Gene expression of prothrombin in human and rat kidneys: basic and clinical approach

Prothrombin has remarkable affinity for calcium oxalate crystals. It is produced in renal tubular cells and is detected as a urinary form of prothrombin F1. The aim of this basic study was (1) to isolate prothrombin mRNA from normal human and rat kidneys; (2) to confirm expression level changes in stone-forming rat kidneys; and (3) to analyze the DNA sequence of renal prothrombin. The aim of the clinical investigation was to measure the serum levels of renal prothrombin in clinical cases of various urologic diseases. The expression of prothrombin mRNA in human kidneys and male Wistar rat kidneys was investigated using reverse transcription-PCR, with prothrombin (F1, F2, and thrombin) primers. Renal prothrombin levels were measured in the sera of patients with renal cell carcinoma, renal transplant donors, patients with chronic renal failure, and renal transplant recipients, using an enzyme-linked immunosorbent assay. Expression of cyclophilin as well as prothrombin mRNA could be detected. Prothrombin mRNA expression levels seemed to be increased in stone-forming rats. The DNA sequence of renal prothrombin differed from that of liver prothrombin at three points. Repeated measurements of renal prothrombin showed that values were high during the acute tubular necrosis period and tended to decrease with the recovery of renal function. Prothrombin mRNA expression could be confirmed in human and rat kidneys, as well as in stone-forming rat kidneys. Serum concentration measurements can be considered useful for assessment of recovery from acute tubular necrosis after renal transplantation and for diagnosis of acute rejection.

Apoptosis observed in BALB/3T3 cells having ingested Staphylococcus aureus

Staphylococcus aureus was previously shown to be internalized by murine fibroblast. We examined the intracellular events of S. aureus ingested by BALB/3T3 cells. After uptake of strains A191 and A151, isolates from atopic lesion, and a laboratory strain, Cowan I, for 1 hr, BALB/3T3 cells were incubated with 1.25 microg/ml lysostaphin. Laddering of the DNA in multiples of approximately 180 bp occurred within 4 hr following bacterial addition in BALB/3T3 cells infected with A191 and within 18 hr in BALB/3T3 cells infected with A151: histochemical staining by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling method revealed that the rate of the fragmentation of nucleic DNA in Cowan I-infected BALB/3T3 cells at 21 hr following bacterial addition was 0.52 +/- 0.25%, significantly higher than that in the control cells. Transmission electron micrographs of BALB/3T3 cells at 4 hr following A191 addition showed that the apoptotic features, including electron-dense nucleus and plasma membrane blebbing, occurred in some cells in which many staphylococci escaped the endosome and went on to cell division. At the same time, A151 organisms enclosed with endosome membrane were static in the intact BALB/3T3 cells. The significant increase of A191 was confirmed by counting intracellular live bacteria during 2- to 6-hr incubation. These results suggest that internalized S. aureus escapes the endosome, multiplies and induces apoptosis in the fibroblast cell.

Overproduction of Th2-specific chemokines in NC/Nga mice exhibiting atopic dermatitis-like lesions

We have examined the expression of chemokines and their receptors in the atopic dermatitis-like (AD-like) lesions of NC/Nga mice. Such lesions develop when the mice are kept in conventional conditions, but not when they are kept isolated from specific pathogens. The thymus- and activation-regulated chemokine TARC is unexpectedly highly expressed in the basal epidermis of 14-week-old mice with lesions, whereas it is not expressed in the skin without lesions. Production of TARC by keratinocytes was confirmed by culturing murine keratinocytic cell line cells (PAM212) with TNF-alpha, IFN-gamma, or IL-1beta. Expression of another Th2 chemokine, macrophage-derived chemokine (MDC), was observed in the skin from mice kept in both conventional and pathogen-free conditions, but expression of MDC was increased severalfold in the skin with lesions. The cellular origin of MDC was identified to be dermal dendritic cells. Infiltration of the skin by IL-4-producing T cells and mast cells, and the increase of CCR4 mRNA in the skin, coincided with the development of AD lesions. These observations indicate that TARC and MDC actively participate in the pathogenesis of AD-like lesions in NC/Nga mice and that these Th2 chemokines could be novel targets for intervention therapy of AD in humans.

Overexpression of IL-1ra gene up-regulates interleukin-1beta converting enzyme (ICE) gene expression: possible mechanism underlying IL-1beta-resistance of cancer cells

We investigated the interaction of endogenous interleukin (IL)-1beta, IL-1ra, and interleukin-1beta converting enzyme (ICE) in four human urological cancer cell lines, KU-19-19, KU-1, KU-2 and KU-19-20. Northern blot analysis showed that IL-1beta gene was expressed in all cell lines. On the other hand, in KU-19-19 and KU-19-20, the gene expressions of both IL-1ra and ICE were suppressed. MTT assay revealed that IL-1beta (10 ng ml(-1)) promoted cell growth in KU-19-19 and KU-19-20, while it inhibited in KU-1 and KU-2. An ICE inhibitor, Acetyl-Tyr-Val-Ala-Asp-CHO (YVAD-CHO) blocked IL-1beta-induced growth inhibition in KU-1 and KU-2. Overexpression of the secretory type IL-1ra with adenovirus vector (AxlL-1ra) enhanced ICE gene expression, while exogenous IL-1ra (100 ng ml(-1)) did not enhance it. Furthermore, AxIL-1ra treatment promoted endogenous IL-1beta secretion and induced significant growth inhibition and apoptotic cell death on KU-19-19 and KU-19-20. Treatment with either IL-1ra (100 ng ml(-1)), IL-1beta antibody (100 microg ml(-1)), or YVAD-CHO blocked AxlL-1ra-induced cell death in KU-19-19 and KU-19-20. These results suggest that IL-1beta-sensitivity depends on the level of ICE gene expression, which is regulated by the level of endogenous slL-1ra expression. This is a first report on the intracellular function of slL-1ra and these findings may provide key insights into the mechanism underlying the viability of cancer cells.

Strip biopsy of superficial bladder tumors using an electrosurgical snare

BACKGROUND/METHODS

Transurethral strip biopsy of bladder tumors using an electrosurgical snare was tested to determine whether or not this technique provides any advantage to the histologic examination of bladder cancers and to the management of superficial bladder tumors as a routine treatment.

RESULTS/DISCUSSION

Our research results confirm that the strip biopsy technique can be applied as an alternative transurethral management procedure for treatment of superficial bladder tumors. Moreover, the results demonstrate that the procedure can also provide significantly greater histologic diagnostic advantages for bladder cancers than are possible through cold cup biopsy or transurethral resection.

Active participation of CCR5(+)CD8(+) T lymphocytes in the pathogenesis of liver injury in graft-versus-host disease

We examined the molecular pathogenesis of graft-versus-host disease-associated (GVHD-associated) liver injury in mice, focusing on the role of chemokines. At the second week after cell transfer in the parent-into-F1 model of GVHD, CD8(+) T cells -- especially donor-derived CD8(+) T cells -- infiltrated the liver, causing both portal hepatitis and nonsuppurative destructive cholangitis (NSDC). These migrating cells expressed CCR5. Moreover, macrophage inflammatory protein-1alpha (MIP-1alpha), one of the ligands for CCR5, was selectively expressed on intralobular bile duct epithelial cells, endothelial cells, and infiltrating macrophages and lymphocytes. Administration of anti-CCR5 antibody dramatically reduced the infiltration of CCR5(+)CD8(+) T lymphocytes into the liver, and consequently protected against liver damage in GVHD. The levels of Fas ligand (FasL) mRNA expression in the liver were also decreased by anti-CCR5 antibody treatment. Anti-MIP-1alpha antibody treatment also reduced liver injury. These results suggest that MIP-1alpha-induced migration of CCR5-expressing CD8(+) T cells into the portal areas of the liver plays a significant role in causing liver injury in GVHD; thus, CCR5 and its ligand may be the novel target molecules of therapeutic intervention of hepatic GVHD.

[A case of interstitial pneumonitis caused by intravesical bacillus Calmette-Guérin instillation]

A 61-year-old man was referred to our hospital due to positive urine cytology. He underwent multiple cold punch biopsies of the bladder and the histopathological finding was transitional cell carcinoma (TCC), carcinoma in situ (CIS), grade 3. He was treated with 121.5 mg of bacillus Calmette-Guérin (BCG) (Connaught strain) suspended in 50 ml of saline instilled into the bladder at weekly intervals. After the third instillation he developed a fever up to 39 degrees C, pain on urination and an elevation of liver enzymes. Antituberculous drugs were administered and he was re-admitted for further evaluation. The chest radiograph showed diffuse extensive bilateral lung densities. His chest computed tomographic (CT) scan showed bilateral interstitial pneumonitis. All cultures from his blood, urine, sputum, and bronchoalveolar lavage remained negative for mycobacteria. He was diagnosed as having a hypersensitivity reaction of bilateral lung after immunotherapy with BCG. Pulse steroid therapy was done. The chest radiograph, findings improved and he was clinically asymptomatic after steroid therapy.

The value of gamma-seminoprotein in combination with prostate specific antigen in detecting prostate cancer

BACKGROUND

The present study was undertaken to investigate the value of gamma-seminoprotein (gamma-Sm) and the gamma-Sm/prostate specific antigen (PSA) ratio in combination with serum PSA in detecting prostate cancer.

METHODS

Prostate specific antigen, gamma-Sm and the gamma-Sm/PSA ratio were evaluated in 112 patients with untreated prostate cancer and 90 patients without prostate cancer who had serum PSA and gamma-Sm levels above their respective detection limits.

RESULTS

When data for all of the patients were analyzed, serum PSA and gamma-Sm levels were significantly higher and the gamma-Sm/PSA ratio was significantly lower in patients with prostate cancer than patients without prostate cancer. The serum PSA and gamma-Sm levels significantly increased and the gamma-Sm/PSA ratio significantly decreased with advancing clinical stage in patients with prostate cancer. Among the patients with serum PSA levels ranging from 1.8 to 6 ng/mL, the gamma-Sm/PSA ratio was significantly lower (P < 0.05) and gamma-Sm levels were lower (P = 0.054) in the patients with prostate cancer than in those without prostate cancer, but serum PSA levels were not significantly different (P = 0.53). A receiver operating characteristic (ROC) analysis demonstrated that the areas under the ROC curves were 0.54 for PSA, 0.65 for gamma-Sm and 0.69 for the gamma-Sm/PSA ratio for prediction of prostate cancer in the PSA range from 1.8 to 6 ng/mL, although the ROC analysis suggested that the gamma-Sm/PSA ratio does not provide significant advantage over PSA in detecting prostate cancer when all of the patients were analyzed.

CONCLUSIONS

These results suggest that the gamma-Sm/PSA ratio and gamma-Sm may facilitate differentiation between patients with and without prostate cancer who have intermediate PSA levels.

Different modulation of cholinergic neuronal systems by dynorphin A (1-13) in carbon monoxide-exposed mice

The effects of dynorphin A (1-13), a kappa-opioid receptor agonist, on the content of acetylcholine (ACh) and high K+-induced release of endogenous ACh were studied in mice exposed to carbon monoxide (CO). Mice were exposed to CO 3 times at 1-hr intervals and used 7 days after CO exposure. Administration of dynorphin A (1-13) (1.5 and 5.0 nmol/mouse, intracerebroventricularly) 15 min before killing significantly increased the ACh content in the striatum and hippocampus of control mice, but had no effect on the ACh content in CO-exposed mice. Dynorphin A (1-13) did not change the choline acetyltransferase (EC 2.3.1.6) activity in control or CO-exposed mice. The high K+-induced endogenous ACh release from hippocampal slices in CO-exposed mice was significantly lower than that of controls, although exposure to CO did not affect the basal release of endogenous ACh from hippocampal slices compared with controls. Dynorphin A (1-13) caused dose-dependent decreases in high K+-induced release of endogenous ACh from hippocampal slices in control mice. This inhibitory effect of dynorphin A (1-13) was blocked by co-perfusion with nor-binaltorphimine, a selective K-opioid receptor antagonist. On the other hand, dynorphin A (1-13) did not decrease high K+-induced release of endogenous ACh from hippocampal slices in CO-exposed mice. These results suggest that dysfunction of the cholinergic system occurred after exposure to CO, and as a result the inhibitory effects of dynorphin A (1-13) may be blocked in CO-exposed mice.

N-acetylcysteine modifies cis-dichlorodiammineplatinum-induced effects in bladder cancer cells

We previously demonstrated a role of reactive oxygen species (ROS) in cytotoxicity induced by cis-dichlorodiammineplatinum (CDDP) in combination with glutathione (GSH) depletors in bladder cancer cells. However, the relationship between CDDP and ROS is still unclear, although many mechanisms of drug resistance have been well characterized. The present study was undertaken to investigate the effects of N-acetylcysteine (NAC), a GSH precursor, on the CDDP-induced effects in bladder cancer cells (KU1). The cytotoxic effects of CDDP were significantly blunted by NAC (1 mM) in KU1 cells. The IC50 of CDDP only (10.2+/-1.2 microM) is significantly lower than that of CDDP with NAC (IC50: 20.3+/-1.6 microM) in KU1 cells. NAC also significantly increased the intracellular concentration of GSH in KU1 cells (37.2+/-1.6 nmol/10(6) cells), compared to controls (15.9+/-7.6 nmol/10(6) cells). While CDDP produced a significant increase in ROS as measured in terms of dichlorofluorescein (DCF) production in KU1 cells in a time-dependent manner, pretreatment with NAC significantly reduced CDDP-induced intracellular DCF in KU1 cells. Moreover, TdT-mediated dUTP-biotin nick-end labeling (TUNEL) assay showed that CDDP-induced apoptosis (31.1+/-3.8%) was significantly inhibited by pretreatment with NAC in KU1 cells (11.2+/-2.6%). These results demonstrated that NAC scavenges CDDP-induced ROS and inhibits CDDP-induced cytotoxicity, suggesting that ROS mediate the CDDP-induced cytotoxicity in bladder cancer cells.

Prognostic significance of flow cytometric deoxyribonucleic acid analysis for patients with superficial bladder cancers: a long-term follow-up study

Flow cytometric DNA ploidy analysis for human bladder cancers may provide significant diagnostic and prognostic potential. We have previously reported that combined use of histologic and flow cytometric parameters may offer additional information regarding the clinical outcome for bladder cancer patients. However, the evaluation included both superficial and muscle-invasive tumors. In the present manuscript, we present our study on whether flow cytometric determination yields significant prognosticators beyond the classical histologic evaluation only in the patient with superficial bladder cancer. A total of 217 patients with untreated bladder cancer were evaluated, using fresh bladder tumor specimens. Tumor grading (grade 1, 2, and 3) and stage (pTa + pT1a and pT1b) served as the histologic prognostic parameters. Multiple flow cytometric parameters assessed included DNA index, percentage S-phase cells, percentage G2/M-phase cells, and hypertetraploid cell presence. Multivariate survival analysis was performed using the SAS proportional hazard regression procedure to study statistical individual prognostic values of both the histologic and the flow cytometric parameters. Clinical follow-up of more than 60 months was required, with the mean follow-up being 116.3 +/- 18.6 months. Hypertetraploid cell presence was the single most important prognostic factor (p < 0.01; risk ratio: 14.3), with the second being tumor grade (p < 0.05; risk ratio: 4.6). No other parameters, including tumor stage, the DNA index, and cell phase fractions, contributed to the model. These results indicate that hypertetraploid cell presence found by flow cytometric determination may provide additional information regarding the clinical outcome for superficial bladder cancer patients, and can be used as an indicator for decision making in treatment of superficial bladder cancer patients.

Application of region-specific immunoassay for human chromogranin A: substantial clue for detection and measurement of chromogranin A in human plasma

Chromogranin A (CgA), a secretory protein, is co-released with catecholamines from storage vesicles. It is known to be elevated in the circulation of patients with neuroendocrine and endocrine tumors. For further investigation of the protein, especially in humans, it is essential to facilitate quantitative analysis of the protein in human biological materials. In order to introduce novel immunological methodology for this purpose, we purposely selected human CgA(344-374) for the synthetic immunogen to produce region-specific CgA antibodies. The anti-synthetic peptide antibody thus obtained made it possible to develop an immunological method for measurement and characterization of CgA in human plasma. The plasma CgA-immunoreactivity (LI) level measured by the method was 0.31+/-0.01 pmol/ml (mean+/-SEM) in normal subjects and 1.55+/-0.29 pmol/ml in pheochromocytoma. On gel chromatography and HPLC analysis of the plasma of patients with pheochromocytoma, the region-specific assay system enabled us to show the presence of N-terminal truncated CgA, besides CgA itself. By following up changes of plasma CgA-LI in a pheochromocytoma patient using samples that were collected consecutively over a two-year period, the present assay system using the region-specific antibody, anti-human CgA (344-374) serum, was confirmed to be extremely valuable for the measurement of CgA-LI in human plasma. The characteristic features and high sensitivity of the present assay system will give us a substantial clue to the detection and measurement of CgA to develop further investigation of the protein in humans.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1997). III Secular changes in susceptibility]

Susceptibilities to various antimicrobial agents were examined for Enterococcus faecalis, Staphylococcus aureus, Echerichia coli, Klebsiella spp., and Pseudomonas aeruginosa that were isolated from patients with urinary tract infections (UTIs) in 9 hospitals during June 1997 to May 1998, and the results were compared with those obtained during the same period in earlier years. 1. E. faecalis The MIC90s of quinolones for E. faecalis isolated from uncomplicated UTIs have changed better state during the latest period. Among E. faecalis strains, those with high susceptibilities to ampicillin (ABPC) and minocycline (MINO) appeared to had decreased during period of 1995-1997, which recovered during the latest period. 2. S. aureus The sensitive strains of S. aureus to imipenem (IPM) and clindamycin (CLDM) had increased during the period of 1996-1997, but those have decreased again during the latest period. 3. E. coli The susceptibilities of E. coli to MINO have been better in the latest period with the MIC90 was ranged from 2 to 4 micrograms/ml. The susceptibilities to quinolones of E. coli isolated from complicated UTIs had decreased during the period of 1995-1997, but those have recovered during the latest period. 4. Klebsiella spp. Among Klebsiella spp. strains isolated from uncomplicated UTIs, those with low susceptibilities to almost cephems have increased in the latest period. To other antimicrobial agents, the susceptibilities of Klebsiella spp. did not show any changes during the latest period. 5. P. aeruginosa The susceptibilities to most agents of P. aeruginosa did not show any changes, the decreased susceptibilities to cefozopran (CZOP), carbapenems and monobactams of P. aeruginosa observed in 1996 appeared to have been retrieved in 1997. These susceptibility changes should be utilized in determining clinical treatments.

Different effects of fibronectin on the phagocytosis of Staphylococcus aureus and coagulase-negative staphylococci by murine peritoneal macrophages

Fibronectin is known to be an important factor in colonization by Staphylococcus aureus of host tissues as well as other extracellular matrix proteins such as collagen and laminin. We investigated the effect of fibronectin on the phagocytosis of the S. aureus Cowan I strain by macrophages and of coagulase-negative staphylococci (CNS) strains for comparison. Fibronectin-reduced serum in place of normal serum lowered the phagocytic activity of the macrophages on the Cowan I strain. Purified fibronectin enhanced the phagocytic activity of the strain in a dose-dependent manner. On the other hand, fibronectin did not show any opsonic effect on the ingestion of CNS strains, though the binding of fibronectin occurred equally well in CNS strains and the Cowan I strain. Fibronectin-binding protein (FnBP), the specific fibronectin receptor on the surface on S. aureus, was detected in both the Cowan I strain and CNS strains. Polymerase chain reaction confirmed that not only the Cowan I strain, but also CNS strains possessed the FnBP gene. These results indicate that fibronectin shows an opsonic effect on the S. aureus, Cowan I strain but not on CNS strains, and suggest that the binding of fibronectin to FnBP is not sufficient for efficient phagocytosis of the staphylococci strains by macrophages.

Retroperitoneoscopic adrenalectomy by a lumbodorsal approach: clinical experience with solo surgery

Laparoscopic adrenalectomy by transperitoneal approaches necessitates the retraction of intraperitoneal organs and, hence, the creation of extra ports for retractors and assistants. The feasibility of retroperitoneoscopic adrenalectomy by a lumbodorsal approach was assessed in 26 patients with adrenal tumors. In six patients the procedure was carried out as solo surgery using the ABSOP robot camera holder, and the performance was compared with that reported for the most recent series of six cases operated upon with one human assistant. The procedures were successful in 25 patients. One patient had to be converted due to tension pneumothorax caused by diaphragmatic injury. The mean blood loss was 43.5 +/- 67.5 ml, and the procedure time averaged 144 +/- 33 min. We required an average of only 3.1 trocars to accomplish solo surgery in 5 of 6 patients (83%). The number of lens smearings decreased to one-fourth of that observed by a human assistant.

Management of incidentally discovered adrenal masses

The incidental discovery of adrenal masses in radiologic imaging studies is becoming increasingly common. Herein we present our experience with 59 cases of incidentally discovered and surgically removed adrenal masses. Of 59 adrenal incidentalomas, 15 cases were hypersecretory tumors, including 11 pheochromocytomas; only 3 were adrenocortical carcinomas. The prevalence of incidentally discovered adrenal masses and their differential diagnosis and management are discussed in a review of the literature.

Prostate-specific membrane antigen-derived primers in a nested reverse transcription polymerase chain reaction for detecting prostatic cancer cells

The detection of prostate-specific membrane antigen (PSM) mRNA in the peripheral blood of prostate cancer patients by a nested reverse transcriptase-polymerase chain reaction (RT-PCR) assay is a useful and sensitive method for the identification of small foci of metastatic lesions. In this study, a nested RT-PCR assay was performed using the two different PSM-derived oligonucleotide primer sets reported by Israeli et al. and Loric et al. (termed PSM primers-1 and primers-2, respectively, in this report), and the differences in the specificity and sensitivity of these primer sets for detecting prostate cancer cells in the blood are discussed. The PCR assay using PSM primers-1 showed DNA bands for 4 of 7 cases of metastatic prostate cancer and amplified the untreated genomic DNA, while that using PSM primers-2 showed 6 bands without the amplification of the genomic DNA. In conclusion, PSM primers-2 is superior to PSM primers-1 for the detection of PSM mRNA in the peripheral blood of prostate cancer patients.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1997). I. Susceptibility distribution]

The frequencies of isolation and susceptibilities to antimicrobial agents were investigated on 560 bacterial strains isolated from patients with urinary tract infections (UTIs) in 9 hospitals during the period of June 1997 to May 1998. Of the above bacterial isolates, Gram-positive bacteria accounted for 29.3% and a majority of them were Enterococcus faecalis. Gram-negative bacteria accounted for 70.7% and most of them were Escherichia coli. Susceptibilities of several isolated bacteria to antimicrobial agents were as followed; 1. Enterococcus faecalis Ampicillin (ABPC) showed the highest activity against E. faecalis isolated from patients with UTIs. Its MIC90 was 1 microgram/ml. Imipenem (IPM) and vancomycin (VCM) were also active with the MIC90s of 2 micrograms/ml. The others had low activities with the MIC90s of 16 micrograms/ml or above. 2. Staphylococcus aureus including MRSA VCM and arbekacin (ABK) showed the highest activities against both S. aureus and MRSA isolated from patients with UTIs. The MIC90s of them were 1 microgram/ml. The others except minocycline (MINO) had low activities with the MIC90s of 32 micrograms/ml or above. More than a half of S. aureus strains (including MRSA) showed high susceptibilities to gentamicin (GM) and MINO, the MIC50s of 0.25 microgram/ml or 0.5 microgram/ml. 3. Enterobacter cloacae IPM showed the highest activity against E. cloacae. The MICs for all strains were equal to or lower than 1 microgram/ml. The MIC90s of ciprofloxacin (CPFX) and tosufloxacin (TFLX) were 1 microgram/ml, the MIC90s of amikacin (AMK) and ofloxacin (OFLX) were 4 micrograms/ml, the MIC90 of GM was 16 micrograms/ml. Among E. cloacae strains, those with low susceptibilities to quinolones have decreased in 1997, compared with those in 1996. But the other drugs were not so active in 1997 as 1996. 4. Escherichia coli All drugs except penicillins were active against E. coli with the MIC90s of 8 micrograms/ml or below. Particularly, flomoxef (FMOX), cefmenoxime (CMX), cefpirome (CPR), cefozopran (CZOP), IPM, CPFX and TFLX showed the highest activities against E. coli with the MIC90s of 0.125 microgram/ml or below. 5. Klebsiella pneumoniae K. pneumoniae was susceptible to almost all the drugs except penicillins. Carumonam (CRMN) had the strongest activity with the MICs for all strains equal to or lower than 0.125 microgram/ml. FMOX, CPR, CZOP, CPFX and TFLX were also active with the MIC90s of 0.125 microgram/ml or below. The MIC90s of quinolones had changed into a better state in 1997, compared with those in 1996. 6. Proteus mirabilis Almost all the drugs except ABPC and MINO showed high activities against P. mirabilis. CMX, ceftazidime (CAZ), latamoxef (LMOX), CPR, cefixime (CFIX), cefpodoxime (CPDX) and CRMN showed the highest activities against P. mirabilis. The MICs of them for all strains were equal to or lower than 0.125 microgram/ml. CPFX and TFLX were also active with the MIC90s of 0.125 microgram/ml or below. 7. Pseudomonas aeruginosa The MIC90 of GM was 8 micrograms/ml, the MIC90s of AMK, IPM and meropenem (MEPM) were 16 micrograms/ml. The others were not so active against P. aeruginosa with the MIC90s of 32 micrograms/ml or above. The MIC90s of quinolones had changed into a lower state in 1997, compared with those in 1996. 8. Serratia marcescens IPM showed the highest activity against S. marcescens. Its MIC90 was 2 micrograms/ml. GM was also active with the MIC90 of 4 micrograms/ml. The MIC90s of the others were 16 micrograms/ml or above. The MIC50s of CRMN was 0.125 microgram/ml or below, the MIC50s of CPR and CZOP were 0.25 microgram/ml.

An essential role for nuclear factor kappa B in preventing TNF-alpha-induced cell death in prostate cancer cells

PURPOSE

Although tumor necrosis factor-alpha (TNF-alpha) induces a strong cytotoxic effect on cell growth, many authors have reported that various cancer cells are resistant to TNF-alpha and the basis for this sensitivity or resistance to TNF-alpha remains to be elucidated. Since nuclear factor kappa B (NF-kappaB) activation has recently been reported to inhibit TNF-alpha-induced cell death, we studied whether NF-kappaB also assumes a protective role in TNF-alpha-induced cell death in prostate cancer cells.

MATERIALS AND METHODS

We used two human prostate cancer cell lines of DU145 and PC-3. We prepared two different NF-kappaB inhibitors, pyrrolidine dithiocarbamate (PDTC) and NF-kappaB decoy. NF-kappaB DNA binding activity was detected by electrophoretic mobility shift assay (EMSA). Cell survivals were measured by MTT assay. Induction of apoptosis was detected by nuclear staining and measured by fragmented DNA ELISA.

RESULTS

EMSA showed that NF-kappaB inhibitors continuously inhibited TNF-alpha-induced NF-kappaB activation. Cell growth was not inhibited by either TNF-alpha (50 ng./ml. or less) or NF-kappaB inhibitors. However, both PCA cells treated with TNF-alpha (20 ng./ml.) plus NF-kappaB inhibitors showed significant growth inhibition compared with controls (p<0.05). Nuclei of PCA cells appeared severely fragmented by this combination therapy. Furthermore, the levels of DNA fragmentation were significantly elevated in PCA cells treated with TNF-alpha (20 ng./ml.) plus NF-kappaB inhibitors compared with controls (p<0.05).

CONCLUSIONS

NF-kappaB activation is suggested to produce the resistance of DU145 and PC-3 to TNF-alpha and that the combination of TNF-alpha and NF-kappaB inhibitors could be constituted an effective therapy to TNF-alpha-resistant human prostate cancer cells.

[Effective treatment of AFP-producing lung cancer with UFT]

The main form of chemotherapy for non small cell lung cancer is a multiple combination therapy centered on cisplatin (CDDP). We herein report a case in which a favorable course was obtained for a patient with extremely rare AFP-producing lung cancer by single oral administrations of UFT, following extirpation of brain metastasis. The patient was an 80-year-old male whose main complaints were headache and aphasia. Following close examination, a diagnosis was made of moderately differentiated adenocarcinoma with the primary lesion in S6 of the right lung. A metastatic lesion was found in the left occipital lobe. Blood AFP was an abnormally high 17,000 ng/ml. No tumorous lesions were found in the liver. The brain metastasis were extirpated to alleviate cranial nerve symptoms, and the tissue was found to be the same as that of the primary lesion. AFP staining of the tumor tissue revealed positive cells. Because there was proliferation in the primary tumor following surgery, administration of UFT (300 mg/day Tegafur) was begun. Four weeks later the tumor had begun to shrink, and at 15 weeks was judged to be a partial response. A reduction in AFP was also seen. The patient showed absolutely no side effects from UFT, thus enabling outpatient treatment. Good results were obtained both in reducing the tumor and in maintaining the patient's quality of life.

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (1997). II. Background of patients]

Clinical background was investigated on patients with urinary tract infections (UTIs) from whom 603 bacterial strains were isolated in 9 hospitals during the period from June, 1997 through May, 1998. 1. Distribution of age and sex of patients and type of infections Among males, those with ages less than 50 years were only 12.5%, and those in the 70's were most frequent (33.3%). Among females, those with ages less than 20 years were only 3.4%, and those in the 60's were the most frequent (22.9%). With regard to type of infections, more than a half of infections among males with ages 50 years or older were of complicated types, but most of infections among females were of uncomplicated types, especially those of ages less than 50 years. 2. Ages of patients and types of pathogens Escherichia coli was the most frequently isolated in uncomplicated and complicated UTIs without indwelling catheters. In complicated UTIs with indwelling catheters, Pseudomonas aeruginosa and Enterococcus faecalis had mainly detected, they had no relationship with ages. 3. Effect of antibiotic use on isolation frequencies of pathogens Use of antibiotics decreased pathogens isolated from patients with uncomplicated UTIs drastically (183 isolates before antibiotics compared to 13 after). Even isolated pathogens from patients with complicated UTIs decreased drastically with the use of antibiotics when indwelling catheters were not in use (175 isolates before antibiotics compared to 53 after), but when indwelling catheters were in use, antibiotics slightly decreased (109 isolates before antibiotics compared to 70 after). 4. Surgical procedures and types of causative organisms for UTIs E. faecalis were more isolated when a surgical procedures were used, and E. coli were more isolated when, they were not used in uncomplicated and complicated UTIs without indwelling catheters. In complicated UTIs with indwelling catheters, E. coli and E. faecalis were more isolated when a surgical procedures were used, and P. aeruginosa and Staphylococcus aureus were more isolated when they were not used.

Erectile function and nocturnal penile tumescence in patients with prostate cancer undergoing luteinizing hormone-releasing hormone agonist therapy

BACKGROUND

Luteinizing hormone-releasing hormone (LHRH) agonists have been widely used as effective agents in endocrine therapy for prostate cancer. Continuous administration of the drug results in profound suppression of testicular androgen production. However, the side effects on erectile function have not been fully investigated.

METHODS

We studied the influences of testosterone suppression on male sexual function and nocturnal penile tumescence in nine sexually active patients with prostate cancer who were treated with an LHRH agonist.

RESULTS

Following reduction of serum testosterone concentrations to a castration level by the administration of the LHRH agonist, sexual desire, sexual interest and sexual intercourse were totally annulled, with significant changes in frequency, magnitude, duration and rigidity of nocturnal erections observed in all patients.

CONCLUSIONS

These results demonstrate that the LHRH agonist strongly suppresses erectile function and sexual activity. Taking into account the quality of sexual function for relatively young and sexually active patients and their partners, it is necessary to establish effective modalities that minimize the adverse effects on sexual function for the treatment of patients with prostate cancer.

Induction of apoptosis of cytokine-producing bladder cancer cells by adenovirus-mediated IkappaBalpha overexpression

We investigated whether the cell growth and apoptosis of multiple cytokine-producing bladder cancer cells can be regulated by nuclear factor kappaB (NF-kappaB). The bladder cancer cell line KU-19-19, obtained from a 76-year-old man who demonstrated marked leukocytosis, produces multiple cytokines and demonstrates autocrine growth by granulocyte colony-stimulating factor (G-CSF). Electrophoretic mobility shift assay (EMSA) revealed that NF-kappaB was activated in KU-19-19 but not in other bladder cancer cell lines (KU-1, KU-7, or T-24, respectively). The inhibition of NF-kappaB DNA-binding activity with adenovirus vectors expressing the stable form of the NF-kappaB inhibitor IkappaBalpha (multiplicity of infection [MOI] of 10) inhibited growth and induced apoptosis of KU-19-19, but not KU-1, KU-7, or T-24. The production of several cytokines was suppressed significantly in KU-19-19 by this gene delivery. Although dexamethasone (10 microM) could also suppress cytokine production, it did not induce dramatic cell death in KU-19-19 because it could not inhibit NF-kappaB activation stably and strongly. These results suggest that NF-kappaB activation maintains the cell viability as well as regulates cytokine production in cytokine-producing cancer cells and therefore these in vitro experiments support a rationale for preclinical in vivo studies to demonstrate growth inhibition in established tumors.

Pivotal role of TARC, a CC chemokine, in bacteria-induced fulminant hepatic failure in mice

Thymus and activation-regulated chemokine (TARC) is a recently identified lymphocyte-directed CC chemokine which specifically chemoattracts T helper type 2 CD4(+) T cells in human. To establish the pathophysiological roles of TARC in vivo, we investigated whether a monoclonal antibody (mAb) against TARC could inhibit the induction of hepatic lesions in murine model using Propionibacterium acnes and lipopolysaccharide (LPS). P. acnes-induced intrahepatic granuloma formation in the priming phase is essential to the subsequent liver injury elicited by a low dose of LPS. The priming phase appears to be dominated by Th1 type immune responses determined by the profile of chemokine and chemokine receptor expression. TARC was selectively produced by granuloma-forming cells, and CC chemokine receptor 4 (CCR4)-expressing CD4(+) T cells migrated into the liver after LPS administration. In vivo injection of anti-TARC mAb just before LPS administration protected the mice from acute lethal liver damage, which was accompanied by a significant reduction of both CCR4 mRNA expression and IL-4 production by liver-infiltrating CD4(+) T cells. Moreover, both TNF-alpha and Fas ligand expressions in the liver were decreased by anti-TARC treatment. These results suggest that recruitment of IL-4-producing CCR4(+) CD4(+) T cells by granuloma-derived TARC into the liver parenchyma may be a key cause of massive liver injury after systemic LPS administration.