Ischaemic electrocardiographic changes after massive blood transfusion: findings based on myocardial scintigraphy using 99mTc-MIBI and 123I-MIBG

We performed myocardial scintigraphy on a patient with ischaemic electrocardiographic changes after massive blood transfusion. Although there was no defect by 99mTc-MIBI scintigraphy, 123I-MIBG scintigraphy was observed suggesting denervation after massive blood transfusion. Myocardial scintigraphy using 99mTc-MIBI or 123I-MIBG can be useful for the evaluation of myocardial dysfunction with reversible myocardial infarction.

Analysis of human IgE epitope of Der f 2 with anti-Der f 2 mouse monoclonal antibodies

Der f 2 is one of the major mite allergens recognized by human IgE antibodies of allergic patients. Using five anti-Der f 2 mouse monoclonal antibodies, human IgE epitopes of Der f 2 were analyzed. Among them, two monoclonal antibodies 15E11 and 13A4 inhibited the binding between Der f 2 and human IgE antibodies. To determine major IgE epitopes of Der f 2, epitopes for the monoclonal IgG antibodies were analyzed using 43 single site Der f 2 mutants constructed by site-directed mutagenesis. Binding ability of 13A4 and 15E11 was decreased by the amino acid replacement around the C-terminus, and around 73rd, respectively. These results suggest that the C-terminal portion and the central portion around 73rd of Der f 2 were recognized by human IgE antibodies as major epitopes. The location of the putative IgE epitopes on 3-D structure of Der f 2 is also discussed.

Molecular cloning and characterization of the mouse ceramide glucosyltransferase gene

Ceramide glucosyltransferase (glucosylceramide synthase, GlcT-1, EC 2.4.1.80) catalyzes the first step in glycosphingolipid synthesis, the transfer of glucose from UDP-glucose to ceramide. The product, glucosylceramide, serves as a core structure for over 300 species of glycosphingolipids. The enzyme is a key regulatory factor controlling intracellular levels of ceramide and glycosphingolipids. We have cloned the gene for mouse ceramide glucosyltransferase, Ugcg. The gene spans approximately 32 kb and is composed of 9 exons and 8 introns. The promoter region was found to lack TATA and CAAT boxes but contains Spl binding sites, which are indicators of typical housekeeping genes. In addition to these general transcription factor binding sites, the motifs for AhR, NF-kappaB, AP-2 and GATA-1 binding sites were found.

[Basic study of MR-dacryocystography]

We developed MR-dacryocystography as a non-invasive, safer imaging technique for canaliculi, the nasolacrimal duct and lacrimal sac by dropping saline solution and diluted Gd-DTPA solution into the eye. The diluted Gd-DTPA solution was found to create no local irritation in the eyes of rabbits and normal volunteers. Lacrimal sacs and ducts were well visualized in all of 10 normal volunteers by using the saline solution or the diluted Gd-DTPA solution. Canaliculi were visualized in 4-7 cases on thin-slice axial images. MR-dacryocystography was suggested to be a useful screening examination for lacrimal outflow disorders.

Risk factors for the development of hypertension: a 6-year longitudinal study of middle-aged Japanese men

OBJECTIVE

To identify the factors related to the development of hypertension on the basis of annual health examinations at the workplace.

SETTING

A cohort of Japanese male office workers who were reexamined for six successive years after their initial examinations in 1990.

SUBJECTS

The study cohort comprised 1089 hypertension-free subjects aged 30-54 years. Six-year follow-ups were completed for 934 subjects (85.8%)

RESULTS

An analysis using the Kaplan-Meier method showed that the incidence of hypertension above the borderline level increased significantly with increasing age, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol level, uric acid level, total protein level, hematocrit level, and alcohol intake. This increase was significant for systolic blood pressure, diastolic blood pressure, and hematocrit level. The highest cumulative incidences both of hypertension above the borderline level and of definite hypertension were observed among those with 85-89 mmHg diastolic blood pressure, and the second highest among those with 130-139 mmHg systolic blood pressure. Multivariate analysis using the Cox proportional hazards model indicated that age, systolic blood pressure, diastolic blood pressure, and alcohol intake were independent factors associated with the incidence of hypertension above the borderline level. Systolic blood pressure, diastolic blood pressure, and hematocrit level proved to be independently predictive of hypertension, and alcohol intake was of borderline significance as a risk factor for hypertension.

CONCLUSION

High normal blood pressure is the strongest predictor for the development of hypertension among middle-aged Japanese men. In addition, high alcohol intake and high hematocrit level may be contributory factors.

Reduced serum T3 level in a patient with nodular goiter and cardiac myxoma

We report the unusual case of an 87-year-old woman with cardiac myxoma and adenomatous goiter. She exhibited slight elevations of serum interleukin-6 (IL-6), but levels of thyroid hormones such as T3, free T3 and free T4 were all abnormally low. Interleukin-6 may potentiate the alteration of thyroid metabolism.

Molecular cloning and expression of mouse ceramide glucosyltransferase

Ceramide glucosyltransferase (EC 2.4.1.80) catalyzes the first glycosylation step of glycosphingolipid (GSL) synthesis, the transfer of glucose from UDP-Glucose to hydrophobic ceramide and generate glucosylceramide (GlcCer). We have cloned mouse ceramide glucosyltransferase cDNA from a brain cDNA library by PCR based homology cloning. The nucleotide sequence determination revealed that mouse ceramide glucosyltransferase cDNA encodes 394 amino acids with a calculated molecular mass of 45 kDa. The amino acid sequence of mouse ceramide glucosyltransferase showed 98% identity with the human sequence. Homology searches against currently available databases identified three homologous proteins in Caenorhabditis elegans and one homologous protein in Cyanobacteria. Highly conserved sequences of ceramide glucosyltransferases and the homologs among a wide variety of organisms suggest biological significance of the lipid glucosylation system.

Glucosylceramide synthase and glycosphingolipid synthesis

In mammalian cells, there are two major classes of sphingolipids---sphingomyelin and glycosphingolipids (GSLs)--both of which are synthesized from the hydrophobic molecule ceramide. The synthesis of most GSLs begins with glucosylation of ceramide to form glucosylceramide (GlcCer), which, in turn, serves as the source of 300-400 GSLs. Although most of these GSLs have been characterized chemically, the biological functions of ceramide glycosylation and GSLs still remain enigmatic. The recent description of a GSL-deficient cell line and isolation of cDNA for GlcCer synthase provide new insights into GSL functions.

Thermal and deformation analyses of side-cooled monochromator mirrors for the SPring-8/Figure-8 soft X-ray undulator

The numerical results for a bent parabolic mirror monochromator designed for the SPring-8/Figure-8 soft X-ray undulator are described. A thermal and structural finite-element analysis is presented for side-cooled premirrors of the bent parabolic mirror monochromator. Using a ray-tracing code, the effect of the final induced figure errors on the performance of the premirror are discussed.

Affinity extraction of proteins with a reversed micellar system composed of Cibacron Blue-modified lecithin

Crude soybean lecithin was used as a novel surfactant to form reversed micelles in n-hexane. Cibacron Blue F-3GA (CB) was directly immobilized to the reversed micelles by a two-phase reaction. The reversed micellar system without CB showed low solubilizing capacity for low molecular weight proteins, lysozyme, and cytochrome c due to the weak electrostatic interactions. The introduction of CB significantly increased the solubilization of lysozyme because of its affinity binding to CB but showed no effect on the solubilization of cytochrome c since it did not bind to CB. Although bovine serum albumin had an affinity for CB, it was not extracted to the reversed micelles containing CB because its high molecular weight resulted in a significant steric hindrance effect. Thus the reversed micellar system had a high selectivity resulting from both biospecific and steric hindrance effects. The extraction yield of lysozyme decreased significantly with increasing ionic strength. Therefore, the back extraction of lysozyme was carried out using a stripping solution with an ionic strength of 0.865 mol/L. The overall recovery yield of lysozyme after back extraction could be increased to 87% by stripping for 2 h. The recovered lysozyme exhibited an activity equivalent to native lysozyme, and its secondary structure was also unchanged.

Mutagenic interactions between X-rays and two promutagens, o-phenylenediamine and N-nitrosodimethylamine, in the stamen hairs of Tradescantia clone BNL 4430

Mutagenic interactions between X-rays and two promutagens, o-phenylenediamine (PDA) and N-nitrosodimethylamine (DMN), were studied in the stamen hairs of Tradescantia clone BNL 4430, a blue/pink heterozygote. The young inflorescence-bearing shoots with roots of this clone cultivated in a nutrient solution circulating growth chamber were used as tester plants. After determining dose-response curves for X-rays. PDA and DMN, combined treatments with PDA or DMN and X-rays were conducted, exposing acutely to X-rays 20 h before starting, at the midpoint of, or 20 h after completing the PDA or DMN treatments for 4 h. Clear synergistic effects in inducing somatic pink mutations were detected when X-rays were irradiated before the PDA or DMN treatments, resembling those confirmed earlier between maleic hydrazide (MH) and X-rays. On the contrary, clear antagonistic effects were observed when X-rays were given after the PDA or DMN treatments, also resembling those between MH and X-rays. When X-rayed at the midpoint of the PDA or DMN treatments, merely additive and synergistic effects were observed, respectively, differing from the antagonistic effects between MH and X-rays. The mutagenic synergisms detected were considered to be the results of interactions between DNA strand breaks (and the resultant chromosome breaks) induced by X-rays and those by PDA or DMN, whereas the mutagenic antagonisms observed were presumed to be due to X-ray-caused inhibition of the activation of PDA and DMN in the stamen-hair cells. The time periods required for penetrations into floral tissues and/or activations into mutagens seem different among PDA, DMN and MH.

[Magnesium and calcium changes in serum and atrial muscle caused by open heart surgery and the effect of preoperative oral magnesium administration]

The study was undertaken to compare magnesium and calcium serum concentration levels and magnesium and calcium atrial muscle content of between the non-magnesium group (20 patients) and the magnesium group (11 patients) in the perioperative period of open heart surgery. In addition, the incidence of arrhythmias was compared between the two groups. Late ventricular potentials and postoperative ventricular arrhythmias were evaluated in both groups. The patients of the magnesium group were administered a daily oral intake of 3.0 g of magnesium oxide for ten days before operation. In both groups, serum concentration of magnesium decreased abruptly due to hemodilution after the operation and began increasing gradually from 24 hours after the operation. However, in the non-magnesium group the concentration decreased below the normal range in the 24 hour period after the operation and elevated to above the preoperative value from the third to fifth postoperative days. In the magnesium group serum concentration of magnesium was higher during the 24 hours after the operation and lower from the third to fifth postoperative days than the non-magnesium group. Thus, the fluctuation was smaller in the magnesium group than the non-magnesium group. Serum concentration of calcium also decreased abruptly after the operation and gradually increased in the postoperative days in both groups. However, the level was always higher in the magnesium group than the non-magnesium group. The concentration ratio of serum calcium to magnesium was relatively unchanged postoperatively in the magnesium group, whereas it decreased significantly from the second to seventh postoperative days in the non-magnesium group. Magnesium and calcium contents in the atrial muscle were measured before and after cardiopulmonary bypass. Before bypass, magnesium and calcium contents were higher in the magnesium group than the non-magnesium group. However, in the non-magnesium group the calcium content increased significantly after bypass compared to pre-bypass levels, whereas it was unchanged in the magnesium group. Ventricular arrhythmias severer than grade 3 were found in 4 cases in the non-magnesium group. On the other hand, no ventricular arrhythmias severer than grade 3 were found in the magnesium group. As to the incidence of supraventricular arrhythmias, no difference was demonstrated between both groups. The appearance of late ventricular potentials on signal averaged electrocardiograms was found variable and often transient, and no association was found between the appearance of late ventricular potentials and the incidence of ventricular arrhythmias. Smaller fluctuations of magnesium and calcium concentrations in serum as well as in the atrial muscle were observed in the postoperative days in the magnesium group. Magnesium and calcium ratio also showed smaller fluctuations in the postoperative days in the magnesium group. In conclusion, these factors, along with suppression of calcium influx in the cardiac muscle, appeared to serve to reduce the incidence of ventricular arrhythmias in the magnesium group.

Solution structure of Der f 2, the major mite allergen for atopic diseases

House dust mites cause heavy atopic diseases such as asthma and dermatitis. Among allergens from Dermatophagoides farinae, Der f 2 shows the highest positive rate for atopic patients, but its biological function in mites has been perfectly unknown, as well as the functions of its homologs in human and other animals. We have determined the tertiary structure of Der f 2 by multidimensional nuclear magnetic resonance spectroscopy. Der f 2 was found to be a single-domain protein of immunoglobulin fold, and its structure was the most similar to those of the two regulatory domains of transglutaminase. This fact, binding to the bacterial surface, and other small pieces of information hinted that Der f 2 is related to the innate antibacterial defense system in mites. The immunoglobulin E epitopes are also discussed on the basis of the tertiary structure.

[Buckwheat allergy in 90,000 school children in Yokohama]

Hypersensitivity to buckwheat allergen frequently causes anaphylactic type reactions including urticaria, wheezing, dyspnea and/or shock. Though the susceptible pupil would be recommended to be careful for school lunch and picnic meals, the prevalence of buckwheat allergy in school children has not yet been elucidated. In this study, data on the children allergic to buckwheat were collected by sending questionnaire to 341 nurses in elementary school in Yokohama. Among the total subjects of this investigation, 92,680 children, the incidence of buckwheat allergy was determined 0.22% (140 boys and 54 girls). This percentage was not so low level besides the prevalence of such allergic diseases as bronchial asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis and food allergy was 5.6%, 4.2%, 3.1%, 1.6%, and 1.3%, respectively. Although a large majority of clinical symptoms of buckwheat allergy were urticaria (37.3%), skin itching (33.3%), and wheezing (26.5%). Four children (3.9%) experienced anaphylactic shock having a need of medical emergency treatment. The incidence of anaphylactic shock due to buckwheat was higher than those due to egg and milk allergy. Actually 7 pupil was provoked allergic reaction by buckwheat noodle served at school lunch, and 1 pupil at picnic meals. Thus, school children allergic to buckwheat is not rare, and it is important to withdraw buckwheat food from school lunch and picnic meals.

Young inflorescence-bearing shoots with roots of Tradescantia clone BNL 4430 cultivated in nutrient solution circulating systems: an alternative to potted plants and cuttings for mutagenicity tests

The use of young inflorescence-bearing shoots with roots of Tradescantia clone BNL 4430 cultivated in a nutrient solution circulating (NSC) growth chamber was tested and developed as an alternative method for using Tradescantia plants in mutagenicity testings. The NSC growth chamber was designed for our requirements, based on trial cultivations of the shoots with roots in its smaller-sized prototype. The nutrient solution used was a 1/2500 Hyponex solution. The characteristics of this clone, i.e., many new shoots constantly emerging from the basal nodes one after another and its short height favorable for early flowering, made it possible to prepare many young inflorescence-bearing shoots with roots at one time. A simplified NSC cultivation system could also be developed at a lower cost, and by using it together with the NSC growth chamber, recycling of untreated materials was established for supplying steadily enough amounts of young inflorescence-bearing shoots with roots for mutagenicity testings. Compared with traditional methods of using potted plants or cuttings, the new method exhibited more stable flower production, better stamen-hair growth and a significantly lower spontaneous (background) mutation frequency, and could produce more inflorescences per space. The use of such young inflorescence-bearing shoots with roots was therefore judged to be satisfactory to serve as a new mutagenicity test system alternating with potted plants and cuttings.

Hydrophilic surroundings requisite for the solubilization of proteins related with their hydrophobicity in the AOT reversed micellar extraction

The reversed micellar extraction (AOT/isooctane system) using the phase transfer method was investigated in relation to the AOT concentration and the water solubilization for ribonuclease A, lysozyme and cytochrome c. The minimal AOT concentration required for 100% forward extraction was obtained for these proteins. At the minimal AOT concentration, the hydrophilic surroundings, i.e. the molar ratio of water to extracted protein in the organic phase, were independent of the protein concentration for each protein. The hydrophilic surroundings of these proteins were linearly related with Fisher's polarity ratio, p, as an index of the hydrophobicity of the protein. Using this linear relation, a procedure to estimate the sufficient AOT concentration for the protein extraction was proposed. In the cases of cytochrome c and lysozyme, the water concentration was larger than that in the protein-free system in spite of the same AOT condition. On the contrary, in the case of ribonuclease A, this large water uptake in the organic phase was not observed. These differences of water uptake were discussed in relation to the location of the protein in the AOT reversed micelles.

Simultaneous thrombolysis of superior mesenteric artery and bilateral renal artery thromboembolisms with three transfemoral catheters

Successful treatment was achieved for a patient with superior mesenteric artery thromboembolism concomitant with bilateral renal artery thromboembolism. Thrombi of the three vessels were lysed simultaneously with a three-catheter technique using short-term, high-dose urokinase followed by overnight infusion with low-dose urokinase.

Acute myocardial infarction due to vasospasm in a 13-year-old-boy

We describe an unusual case of acute myocardial infarction due to vasospasm in a 13-year-old boy. He was admitted to our hospital with severe congestive heart failure and shock. He had experienced a feeling of chest oppression with dyspnea while running, which grew worse. He then lost consciousness and was brought by ambulance to our intensive care unit. He had had similar but milder episodes of chest oppression months earlier. The family history revealed that his father had died suddenly from hypertrophic cardiomyopathy and that his grandmother also had hypertrophic cardiomyopathy. On admission, the patient was bathed in a cold sweat, his pulse was weak, and his blood pressure was too low to measure. Coarse crackling and wheezing were audible in both lung fields. Administration of catecholamine and intra-aortic balloon pumping failed to stabilize the hemodynamic variables, but percutaneous cardiopulmonary support proved to be lifesaving. Coronary arteriography performed during his convalescence showed on evidence of atherosclerosis. The acetylcholine provocation test ultimately revealed a diagnosis of acute myocardial infarction due to vasospasm.

[The HIV/AIDS Epidemic in Cambodia]

In December 1995 and March 1996, we visited institutes which were conducting epidemiological studied of HIV/AIDS in Cambodia, and obtained data for further collaborative study between Japan and Cambodia. Data included information on AIDS patients and HIV infected persons, and behavioral epidemiology of CSWs (Commercial Sex Workers). The cumulative reported number of AIDS patients and HIV infected persons in Cambodia was 86 and 2,536 cases respectively in 1995. The cause of infection was mostly heterosexual contact with very few cases from injecting drug use (IDU) and other causes. The seroprevalence rate of HIV antibody among donated blood rapidly increased from 0.08% in 1991 to 4.47% in 1995, and those among CSWs and pregnant women were 37.9% and 2.6%, respectively, in 1995. The average rate of condom use among CSWs was 66%, but the rate of usual usage was only 14%. These results indicate that the HIV/AIDS epidemic had spread rapidly through CSWs, that it had been spread among peoples in communities, and that usage of condoms among CSWs was insufficient in Cambodia. Without strong countermeasures against HIV/AIDS in this country, HIV/AIDS epidemic may spread significantly to not only peoples in this country but also those in neighbouring countries in the future.

[Atopic dermatitis and related factors observed at infant physical examination at health centers]

We investigated the incidence of atopic dermatitis and related factors at infant physical examination at health centers. Subjects were 900 infants (290 four-month-old infants, 298 one-year and six month-old infants, 312 three-year-old infants) who participated in infant physical examinations in Kanazawa-ku, Yokohama City. Overall, we analyzed 696 infants whose mothers had cooperated with the survey by completing questionnaires during physical examinations, and who submitted to examination by consulting dermatologists. The incidence of atopic dermatitis was 11.6% in 4-month-old infants, 12.2% in 1.5-year-old infants, and 12.1% in 3-year-old infants. The following were found to be related to the atopic dermatitis of infants. 1. Family history of atopic dermatitis in their mothers and older siblings. 2. Mothers' limited diet during pregnancy (avoiding some food which are suspected allergens). 3. Past history of molluscum contagiosum. 4. The frequency of taking bath. While epidemiological surveys of atopic dermatitis have previously been performed, the criteria at each survey was not identical and results could not be compared precisely. In this survey, 1. Dermatologists specializing in atopic dermatitis performed examinations. 2. All diagnoses were made according to standardized criteria which are applied nationwide. 3. All subjects were from a specific region. Because of this approach, this survey provides important information that can form the basis of comparison for future epidemiological surveys of atopic dermatitis.

Suprarenal inferior vena cava filter placement prior to transcatheter arterial embolization (TAE) of a renal cell carcinoma with large renal vein tumor thrombus: prevention of pulmonary tumor emboli after TAE

To prevent embolization of necrotic renal vein tumor after transcatheter embolization of a left renal cell carcinoma, we placed a suprarenal Bird's nest inferior vena cava filter. The patient tolerated the procedure well and had extensive tumor infarction including the tumor thrombus on 6-month follow-up computed tomography.