the lens stalk area may be a possible cause of the lack of apoptosis, inducing its faulty separation.

Prenatal diagnosis of agnathia-holoprosencephaly: three-dimensional imaging by helical computed tomography

We report a case of agnathia-holoprosencephaly which was prenatally diagnosed based on helical computed tomography (CT) images obtained at 23 weeks of gestation. Ultrasound examination first showed the presence of alobar holoprosencephaly, but the facial structures were not clearly detailed. However, three-dimensional imaging by helical CT precisely demonstrated the most striking feature of agnathia: absence of the mandible. This technique provided us valuable information that contributed to the in utero diagnosis. In utero helical CT is a useful examination tool for the diagnosis of osteogenic abnormalities.

The relationship between microvessel density, the expression of vascular endothelial growth factor (VEGF), and the extension of nasopharyngeal carcinoma

OBJECTIVE

The present study was aimed at clarifying whether the microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF) were related to the degree of local invasion and metastasis in nasopharyngeal carcinoma (NPC).

STUDY DESIGN

We measured the MVD and examined whether VEGF was expressed in NPC tissue using histological study combined with immunohistochemistry.

METHODS

MVD and VEGF expression was measured in 73 specimens of NPC, 15 benign tumors of nasopharyngeal region, and 20 nasopharyngeal tissue without tumor. MVD and VEGF expression in NPC was compared between a metastasis group (49 specimens) and a non-metastasis group (24 specimens).

RESULTS

Both MVD and VEGF expression were markedly increased in NPC tissue as compared with those in benign tumors of nasopharyngeal region. Both MVD and VEGF expression in NPC tissue with metastasis were statistically significantly increased as compared with those in NPC without metastasis. Therefore, the invasion and metastasis of NPC cells were closely related to MVD and the expression of VEGF in NPC tissue.

CONCLUSION

The metastatic potency of NPC tissue and the prognosis of the patients with NPC can be estimated by measuring MVD and the expression of VEGF in NPC tissue. Drugs that have inhibitory actions on angiogenesis could be useful to prevent metastasis of NPC cells in the patients.

Early onset sarcoidosis masquerading as juvenile rheumatoid arthritis

Symptoms of early onset sarcoidosis characterized by skin eruptions, arthritis, and uveitis mimic those of systemic type juvenile rheumatoid arthritis (JRA). We report 2 Japanese patients with early onset sarcoidosis, both of whom were initially diagnosed and treated as having JRA. Intermittent fever and synovial swelling may mask sarcoidosis in children less than 4 years old.

A novel strategy for cancer therapy by mutated mammalian degenerin gene transfer

Mammalian degenerin (MDEG) is a member of the amiloride-sensitive sodium ion channel family, and its site-directed active mutant (MDEG-G430F) induces massive Na+ influx into cells, leading to cell ballooning and cell bursting. We attempted a novel therapeutic approach for gastric cancers by transferring MDEG-G430F into cancer cells using tumor-specific promoters. In carcinoembryonic antigen (CEA)-producing gastric cancer cells, the level of cell death observed when MDEG-G430F was used with a CEA promoter was similar to that observed when using a potent nonspecific promoter such as the cytomegalovirus promoter. In an in vivo study, fusogenic liposome complexes containing MDEG-G430F driven by the CEA promoter were injected intraperitoneally into CEA-producing gastric cancer cells in a mouse peritoneal dissemination model. Although all 15 of the control mice were dead by 50 days postinoculation, 13 of the 15 mice treated with MDEG-G430F survived. These results indicate that transferring MDEG-G430F into cancer tissues using tumor-specific promoters can achieve striking and selective cancer cell death irrespective of the transcriptional efficiency of the promoters used in vivo, and suggest that this approach is a promising new strategy for cancer gene therapy.

Antigens expressed in feline enteroepithelial-stages parasites of Toxoplasma gondii

In an investigation aimed to identify Toxoplasma gondii antigens expressed in feline enteroepithelial-stages parasites, a cDNA library was constructed and fourteen positive clones were isolated by immunoscreening using sera from cats immunized with feline enteroepithelial-stages parasites. By DNA sequence homology analysis, these fourteen isolated clones were classified into four groups: hypoxanthine-guanine phosphoribosyl transferase (HGPRT) cDNA, heat shock protein 70 (HSP70) cDNA, 14-3-3 protein homologue cDNA, and cDNA encoding an unknown product. In an indirect immunofluorescence antibody test, sera from mice immunized with the recombinant protein encoded by the cDNA for HGPRT, HSP70, 14-3-3 protein, or the unknown product each showed a relatively high level of immunoreactivity with feline enteroepithelial-stages parasites.

Postpartum thyroid dysfunction in women with normal thyroid function during pregnancy

OBJECTIVE

The aim of this study was to establish the risk of postpartum thyroid dysfunction (PPTD) in women who had normal thyroid function during pregnancy and no history of thyroid disease.

DESIGN

Four thousand and twenty-two consecutive pregnant women were screened for thyroid function and antithyroid antibody. Among women with normal thyroid function during pregnancy and no history of thyroid disease, thyroid function were assessed in 131 of 388 antithyroid antibody positive (Group I) and 1030 of 3503 antibody negative (Group II) women at 1 and 3 months postpartum. In Group I women who experienced PPTD, the frequency of later manifestation of Hashimoto's disease was compared according to titres of antithyroid antibodies.

MEASUREMENTS

Blood samples in early pregnancy, and at 1 month and 3 months postpartum were obtained using the dried blood spot method. Levels of fT4 were measured by RIA, TSH by fluoroimmunoassay or ELISA, antimicrosome antibody (AMC) and antithyroglobulin antibody (ATG) by indirect agglutination reactions.

RESULTS

The prevalence of PPTD at 1 month and 3 months postpartum were found to be 6.9% and 21.3% in Group I, and 5.3% and 4.7% in Group II, respectively. The prevalence of PPTD was significantly higher at 3 months postpartum in Group I (P<0.05). 27.3% of women with PPTD in Group I were later found to have Hashimoto's disease and 9.1% manifested hypothyroidism without goitre. A high AMC titre (> or = 25600) at 3 months postpartum in women with PPTD was related to the manifestation of Hashimoto's disease. AMC titres of PPTD women and women who developed Hashimoto's disease were significantly higher than those of control women who did not experience PPTD.

CONCLUSION

A high prevalence of PPTD was found in women with antithyroid antibodies who were euthyroid during pregnancy. Prolonged follow-up of the subsequent thyroid function may be needed in women who experience PPTD and/or show a high titre of antithyroid antibody.

A potentially novel peptidase, resembling but distinct from neutrophil elastase, produced by carcinoma cells

Neutrophil elastase (NE) is the only neutral protease that can degrade broad substrates of extracellular matrix components. In the present study, we describe the NE-like molecule expressed in many carcinoma cells, which has similar activity to NE and pancreatic elastase, but is immunologically different from NE, and is not inhibited by NE or pancreatic elastase inhibitor at all. Intracellular activity of NE or pancreatic elastase and immunological reactivity of NE in ten carcinoma cell lines and freshly purified neutrophils were measured by CellProbe and enzyme immunoassay, respectively. The NE and pancreatic inhibitory effect to the extracts of the ten cell lines was further examined using NE and pancreatic elastase inhibitor (ONO-5046.Na). Only two carcinoma cell lines out of ten had low immunoreactive NE, whereas neutrophils had high immunoreactivity in the extract. Flow cytometric analyses demonstrated that five out of 11 carcinoma cell lines had a high degrading activity of Ala-Ala-Pro-Val site in more than half of the population. SUIT-2 had the highest activity, but had no immunoreactivity for NE. Furthermore, the NE-like activity in the SUIT-2 cells was not inhibited by ONO-5046.Na. The present study demonstrated the NE-like molecule expressed in many types of carcinoma cells, which is potentially a new and specific protease produced by cancer cells. It would be of great interest to identify this NE-like molecule specific to the tumor, leading to a possible promising treatment of advanced carcinomas.

Factors influencing the expression of Fas and Fas ligand on newborn murine keratinocytes and fibroblasts

OBJECTIVE

To investigate the expression of Fas, FasL mRNA and proteins on keratinocytes and fibroblasts, and the influence by retinoid acid (RA) and dexamethasone (Dex).

METHODS

RNase protection assay and flow cytometry were used.

RESULTS

Fas mRNA was expressed on neonatal murine keratinocytes and was up-regulated by all-trans retinoid acid and down-regulated by Dex. RA and Dex also increased the Fas protein expression on keratinocytes. Newborn murine keratinocytes express FasL mRNA, which was up-regulated by RA and Dex, while its protein expression was moderately induced by RA. Newborn murine fibroblasts also expressed Fas and FasL mRNA, which were up-regulated by the RA and Dex.

CONCLUSIONS

The results indicated that RA and Dex might regulate apoptosis of keratinocytes and fibroblasts via the Fas-FasL system.

Activation of T-cell receptor-gammadelta+ cells in the intestinal epithelia of KN6 transgenic mice

We analysed the properties of intraepithelial lymphocytes of small intestine (SI-IEL) in KN6-transgenic (Tg) mice expressing cDNA of T-cell receptor (TCR)-gammadelta specific for the T22b molecule. While most splenic Tg TCR-gammadelta+ cells from KN6-Tg mice with H-2d/d background (Tgd/d mice) were Thy-1+ CD8alpha- CD44dull+ CD45RB+ CD69-, Tg TCR-gammadelta+ cells in SI-IEL (Tg gammadelta-IEL) were heterogeneous in the expression of Thy-1, CD8alpha and CD44 molecules and predominantly CD45RB+ CD69+. Tg gammadelta-IEL exhibited a much reduced proliferative response to the antigen (irradiated H-2b splenocytes) than splenic Tg TCR-gammadelta+ cells; the CD44+ subset, but not the CD44- subset, in Tg gammadelta-IEL responded to the antigen. Furthermore, Tg gammadelta-IEL, but not splenic Tg TCR-gammadelta+ cells, displayed cytolytic activity whether they were prepared from conventional or germ-free KN6-Tg mice. Comparative analysis of young and aged KN6-Tg mice revealed that the proportion of CD44+ cells in Tg gammadelta-IEL increased but the proliferative response of Tg gammadelta-IEL to the antigen attenuated in association with ageing. Moreover, although Tg gammadelta-IEL from Tgb/d mice contained a higher proportion of CD44+ cells than Tgd/d mice, they did not respond to the antigen. These results demonstrate that Tg TCR-gammadelta+ cells lose the ability to recognize the antigen following activation in the intestinal epithelia.

Three cases of pityriasis rubra pilaris successfully treated with cyclosporin A

BACKGROUND

Pityriasis rubra pilaris (PRP) is reported to respond poorly to cyclosporin A (CsA).

OBJECTIVE

We attempted to determine the efficacy of CsA in the treatment of classic adult-type PRP.

METHODS

Three patients with classic adult-type PRP were treated with 5 mg/kg/day CsA.

RESULTS

A sustained clinical response was achieved within 2-4 weeks of therapy. Relapses were noted when the CsA dose was decreased to 1.2 mg/kg/day.

CONCLUSION

CsA should be considered in the treatment of classical adult-type PRP.

Generalized melanosis in metastatic malignant melanoma: the possible role of DOPAquinone metabolites

Generalized melanosis occurs very rarely as a complication of malignant melanoma, and the pathogenesis of this condition is still unclear. Histological examination of pigmented skin and measurements of the DOPAquinone metabolites 5-S-cysteinyldopa (5-S-CD) and 6-hydroxy-5-methoxyindole-2-carboxylic acid (6H5MI2C) in the patient's serum and urine were carried out. Histological examination revealed basal hyperpigmentation, discrete melanoma cells and melanophages around the blood vessels and an unusual melanin deposition within collagen bundles in the dermis. The levels of 5-S-CD and 6H5MI2C were dramatically increased both in the patient's serum and urine. The deposition of DOPAquinone metabolites secreted by the melanoma cells may contribute to the unusual melanin deposition within collagen bundles in the affected dermis.

Selective upregulation of fibroblast Fas ligand expression, and prolongation of Fas/Fas ligand-mediated skin allograft survival, by retinoic acid: the skin as a retinoide-inducible immune privilege site

Fas/Fas ligand-mediated lymphocyte apoptosis has been implicated in the suppression of immune responses and may cause immune privilege. Human corneas exhibit immune privilege and can be transplanted across allogeneic barriers without immunosuppressive therapy, perhaps, because corneal keratinocytes express Fas ligand. To characterize Fas and Fas ligand expression in skin, we examined expression by murine keratinocytes, dermal fibroblasts, melanocytes, and human umbilical endothelial cells. We also studied the regulation of Fas and Fas ligand in skin cells by retinoic acid, vitamin D3, and dexamethasone as well as various cytokines. Among the molecules and cells tested, retinoic acid selectively upregulated the expression of Fas ligand molecule by fibroblasts. Retinoic acid-induced Fas ligand+ fibroblasts killed Fas+ target cells, and this killing was blocked by anti-Fas ligand antibody. The function of Fas ligand on dermal fibroblasts in vivo was tested in a cutaneous allograft system. Histoincompatible BALB/C mouse (H-2d) donor skin was grafted on to allogeneic C57BL/6 mice (H-2b). Daily local injection of retinoic acid blocked inflammation and extended graft survival for more than 10 d. Injection of retinoic acid into Fas ligand mutated gld/gld donor skin did not prevent leukocyte infiltration into the allograft or prolong graft survival. These experiments indicate that, in skin, retinoic acid selectively increases Fas ligand expression by fibroblasts and that retinoic acid has potent Fas/Fas ligand-dependent immunosuppressive activity.

Relationship between plasma cytokine concentration and multiple organ failure in patients with acute pancreatitis

The dynamic aspects of circulating cytokines and cytokine modulators and their relationship with development of multiple organ failure (MOF) in patients with acute pancreatitis were analyzed. All cytokine and C-reactive protein levels in the circulation were higher than those in the MOF group. In particular, plasma concentrations of soluble tumor necrosis factor receptors (sTNF-RI and sTNF-RII) were significantly higher in patients with MOF than in those without even at admission. Furthermore, plasma concentrations of sTNF-Rs and interleukin-1 (IL-1) receptor antagonist (IL-1ra) were much higher than those of their counterparts, TNFalpha and IL-beta, respectively. These results suggest that the plasma concentrations of sTNF-Rs are useful predictors for the development of MOF, and actions of TNF-alpha and IL-1beta could be regulated by their modulators (soluble receptor and receptor antagonist, respectively) in the pathologic condition of severe acute pancreatitis.

Histochemical studies on glycosaminoglycans in Bruch's membrane of postnatal rat eyes

Localization of glycosaminoglycans (GAG) in Bruch's membrane of postnatal rat eyeballs was examined histochemically. Fixed eyeballs from postnatal rats (ages 5 days and 8 weeks) were routinely processed and embedded in paraffin wax or Quetol 651 resin. Paraffin-embedded tissue sections were stained with hematoxylin and eosin or sensitized high iron diamine procedure in combination with selective methods such as GAG-degrading enzyme digestions and/or a chemical modification, and examined by light microscopy. Quetol 651-embedded ultrathin sections were stained with heavy metals and examined by electron microscopy. In rats at postnatal day 5, Bruch's membrane contained mainly chondroitin sulfate (CS) and heparan sulfate (HS). In contrast, at 8 weeks after birth the membrane included a large amount of dermatan sulfate (DS) and HS. According to electron microscopic findings, Bruch's membrane on day 5 consisted of only 3 layers without a central elastic layer. However, at 8 weeks after birth the membrane was constructed of 5 layers. These findings suggested that the difference in GAG molecular species in the membranes at 5 days and at 8 weeks after birth could be correlated with the development and maturation of the collagenous layer in Bruch's membrane. Moreover, maturation of Bruch's membrane may contributes to the architectural stabilization of the outer portions of the photoreceptor cells.

Retinal fascin: functional nature, subcellular distribution, and chromosomal localization

PURPOSE

To investigate the functional properties, subcellular localization, and chromosomal location of retinal fascin.

METHODS

Recombinant retinal fascin protein was prepared by using a baculovirus-insect expression system. Actin-binding and -bundling assays were performed with chick actin purified from skeletal muscle. Western blot analysis and immunohistochemistry were performed with a polyclonal antibody raised against bovine retinal fascin. A human retinal cDNA library was screened with an expressed sequence tag cDNA fragment. Chromosomal location was determined with fluorescent in situ hybridization.

RESULTS

The actin-binding and actin-bundling activities of retinal fascin were demonstrated by high- and low-speed centrifugation assays. Formation of filamentous (F)-actin bundles by retinal fascin in vitro was also morphologically confirmed by fluorescence microscopy and electron microscopy. Immunohistochemical analysis revealed that retinal fascin protein was localized specifically in the outer and inner segments of the photoreceptor cells in the retina. Two splicing variants of human retinal fascin cDNA were also located. One clone encoded 492 amino acids, and the other encoded 516 amino acids. The gene encoding retinal fascin was localized to human chromosome 17, region q24 -25.

CONCLUSIONS

These results suggest that retinal fascin may play a role in formation of unique morphologic structures of the photoreceptor cells and is a candidate gene for retinal degenerative disorders.

Serum itraconazole and hydroxyitraconazole concentrations and interaction with digoxin in a case of chronic hypertrophic pachymenigitis caused by Aspergillus flavus

A patient treated with itraconazole (ITCZ) under the diagnosis of Aspergillus flavus-induced chronic hypertrophic pachymeningitis is presented. The reason for the successful cure of this patient was investigated by the pharmacokinetic analysis of serum levels of ITCZ. Concurrently administered digoxin was also investigated for its drug-drug interaction. The patient (a 75-year-old male) developed ophthalmopathy, and was diagnosed as having A. flavus hypertrophic pachymeningitis by pachymeninx biopsy. After admission, he was treated with FLCZ, AMPH, 5-FC and MCZ. The infection tended to subside with the AMPH administration. Since renal insufficiency was induced by AMPH and the other antifungal drugs were ineffective, daily administration of 200 mg of ITCZ was initiated, and the inflammatory signs and symptoms gradually subsided. The symptoms did not recur during the 36 months of itraconazole treatment after discharge, and it was concluded that ITCZ was effective for A. flavus hypertrophic pachymeningitis. Pharmacokinetic parameters of ITCZ and OH-ITCZ as follows: ITCZ: Cmax 93.2 ng/ml, T1/2 beta 11 hours, AUC0-24 999 ng.h/ml, OH-ITCZ: Cmax 159.4 ng/ml, T1/2 beta 16. 2 hours, AUC0-24 of 1391 ng.h/ml. Both ITCZ and OH-ITCZ reached steady states seven days after administration began. The ITCZ and OH-ITCZ levels in serum collected 36 months after the initiation of administration were 452.9 ng/ml and 1233.6 ng/ml, respectively. Cmax and AUC0-24 of ITCZ and OH-ITCZ on the second day were markedly lower than those in healthy adults reported by Oguchi et al., and hypoalbuminemia observed at administration on that day was considered the most probable cause. It was assumed that the most plausible reason for a successful cure even at a low dose of ITCZ was the increase of distribution to tissue by the increase of the unbound form. Digoxin was concurrently given to this patient at 0. 125 mg/day, but the blood digoxin level was not elevated. Consideration of the blood level of albumin is believed to be important for evaluating the blood concentration of ITCZ.

gp100 mRNA is more sensitive than tyrosinase mRNA for RT-PCR amplification to detect circulating melanoma cells in peripheral blood of melanoma patients

Two different melanocyte-specific mRNAs are studied as markers for circulating melanoma cells in vitro using the human melanoma cell line G361 and in vivo using blood samples from Japanese melanoma patients at different clinical stages. These mRNAs encode tyrosinase, the most essential enzyme for melanin synthesis, and gp100, a melanosomal matrix glycoprotein recognized by monoclonal antibody HMB-45. We used reverse-transcription polymerase chain reaction (RT-PCR) to detect tyrosinase mRNA and gp100 mRNA in peripheral blood. Since melanocytes would not normally be present in peripheral blood, the detection of those transcripts should indicate the presence of circulating melanoma cells. RT-PCR detection of these two mRNAs was highly sensitive and specific. Our in vitro study showed that as few as 10 melanoma cells in 0.125 ml normal blood could be detected. In in vivo study, 130 blood samples from 55 melanoma patients gave positive and variably sensitive results, whereas no samples from healthy controls or patients with other cancers gave positive results. Tyrosinase mRNA was not detected in any of the melanoma patients. gp100 mRNA was detected in 12 of 55 melanoma patients, in none of five stage I patients (0%), in four of 26 stage II patients (15.4%), in one of six stage III patients (16. 7%) and in seven of 18 stage IV patients (38.9%). Thus gp100 mRNA is a more sensitive marker for detecting circulating melanoma cells compared with tyrosinase mRNA.

Detection of circulating melanoma cells by RT-PCR amplification of three different melanocyte-specific mRNAs in a mouse model

Three different melanocyte-specific mRNAs are studied as potential markers for circulating melanoma cells in the serum of mice inoculated subcutaneously with B16F10 melanoma cells. These three mRNAs encode tyrosinase, tyrosinase related protein-2 (TRP-2) and Pmel17, proteins that are essential for the synthesis of melanin and are expressed specifically in melanocytes. We used reverse-transcription polymerase chain reaction (RT-PCR) to detect these three different melanocyte-specific mRNAs in the sera of B16F10 bearing mice. Since melanocytes would not normally be present in the blood, the detection of those transcripts should indicate the presence of circulating melanoma cells. RT-PCR detection of all three mRNAs was highly sensitive and specific. Our in vitro studies show that as few as 10 melanoma cells can be detected in 125 microl blood and that in vivo, melanoma cells can be detected in blood samples from B16F10 melanoma bearing mice. Of these three mRNAs, Pmel17 mRNA is the most sensitive marker for detecting circulating melanoma cells compared with tyrosinase mRNA and TRP-2 mRNA. Moreover, this mouse model might be useful for basic research of malignant melanoma patients with haematogenous metastasis.

Apoptosis is associated with formation and persistence of the embryonic fissure

PURPOSE

The role of apoptosis in the transitory ocular embryonic structures has not been clarified yet, therefore, in the present study we focused on one of the transitory ocular structures, the embryonic fissure. To elucidate the developmental mechanism of the embryonic fissure, we observed cell death by apoptosis in the optic cup during early development in mice.

METHODS

Pairs of C57BL6N/Jcl mice, each comprising an estrous female and a potent male, were caged together overnight. Females that had vaginal plugs the next morning were considered at day 0 of pregnancy. The embryos or fetuses were removed by laparotomy on days 9, 10, 11, 12, 13, 14, 16, and 18 of gestation. Tissue blocks of the eyes were fixed and embedded in paraffin wax. Serial frontal sections of the eye were cut and stained with the TUNEL method and then counterstained by hematoxylin or methyl green solution. We examined TUNEL-positive cells in the optic cup by light microscopy.

RESULTS

TUNEL-positive cells were seen at the lower nasal side of the optic cup, corresponding to the presumed embryonic fissure area, on day 9 of gestation before the formation of the embryonic fissure. Many TUNEL-positive cells were present at the lips of the embryonic fissure on days 10, 11, and 12. In contrast, TUNEL-positive cells were not detectable in the corresponding area on day 13 after the complete closure of the embryonic fissure.

CONCLUSIONS

Apoptosis is anatomically closely associated, and appears to be essential for the formation and persistence of the embryonic fissure.

[Pharmacokinetics of panipenem in neonates and dosage recommendation]

The pharmacokinetics of panipenem/batamipron (Carbenin; PAPM/BP) was studied in 17 neonates of the postconceptional age (PCA) of 25.6 to 43.1 weeks. PAPM/BP was administered at 10 mg/kg to 20 mg/kg every 12 hours over 60 minutes by intravenous infusion. Blood samples were obtained just prior to the infusion, one or two hours and six hours after the infusion. All the data for the 85 serum PAPM concentrations were analyzed by one-compartment model using a nonlinear mixed-effect model (NONMEM). The pharmacokinetic parameters in these population are given below: CLPAPM; 0.239 +/- 0.206 (L/hr), VdPAPM; 0.97 +/- 0.80 (L), Half Life; 3.1 +/- 0.5 (hr). Half life in the patients with PCA < 34 (2.66 +/- 0.44 hr) were significantly lower (p < 0.001) than that with PCA > or = 34 (3.39 +/- 0.23 hr). Our results suggest that postnatal alterations in the PAPM excretion are related to maturational changes in the renal function and that we should consider the values of PCA when determining the initial PAPM/BP dosing regimen in neonates. We conclude that the dosage of 10 mg/kg to 20 mg/kg every 12 hours are adequate treatment for neonatal infectious disease.