Reactivity of glomerular and serum IgA1 to jacalin in IgA nephropathy

To analyze O-linked oligosaccharides (O-glycans) in the hinge region of IgA1 in IgA nephropathy (IgAN), the reactivity of IgA1 to jacalin, which specifically binds to O-glycans, was investigated. Initially, renal biopsy specimens from 5 patients with IgAN and 3 patients with other renal diseases were investigated in an immunofluorescence study with jacalin, monoclonal antihuman IgA1 and IgA2 antibodies. All of the renal biopsy specimens of IgAN and none of other renal diseases were positively stained by both FITC-labeled jacalin and monoclonal anti-IgA1 antibody. The glomerular staining patterns of FITC-jacalin were similar to those of the monoclonal anti-IgA1 antibody. IgA2 was negative in all specimens. Based on the positive reactivity of deposited IgA1 to jacalin, the binding ability of serum IgA1 to jacalin was evaluated by inhibition assay using D-galactose in patients with IgAN (n = 58), other primary glomerulonephritides (PGN) (n = 41), and healthy controls (n = 52). The frequencies of the patients with serum IgA1 having a high affinity for jacalin were significantly greater in IgAN (19/58, 32.8%) compared with the healthy controls (2/52, 3.8%) and other PGN (4/41, 9.8%). These results suggested that the increased reactivity of O-glycan(s) in the IgA1 hinge region to jacalin is due to an unusual glycosylation of serum IgA1 in IgAN.

Human trehalase: characterization, localization, and its increase in urine by renal proximal tubular damage

By using polymerase chain reaction, cDNA encoding human renal trehalase has been isolated. The partial amino acid sequence deduced by the cDNA showed homologies in rabbit, Tenebrio molitor and silkworm trehalase. Northern blots showed renal trehalase mRNA to be about 2.0 kb. To examine the properties of renal and urinary human trehalase, the trehalase cDNA was inserted in the pMAL-cRI vector downstream from the malE gene, which encodes maltose-binding protein. Transfection of the recombinant pMAL-cRI in Escherichia coli provided high levels of expression of the maltose binding protein-trehalase fusion protein. A rabbit was immunized with purified fusion protein, and antihuman trehalase antibodies were obtained. Immunoblot analysis disclosed that renal and urinary trehalase exhibited a molecular mass of about 75 kDa. Analysis by indirect fluorescent microscopy demonstrated that the enzyme located in only proximal tubular cells. Urinary trehalase activity was low in the healthy infants and elevated in patients with asphyxia. Markedly high activity was observed in a patient with Lowe syndrome. The immunoreactive urinary trehalase with 75 kDa was increased dependent on the elevation of the activity. On the basis of these findings, we conclude that the increase of urinary trehalase reflects the extent of renal tubular damage, and we propose that urinary trehalase can be a specific marker of renal tubular damage.

[Pryce type I intralobar pulmonary sequestration]

A 53-year-old woman had a abnormal shadow in the left lower lung field on a chest radiograph, and occasional bloody sputum. CT scans and an MRI showed an abnormal vessel shadow between the aorta and the heart. An aortogram showed an abnormal artery originating from the descending aorta and entering the left lower lobe, and a pulmonary angiogram revealed no blood supply to the left basal segments. Pryce type I pulmonary sequestration was diagnosed. The patient underwent surgery, and the abnormal artery, 13 mm in diameter, was found to be connected from the descending aorta to the left lower lobe. The abnormal artery was dissected, and the left lower lobe was removed. The postoperative course was uneventful. We collected data on 24 cases of Pryce type I pulmonary sequestration reported in Japan. Such cases are comparatively rare and males are affected more often than females. The patient in the present case was the oldest woman to have undergone surgery for this condition in Japan. In patients who underwent surgery the greatest diameter of the abnormal artery was 18 mm.

Lipoprotein derangement during steroid treatment in minimal-change nephrotic syndrome

To study the pathophysiology of hyperlipidemia in nephrotic syndrome, we compared lipid metabolism in the nephrotic stage (stage 1) and in stage 2, when albuminuria had subsided, in 11 patients with minimal-change disease treated with corticosteroid. High-density lipoprotein (HDL) levels were decreased and HDL contained more cholesterol and triglyceride per unit of protein in stage 1 in the patients than in age-matched healthy controls. The urinary protein level was positively correlated only with low-density lipoprotein (LDL) levels, suggesting that the increased albumin clearance stimulated LDL production. Serum cholesterol levels were positively correlated with apolipoprotein E levels and were negatively correlated with lecithin-cholesterol acyltransferase activity in the nephrotic stage; the opposite correlations were seen in controls. Although triglycerides in HDL had normalized at stage 2, triglycerides in LDL and very-low-density lipoprotein did not return toward normal until stage 3, when serum cholesterol levels were normalized.

Effects of amino acids on the growth of an anaerobic rumen fungus Neocallimastix sp N 13

The amino acid requirements of Neocallimastix sp N 13 isolated from sheep rumen were studied using supplements containing either ten essential amino acids (10 EAA) or eight nonessential amino acids (8 NEAA), or both (18 AA). Although the fungus could grow in a medium containing ammonium sulphate as the sole source of nitrogen, amino acid supplements, especially 18 AA, greatly stimulated its growth. Omission of the sulphur-containing amino acids (SCAA) from the 18 AA mixture markedly reduced the growth-stimulating effect, and sulphide, but not sulphate, substituted for SCAA only partly compensated for this omission. Omission of aromatic, branched chain, basic, acidic, aliphatic and hydroxy amino acids, and proline, singly or in combination, all reduced fungal growth to some degree as compared with the 18 AA supplement. A three amino acid (leucine, methionine and histidine) supplement was a potent stimulator for the fungus, whereas another three amino acid combination (glutamic acid, methionine and serine) was ineffective. The results indicated that Neocallimastix sp N 13 effectively utilized amino acids for its growth, but the requirements for the different amino acids differed from those of N patriciarum.

Two cases of recurrent herpetic infection of the tongue

Recently, a number of reports have been published on recurrent herpetic infection of the oral mucosa. In most of these cases, the infected tissue is the fixed intraoral mucosa, such as the gingiva or hard palate. Infection of movable mucosa such as the tongue, which is reported in the present paper, has not been reported in detail previously. In each of the two cases reported in the present paper, intraoral lesions were diagnosed as recurrent herpes-glossitis after isolation of the herpes simplex virus (HSV).

Electromagnetic interference of an external temporary pacemaker during maxillofacial and neck surgery

Indirect inhibition of an external temporary pacemaker by electrocautery is reported. Before induction of general anesthesia for a hemimaxillectomy and radical neck dissection, a temporary transvenous demand pacemaker was inserted into a patient with a first-degree atrioventricular block and complete left bundle-branch block. Although we provided common precautions to prevent electromagnetic interference by electrocautery, pacing failure still occurred. It was thought to be caused by current dispersing from the active electrocautery electrode. This case suggests that occipital placement of the electrocautery ground plate should be considered during neck surgery in a patient requiring a temporary pacemaker.

Endothelin-1 has a priming effect on production of superoxide anion by alveolar macrophages: its possible correlation with bronchopulmonary dysplasia

The purpose of this study was to clarify the role of endothelin (ET)-1 in the development of bronchopulmonary dysplasia (BPD). Tracheal aspirates were obtained from 27 newborn babies with respiratory distress (13 with BPD and 14 without BPD) who were mechanically ventilated. Production of superoxide anion (O2-) by rabbit alveolar macrophages was determined by preincubation with the tracheal aspirate supernatant (TAS) and stimulation with phorbol myristate acetate (PMA). O2- production was demonstrated only when PMA was added to the experimental system and was enhanced with TAS of infants who later developed BPD compared with TAS from infants without BPD. The effects of ET-1 and ET-3 on O2- production and the blockade by anti-ET-1 antibody and BQ123 (ET A receptor antagonist) were also examined. The enhancing effect was blocked by either anti-ET-1 antibody or BQ123. PMA-stimulated production of O2- increased when cells were preincubated with several doses of ET-1 (5 x 10(-13) to 2 x 10(-12) M), whereas ET-3 was without effect. TAS contained significant amounts of immunoreactive ET-1, and there was a close positive correlation (r = 0.764) between the activity of O2- production and immunoreactive ET-1 levels in TAS samples. These results may be interpreted to indicate that ET-1 synthesized by and secreted from tracheal epithelial cells and/or alveolar macrophages has a priming effect on alveolar macrophages to produce O2-, thus possibly contributing to the development of BPD.

Visual inputs to cerebellar ventral paraflocculus during ocular following responses

The activity of cerebellar Purkinje cells was recorded in the ventral paraflocculus (VPFL) of alert monkeys during ocular following responses induced by brief movements of the visual scene. The mossy fiber input evoked 'simple-spikes' which increased their activity during either ipsiversive or downward motion of the visual scene. On the other hand, the 'complex-spikes' evoked by the climbing fiber input increased their activity during either contraversive or upward movement. To further define the sources of the visual input to the VPFL, we recorded single units in the dorsolateral pontine nucleus (DLPN), which is known to project to the VPFL as mossy fibers, and in the pretectal nucleus of the optic tract (NOT), which is known to project to the inferior olive whose neurons project to the cerebellum as climbing fibers. In both areas, most neurons were directionally selective, and responded to the moving visual scene with very short latencies (approximately 40-60 ms). These results suggest that both DLPN and NOT neurons deliver information concerning movements of the visual scene to the VPFL through different pathways.

Steroid therapy during the early stage of progressive IgA nephropathy. A 10-year follow-up study

This study was undertaken to clarify the effect of corticosteroids on the long-term clinical course of the early stage of progressive IgA nephropathy. The early stage of progressive IgA nephropathy was defined as having moderate proteinuria between 1 and 2 g/day, creatinine clearance values of 70 ml/min or more, and a histological severity score of 7 or more. The number of patients who fulfilled these three conditions during 12 years from 1972 and then were continuously followed up for 10 years or more in our renal unit was 46. Twenty of them received steroid treatment for an average period of 18 months, and the remaining 26 patients had no steroid treatment. The initial data of proteinuria, creatinine clearance values, frequency of hypertensive cases, and histological scores of 7 or more were not different between the two groups: 1.4 +/- 0.4 vs. 1.3 +/- 0.3 g/day, 85 +/- 14 vs. 88 +/- 13 ml/min, 25 vs. 38%, and 10.7 +/- 2.5 vs. 11.0 +/- 3.0, respectively. During the follow-up period of 10 years, the renal survival rate was significantly different between the two groups (100 vs. 84% 5 years after starting therapy and 80 vs. 34% 10 years later; p < 0.001). The final creatinine clearance values were significantly different between the two groups (54 +/- 35 vs. 20 +/- 29 ml/min; p < 0.005). On the other hand, the patient groups with mild histological changes or decreased renal function due to moderate proteinuria showed no significant differences in the final outcome. These results indicate that corticosteroids are beneficial in stabilizing the renal function for a long time during the early stage of progressive IgA nephropathy, although this study was not a randomized one.

Cytokine production by SV40-transformed adherent synovial cells from rheumatoid arthritis patients

We examined the mRNA levels for various cytokines, including IL-1 alpha, IL-1 beta, TNF alpha, TGF-beta 1, GM-CSF, IL-6, IL-8, bFGF, PDGF-A, PDGF-B and IL-1ra, and IL-1 beta converting enzyme, and the protein levels of some of these cytokines in 19 SV40-transformed synovial cell clones. Among those tested, the mRNA levels for IL-6, bFGF and PDGF-A in rheumatoid arthritis (RA) cell clones were greater than those in non-RA cell clones. Moreover, except for one osteoarthritis (OA) cell clone, the mRNA levels for IL-8 in RA cell clones were also greater than those in non-RA cell clones. Although the protein levels were not always correlated with the mRNA levels, the exception being the same OA cell clone, the protein levels of cytokines, such as IL-1 alpha, IL-1 beta, IL-6 and IL-8, in RA cell clones were greater than those in non-RA cell clones. TNF-a was not detected in any cells tested at either the mRNA or the protein level. TNF-alpha upregulated the expression of GM-CSF mRNA in both RA cell clones and one OA cell clone, but not in the other OA cell clone or the normal cell clone. Taken together, these SV-40 transformed synovial cell clones retained many of the original characteristics in terms of cytokine production.

Cartilage-hair hypoplasia associated with IgG2 deficiency

We report on a 1 year old boy with cartilage-hair hypoplasia (CHH). He suffered from recurrent upper respiratory infections and short-limbed dwarfism. As with most patients with CHH, he had impaired cellular immunity as determined by lymphocyte reactivity. In addition, he had a selective IgG2 deficiency. This combination of immunodeficiencies has not previously been reported for patients with CHH. His recurrent upper respiratory infections were likely to be associated with cellular immunodeficiency and IgG2 deficiency.

[Two cases of multiple liver metastases (H3) from colon cancer treated by home hepatic arterial infusion chemotherapy]

Two cases with unresectable multiple liver metastases to both lobes (H3) from colon cancer, in which cases the life expectancy usually does not exceed 1 year, were treated with home hepatic arterial infusion chemotherapy employing implantable port system. They could live over one year with good performance status. Drug treatment consisted of the administration of carboplatin (CBDCA), 150 mg/body, given in a minute for one day and 5-fluorouracil (5-FU), 250 mg/body, given in a 5-hour intra-arterial infusion daily for 5 days. Cycles were administered every 2 weeks. Home hepatic arterial infusion chemotherapy using an implantable port system, which offers good local control of liver metastases, a high patient quality of life without the need for hospitalization, is suitable for treatment of unresectable liver metastases.

Development of a multichannel Fourier transform spectrometer

We devised a novel type of multichannel Fourier transform spectrometer (MCFTS) that incorporates a Wollaston prism, polarizing interferometer combined with two Savart plates and a phase-retarding plate. This original MCFTS produces a number of lines of folded interferograms recorded with a two-dimensional imaging detector such as a CCD detector. In the present type of MCFTS, the total incident light is available except for a small amount of reflection loss. It is possible to enhance the signal-to-noise ratio. The enhancement of the resolving power is also expected by the connection of the interferograms with a newly developed method.

Effect of prior portosystemic shunt on early hepatic hemodynamics and sinusoids following 84% hepatectomy in dogs

The effects of a prior portosystemic shunt (PSS) on the hepatic hemodynamics and sinusoids shortly after an 84% hepatectomy (Hx) were investigated in dogs. Fifteen mongrel dogs were divided into three groups, a 70% Hx group (n = 5), an 84% Hx group (n = 5) and an 84% Hx+PSS group (n = 5). In the last group, a shunt was inserted between the splenic and femoral veins prior to the hepatectomy. The systemic and hepatic hemodynamics were measured, before and 180 min after the hepatectomy, and the remaining liver tissue was then examined immunohistochemically by light microscopy using the thrombomodulin (TM) staining method. The postoperative portal vein pressure and the vascular resistance were significantly lower in the PSS group than in the 84% non-PSS group. The total postoperative hepatic blood flow was higher in the 84% non-PSS group than in the other two groups. Immunohistochemical observation after TM staining indicated that the sinusoidal endothelial cells in the 84% non-PSS group were markedly damaged 3 h after surgery. We conclude that a prior PSS improves the hepatic hemodynamics and is beneficial to the sinusoids within the first few hours of an 84% hepatectomy in dogs.

beta-Carbolinium cations, endogenous MPP+ analogs, in the lumbar cerebrospinal fluid of patients with Parkinson's disease

We measured beta-carbolinium cations (BC+s) endogenous analogs of the N-methyl-4-phenylpyridinium ion (MPP+), in the lumbar CSF of 22 patients with idiopathic Parkinson's disease (PD) and 11 age-matched controls without any symptoms of parkinsonism. Among the BC+s, 2,9-diemethylnorharmanium cation (2,9-Me2NH+), the most potent neurotoxicant that mirrors MPP+ in mitochondria toxicity, was present in 12 patients with PD but not in controls. Although the 2-monomethylated beta-carbolinium cations (2-MeBC+s), which were present in almost all subjects, registered a slightly higher level in PD patients than in controls, the difference was not significant. The total BC+ content, sum of 2-MeBC+ and 2,9-Me2NH+ levels, was significantly higher in PD patients than in controls. The 2-MeBC+ contents significantly increased with the progression of the PD, but 2,9-Me2NH+ decreased as the disease exacerbated, although levels varied within a wide range. The present results strongly support the hypothesis that "bioactivated" BC+s, especially 2,9-Me2NH+s, may be the endogenous causative factors underlying PD.

Cerebral infarction in acute promyelocytic leukemia at initial presentation

We report on a 3 year old girl with acute promyelocytic leukemia (APL) with cerebral infarction due to disseminated intravascular coagulation (DIC) at initial presentation. She was hospitalized because of unconsciousness and petechiae on the chest wall and extremities. Cerebral ischemia and infarction were found on computed tomography scan and magnetic resonance imaging. Peripheral blood content was hemoglobin 7.3 g/dL, white blood cells 1.0 x 10(3) cells/microL (31% blasts) and platelet count was 12 x 10(3) cells/microL. Fragmented erythrocytes were frequently observed on May-Giemsa stained blood smears. Bone marrow aspirates showed normal cellularity, with 60.4% blasts, containing faggot cells. The blasts were positive for peroxidase. Therapy was begun; however, the patient died 1 week after admission.

A microbiological and immunological study of endodontic-periodontic lesions

The microflora and humoral immune response in tissue from the periodontal pockets and root canals of five teeth with endodontic-periodontic lesions were examined. We found more microbes in the periodontal pockets than in the root canals. The flora in the periodontal pockets was dominated by rods and motile organisms, whereas that in the root canals was largely rods and cocci. We detected no spirochetes in the root canals. The cultivable microflora in the periodontal pockets comprised a high number of different species of bacteria, whereas those in the root canals included only a small number of species. There was no correlation between microbial isolates and antibody titer in the apical tissues or periodontal pockets. We conclude from these studies that the microflora of infected root canals is simple and limited, and that the local humoral immune response does not seem to affect the pathogenesis of disease directly.

Antigenic analysis of Japanese encephalitis viruses in Asia by using monoclonal antibodies

Based on our previous study using monoclonal antibodies against three Japanese encephalitis (JE) virus strains, Nakayama-RFVL, Beijing 1 and Kamiyama, 25 JE virus strains isolated mainly in Japan and some from Southeast Asia between 1935 and 1979 fell into five antigenic groups, Nakayama, Beijing 1, Kamiyama, Muar and 691004. In the present study, monoclonal antibodies against Muar and 691004 strains were produced to analyze immunological characteristics of JE virus in detail. We obtained the Muar group-specific antibody and three anti-691004 monoclonal antibodies which showed different reactivities. Furthermore, antigenic comparison of the 22 JE virus strains isolated in Asia between 1963 and 1984 was performed by using the 15 monoclonal antibodies characterized by the different reactivities against the above five antigenic groups. Of these 22 strains, the 17 strains reacted with the Kamiyama group-specific monoclonal antibody, but anti-Nakayama, anti-Beijing 1 and anti-Muar group-specific monoclonal antibodies showed no reactivities with any of the strains. This suggested that the currently prevalent JE virus strains in Asia belonged to the Kamiyama group. The other five strains, ThCMP 1982, KE083, KE093, 733913 and Ling, did not react with the above four group-specific monoclonal antibodies, but all except the KE093 strain showed a similar pattern to the Kamiyama strain on the basis of the reactivities against the other 11 antibodies. The KE093 strain isolated from Thailand in 1983 showed immunologically outstanding difference from other strains.

Inhibitory effects of bisbenzylisoquinoline alkaloids on induction of proinflammatory cytokines, interleukin-1 and tumor necrosis factor-alpha

Bisbenzylisoquinoline alkaloids are known to affect immune responses as well as inflammatory responses, and have been used for the treatment of inflammatory symptoms in China. This study is aimed at elucidating the inhibitory effects of two alkaloids, fangchinoline and isotetrandrine, on the induction of the proinflammatory cytokines, interleukin-1 (IL-1), and tumor necrosis factor-alpha (TNF-alpha), by Staphylococcus aureus Cowan 1 (SAC)-stimulated human peripheral blood mononuclear cells. These two alkaloids inhibited cytokine production in a dose-dependent manner, and they inhibited it by more than 90% at 10 micrograms/ml at every time point examined. Of note was that these two alkaloids appeared to inhibit IL-1 beta production more effectively than IL-1 alpha production. When the levels of cytokine mRNA were measured by semiquantitative RT-PCR, these alkaloids reduced the levels of the mRNAs of IL-1 beta and TNF-alpha, but not that of beta 2-microglobulin, suggesting that these alkaloids may suppress cytokine transcription selectively.