(BALB/c x C57BL/6)F1 mice are tolerant to undetectable mixed haplotype A beta dA alpha b and mixed isotype A beta dE alpha d self class II molecules

The existence of mixed haplotype A beta dA alpha b and mixed isotype A beta dE alpha d molecules was demonstrated in A beta d gene introduced C57BL/6 (B6) transgenic and in A beta dE alpha d double gene introduced B6 transgenic mice, respectively. Using alloreactive and antigen reactive T-cell clones, these mixed class II molecules were shown to function as mixed lymphocyte culture reaction (MLR) stimulating determinants and restriction elements for antigen recognition by T cells. The amounts of expression of these mixed class II molecules were sufficient for the stimulation of alloreactive T cells in primary MLR culture. (BALB/c x B6)F1 (CBF1) mice were shown not to express functional mixed haplotype and mixed isotype class II molecules using alloreactive and antigen reactive T-cell clones. Interestingly, however, CBF1 mice did not respond to such mixed haplotype and mixed isotype class II molecules. These results show that CBF1 mice do not respond to undetectably-expressed class II molecule and suggest that they are tolerant to undetectable self class II molecules. The possible interpretations for this are discussed.

[A case of ganglioglioma with choked disc]

A case of ganglioglioma associated with choked disc is reported. A 19-year-old girl was admitted to our hospital because of blurred vision. Neurologically, the patient had nothing but choked disc. The CT showed a large cystic mass with calcification in the left parieto-occipital lobe. The MRI revealed that the cyst was delineated by a membrane and that its dorsal side was solid, showing enhancement by Gd-DTPA. Cerebral angiography showed no tumor stain. Left parieto-temporo-occipital craniotomy was performed and the tumor was removed subtotally. Histopathological examination demonstrated the typical pattern of ganglioglioma. The most common symptom of ganglioglioma is convulsions. Symptoms of increased intracranial pressure have been reported sporadically in the literature. It was clinically noted that the cause of the increased intracranial pressure in this patient was enlargement of the cyst associated with ganglioglioma.

[A case of arteriovenous malformation in a neonate]

Although arteriovenous malformation (AVM) is considered a congenital disease, few cases of AVM are manifested clinically in the neonatal period. In this paper a neonatal case of AVM manifested as intracranial hemorrhage is reported. A newborn female infant 12 days after birth, was admitted to a hospital with the chief complaint of sudden onset of vomiting and fever. Neurological examination revealed left hemiparesis with bulging of the anterior fontanel. CT examination demonstrated a large mass lesion with hemorrhage in the right parietal lobe. The lesion was enhanced with contrast medium. Consent for surgery was not able to be obtained from her family, so she was treated conservatively. A gradually enlarging cyst surrounding the mass appeared in follow-up CT examination. Her left hemiparesis and bulging of the anterior fontanel remained unchanged, and a rather good general health condition was maintained. Consent for surgery was finally obtained from her parents and the patient was transferred to our hospital three months after the onset of the symptoms. Cerebral angiogram showed AVM with a big aneurysmal sac. The feeder arteries of the AVM arose from the right middle cerebral artery and the anterior cerebral artery. The drainers poured into the superior sagittal sinus. AVM was removed totally by right parietal craniotomy on the 24th January, 1989. Postoperatively, her left hemiparesis started to improve gradually. Her general condition was also good, and she showed no neurological deficits at the age of 8 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Seasonality in early loss of one fetus among twin pregnancies

Ultrasonographic examinations were performed on 519 pregnant women in the first trimester at three hospitals in Tokyo from August 1985 to March 1987. Among 519 women, two fetal heart movements (FHMs) were confirmed in six cases. In two of these six cases, one of two FHMs disappeared two weeks later, and these were considered the "vanishing twin". In eight cases among those with ultrasonographic image of echo-free-space (EFS) in the uterus, the observed EFS was considered to be a probable empty gestational sac (GS-like-EFS-image). Seven of eight GS-like-EFS-images were observed in October-December (p less than 0.01) and two "vanishing twin" cases were also observed in the same season. Spontaneous abortion occurred in 11 cases and these were also more frequently observed in October-November (p less than 0.05). Some abortive factor is supposed to have prevailed in October-December. All six women having twin fetuses (including the "vanishing twin" cases) were born in January-May (p less than 0.05) and those having GS-like-EFS-images or terminating their pregnancy in spontaneous abortion were also born more frequently in the same season. Twin-prone and abortion-prone characteristics of the women born in this season are considered.

Direct evidence for the contribution of the unique I-ANOD to the development of insulitis in non-obese diabetic mice

Insulin-dependent diabetes mellitus is characterized by the infiltration of lymphocytes into the islets of Langerhans of the pancreas (insulitis) followed by destruction of insulin-secreting beta-cells leading to overt diabetes. The best model for the disease is the non-obese diabetic (NOD) mouse. Two unusual features of the class II major histocompatibility complex (MHC) of the NOD mouse are the absence of I-E and the presence of unique I-A molecules (I-ANOD), in which aspartic acid at position 57 of the beta-chain is replaced by serine. This feature is also found in the HLA-DQ chain of many Caucasians with insulin-dependent diabetes mellitus. We have previously reported that the expression of I-E prevents the development of insulitis in NOD mouse. Here we report that the expression of I-Ak (A alpha kA beta k) in transgenic NOD mice can also prevent insulitis, and that this protection is seen not only when the I-A beta-chain has aspartic acid as residue 57, but also when this residue is serine. These results show that the single amino-acid substitution at position 57 of the I-A beta-chain from aspartic acid to serine is not sufficient for the development of the disease.

Investigation of the genetic regulation in allergic rhinitis

Human leukocyte antigen (HLA) population and family studies were performed to determine whether a specific HLA type is associated with allergic rhinitis. We analyzed hereditary characteristics of allergic rhinitis using 27 nuclear families. According to the results of HLA typing, we concluded that allergic rhinitis is certainly regulated by HLA haplotype linked autosomal recessive inheritance. In addition, the frequency of HLA DQw3 antigen, one of the HLA class II antigens, was higher in the patients allergic to Dermatophagoides farinae, Japanese cedar pollen and/or orchard grass pollen than in non-allergic controls. Secondly, the HLA DQw3 antigen was analyzed in detail by means of HLA DNA typing. Regardless of the type of cDNA probes or restriction enzyme, the serologically defined HLA DQw3 region was highly polymorphic at the DNA level. Furthermore, when we used DQ beta as a probe and BamHI as a restriction enzyme, the 8.1 and 6.3 kb restricted fragments were detected in lower frequency and 3.5 kb fragment in higher frequency in the patients of allergic rhinitis than in non-allergic controls. Further studies by the cloning of these fragments in the patients and the controls to clarify their function may be necessary to define molecular mechanism of the onset of allergic rhinitis.

Computed tomography controlled aspiration surgery for hypertensive intracerebral hemorrhage. Experience of more than 400 cases

To overcome the disadvantages of conventional surgery, we developed our own method of computed tomography controlled stereotactic aspiration surgery for hypertensive intracerebral hemorrhage. A new ultrasonic surgical aspirator was also developed to facilitate aspiration of a dense clot in the acute stage. Between 1980 and 1988, 437 patients with hypertensive intracerebral hemorrhage underwent aspiration surgery. Computed tomography controlled stereotactic aspiration surgery can be performed in hematomas of any site or any stage with minimal tissue damage, even in aged patients. Aspiration surgery led to a favorable clinical experience and outcome, especially in the acute stage.

Application of thrombin-antithrombin III complex for detecting a latent hypercoagulable state in patients with coronary artery disease

It is thought that a hypercoagulable state contributes to the pathogenesis of coronary artery disease (CAD), but few sensitive markers have been available for detecting the state. In the present study the plasma level of thrombin-antithrombin III complex (TAT), a specific indicator of thrombin generation in blood, was investigated before and after a submaximal exercise test in 18 patients with CAD and in 12 healthy controls. The mean (+/- SEM) value of plasma TAT before the exercise was 3.30 (0.81) ng/ml in the patient group and 1.49 (0.08) ng/ml in controls, and its level increased to 29.22 (5.74) ng/ml and 12.07 (2.89) ng/ml after the exercise, respectively. Thus, the TAT value in the patient group was higher than that in the controls both before and after the exercise. However, no differences could be found between the groups in the following parameters; prothrombin time, activated partial thromboplastin time, antithrombin III, fibrinogen, FDP, plasminogen, alpha 2-plasmin inhibitor, and alpha 2-macroglobulin. Through these results it was concluded that plasma TAT level could be a sensitive marker for latent activation of blood coagulation, and also that the results of these experiments showed that patients with CAD were in a latent hypercoagulable state.

Relationship between tumorigenicity and the dosage of lymphoma- vs. normal-parent-derived chromosome 15 in somatic cell hybrids between lymphoma cells with rearranged pvt-1 gene and normal cells

Somatic cell hybrids were generated between YACUT, a doubly drug-resistant subline of YAC-1 (a Moloney-virus-induced T-cell lymphoma of strain A/Sn origin with 2 proviral insertions near the pvt-1 locus) and normal diploid fibroblasts of CBAT6T6 origin. Three independent fusions were performed. Three uncloned hybrid cultures and 9 independently-derived clones were tested for tumorigenicity by the inoculation of graded cell numbers into syngeneic hosts. One of 3 uncloned hybrid cultures and 3 of 9 clones were weakly tumorigenic (take incidence 0%), and 1 of 3 uncloned hybrid cultures and 6 clones were highly tumorigenic (take incidence greater than 80%). One weakly tumorigenic hybrid and 3 weakly tumorigenic clones carried 3 copies of the tumor-derived chromosome 15 and 2 copies of the normal fibroblast-derived t(14;15) chromosomes. In contrast, 2 highly malignant hybrid clones lost one copy of the normal-fibroblast-derived t(14;15), but contained increased numbers (3.44-4.44) of the tumor-derived chromosome 15. Four tumorigenic segregants selected from the weakly tumorigenic fibroblast hybrids by in vivo inoculation showed the same cytogenetic change as the highly tumorigenic hybrid clones, in that the ratio of the normal:tumor-derived chromosomes 15 changed from 1.18-1.55 to 4.11-5.71. Tumorigenicity was thus associated with a modified balance between the tumor vs. the normal-parent-derived 15-chromosomes. Instead of the usual 3:2 ratio, the tumor-derived 15-chromosomes increased disproportionately, whereas the relative number of the normal-parent-derived 15-chromosome decreased, as a rule. These results suggest that amplification of the lymphoma-derived chromosome 15 favors tumorigenicity, but that this effect is counteracted by some influence emanating from the normal-parent-derived homologous chromosome.

Epstein-Barr virus-transformed pro-B cells are prone to illegitimate recombination between the switch region of the mu chain gene and other chromosomes

Six independently maintained sublines of FLEB 14, a fetal-liver-derived Epstein-Barr virus-transformed pro-B cell line that has not yet rearranged its immunoglobulin genes, were examined after in vitro propagation during 19-36 months. Two lines showed no immunoglobulin heavy chain gene rearrangement, whereas one allele was rearranged with breakpoints inside the switch region of the mu chain gene in the remaining four. These rearrangements had been generated by the translocation of different chromosome fragments to the immunoglobulin heavy chain gene cluster-carrying 14q32 band in each of the four lines. Previously, a similar rearrangement was found in a fifth subline concurrently with a reciprocal 6;14 translocation. The transposed pieces have been derived from chromosomes 16 and 18 in two of the more recently rearranged lines. Their origins could not be determined in the remaining two lines, but they were different from each other and the other three 14q+ markers. The 14q+ marker-carrying variant has replaced its diploid progenitor suggesting that the translocation has conveyed some in vitro growth advantage on its carrier. This was also supported by the duplication of the 14q+ marker and the loss of its normal chromosome 14 homologue in one subline during serial culturing. The vulnerability of the switch region of the mu chain gene to illegitimate recombination at the pro-B stage and the possible relevance of this finding for the origin of the Burkitt lymphoma-associated 8;14 (immunoglobulin heavy chain gene cluster/MYC) translocation is discussed.

Detection of impaired fibrinolytic activity in coronary artery disease--electrophoretic and immuno-blotting analysis of tissue plasminogen activator

In present study, we investigated the fibrinolytic activities and plasma antigen levels of tissue plasminogen activator (tPA) before or after a submaximal exercise in patients with coronary artery disease (CAD). We also investigated tPA phenotypes in plasma by electrophoretic and immuno-blotting analysis. Euglobulin fractions obtained from plasma were submitted to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting analysis. There were no differences in plasma antigen levels of tPA between the study group and controls before or after the exercise, however CAD patients showed lower fibrinolytic activities after the exercise than controls. SDS-PAGE followed by immuno-blotting with an antisera against human tPA revealed two bands at molecular weights (m.w.) of 70,000 and 120,000. The band at m.w. of 70,000 corresponded to free tPA and that of 120,000 was considered to be identical to a complex of tPA with its inhibitor. Furthermore, we found a decrease in free tPA in the patients with low fibrinolytic activities. From these results it was concluded that impaired fibrinolytic activities, probably due to decreased free tPA, observed in CAD patients, might be an important factor in the pathogenesis of CAD.

Liver-specific and high-level expression of human serum amyloid P component gene in transgenic mice

To analyze the regulation of human serum amyloid P component (SAP) gene expression, we have produced seven transgenic mice. The 3.3 kb human SAP genes containing about 0.8 kb of 5' and 1.5 kb of 3' flanking region were injected into fertilized eggs of C57BL/6 mice. In five of the seven transgenic mice, human SAP was detected in the sera and serum concentrations were higher than that of human serum in three lines. The human SAP gene was expressed only in the liver. Amounts of human mRNA in the liver and serum concentrations of human SAP were roughly proportional to the copy number of the integrated gene. Human SAP production lowered the serum levels of mouse endogenous SAP. With the intraperitoneal administration of lipopolysaccharide, the mRNA levels in the liver and serum levels of mouse SAP increased several-fold in both the control and transgenic mice. On the other hand, neither the mRNA nor the serum levels of human SAP increased significantly.

Development of autoimmune insulitis is prevented in E alpha d but not in A beta k NOD transgenic mice

Two lines of E alpha d-expressing NOD mice were established by continuously backcrossing [E alpha d B6 transgenic mice x NOD] F1 to parental NOD or directly microinjecting the E alpha d gene into fertilized NOD eggs. Similarly, A beta k-expressing transgenic NOD mice were produced. Subsequent histological examination of pancreatic tissues revealed that autoimmune insulitis was prevented in E alpha d backcross and transgenic mice but not in A beta k transgenic mice.

Serological evaluation of ultrasound examination for chronic schistosomiasis japonica in a previously endemic area--the Chikugo River Basin, Japan

Ultrasound diagnosis of chronic schistosomiasis japonica was assessed by comparison with the results of serological tests using enzyme-linked immunosorbent assay (ELISA) with egg and adult worm antigen, and the circumoval precipitation test. The subjects were persons resident in the Chikugo River Basin in Kyushu, southwest Japan, where schistosomiasis used to be highly prevalent. Of 93 individuals with a past history of infection, 37 (39.8%) presented the characteristic echo pattern of the disease (network, sieve, mottled or mixed pattern). In the serological tests, the ultrasound (US)-positive subjects showed a significantly higher IgG antibody-positive rate in ELISA (81.1% for egg-ELISA), than the US-negative subjects (37.5% for egg-ELISA). Individuals bearing dead Schistosoma japonicum eggs proven by tissue biopsy showed a similar antibody-positive rate (76.5% for egg-ELISA) to that of the US-positive subjects. Sera of a group which had no schistosomiasis characteristic echo pattern, but had liver fibrosis, hepatomegaly or liver cirrhosis as shown by US, were also highly positive (71.4% for egg-ELISA). The present serological studies thus confirmed the usefulness of ultrasound diagnosis for chronic schistosomiasis japonica. Furthermore, we were able to determine certain indications of liver abnormality currently undefined in the normally utilized US classifications.

[Surgical treatment for hypertensive cerebellar hemorrhage--indication and characteristics of stereotaxic aspiration surgery]

From May 1976, through May 1985, eighty-nine patients with hypertensive cerebellar hemorrhage were admitted to our university hospital and affiliated hospitals. The age at onset ranged from 42 to 86 years, with a mean of 65.1 years. Thirty-one of these patients underwent conservative treatment, 20 were given ventricular drainage, 23 underwent suboccipital craniectomy and 15 underwent stereotaxic aspiration surgery. The patients were classified into four categories according to the grading of hypertensive cerebellar hemorrhage proposed by Matsumoto in 1982. Twenty-two cases were of benign type, 20 were moderate type, 30 were severe type, and 17 were fulminant type. The 22 benign type cases showed good recovery (ADL 1 or ADL 2), whereas the mortality rate of severe type cases was 26.7%, and that of fulminant type cases was 70.6%. The site and extension of hematoma were identified by CT. Fourty cases (45.0%) were confined to the left hemisphere, and 19 (21.3%) were localized in the vermis. When the hematoma volume was more than 15 ml, surgical evacuation of the hematoma was considered. Since 1981, stereotaxic aspiration surgery has been performed in cases of hypertensive cerebellar hemorrhage with a mean patient age of 66.9 years, ranging from 51 to 82 years. Patients treated have consisted of 2 with moderate type hemorrhage, 10 with severe type, and 3 with fulminant type, with an overall surgical mortality rate of 33.3%. However, the outcome of fulminant type hemorrhage has remained ADL 2 or ADL 3. The benefits of this type of surgery are that it is not only indicated as an emergency treatment for patients who are aged or at high risk, but that it can be also performed for fulminant type hemorrhage.

Fibrinopeptide A (FPA) levels in atrial fibrillation and the effects of heparin administration

It has been reported that a patient with atrial fibrillation (AF) is in the hypercoagulable state and that this state results in a high incidence of systemic thromboembolisms. In this paper, we have investigated plasma fibrinopeptide A (FPA) levels and the effects of subcutaneous administration of heparin on these levels in patients with AF. Forty-five patients with hypertension (HT) or mitral stenosis (MS) were classified into four groups according to whether they had AF complications; i.e. HT with normal sinus rhythm (NSR), HT with AF, MS with NSR and MS with AF. Patients with AF demonstrated significantly higher plasma FPA levels and lower plasma antithrombin III (AT III) activities than those with NSR. When low dose heparin was administered to patients with AF, plasma FPA levels were decreased to the near normal range, accompanied by an increase in heparin-AT III complex activity and heparin concentration 0.5-1.0 h after injection. These levels were maintained for 5 h. From these results it was concluded that patients with AF were in the hypercoagulable state and that the measurement of plasma FPA levels provided a possibility to detect the underlying activation of blood coagulation.

In vitro production of human antibodies specifically reactive with human gastric cancer cells of established lines and autologous tissues

Human lymphocytes derived from regional lymph nodes adjacent to the primary gastric cancer were transformed with Epstein-Barr virus (EBV) to establish lymphoblastoid cell lines secreting human antibodies reactive with cell surface antigens expressed on the gastric cancer cells. The EBV transformation technique was applied to lymph node lymphocytes obtained from 4 gastric cancer patients. As a result of mass screening with the radioactive cell binding assay for the production of anti-gastric cancer related antibodies, one culture (TGc-106) among 1,400 microcultures was identified to secrete human antibody specifically reactive with an established human gastric cancer cell line as target (MKN-45). Furthermore, it was demonstrated with the autologous assay system by the histoimmunofluorescence method that cell surface antigens of autologous gastric cancer cells could be clearly defined with human antibody from one culture (TEb-079) out of 470 microcultures established from a gastric cancer patient (GCP-26); there was no reactivity against the surrounding normal cells constructing the gastric wall. The immunoglobulin class of the human antibodies produced both in TGc-106 and TEb-079 was determined from immunodiffusion tests to be IgM.

The role of chromosome 15 in murine leukemogenesis. II. Relationship between tumorigenicity and the dosage of lymphoma vs. normal-parent-derived chromosomes 15 in somatic cell hybrids

Somatic cell hybrids were generated between an MCF-virus-induced 15-trisomic T-cell lymphoma of AKR origin with a proviral insertion near the c-myc locus, and normal diploid fibroblasts or lymphocytes of CBAT6T6 origin. Three lymphoma/fibroblast fusions were performed. Six independently-derived clones from 2 fusions were tested for tumorigenicity. Three of the 6 clones were weakly malignant (take incidence 20% below), and 3 were strongly malignant (take incidence over 80%). All 3 lymphoma/lymphocyte hybrids and 6 derived clones were strongly malignant. All hybrids contained a nearly complete chromosomal complement of both parental cells. This was confirmed at the molecular level by determining the ratio of germ-line (G) vs. rearranged (R) myc-carrying Eco RI fragments that showed the expected 1.9-2.7:1 proportion. Malignant segregants selected from the weakly malignant lymphoma/fibroblast hybrids by in vivo inoculation showed changed 15-chromosome ratios. Four out of the 6 clones showed amplification of the lymphoma-derived 15-chromosome that carries the R-myc fragment and a concomitant decrease in the average number of the G-myc-carrying chromosomes. This was deduced from the fact that the G:R ratio was between 2 and 3:1 in the in vitro hybrids but became inverted (1:2-3) in the tumors. Two tumors showed no amplification of R-myc. G-myc was decreased. One of these tumors showed a change in the G:R ratio from 2.5:1.0 to 1.2:1.0, while the other was essentially unchanged (1.9:1.0 in the in vitro clone and 2.2:1.0 in the derived tumor). These findings support the notion that both the amplification of the lymphoma-derived 15-chromosome with the retrovirally rearranged c-myc carrying fragment and/or the loss of the G-myc-carrying 15-chr can contribute to the tumorigenic potential of the hybrids.

[The problem of student suicide]

This study is a psychiatric survey of the student suicide at the Tokyo University. Counting the cases reported as such to the university administration, a total of 65 students committed suicide during the 20 years from 1962 till 1981. This amounts to a yearly average of 25.6 cases per 100,000 students. A comparison of this quota with that of several Japanese and foreign universities is made. In 1970, the year in which the students unrest at the Japanese universities reached its peak, the frequency of the suicide fell to its all time low. A possible explanation of this phenomenon is proposed. Out of the 65 students who committed suicide, 25 (38%) have at least once visited the psychiatric clinic of the Tokyo University. In view of the high percentage of the mentally disturbed students in the total number of suicides, the importance of measures taken of foster the mental health of the students is stressed for reasons of suicide prophylaxis. The issue in most of these cases was the conflict between the required scholastic accomplishments and the failure of achieving them. The resulting frustration becomes the immediate motive of the suicide. Therefore, a more intensive psychiatric care of such students is recommended especially during the examination season from January till May, when in Japan the students are exposed to the highest psychological stress. Out of 25 mentally disturbed students who ended by committing suicide, 18 revealed their desire to die in a more or less expressed way already during the time of their psychiatric treatment or consultation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical studies on cefuzonam in obstetric and gynecological infections]

Seventeen patients with gynecological infections (5 cases each of Bartholin's abscess and adnexitis, 4 cases of endometritis and 1 case each of bartholinitis, pyosalpinx and vulvar abscess) were treated with cefuzonam (CZON, L-105) administered by intravenous drip infusion, 1-2 g twice daily, for 4 to 12 days (6 g to 23 g in total). The clinical effectiveness reached 94.1%, including 1 excellent case, 15 cases good, and a poor case. Bacteria were detected in 9 cases, and with CZON treatment, bacterial eradications were obtained in 6 case, but, in 3 cases, bacterial replacements were observed. No abnormal laboratory findings were noted. From the above results, CZON seemed to be a highly effective and useful agent for gynecological infections.