Human seminal plasma proteinase inhibitor: action toward some trypsin-like arginine amidases from humans

Human seminal plasma trypsin-like proteinase inhibitor (HSTPI) was separated and examined by trypsin Cellulofine affinity adsorption and Cellulofine GCL-300 gel filtration and its inhibitory action toward some arginine amidases obtained from the urine, semen, and blood of humans. HSTPI showed strong inhibitory action toward two types of human seminal plasma basic arginine amidases (BHSAA-L and -A), human seminal plasma acidic arginine amidase with affinity to lima bean trypsin inhibitor (LBTI) column (AHSAA-L), and human acrosin and thrombin. Conversely, no or little inhibition was observed toward human urinary arginine amidase-2, human high molecular weight urokinase, or human seminal plasma acidic arginine amidase with affinity to aprotinin column (AHSAA-A, tissue kallikrein). Measurement of Ki values of BHSAA-L with affinity to LBTI column toward HSTPI and LBTI revealed that the arginine amidase had a stronger affinity for LBTI than that for HSTPI. This indicates that it is the difference in Ki values that allows BHSAA-L to be separated by the LBTI affinity adsorption method from human seminal plasma containing a large amount of HSTPI.

Parvovirus B19-associated haemophagocytosis in Evans syndrome: aplastic crisis accompanied by severe thrombocytopenia

A 36-year-old man who had been treated for Evans syndrome (ES) developed an aplastic crisis caused by acute human parvovirus B19 (HPV) infection. Profound thrombocytopenia (8.0 x 10(9)/l) followed with a sudden increase in platelet-associated IgG (PAIgG) (1376.9 ng/10(7) plts). Bone marrow examination revealed a considerable number of haemophagocytic histiocytes without any disturbance of megakaryopoiesis. To our knowledge this is the first case of aplastic crisis with virus-associated haemophagocytosis in a patient with ES, which provides an interesting insight into the mechanisms for thrombocytopenia in HPV infection.

[Retrograde systemic venous perfusion with selective jugular cannulation]

46 patients underwent surgery for the ascending aorta and the aortic arch using continuous hypothermic retrograde systemic venous perfusion (RSVP). Good cerebral protection has been obtained by this method in most patients including four in whom periods of retrograde perfusion exceeded 90 minutes (the longest 140 min). In first 19 patients retrograde perfusion was performed through conventional caval cannulae, but one of them sustained serious neurological damage despite a relatively short duration of retrograde perfusion probably due to impediment of retrograde flow to the brain with venous valves at the jugular-subclavian junction. Then we have developed a new technique that employs a cavoatrial cannula inserted selectively into the internal jugular vein beyond the valve at the venous angle and have applied this technique in last 27 patients.

The neurosurgical management of brain metastasis from colorectal cancer: a report of three cases

We report herein three cases of brain metastasis from primary colorectal cancer in which the metastatic lesion was resected to effectively relieve neurological symptoms. Case 1 was a 61-year-old woman with a solitary brain metastasis from colorectal cancer and no other metastases; case 2 was a 59-year-old woman who died from liver metastasis 11 months after resection of the metastatic brain tumor; and case 3 was a 68-year-old woman with multiple metastases to the lungs and bones detected before the brain metastasis. According to 16 cases previously reported in the Japanese literature and our 3 cases, the interval between diagnosis of the primary cancer and discovery of brain metastasis was 23 months on average, while the median survival after the discovery of brain metastasis was 7 months. Brain metastases with liver and lung metastases were seen more frequently than brain metastases alone. In these three cases, chemotherapy appears to have been of no use in preventing recurrence. Thus, we believe neurosurgical management to be appropriate for a solitary lesion and that it should be actively pursued to prolong survival and improve quality of life.

Serological evidence of pneumonia virus of mouse (PVM) infection in laboratory rats

PVM specific antibody was determined using 3 serological tests (Parker's original hemagglutination-inhibition [HI] test, modified HI test, and indirect fluorescent antibody [IFA] test). IFA test was found to be the most sensitive method, so that IFA test was considered to be the method of choice for a small scale microbiological monitoring in animal facilities. A total of 1,280 sera including rats, mice, hamsters and rabbits were tested for PVM antibody. The prevalence of PVM antibody was 17.2% (116/674) in conventional rats and 30.0% (160/200) in SPF rats obtained from commercial breeders and research facilities. Furthermore, two samples of 144 conventional rabbits (1.4%) were showed specific antibody positive to the virus. However, hamsters and mice showed no evidence of PVM infection. These results suggest that PVM infection is prevalent, especially in laboratory rats in Japan.

Purification of exfoliative toxin produced by Staphylococcus hyicus and its antigenicity

We previously reported the isolation of an exfoliative toxin from culture filtrates of Staphylococcus hyicus (shET) and reproduction of exfoliation in piglets injected with partially purified shET. In this study, we purified shET and compared the biological and physicochemical properties of shET and Staphylococcus aureus exfoliative toxin (sETA and sETB). shET was purified by ammonium sulfate precipitation, DEAE-cellulofine A-500 column chromatography, Sephadex G-75 gel filtration, and polyacrylamide gel electrophoresis (7.5% polyacrylamide). Purified shET (p-shET) did not cause exfoliation of the epidermis in suckling mice but did cause exfoliation in 1-day-old chickens, whereas sETA and sETB produced by S. aureus caused exfoliation in suckling mice but not in 1-day-old chickens. The molecular mass of p-shET was determined as 27 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. p-shET did not show any cross-reactivity with sETA and sETB in Western immunoblotting analysis or the immunodiffusion test.

Comparative free radical scavenging action of angiotensin-converting enzyme inhibitors with and without the sulfhydryl radical

The free radical scavenging effects of an angiotensin-converting enzyme (ACE) inhibitor containing sulfhydryl (SH; captopril) were compared with those of ACE inhibitors not containing SH (enalapril, enalaprilat, delapril and its de-esterified products). Electron spin resonance (ESR) using 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) as the spin trap showed that enalapril and delapril (0.6-4.8 mmol/l) inhibited hydroxyl radicals concentration-dependently. Captopril (2.4-10 mmol/l), enalaprilat and the de-esterified product of delapril (1.2-4.8 mmol/l) also inhibited hydroxyl radicals in a concentration-dependent manner. The effects of captopril and enalapril (2.4-4.8 mmol/l) on the scavenging of superoxide anion radical were also concentration-dependent. Delapril, its de-esterified product, and enalaprilat weakly inhibited superoxide anion radical. These results indicate that both SH- and non-SH-containing ACE inhibitors scavenge hydroxyl radical more strongly than the superoxide anion radical and that the free radical scavenging action of ACE inhibitors is probably not related only to the presence of the SH radical.

Induction of stress proteins in mouse peritoneal macrophages by oxidized low-density lipoprotein

The synthesis of 23-kDa and 34-kDa proteins in mouse peritoneal macrophages was enhanced when they were incubated with oxidatively modified low-density lipoprotein (LDL). This response required the oxidation of the lipid of the LDL, because native LDL had little effect and acetylated LDL enhanced the synthesis of 34-kDa protein only slightly. Since macrophages can bind and sequester oxidized LDL, they are subjected to an oxidative stress. The results suggest that the 34-kDa protein, which is identical with heme oxygenase, and the 23-kDa protein serve as stress protein that might afford protection against the oxidative stress.

Analysis of fra-2 gene expression

We have analyzed the transcriptional regulation of the fra-2 gene in chicken embryo fibroblasts. Like c-fos, fra-2 was inducible by phorbol ester, cAMP and calcium ionophore, as well as serum. In all three cases, the induction of two species of fra-2 transcript (5.7 kb and 6.8 kb) was delayed and prolonged compared with that of c-fos mRNA. The size difference between the two transcripts was attributable to the heterogeneity of the 3'-end, probably reflecting utilization of different polyadenylation sites. The major transcriptional start point is located at 30 bp downstream of a TATA-like sequence. In the fra-2 promoter region, which is located in a typical CpG island, enhancer consensus sequences such as SCM, SRE, GC boxes and CRE-like sequences were detected upstream of the TATA-like sequence in the same order as that in the 5'-upstream region of the chicken c-fos gene. Fibroblast transfection studies with a series of promoter deletion constructs positioned upstream of bacterial chloramphenicol acetyltransferase indicated, however, that SRE-like sequence is not the sole responsible element for the serum induction, and that a minimal fragment containing no SRE-like sequence is sufficient for this induction. Two typical AP-1 sequences are located between the major transcriptional initiation site and the coding sequence, and the binding activity of protein complexes to these sequences was induced by serum.

Relationship between frontal midline theta activity in EEG and concentration

The relationship between the appearance of EEG theta rhythm in the frontal midline area (Fm theta) and the level of concentration was investigated by using warning signals in simple reaction tasks on 6 male subjects. The result that Fm theta appeared in the foreperiods between the warning and the signal to respond suggests a relation between Fm theta and concentration. Fm theta also appeared, however, at other times. This suggests that a component of Fm theta may not be related to concentration.

Participation of macrophages in segmental endocapillary proliferation preceding focal glomerular sclerosis

We studied infiltrating cells in the glomeruli of eight cases with focal segmental endocapillary proliferation (FSEP) using monoclonal antibodies to leukocyte common antigen, T cells, B cells, and monocytes/macrophages (Mo/M psi). It was demonstrated by sequential biopsies performed in five cases that FSEP preceded focal glomerular sclerosis (FGS). Cell types in FSEP were compared with those in FGS from 17 patients with persistent nephrotic syndrome, ten non-nephrotic patients, and eight patients with nephrotic syndrome which was initially responsive to steroid therapy but relapsed, as well as minimal change specimens from nine nephrotic patients. In the glomeruli, the mean total leukocyte counts increased significantly in the FSEP group (P < 0.01). The serial sections in FSEP revealed that Mo/M psi were the predominant cells and were localized in areas of endocapillary proliferation. T-cell or B-cell infiltration was less marked. The extensive intracapillary distribution of p150,95 antigen belonging to the integrin family and acting as a C3bi receptor suggested that FSEP may be mediated by adhesion molecules expressed on Mo/M psi. These findings indicate that Mo/M psi may play a key role in FGS which shows endocapillary proliferation in the initial stage.

Non-Hodgkin's malignant lymphoma of the bone with intracavitary cardiac involvement

An 84-year-old man with non-Hodgkin's malignant lymphoma presented with a pathological fracture of the femur and also an intra-atrial mass on echocardiography. The patient was given palliative low-dose chemotherapy, but died of tumor dissemination, hypercalcemia, and dehydration. Autopsy revealed diffuse large B-cell lymphoma involving multiple bones and lymph nodes (the latter were not detected during staging), and a solitary mass on the posterior wall of the right atrium. This rare lesion appeared to be due to hematogenous spread, since the myocardium and pericardium were free of tumor infiltration. A literature review indicated that the frequency of cardiac involvement differed between contemporary and earlier reports, mainly due to the availability of increasingly sophisticated diagnostic methods and improvements in chemotherapy.

[A case of anterior mediastinal mature teratoma containing air because of penetration to the lung]

A case of anterior mediastinal mature teratoma containing air because of penetrating to the lung was reported. The patient was a 28-year-old woman. The chest X-ray film on admission showed a homogeneous mass in the anterior mediastinum. This shadow changed to cystic one after ten days later. The tumor was removed together with adhering part of the left lung and pericardium through median sternotomy. Histologically, the wall of cysts contained sebaseous glands, bronchial glands and pancreatic tissue containing both exocrine and endocrine elements.

Attenuation of increased regional myocardial oxygen consumption during exercise as a major cause of warm-up phenomenon

OBJECTIVES

The aim of this study was to test the hypothesis that the warm-up phenomenon is attributable to a reduction of increased myocardial oxygen consumption rather than to increased coronary blood flow during exercise.

BACKGROUND

The underlying mechanism of the warm-up phenomenon is not elucidated.

METHODS

Thirteen patients with effort angina were subjected to two consecutive supine ergometer exercise tests performed 15 min apart. All patients had severe proximal stenosis (> 90%) in the left anterior descending coronary artery. Great cardiac vein flow was measured before and during exercise. Both regional myocardial oxygen consumption and adenosine release were determined.

RESULTS

Exercise was continued for significantly longer before angina onset in the second than in the first exercise test (507 +/- 44 vs. 410 +/- 42 s, p < 0.01). The extent of ST segment depression in lead V5 of the electrocardiogram (ECG) was larger at the time of angina onset in the first (1.7 +/- 0.2 mm) than in the second (1.1 +/- 0.2 mm, p < 0.01) exercise test. Neither systemic hemodynamic variables nor great cardiac vein flow differed between the first and second exercise tests. In contrast, regional myocardial oxygen consumption assessed at 3 min of exercise was significantly (p < 0.01) less in the second than in the first test (8.0 +/- 0.8 vs. 8.7 +/- 0.9 ml/min). Adenosine release during the second test was higher (p < 0.05) than in the first test (2.5 +/- 0.5 vs. 3.9 +/- 0.5 nmol/min at 3 min of the first and second tests, p < 0.01).

CONCLUSIONS

These results indicate that the warm-up phenomenon is not attributable to increased coronary flow but to attenuation of increased regional myocardial oxygen consumption, which may be mediated by adenosine A1 receptor activation.

Chlorpromazine in human scalp hair as an index of dosage history: comparison with simultaneously measured haloperidol

The concentration of chlorpromazine (CPZ) in hair was measured to demonstrate its value as an index of individual dosage history and compliance. An animal study using pigmented rats was conducted to confirm the dose-dependent accumulation of CPZ in hair. The concentration of CPZ in hair, newly regrown on a denuded area of the back after the administration of CPZ for 3 weeks, was 4.6, 8.5 and 16.6 ng.mg-1 hair after daily doses of 1.25, 2.5 and 5 mg.kg-1.day-1, respectively, significantly correlated with the daily dose. The concentration of CPZ in black hairs collected from 23 Japanese patients, who had been taking CPZ in fixed daily doses (30-300 mg/day), ranged from 1.6 to 27.5 ng.mg-1, and was significantly correlated both with the daily dose and with the trough plasma concentration at steady state. Several strands of hair collected from each of 5 patients, whose doses of CPZ had been changed within several months before sampling, were cut into 1-cm pieces successively from the scalp end and the concentration of CPZ in each piece was measured. With the assumption of a hair growth rate of 1 cm per month, the individual history of CPZ doses in all patients could be deduced from the distribution of CPZ along the hair shaft. In 5 patients with grizzled hair the concentration of CPZ in white hairs was much lower (< 10%) than in black hairs, suggesting that the strong affinity of CPZ for hair melanin may explain the accumulation of CPZ in black hair.(ABSTRACT TRUNCATED AT 250 WORDS)

Transfer of 239Pu to mouse fetoplacental tissues

Cross-placental transfer of 239Pu from the mother to fetus was studied in C3H mice. The activity of 239Pu in the conceptus was measured 24 hrs after the intravenous injection of 239Pu citrate on days 10.5 to 16.5 of gestation. More 239Pu was transferred to the conceptus when the plutonium was administered in the later stages of gestation; 0.12% of the injected dose per conceptus on day 10.5 and 1.3% on day 16.5. In all the gestational stages examined, the yolk sac and decidua contained more than 89% of the total activity distributed in the conceptus. The concentration of 239Pu in the yolk sac was about two orders of magnitude greater than that in the fetus. The 239Pu concentration in the maternal liver decreased with the gestational stage. In the early gestational stages the concentration in the maternal liver was greater than that in the yolk sac; but, this relationship was reversed in the later stages.

Dibenzoxepin derivatives: thromboxane A2 synthase inhibition and thromboxane A2 receptor antagonism combined in one molecule

A new series of 6,11-dihydrodibenz[b,e]oxepin derivatives exerting both thromboxane synthase inhibitory (TXS-I) and thromboxane receptor antagonist (TXRA) activities is described. (-)-11-[(3-Pyridylmethyl)thio]-6,11-dihydrodibenz[b,e]oxepin -2- carboxylic acid [(-)-3] and (E)-11-[2-(3-pyridyl)ethylidene]-6,11-dihydrodibenz[b,e]oxepin+ ++-2- carboxylic acid methanesulfonate (11E) exhibited potent inhibitory effects on bovine platelet thromboxane synthase with IC50 values of 4.0 and 14 nM, respectively, and these derivatives also antagonized guinea pig platelet TXA2/PGH2 receptors with Ki values of 85 and 180 nM, respectively. Compound 11E exhibited the dual inhibitory activity in ex vivo experiments and demonstrated a significant protective effect in a rat acute renal failure model.

Induction of a 23 kDa stress protein by oxidative and sulfhydryl-reactive agents in mouse peritoneal macrophages

The synthesis of 23 kDa protein was enhanced when mouse peritoneal macrophages were exposed to oxidative agents such as hydrogen peroxide and menadione, or to sulfhydryl-reactive agents such as diethylmaleate, cadmium chloride and sodium arsenite. After 11 h exposure to these agents the 23 kDa protein was one of the actively synthesized proteins in the macrophages. Under similar conditions the 34 kDa protein previously identified as heme oxygenase, was induced and its synthesis preceded that of the 23 kDa protein. Neither the 23 kDa or the 34 kDa protein was induced by hyperthermia. Conversely, the various oxidative and sulfhydryl-reactive agents employed here did not induce the major heat shock proteins in the macrophages. When the macrophages were activated by bacterial lipopolysaccharide or other stimulants, many proteins are known to be induced, however, the 23 kDa and 34 kDa proteins were not induced. The 34 kDa protein, i.e., heme oxygenase, has been found to be stress-induced in various types of cell, but not the 23 kDa protein. This suggests that the 23 kDa protein is a stress protein predominantly expressed in macrophages.

[Clinical study of fluconazole for systemic fungal infections with hematological disorders]

Fluconazole (FLCZ) was administered orally or intravenously to 161 patients with systemic fungal infections complicated with hematological disorders and it was possible to evaluate clinical efficacies in 109 patients. Systemic fungal infections were documented in 48 patients and suspected in 61 patients. The overall clinical efficiency rates were 43.8% (21/48) in patients with documented fungal infections, and 55.7% (34/61) in patients with suspected fungal infections. Therefore, the overall clinical efficacy rate was 50.5% (55/109). Side effects were observed in 5 patients with an incident rate of 3.1% (5/161), but there was none of them was serious. These results indicate that FLCZ is an agent with good potential in treatment of systemic fungal infections in patients with hematological disorders.

[A study of plasma atrial natriuretic peptide, antidiuretic hormone and cerebral vasospasms in patients with aneurysmal subarachnoid hemorrhage]

The relationship between plasma atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) both of which show high values after subarachnoid hemorrhage and cerebral vasospasm was studied. The subjects were 23 patients who were admitted because of aneurysmal subarachnoid hemorrhage during three years from March, 1989 to March, 1992 and in whom plasma ANP and ADH levels could be determined over time. Cerebral vasospasm was evaluated by the finding of cerebral angiography, clinical symptoms, and presence or not of low density areas on CT. Hyponatremia was defined as the serum sodium level of 130 mEq/l or less for two days or more. Angiographical vasospasm was found in 17 patients (85%), symptomatic vasospasm in 15 patients (65.2%), low density areas on CT in 9 patients (40.9%) and hyponatremia in 8 patients (34.8%). Symptomatic vasospasm was noted in 7 of the 8 patients (87.5%) with hyponatremia, low density areas on CT in 4 patients (50%), the detection rate being high. The plasma ANP and ADH levels were 76.7 +/- 32.1 pg/ml and 2.2 +/- 0.7 pg/ml respectively in the patients with symptomatic vasospasm against 38.3 +/- 21.3 pg/ml and 2.4 +/- 0.6 pg/ml respectively without symptomatic vasospasm, the plasma ANP level being significantly high in the patients with symptomatic vasospasm (p < 0.01). The plasma ANP and ADH were 71.2 +/- 33.8 pg/ml and 2.0 +/- 1.1 pg/ml respectively in the patients with low density areas on CT against 51.2 +/- 31.3 pg/ml and 1.8 +/- 0.5 pg/ml respectively without low density areas on CT.(ABSTRACT TRUNCATED AT 250 WORDS)

[Muscle carnitine contents in severely handicapped children with acute myoglobinuria]

Muscle carnitine was measured in 3 severely handicapped children with acute myoglobinuria. Muscle total carnitine levels were 9.6 +/- 3.0 nmol/mg non collagen protein (m +/- SD, control 15.7 +/- 2.8, n = 19), and free 6.5 +/- 3.0 nmol/mg non collagen protein (m +/- SD, control 12.9 +/- 3.7, n = 19), muscle free carnitine was significantly low in them. Serum carnitine was measured in 22 severely handicapped children. Serum total carnitine was 48.9 +/- 12.3 nmol/ml (m +/- SD, control 60.3 +/- 11.7, n = 14), and free 37.7 +/- 10.0 nmol/ml (m +/- SD, control 46.0 +/- 12.5, n = 14), serum carnitine was also significantly decreased. Secondary muscle and serum carnitine depletion might be one of the potential cause of myoglobinuria in severely handicapped children.

[Pathophysiology of cytoskeleton and extracellular matrix in failing myocardium]

Cytoskeleton of myocytes and extracellular matrix play an essential role for maintaining cellular function. Alterations in humoral factors observed in heart failure, e.g., excess of plasma norepinephrine and angiotensin II, injure the microtubule structure probably through Ca overload and increase the collagen synthesis of the cardiac fibroblast. Recent studies demonstrated that network structures of microtubules and intermediate filaments are disrupted in the myocardium obtained from patients with heart failure. Changes in cytoskeletons and extracellular matrix may affect the contractile function, since they organize the intra- and inter-cellular architectures. Pathophysiological roles of cytoskeletons and extracellular matrix in failing hearts deserve further studies.

Recurrent appearance of 14q+ chromosome associated with lymphoid crisis of Ph-positive chronic myelogenous leukemia

The 14q+ chromosomal anomaly commonly found in cases of lymphoid neoplasm recurrently occurred during the lymphoid crisis of a patient with Philadelphia chromosome (Ph) positive chronic myelogenous leukemia (CML). At presentation lymphoblasts, with pre-B phenotype increased, and both the Ph and 14q+ were found in the same metaphases. After treatment with vincristine and prednisolone, the patient entered into the chronic phase, and only a Ph was detected in 100% of the cells examined. The 14q+ reappeared at the recurrence of the lymphoid crisis, and then disappeared in the second chronic phase. The BCR/ABL mRNA, which is specific for CML, was detected in the blastic cells by a method using reverse transcriptase and polymerase chain reaction. The rearrangement of the immunoglobulin heavy chain gene (JH gene) was also detected in the blastic cells. These results suggest that the 14q+ was closely associated with the lymphoid crisis of the CML patient.