Detection of protein phosphatase activities in sodium dodecyl sulfate-polyacrylamide gel using peptide substrates

A method for detection of protein phosphatase activity toward phosphorylated oligopeptides in SDS-polyacrylamide gel was developed. A synthetic peptide (MHRQETVDC) corresponding to the autophosphorylation site of calmodulin-dependent protein kinase II (residue 281-289) was conjugated to poly-L-lysine and phosphorylated with [gamma-32P]ATP by the action of calmodulin-dependent protein kinase II, and the [32P]-phosphopeptide-polymer conjugate was included as a substrate for protein phosphatases in gels. When a crude extract from rat brain was electrophoresed on polyacrylamide gel containing the [32P]phosphopeptide conjugate, followed by treatment for in situ renaturation and autoradiography, three transparent bands corresponding to apparent molecular weights of 52,000, 58,000 and 74,000, resulting from the removal of the [32P]phosphate from the phosphopeptide conjugate included in the gel were observed, indicating the existence of at least three different phosphoprotein phosphatases catalyzing dephosphorylation of the phosphopeptide in the brain. Among the three, two bands corresponding to molecular weights of 52,000 and 58,000 were not clearly observed when other phosphopeptide-polymer conjugates such as C-syntide-2 and CAMKAKS peptide were included in gels, suggesting that site-specific protein phosphatases can be detected in crude tissue extracts by this in-gel protein phosphatase assay.

A case of neonatal choriocarcinoma

Choriocarcinoma occurring in a placenta and metastasizing to the fetus is quite rare. We describe here a case of such infantile choriocarcinoma, initially appeared as refractory anemia and rapidly metastasized to the liver, lungs, and brain. The placenta looked normal and was not submitted to histological examinations. Neither noninvasive nor invasive diagnostic methods (ultrasonography, computed tomography, magnetic resonance image, scintigraphy, and hepatic arteriography) gave any diagnostic information on the tumor. Liver biopsy was considered too risky due to a possible bleeding. Correct diagnosis was established only after the postmortem examination. Two months after the infant's death, we were informed that the mother was found having hepatic and pulmonary tumors. The importance of the maternal history and measurement of urinary human chorionic gonadotropin is emphasized for a rapid and correct diagnosis of infantile choriocarcinoma.

Time series analysis of the course of Menière's disease

Subjective symptoms of Menière's disease (vertiginous attacks, nonparoxysmal dizziness, tinnitus, hearing loss, headache, stiff neck, nausea etc.) were graded respectively according to severity (0-3 or 0-5) and were recorded daily by affected patients. These recordings, from 20 cases of Menière's disease, were collected and analysed by an original program of time series analysis including autocorrelation, cross-correlation, daily sum of inner ear related factors and general factors, and their moving average. Cluster occurrence of dizzy spells in the active stage and a marked cross-correlation between inner ear factors and general factors were found to constitute a characteristic pattern in Menière's disease in relation to its pathophysiology. Time series analysis was also useful for clinical decision-making, such as evaluation of the effect of treatment, and estimation of prognosis.

Experimental acute glomerulonephritis induced in the rabbit with a specific streptococcal antigen

FITC-labelled IgG obtained from patients convalescing from acute poststreptococcal glomerulonephritis (APSGN) stains glomeruli of patients with early APSGN. We previously reported a streptococcal antigen (preabsorbing antigen (PA-Ag)) that preabsorbed the stain out of sera from the convalescent patients and thus prevented glomerular staining. To confirm the nephritogenicity of PA-Ag, we administered up to 40 mg of this antigen to rabbits for 8 days and observed them for up to 9 weeks. Immunohistological analysis showed diffuse and global glomerular staining for C3 without notable staining for gamma-globulin. Light microscopic examinations revealed slight to moderate proliferative glomerulonephritis with exudative change. Control rabbits, which received similar doses of bovine serum albumin, did not show significant staining for C3. A transient and significant decrease in CH50 was observed from weeks 3 to 7 (9.7 +/- 0.3 U/ml at week 3; normal range 12.9 +/- 0.6 U/ml). This experimental model showed a resemblance to immunological and immunohistological features of APSGN in humans. Although the precise mechanisms are yet to be determined, complement activation by PA-Ag seems to hold a key position in this model and in the human disease.

[A case report of malignant schwannoma of the chest wall]

We described a very rare case of malignant schwannoma of the chest wall, which was surgically resected. The patient, a 40-year-old woman, came to our hospital because of an abnormal shadow in the right chest wall of an X-ray film without any symptoms. Computed tomography revealed a solid tumor attached to the posteroinferior aspect of the intrathoracic chest wall. The tumor was a 2.5 x 2.1 cm, mass originating from the seventh intercostal nerve without pulmonary adhesion, and the patient underwent en bloc resection of the tumor. The pathological diagnosis was malignant schwannoma. The postoperative course was uneventful, and the patient, eight years after the operation is now doing well without local recurrence or distant metastasis. We reviewed seven cases of this type of tumor reported in the Japanese literature.

Infantile choriocarcinoma: a case report with MRI, angiography and bone scintigraphy

Infantile and maternal choriocarcinoma is a very rare disease. We report a case with the characteristic clinical features of infantile choriocarcinoma: developing anemia, hemorrhagic liver tumors, rapid progression to death and maternal choriocarcinoma. Bone scintigraphy showed increased uptake by the liver tumors. In this case there were two possible primary sites: the placenta of this pregnancy and a hydatidiform mole that had been present 2 years previously.

Circulating endogenous thrombopoietin, interleukin-3, interleukin-6 and interleukin-11 levels in patients undergoing allogeneic bone marrow transplantation

To elucidate the physiologic role of thrombopoietin (TPO) for hematologic reconstitution following allogeneic bone marrow transplantation (BMT), serum TPO levels as well as interleukin-3 (IL-3), IL-6 and IL-11 were serially measured in 55 samples from 3 patients who underwent allogeneic BMT using an enzyme-linked immunosorbent assay (ELISA). The TPO level was higher in the serum taken during marrow aplasia than in the pretransplant serum. The serum TPO levels and platelet counts showed a strong inverse relationship in all patients examined. We also sequentially measured endogenous serum TPO levels before and within 36 h after platelet transfusions. Endogenous serum TPO levels were inversely correlated with platelet mass following platelet transfusions. Serum levels of IL-3 had no apparent correlation with platelet counts and serum levels of IL-11 remained below the detection levels (31.3 pg/ml) in all samples. Serum levels of IL-6 were high during myeloaplasia and more upregulated in the febrile period. These findings support the view that TPO is the central regulator for megakaryopoiesis in vivo and the rationale for its clinical use after allogeneic BMT.

Crkl is constitutively tyrosine phosphorylated in platelets from chronic myelogenous leukemia patients and inducibly phosphorylated in normal platelets stimulated by thrombopoietin

Platelet functions such as aggregation and clot retraction are often abnormal in chronic mylogenous leukemia (CML) patients. However, the molecular mechanisms of these altered functions are unknown. As expression of the p210bcr-abl oncogene product, a constitutively active tyrosine kinase, is known to have an essential role in the pathogenesis of CML and tyrosine phosphorylation is intimately involved in various aspects of platelet activation, we examined the pattern of protein tyrosine phosphorylation in platelets from 15 CML patients by immunoblotting with a monoclonal antiphosphotyrosine antibody (4G10). Before and after stimulation with thrombin, the only consistent difference between normal and CML platelets was the presence of a tyrosine phosphorylated protein with a relative molecular weight of 39 kD. This tyrosine phosphorylated protein was identified as crid, an SH2, SH3 containing adapter protein. Thus, as previously demonstrated for neutrophils from CML patients, tyrosine phosphorylation of p39crkl persists in mature platelets. No tyrosine phosphorylation of crid was detected following stimulation with thrombin in normal platelets. However, crkl became incorporated into the Triton X-100 insoluble residue following thrombin stimulation in a manner dependent on platelet aggregation. Further, we found that crkl is an endogenous substrate for calpain, a protease that may be involved in postaggregation signaling processes. This suggests that crkl may be involved in the reorganization of the cytoskeleton during normal platelet aggregation and its tyrosine phosphorylation in CML platelets may contribute to the abnormal platelet function in CML patients. Finally, we found that thrombopoietin induces tyrosine phosphorylation of crk1 in normal platelets and FDCP cells genetically engineered to express human c-Mpl. This suggests that crk1 can be phosphorylated by a kinase other than p210bcr-abl and that crk1 may have a role in signaling by thrombopoietin.

Effect of anoxia on striatal monoamine metabolism in immature rat brain compared with that of hypoxia: an in vivo microdialysis study

We examined in 5-day-old rats the effects of either anoxia or 8% hypoxia on extracellular monoamines such as dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), norepinephrine (NE), 5-hydroxytryptamine (5-HT), and 5-hydroxyindole-3-acetic acid (5-HIAA) using in vivo microdialysis and subsequent HPLC. After stabilization 64 animals were exposed to 100% nitrogen for 16 min and 40 animals to 8% oxygen for 128 min. Both anoxia and hypoxia produced acute increase in the striatal extracellular DA (anoxia: P < 0.001, hypoxia: P < 0.01). Especially in anoxia, DA levels increased transiently to 2000-times the basal levels and 6-times higher than those in hypoxia. NE also increased in both anoxia and hypoxia. DOPAC and HVA decreased during hypoxia (P < 0.01 and P < 0.001, respectively), while those in anoxia were unchanged. In anoxia, decrease tendency of their levels were in short duration and that of 5-HIAA was followed by gradual increase (P < 0.001). These data demonstrated that brief exposure to anoxia or hypoxia had significant influence on striatal monoamine metabolism in immature brain and the pattern of change of monoamine in anoxia was different from that in hypoxia.

Asymptomatic acute poststreptococcal glomerulonephritis following upper respiratory tract infections caused by Group A streptococci

During an observation period of 1-2 years in 2 different districts in Japan, 104 patients were found to have upper respiratory infections caused by group A streptococci. Fourty-nine of these patients were followed prospectively to determine if renal involvement would occur. Twelve patients developed transient serum complement (CH50) depression and urinary abnormality, and 2 of these developed mild hypertension. The latent period was from 1-8 weeks after the streptococcal infection. Renal biopsies of the 12 patients with "asymptomatic" of "subclinical" acute poststreptococcal glomerulonephritis (APSGN) were examined by light, immunofluorescent and electron microscopy. Glomerular lesions ranged from mild proliferative changes to the classical pathology seen in APSGN. The 12 patients were followed for 10 years. Two of them developed persistent or intermittent hematuria, and renal biopsies obtained 4 years after the initial infection revealed mesangial proliferative glomerulonephritis without IgA deposits. The remaining patients showed no abnormal findings after the acute episode. These findings suggested that glomerular involvement after group A streptococcal infection is frequent and mesangial proliferative glomerulonephritis, which was found to develop in some, may rank with IgA nephropathy as a major cause of unexplained microscopic hematuria.

Effects of cardiac output on Doppler transmitral and transtricuspid flow velocity patterns in very low birth weight infants

We studied effects of cardiac output on Doppler transmitral and transtricuspid flow velocities in 24 appropriate for gestational age premature infants. We measured peak flow velocity of early diastole (peak E) and atrial contraction (peak A), ratio of peak flow velocity of early diastole to atrial contraction (peak E/A), total flow velocity-time integral, the first third filling fraction, peak filling rate normalized to stroke volume, and deceleration time (DT). Cardiac output was calculated as the product of the aortic flow velocity-time integral, aortic valve area, and heart rate. The cardiac output increased significantly with advancing gestational age and body weight (r = 0.78 and 0.86, P < 0.01, respectively). With increasing cardiac output, the transmitral as well as transtricuspid peak E, peak E/A, and total flow velocity-time integral increased significantly without any change in the peak filling rate normalized to stroke volume, peak A, and deceleration time. The transmitral as well as transtricuspid peak E did not correlate with the heart rate. Although these results do not establish whether changes in ventricular relaxation process or in cardiac output is responsible for the progressive increase in the peak E and peak E/A. Unchanged peak filling rate normalized to stroke volume of the left and right ventricles suggest that changes in cardiac output with maturity is, in fact, one of the important contributory factors. This evidence should be borne in mind in interpreting ventricular diastolic filling as an index of ventricular diastolic function in premature infants.

Durable molecular remission in a patient with chronic myelogenous leukemia and host-derived hematopoiesis after allogeneic bone marrow transplantation

A 44-year-old woman with Ph-positive CML was treated with TBI, splenic irradiation, Ara-C, and CY. She then received unmanipulated marrow cells from her HLA-identical brother. GVHD prophylaxis was FK506 and MTX. WBC counts reached 1000/microliter on day 28 when all metaphases of marrow cells showed 46XY. However, on day 42, 46XX was detected in two of 20 metaphases, and the percentage of cells with female karyotype subsequently increased. On day 519, all metaphases showed female karyotype. BCR-ABL mRNA and Philadelphia chromosome were never detected throughout her post-transplant course. Fluorescence in situ hybridization (FISH) revealed complete recovery of host-derived hematopoiesis in the bone marrow, however, mixed T cell chimerism in the peripheral blood. This suggests that the persistence of donor-derived T cells may prevent disease recurrence through graft-versus-leukemia effect. The patient remains in a molecular complete remission with host-derived hematopoiesis 749 days post-transplant.

Electrophysiologic comparison between incessant and paroxysmal tachycardia in patients with permanent form of junctional reciprocating tachycardia

To clarify the differences between the incessant and paroxysmal types of the permanent form of junctional reciprocating tachycardia, we performed electrophysiologic studies in 11 patients with long RP' tachycardia using a slowly conducting accessory pathway as the retrograde conduction, and concluded that the short AH intervals during sinus rhythm and tachycardia are very important factors in the development of incessant tachycardia.

[Simultaneous measurement of the tension, elongation, and refractive power of the bovine lens zonule]

We developed a device to measure simultaneously the tension and elongation of the lens zonules, and the refractive power of the lens in 12 bovine eyes. Each sample, which consisted of the lens-zonuleciliary body was fixed to the device at the position of the ciliary process from four directions, and was stretched radially in a container filled with saline solution. The tension was measured by a force transducer, the elongation by a laser-displacement-meter, and the refractive power by a Campbell type refractometer. The refractive power of the lens in the relaxed condition was 24.6 +/- 3.4 D (n = 12, mean +/- standard deviation). When samples were stretched 1 mm from the relaxed condition, the increased change in tension was 2.8 +/- 1.5 g, and the decreased change in refractive power was 1.8 +/- 1.2 D.

Regulation of L-DOPA production by genetically modified primary fibroblasts transfected with retrovirus vector system

Although intracerebral grafting has become established as a new strategy for the treatment of Parkinson's disease, there are many problems regarding such grafts. We focused on the grafting of primary skin fibroblasts. Rat primary skin fibroblasts were transfected with a retrovirus vector containing cDNA of human tyrosine hydroxylase (TH) type 1 (LTHSNL) or of cytomegalovirus promoter (CTHSNL) as a foreign promoter. In these genetically modified fibroblasts, L-DOPA production and release were analyzed in vitro by immunocytochemistry and high-performance liquid chromatography with electrochemical detection (HPLC-ECD). Being supplemented with the biopterin (BH4:(6R)-L-erythro-tetrahydrobiopterin) cofactors required for TH activity, these cells produced and released L-DOPA into the culture medium. When CTHSNL and BH4 were combined, L-DOPA production increased with time, regardless of the number of cell passages, or the duration of liquid nitrogen freezing. This suggests that the foreign gene (THcDNA) containing retrovirus vector integrates into the chromosomal DNA of the target cells (fibroblasts). Primary fibroblasts can be easily obtained and cultured. Thus, genetically modified primary skin fibroblasts transfected with a retrovirus vector system containing the TH cDNA may be promising grafts for transplantation and gene therapy in Parkinson's disease.

Diurnal changes in leaf gas exchange characteristics in the uppermost canopy of a rain forest tree, Dryobalanops aromatica Gaertn. f

Dryobalanops aromatica Gaertn. f. is a major tropical canopy species in lowland tropical rain forests in Peninsular Malaysia. Diurnal changes in net photosynthetic rate (A) and stomatal conductance to water vapor (g(s)) were measured in fully expanded young and old leaves in the uppermost canopy (35 m above ground). Maximum A was 12 and 10 micro mol m(-2) s(-1) in young and old leaves, respectively; however, because of large variation in A among leaves, mean maximum A in young and old leaves was only 6.6 and 5.5 micro mol m(-2) s(-1), respectively. Both g(s) and A declined in young leaves when T(leaf) exceeded 34 degrees C and leaf-to-air vapor pressure deficit (DeltaW) exceeded 0.025, whereas in old leaves, g(s) and A did not start to decline until T(leaf) and DeltaW exceeded 36 degrees C and 0.035, respectively. Under saturating light conditions, A was linearly related to g(s). The coefficient of variation (CV) for the difference between the CO(2) concentrations of ambient air and the leaf intercellular air space (C(a) - C(i)) was smaller than the CV for A or g(s), suggesting that maximum g(s) was mainly controlled by mesophyll assimilation (A/C(i)). Minimum C(i)/C(a) ratios were relatively high (0.72-0.73), indicating a small drought-induced stomatal limitation to A and non-conservative water use in the uppermost canopy leaves.

[Long-term results of emergency coronary artery bypass grafting]

During a 20-year period, 364 patients underwent coronary artery bypass grafting (CABG) for the treatment of ischemic heart disease. Among these patients, 28 underwent emergency surgery. The reasons for performing emergency CABG were unstable angina in 15 patients, impending myocardial infarction in 12 patients, and congestive heart failure in 1 patient. Eleven patients died postoperatively. Eight variables were examined by univariate analysis for their influence on the occurrence of a hospital death. IABP and acute coronary occlusion were found to be predictors of hospital death and previous myocardial infarction was a predictor of hospital survival. Seventeen patients were followed up for 12 years. There was no cardiac death and actuarial survival at 12 years was 63%. The 14 survivors are now in NYHA functional class I or II. Although the operative mortality rate is high after emergency CABG, the patient's prognosis is good.

Effect of intraatrial reentry on initiation of atrioventricular reentrant tachycardia

We studied the effect of intraatrial reentry (IAR) on initiation of orthodromic reentrant tachycardia (ORT) in 150 patients with Wolff-Parkinson-White syndrome using His-bundle recording and the atrial extrastimulus technique. IAR was initiated by premature atrial stimulation in 44 patients (29%), and it was followed by ORT in 16 patients (11%). In 8 patients (5%), IAR promoted the initiation of ORT, whereas in 5 patients (3%), IAR inhibited the initiation of ORT. These findings suggest that ORT is frequently induced following IAR. IAR, which was frequently observed during electrophysiological studies, seems to play an important role in the initiation of ORT.

Role of gestational age and body weight on Doppler transmitral flow velocity pattern in very low birth weight infants

Doppler transmitral flow velocity was measured in premature infants. The early diastolic peak velocity, the peak velocity of early diastole/peak velocity of atrial contraction ratio, and total flow velocity-time integral increased significantly with advancing gestational age and body weight. The peak filling rate normalized to stroke volume (NPFR) did not correlate with gestational age or body weight. Moreover, mean NPFR was not significantly different between premature and term infants. Thus NPFR demonstrates that changes in the left ventricular filling patterns with advancing gestational age and increasing body size are related to the progressive increase in loading conditions, rather than to sequential changes in myocardial properties.

Long-term results of emergency coronary artery bypass grafting

During a 20-year period, 364 patients underwent coronary artery bypass grafting (CABG) for the treatment of ischemic heart disease. Among these patients, 28 underwent emergency surgery. The reasons for performing emergency CABG were unstable angina in 15 patients, impending myocardial infarction in 12 patients and congestive heart failure in 1 patient. Eleven patients died postoperatively. Eight variables were examined by univariate analysis for their influence on the occurrence of a hospital death. Lack of a history of myocardial infarction, intraaortic balloon pumping (IABP) and acute coronary occlusion were all found to be predictors of hospital death. Seventeen patients were followed up for 12 years. There was no cardiac death and actuarial survival at 12 years was 63%. The 14 survivors are now in NYHA functional class I or II. Although the operative mortality rate is high after emergency CABG, a fair prognosis can be expected if the patients survive surgery.

[Underlying cardiac disease in infective endocarditis]

Underlying cardiac lesions in 39 adult cases with infective endocarditis were studied. 18 cases (46%) of the patients had no evidence of preexisting cardiac disease and infection frequently involved aortic valve. The patients without preexisting cardiac disease and 4 patients with an intracardiac substitute including pacemaker lead and aortic valve prosthesis required a surgery during an active infective endocarditis. All cases of active infective endocarditis accompanied with rheumatic valvular disease underwent surgery after a suppression of active inflammation by medical treatment.

CD7 positive acute lymphoblastic leukemia successfully treated with high dose cytosine arabinoside and mitoxantrone: a case report

A 45-year-old woman with acute lymphoblastic leukemia (ALL) who failed to achieve complete remission (CR) after one course of induction chemotherapy with vincristine, daunorubicin, prednisolone and l-asparaginase was successfully treated with a high dose of cytosine arabinoside (Ara-C) and mitoxantrone. The leukemic blasts were CD7, 19, 33, and 38 antigens positive, and had a rearrangement in the T-cell receptor delta chain gene. The karyotype was normal. Primary induction failure and positivity for myeloid antigens are both reported to be poor prognostic factors for ALL. Nevertheless, this patient was successfully treated with the high dose Ara-C and mitoxantrone, and she remains in CR for over 20 months. Combination chemotherapy with high dose Ara-C and mitoxantrone may be of benefit for refractory ALL with both CD7 and myeloid antigens.

[A case report of mediastinitis due to methicillin resistant Staphylococcus aureus after total aortic arch replacement]

A 78-year-old man underwent total aortic arch replacement for ruptured aortic arch aneurysm. Two weeks after the surgery, high fever and leucocytosis developed. He was placed on a regimen of antibiotics. However, mediastinitis eventually ensued five weeks later with the pus draining from the sternotomy wound. The culture revealed a Methicillin resistant staphylococcus aureus. The infected tissue was debrided from the mediastinal cavity 40 days postoperatively. The cavity was kept open and was intermittently irrigated with 2% Providone-iodine for three days. Subsequently, an omental graft was placed. The infection successfully subsided gradually and the patient has been well for a year and a half after the initial surgery. The procedure is considered to be extremely effective for the management of a drastic infection involving thoracic aortic prosthesis.