Structural relationship between the S1 and S4 subunits of pertussis toxin

Pertussis toxin, the most important protective antigen of Bordetella pertussis, is a 106-kDa hexameric protein composed of an A-protomer (subunit S1) and a pentameric B-oligomer (S2 + S3 + 2S4 + S5). The most potent mouse-protective monoclonal antibodies against both respiratory and intracerebral infections were specified for either S1 or S4 and competed with each other in binding to epitopes of native pertussis toxin captured by haptoglobin or in solution, although they did not compete on unfolded pertussis toxin. These data suggest that the protective epitope(s) of S1 and S4 are very closely correlated; they are probably close together sterically. Non-protective anti-S1 and anti-S4 monoclonal antibodies recognized inner antigenic determinants which are not exposed on the surface of native pertussis toxin and interfered with association of the A-protomer and the B-oligomer. These data suggest that the A-protomer and the S4 subunit of the B-oligomer may be closely associated in the native hexameric pertussis toxin molecule.

Production of immunoreactive polymorphonuclear leucocyte elastase in human breast cancer cells: possible role of polymorphonuclear leucocyte elastase in the progression of human breast cancer

Breast cancer cells are known to express various proteolytic enzymes, which make them invasive and favour their dissemination to distant sites. However, it is unclear whether breast cancer cells have the ability to produce polymorphonuclear leucocyte elastase (PMN-E). We measured immunoreactive (ir) PMN-E content in the conditioned medium of two breast cancer cell lines, MCF-7 and ZR-75-1, and two normal breast epithelial cell lines, HBL-100 and Hs 578Bst, using a highly specific and sensitive enzyme immunoassay. Furthermore, ir-PMN-E content was determined in tissue extracts from 62 human breast cancers. ir-PMN-E content in the culture medium of MCF-7 cells and ZR-75-1 cells increased as a function of time, regardless of the presence or absence of oestradiol. On the other hand, no detectable ir-PMN-E was secreted into the culture medium of HBL-100 and Hs 578Bst cells. ir-PMN-E was detectable in 59 of 62 tissue extracts prepared from human breast cancers, the concentration ranging from 0.12 to 19.17 micrograms per 100 mg of protein. When 62 breast cancer specimens were categorised into four groups in terms of clinical stage, ir-PMN-E content in breast cancer tissue was significantly higher in stage III (8.90 +/- 5.13 micrograms 100 mg-1 protein) and stage IV (12.19 +/- 5.44 micrograms 100 mg-1 protein) patients than in stage I (1.64 +/- 1.54 micrograms 100 mg-1 protein) and stage II (4.23 +/- 3.74 micrograms 100 mg-1 protein) patients. Breast cancer patients with high levels of ir-PMN-E showed significantly shorter disease-free survival and overall survival than those with low levels of ir-PMN-E at the cut-off point of 8.99 micrograms 100 mg-1 protein. In the multivariate analysis, ir-PMN-E content was found to be a significant prognostic factor for disease recurrence and death in human breast cancer.

[Pharmacokinetic and clinical studies with cefozopran in the pediatric field. Pediatric Study Group of Cefozopran]

We investigated pharmacokinetics and clinical effectiveness of a newly developed cephem antibiotic cefozopran (SCE-2787, CZOP) against various pediatric infections in 18 institutions and their affiliates. We obtained the following results. 1. Serum concentration and urinary excretion rates Pharmacokinetics of CZOP in children was examined after intravenous injection and 30-minute drip infusion of 10, 20 and 40 mg/kg of CZOP. Peak serum concentrations of CZOP in 30 minutes after intravenous injection were 21.7, 51.5 and 77.8 micrograms/ml, respectively, showing a clear dose response. Half-lives were 1.99, 1.85 and 1.67 hours, respectively. In the first 6 hours after administration, urinary excretion rates of CZOP were 87.3, 67.4 and 84.1%, respectively. In the cases of 10, 20 and 40 mg/kg administration of CZOP 30-minute drip infusion, peak serum concentration of CZOP in 30 minutes, when the infusion was completed, were 38.1, 72.8 and 95.6 micrograms/ml, respectively. Again, there was a clear dose response. Half-lives were 1.67, 1.69 and 1.43 hours, respectively. In the first 6 hours after administration, urinary excretion rates of CZOP were 53.9, 59.7 and 77.3%, respectively. Cerebrospinal fluid concentrations of CZOP administered by intravenous injection of 50 mg/kg to patients with purulent meningitis were 1.6 to 43.4 micrograms/ml in 1 to 1.5 hours after administration. 2. Clinical study Clinical efficacy was evaluated in 337 cases. The largest number of cases, 138 cases, were found in 2 to < 6-year olds. The majority of the patients were under age 9, and 70 cases were of less than 1-year old infants. 183 cases were males and 154 cases were females. In terms of illness, a majority, or 185 cases, suffered from pneumonia, followed by 39 cases of UTI and 23 infections of the skin and soft tissue. There were 7 cases of purulent meningitis. In 218 cases, CZOP was administered at a daily dose of 60- < 80 mg/kg. The drug was administered for 6-10 days, the most frequent duration, in 188 cases. In the cases where causative organisms were identified (group A), the efficacy rates ("excellent" and "good") obtained were 100% (5/5) against purulent meningitis, 100% (2/2) against sepsis, 98.3% (119/121) against pneumonia, 100% (13/13) against acute bronchitis, 100% (11/11) against upper respiratory tract infection, 96.3% (26/27) against UTI. Overall, "excellent" and "good" responses were observed in 97.5% (197/202) of cases with known causative organisms.(ABSTRACT TRUNCATED AT 400 WORDS)

A new surgical approach to apical segment lung diseases, including carcinomas and inflammatory diseases

A new surgical approach to lung cancer and inflammatory pulmonary diseases has been developed. This approach focuses on diseases located in the apical segments of the lung and showing invasion or severe adhesion to the apical thoracic wall or to vital organs near the thoracic dome (including superior sulcus tumors). The conventional posterolateral approach leaves the surgeon "blind" because it forces the surgeon to perform the operation looking up through a tube from the bottom. This limited view makes accurate assessment of the surrounding vital organs involved in these diseases almost impossible and also increases the risk of injury to adjacent vital organs. The incision in this new approach allows extensive retraction of the scapula to provide easier access to the posterior chest wall. Because the incision curves upward anteriorly, rather than downward as usual, it gives excellent exposure of the apical anterior thoracic region. In the few cases in which we have used this approach, we have found that the surgical field is in plain view and that the operation is consequently safer and easier. So far we have not encountered any complications, and we can recommend this approach with confidence.

Epstein-Barr virus lytic cycle spreads via cell fusion in a nasopharyngeal carcinoma hybrid cell line

NPC-KT cl.S61, a subclone derived from an epithelial-nasopharyngeal carcinoma hybrid cell line NPC-KT, showed extensive Epstein-Barr virus (EBV) production and cell fusion when the EBV replicative cycle was induced by 5-iodo-2'-deoxyuridine. On the contrary, parental NPC-KT cells produced virus at a lower level and did not show cell fusion. Cell fusion in cl.S61 cells was blocked by 2-deoxyglucose and acyclovir, inhibitors of glycosylation and EBV DNA polymerase, respectively, with a concomitant decrease in the number of cells expressing EBV growth-associated antigens. However, the frequency of virus antigen expression in parental NPC-KT cells was not significantly affected by these drugs. This result suggests that efficient production of EBV from cl.S61 cells is due to the spreading of viral replicative cycle via cell fusion. It was also demonstrated by in situ autoradiography that cl.S61 cells producing virus fused to not only EBV receptor/CR2 positive Raji and BJAB cells, but also to receptor-negative Jurkat cells. The possible mechanism of EBV entry into cells devoid of virus receptor by cell fusion is discussed.

Thyroid allograft after total thyroidectomy in a rat model

The fact that in vitro culture of murine organ allografts prior to transplantation enhances graft survival is commonly accepted. In this study, we examined the possibility of thyroid allotransplantation for the therapy of total thyroidectomy in the rat model. Transplanted thyroid function was determined by 125I uptake ratio and evaluated by immunohistochemical and microautoradiographical assessments. Fully allogeneic thyroid glands cultured for 8-24 hr in Hank's balanced salt solution (HBSS) at pH 6.3 or 7.2 were transplanted to rats under the kidney capsule. Five weeks after allotransplantation, thyroid glands cultured for 16 hr in HBSS at pH 6.3 presented prolonged survival. This procedure could be used as an initial therapy not only for total thyroidectomized patients but also for patients with primary hypothyroidism.

Identification of defect in the genes for bilirubin UDP-glucuronosyl-transferase in a patient with Crigler-Najjar syndrome type II

Crigler-Najjar syndrome (CN) type II is characterized by severe chronic nonhemolytic unconjugated hyperbilirubinemia due to reduced hepatic bilirubin UDP-glucuronosyl-transferase (UGT) activity. Two bilirubin UGT isozymes, UGT1A and UGT1D, have been identified. We analyzed the DNA sequence of the bilirubin UGT genes in a 5-year-old Japanese male patient with CN type II, who had consanguineous parents. Point mutations were found on exons 1 of the UGT1A and UGT1D genes. The abnormalities were single nucleotide substitutions of G by A and of T by C at base position 211 of UGT1A cDNA and at base position 395 of the UGT1D, respectively. We found another single nucleotide substitution of T by G on exon 5 common to both genes at base position 1456 of the UGT1A cDNA or 1459 of the UGT1D cDNA. These three mutations result in changes of glycine to arginine and of tyrosine to aspartic acid at amino acid positions 71 and 486 of the UGT1A protein, and of leucine to proline and of tyrosine to aspartic acid at amino acid positions 132 and 487 of the UGT1D protein, respectively. Our patient was homozygous for all defects and his parents and elder brother were heterozygous for all defective alleles. The findings suggest that the CN Type II is inherited as an autosomal recessive trait.

A study on sex differences in temporary threshold shift (TTS) considering the menstrual cycle of women

The purpose of the present study was to compare temporary threshold shift (TTS) of women at varying phases of the menstrual cycle, and to compare the TTS of women with TTS of men. The menstrual cycle was divided into three phases: preovulation, postovulation and menstruation. Nine women and seven men were, after 5 min rest, exposed to continuous white noise of 100 dB for 8 min. The audiometry was done with 1,000, 2,000, 3,000, 4,000, 6,000 and 8,000 Hz test tones at 2, 5, 10, 15, 20, 25 and 30 min of recovery. The largest threshold shift was found at 6,000 Hz for women and at 4,000 Hz for men. In the three phases of the female menstrual cycle, TTS at 2,000, 3,000 and 4,000 Hz was smaller in the postovulatory phase than in the other two phases. Men showed a larger TTS at 3,000 and 4,000 Hz and a smaller TTS at 6,000 Hz than women in all phases of the menstrual cycle.

Clostridium perfringens invasiveness is enhanced by effects of theta toxin upon PMNL structure and function: the roles of leukocytotoxicity and expression of CD11/CD18 adherence glycoprotein

Clostridium perfringens infections are characterized by the lack of an inflammatory response at the site of infection and rapidly progressive margins of tissue necrosis. Studies presented here investigated the role of theta toxin from C. perfringens in the pathophysiology of these events. Mice passively immunized with neutralizing monoclonal antibody against theta toxin and challenged with an LD100 of log phase C. perfringens had significantly less mortality than untreated controls. Intramuscular injection of killed, washed C. perfringens in mice induced a massive time-dependent influx of polymorphonuclear leukocytes (PMNL) into tissue; injection of either viable, washed C. perfringens or killed organisms plus theta toxin dramatically attenuated PMNL influx although PMNL accumulated in adjacent vessels. The anti-inflammatory effects could not be attributed to an absence of chemoattractants since C. perfringens proteins had chemotactic factor activity, and killed bacilli generated serum-derived chemotactic factors. Scanning and transmission electron microscopy demonstrated the dramatic leukocidal effects of high doses of theta toxin on PMNL. In contrast, sublethal concentrations of theta toxin primed PMNL chemiluminescence, disrupted PMNL cytoskeletal actin polymerization/disassembly, and stimulated functional upregulation of CD11b/CD18 adherence glycoprotein. In summary, these results demonstrate that theta toxin is an important virulence factor in C. perfringens infection. In a concentration-dependent fashion, theta toxin contributes to the pathogenesis of clostridial gangrene by direct destruction of host inflammatory cells and tissues, and by promoting dysregulated PMNL/endothelial cell adhesive interactions.

[A case report of aneurysm of the diverticulum of the ductus arteriosus]

A 59-year-old man who was admitted with hoarseness and diagnosed as aneurysm of the diverticulum of the ductus arteriosus was reported. In our case, enhanced computed tomography and aortography gave reliable informations. Operation was performed through a posterolateral thoracotomy under partial cardiopulmonary bypass. The aneurysm was successfully resected and defect of the aortic wall was covered with Dacron patch. Postoperative course was uneventful. To our knowledge, this is 12th surgically treated case in Japan.

Structural difference between polymerized and non-polymerized fragment X, obtained by plasmin digest of fibrinogen

Fragment X (LMrFX) was obtained as low molecular weight preparations from a late stage 2 plasmin digest of human fibrinogen. The thrombin-treated LMrFX preparations, which resulted in impaired polymerization, were further subfractionated into polymerized and non-polymerized components. The fractions were examined by SDS-PAGE and immunochemical methods. In polymerized fractions, more peptide bands were observed on SDS-PAGE in the reduced state than in non-polymerized fractions. Both fractions contained a similar number of internal cleavages in the A alpha, B beta and gamma chains, which are linked by disulfide bonds. Thus, the partial deficiencies in polymerization sites of the carboxy terminal region of the gamma chain and the amino terminal portions of the B beta chain, as well as internal cleavage, were considered to participate in the impairment of the thrombin-induced polymerization of LMrFX.

Transfusion-associated graft-versus-host disease

We reported two patients showed similar clinical course after blood transfusion. Case 1 was 74-year-old female, received transfusion of 200 ml of whole blood from her son, because of hemorrhagic shock for fematemesis from gastric ulcer. After transfusion, she died of liver dysfunction and severe aplastic anemia. Case 2 was a 73-year-old male, received transfusion of three unites of concentrated red blood cells for anemia following the orthopaedic treatment. High fever and erythema was appeared suddenly after transfusion. He died of liver dysfunction and the autopsy was performed. In case 1 the diagnosis was transfusion-associated graft-versus-host disease (GVHD) and in case 2 drug-induced-aplastic anemia (DIAA) was suspected. Differentiating the diagnosis between GVHD and DIAA is clinically difficult.

Expression of alpha 7 integrin cytoplasmic domains during skeletal muscle development: alternate forms, conformational change, and homologies with serine/threonine kinases and tyrosine phosphatases

We recently reported the cloning and sequencing of the alpha 7 integrin chain and its regulated expression during the development of skeletal muscle (Song et al. (1992) J. Cell Biol. 117, 643–657). The alpha 7 chain is expressed during the development of the myogenic lineage and on adult muscle fibers and this suggests that it participates in multiple and diverse functions at different times during muscle development. One interesting portion of this isoform is its cytoplasmic domain; comprised of 77 amino acids it is the largest in the alpha chains thus reported. In these experiments we begin to study the potential functions of the alpha 7 cytoplasmic domain by analyzing homologies between the rat and human sequences, by immunologic studies using an anti-cytoplasmic domain antiserum, and by identifying two alternate forms. In keeping with the nomenclature used to describe the alpha 3 and alpha 6 alternate cytoplasmic domains, we refer to the originally reported species as alpha 7B and the two additional forms as alpha 7A and alpha 7C. These three cytoplasmic domains likely arise as a consequence of alternate splicing. A splice site at the junctions of the transmembrane and cytoplasmic domains is used to generate the alpha 3, alpha 6 and alpha 7 A and B forms. The alpha 7A form RNA contains an additional 113 nucleotides compared to the B form, and a common coding region in the A and B form RNAs is used in alternate reading frames. Part of the coding region of alpha 7B appears to be used as the 3′-untranslated region of the alpha 7A form. The alpha 7C mRNA is 595 nucleotides smaller than the alpha 7B RNA and part of the 3′-untranslated region of the alpha 7B isoform is used as coding sequence in alpha 7C. There is developmental specificity in expression of these alternate mRNAs: alpha 7A and alpha 7C transcripts are found upon terminal myogenic differentiation whereas alpha 7B is present earlier in replicating cells and diminishes upon differentiation. We suggest this selective expression of the alpha 7 cytoplasmic domains underlies the diversity in function of the alpha 7 beta 1 integrin at different stages of muscle development. Immunochemical analyses indicate that the alpha 7B cytoplasmic domain undergoes a change in conformation in response to binding laminin or upon crosslinking initiated with antibody reactive with the integrin extracellular domain. Crosslinking also promotes association of the integrin with the cell cytoskeleton.(ABSTRACT TRUNCATED AT 400 WORDS)

Tracheal reconstruction after lower tracheal resection using the inverted right bronchus--an experimental study

An experimental study of tracheal reconstruction after lower tracheal resection using the inverted bronchus was performed in 8 dogs. After right upper lobectomy, the five cartilage rings of the lower trachea, ending three cartilage rings above the carina, was circumferentially resected; the right bronchus was transected just above the right second carina, the portion of the transected trachea above the carina was closed, and the right bronchus was inverted. The peripheral end of the upper trachea was anastomosed to the inverted right bronchus, and the intermediate bronchus was anastomosed to the lateral wall of the left bronchus. After completion of the airway reconstruction, the anastomotic site was wrapped with an omental flap. Although anastomotic complication were observed in two dogs, all the dogs survived the operation. Bronchoscopically and histopathologically, the findings for the inverted bronchus were almost normal three to four weeks after the operation. The clinical relevance of such a tracheal reconstruction is discussed.

[The effectiveness of ulinastatin on granulocyte H2O2 production in acute lung injury rat model]

Oxygen radicals produced by granulocytes play an important role in acute lung injury. The effectiveness of ulinastatin in adult respiratory distress syndrome and an acute lung injury animal model has been reported. We investigated the effect of ulinastatin on oxygen radical production in the intact pulmonary circulation of a rat acute lung injury model using our new method, which demonstrated the granulocyte adhesion and H2O2 production in vivo. The pulmonary microcirculation was observed by intravital fluorescence microscopy and a TV monitor using a SIT TV camera. Then images were recorded on a videotape. The granulocytes and H2O2 were stained with an intravenous injection of acridine red and dichlorofluorescin diacetate, respectively. The images which were recorded on the videotape were digitized by a computer image digitizer and analyzed with a personal computer and the software Ripp II. When the rat received a continuous infusion of endotoxin (4.5 mg/kg/hour) for 2 hours, the granulocytes adhered to the pulmonary capillaries and generated H2O2 (n = 25 p < 0.001 respectively, compared with the control rat which received saline alone). Then, the acute lung injury model rat was infused with 50,000 U/kg of ulinastatin just before endotoxin infusion and also received a continuous infusion of ulinastatin (50,000 U/kg/hour) for 2 hours. Ulinastatin inhibited the granulocyte adhesion to the pulmonary capillaries (n = 25, inhibition rate: 46% p < 0.001) and H2O2 production (n = 25, inhibition rate; 51% p < 0.001) caused by the continuous infusion of endotoxin. In conclusion, ulinastatin significantly inhibits the granulocyte adhesion and H2O2 production in the intact pulmonary circulation of a rat acute lung injury model.

NMR studies of G:A mismatches in oligodeoxyribonucleotide duplexes modelled after ribozymes

The structures of two oligodeoxyribonucleotide duplexes, the base sequences of which were modelled after both a hammerhead ribozyme and a small metalloribozyme, were studied by NMR. Both duplexes contain adjacent G:A mismatches; one has a PyGAPu:PyGAPu sequence and the other a PyGAPy:PuGAPu sequence. It is concluded on the basis of many characteristic NOEs that in both duplexes G:A base pairs are formed in the unique 'sheared' form, where an amino proton instead of an imino proton of G is involved in the hydrogen bonding, and G and A bases are arranged 'side by side' instead of 'head to head'. A photo-CIDNP experiment, which gives unique and independent information on the solvent accessibility of nucleotide bases, also supports G:A base pairing rather than a bulged-out structure of G and A residues. This is the first demonstration that not only the PyGAPu:PyGAPu sequence but also the PyGAPy:PuGAPu sequence can form the unique sheared G:A base pairs. Taking the previous studies on G:A mismatches into account, the idea is suggested that a PyGA:GAPu sequence is a minimum and essential element for the formation of the sheared G:A base pairs. The sheared G:A base pairs in the PyGAPu:PyGAPu sequence are suggested to be more stable than those in the PyGAPy:PuGAPu sequence. This is explained rationally by the idea proposed above.

v-Src activates the expression of 92-kDa type IV collagenase gene through the AP-1 site and the GT box homologous to retinoblastoma control elements. A mechanism regulating gene expression independent of that by inflammatory cytokines

The 92-kDa type IV collagenase (matrix metalloproteinase-9; MMP-9) is frequently expressed in cells showing an invasive nature during physiological and pathological processes, and the expression is strictly controlled by a variety of trans-membrane signals. Binding sites for NF-kB, Sp-1, and AP-1 are reportedly required for induction of MMP-9 gene expression by tumor necrosis factor-alpha or 12-O-tetradecanoylphorbol-13-acetate. Comparison of the sequence of the newly cloned mouse MMP-9 promoter region with our previous human isolate revealed that, in addition to the above mentioned elements, four units of GGGG(T/A)GGGG sequence (GT box) were conserved between the two species. In this study, we have demonstrated that one of the GT boxes located downstream of the AP-1 site is essential along with the AP-1 site for the activation of the promoter by v-Src but not by tumor necrosis factor-alpha or 12-O-tetradecanoylphorbol-13-acetate. Gel mobility-shift assays revealed that binding proteins for retinoblastoma control element, including Sp-1 family protein, can bind specifically to GT boxes. Thus, the v-Src signals to the AP-1 site and to the GT box homologous to retinoblastoma control element acted synergistically in transcriptional activation. These results suggest that certain v-Src-mediated signals are propagated along pathways that are independent of inflammatory cytokines.

Novel eosinophilic intracytoplasmic inclusions in a meningioma

BACKGROUND

Two forms of inclusion, extracellular and intracytoplasmic, have been reported in meningiomas. The authors recently encountered a case of meningothelial meningioma with unusual round eosinophilic intracytoplasmic inclusions.

METHODS

Ultrastructural and immunohistochemical studies were performed on the surgically removed tissue.

RESULTS

Ultrastructurally, the inclusions were found in the cytoplasm and processes of the tumor cells. Each inclusion consisted of a dense central mass of filaments with a looser, less dense periphery of radiating filaments. At the periphery, crystalloid lamellar structures and granules were intermingled frequently. No limiting membrane was observed. Immunohistochemically, the inclusions were unreactive for five classes of intermediate filaments, actin, ubiquitin, and amyloid.

CONCLUSION

The intracytoplasmic inclusions were ultrastructurally distinct from those reported previously. The molecular aspect of these novel eosinophilic intracytoplasmic inclusions remained uncertain.

An evaluation of mass screening using fecal occult blood test for colorectal cancer in Japan: a case-control study

There is as yet no firm evidence showing that mass screening for colorectal cancer using fecal occult blood tests (FOBTs) reduces the mortality from this cancer. Therefore we evaluated the effectiveness of the screening by a case-control study in Miyagi Prefecture, Japan. The study included as case subjects 28 individuals who had died from colorectal cancer and had had an opportunity to participate in the mass screening before the date of diagnosis as colorectal cancer, and 3 controls for each case subject randomly selected from residents who were alive on the date of death of case subjects and matched by sex, age (within 3 years) and living area using residential files. For each set, i.e., a case subject and 3 controls, screening histories before the date of the diagnosis of the case as colorectal cancer were examined. Both the case subjects and the controls who had participated in the screening at least once within 3 years before the date of diagnosis of the case were classified as "screened." The 28 case subjects consisted of 12 males and 16 females (average age: 60.8 years). The odds ratio of death from colorectal cancer for the screened versus the non-screened persons was 0.24 (95% confidence interval = 0.08-0.76) by the Mantel-Haenszel method. The present study suggests that mass screening using FOBTs for colorectal cancer significantly reduces the mortality from this cancer epidemiologically.