Detection of varicella-zoster virus DNA in maternal breast milk from a mother with herpes zoster

BACKGROUND

We previously reported that varicella-zoster virus (VZV) DNA was detected by polymerase chain reaction (PCR) from maternal breast milk of a post-partum mother with chickenpox.

OBJECTIVES

We tried to decide the route of VZV contamination to maternal milk.

CASE REPORT

A 22-year-old woman developed herpes zoster on her right Th3-4 dermatome.

RESULTS AND CONCLUSIONS

VZV DNA was detected by PCR from peripheral blood and the maternal milk of the right breast, but not from the maternal milk of the left breast. These results suggest that VZV in maternal milk may not derive from VZV-infected mononuclear cells in peripheral blood, but from the VZV-infected epitheliums of the lacteal gland.

A new strategy of gene trapping in ES cells using 3'RACE

"Gene trapping" in embryonic stem (ES) cells is a novel approach to identify a series of genes in mammals concomitant with the production of the corresponding mutant mice. However, this approach is currently unable to identify genes that are not expressed in ES cells. Here we describe a strategy to identify gene trapping clones which is not based on expression of a reporter gene. It uses the neor gene which lacks a polyadenylation signal and has a splice donor signal. Expression of the neor gene as fusion transcripts with the 3' end containing the polyadenylation signal of tagged genes allows the identification of these clones by 3' rapid amplification of the cDNA end in undifferentiated ES cells, even if the genes are not expressed in ES cells. Amplification was observed in about 25% of G418-resistant clones. Sequence analyses suggested the amplifications represent gene trapping events. The feasibility of this approach was further assessed by analysing one clone, PAT-12, in detail.

Acute left atrial thrombus causing cardiogenic shock following mitral valve replacement: report of a case

We report herein the rare case of a 53-year-old woman who developed cardiogenic shock due to an acute left atrial thrombus following replacement of the mitral valve. A definitive diagnosis was not able to be made using precordial echocardiography because of the broad, flat shape of the thrombus; however, transesophageal echocardiography imaged the thrombus in detail. The patient was initially stabilized by percutaneous cardiopulmonary support after which a thrombectomy was successfully performed.

Comparison of the effects of various anticholinergic drugs on human isolated urinary bladder

We investigated the effects of various anticholinergic drugs (atropine, oxybutynin, terodiline and propiverine) on the contractions induced by acetylcholine, KCl, CaCl2, and electrical field stimulation, in human isolated urinary bladder smooth muscles using the muscle bath technique. Urinary bladders were obtained from 20 patients who underwent total cystectomy due to malignant bladder tumor. The detrusor preparations were taken from the intact part of the dome of the bladder. Acetylcholine caused a concentration-dependent contraction in human detrusor preparations. Atropine (10(-9)-10(-6) M), oxybutynin (10(-8)-10(-5) M), terodiline (10(-7)-10(-5) M) and propiverine (10(-7)-10(-5) M) caused parallel shifts to the right of the concentration-response curves to acetylcholine. The rank order of pA2 values was: atropine > oxybutynin > terodiline = propiverine. Atropine did not suppress the maximum contraction to acetylcholine, while the other drugs significantly suppressed the maximum contractions at the higher concentrations. Each drug caused a concentration-dependent inhibition of the KCl (80 mM)- and CaCl2 (5 mM)-induced contractions; the maximum inhibitions of terodiline and propiverine were significantly greater than those of oxybutynin and atropine. Each drug caused a concentration-dependent inhibition of the contraction induced by electrical field stimulation; the maximum inhibitions of terodiline and propiverine were significantly greater than those of oxybutynin and atropine. The results suggest that the drugs have both anticholinergic and calcium antagonistic effects. Furthermore, it also appears that part of the human bladder contraction, which was significantly inhibited by terodiline and propiverine, is an atropine-resistant component.

Malposition of a totally implantable venous access catheter in the azygous vein: report of a case

We report herein the case of a 2-year-old girl with short bowel syndrome who developed chest pain 2 weeks after a totally implantable central venous access catheter had been surgically placed to facilitate total parenteral nutrition. A lateral chest X-ray and contrast flow study subsequently revealed that the catheter tip had been inserted into the azygous vein. Although this complication is very rare, it may be encountered more commonly with the increasing use of this type of venous access. Thus, we believe that a lateral chest X-ray should be routinely performed on all patients following catheter insertion to check for possible malposition of the tip in the azygous vein.

Characteristics of multimodal co-aggregation between Fusobacterium nucleatum and streptococci

The co-aggregation characteristics between Fusobacterium nucleatum and streptococci were examined to clarify the adherence factors participating in the co-aggregation. Nineteen strains of F. nucleatum were classified into 8 groups according to co-aggregation titer and inhibition by L-arginine, L-lysine and N-acetyl-D-galactosamine (or lactose). The inhibition activity was, however, very different from strain to strain. With two fusobacterial strains, two inhibitors, which were both inhibition negative on their own, completely inhibited the co-aggregation when used together in a mixture. In some co-aggregation pairs, the protease treatment of F. nucleatum inactivated one of the adherence factors, and resulted in the change of inhibition characteristics. These results indicate the multimodal co-aggregation of F. nucleatum with streptococci mediated by L-arginine-sensitive, L-lysine-sensitive, N-acetyl-D-galactosamine-sensitive and in some resistant factors, and that the adherence factor or factors participating the co-aggregation change according to the co-aggregation partners.

Gastric microcirculatory disturbance and behaviour of leucocytes after thermal injury: intravital observation of arteriovenous shunting channels in the gastric submucosal layer

In order to investigate the pathogenesis of acute gastric mucosal lesion after thermal injury, microcirculatory disturbance was assessed and observation of the behaviour of leucocytes was performed. Gastric blood flow decreased at 15 min post-thermal injury, and partially improved at 2 h; however, it decreased again at 5 h post-thermal injury. Mucosal microcirculatory disturbance was observed by using vascular labelling with monastral blue B. Deposits of monastral blue B were observed centring mainly on collecting venules but were also observed in the capillaries. Submucosal microcirculatory disturbance was observed through an intravital microscope. The irregularity of the wall and segmental constriction in the venules and presence of an arteriovenous shunting channel was observed in the submucosal layer at 5 h post-thermal injury. The percentage of rolling or sticking leucocytes that passed the confluence of a prevenule and a venule were significantly increased at 5 h after thermal injury. The present study revealed depression of gastric blood flow, mucosal and submucosal microcirculatory disturbance, and a significant increase of rolling and sticking leucocytes in the peripheral part of venules after thermal injury. Leucocyte-endothelial interactions may occur under such conditions and this interaction may play an important role in inducing the microcirculatory disturbance that results in an acute gastric mucosal lesion after thermal injury. The present study also demonstrated the possibility of intravital study of gastric submucosal arteriovenous shunting channels.

PS-990, a novel microbial metabolite, reversibly induces neurite extension in neuroblastoma cells

PS-990, which is a novel microbial metabolite, induced neurite formation in a murine neuroblastoma cell line, Neuro2A. In the presence of PS-990 at 30 micrograms/ml, significant neurite outgrowth was observed. Cultures maintained for 12 h in the presence of PS-990 resulted in the maximal number of neurite-bearing cells, and then the neurites formed were gradually retracted. The retracted cells again yielded the neurite formation when the cells were exposed again to PS-990. PS-990 inhibited both the cell growth and thymidine incorporation into the cells at the same concentration range. Although the type of neurite formation with PS-990 is similar to that with a cyclic AMP analog and indeed PS-990 has an inhibitory potency against calcium and calmodulin-dependent cyclic nucleotide phosphodiesterase, the intracellular cyclic AMP level was not elevated when treated with PS-990. These results suggest that PS-990 reversibly induces neurite formation with arrest of the cell growth through a mechanism distinct from an increase in the intracellular cyclic AMP concentration.

Morphology of ras-transformed cells becomes apparently normal again with tyrosine kinase inhibitors without a decrease in the ras-GTP complex

Radicicol, an inhibitor of protein-tyrosine kinase, was found to cause morphological reversion of v-Ha-ras-transformed NIH3T3 fibroblasts and T24 human urinary bladder carcinoma cells that contain an activated ras mutation. The network of actin stress fibers was restored during the treatment with radicicol. A similar morphological change was observed with another protein-tyrosine kinase inhibitor, herbimycin A. Radicicol did not cause any changes in the proportion of the active GTP binding form of p21ras or its subcellular localization. These results rule out the possibility that the morphological reversion by radicicol is due to direct or indirect inhibition of the p21ras function. Cycloheximide and actinomycin D inhibited the morphological change by radicicol, suggesting that the induced transcription of a gene(s) followed by de novo protein synthesis is required for suppression of the transformed phenotype in ras-transformed cells by tyrosine kinase inhibitors.

Relationship between alpha-tocopherol and polymorphonuclear leukocyte elastase in septic adult respiratory distress syndrome

To elucidate the interrelationship between active oxygen and polymorphonuclear leukocyte elastase (PMN elastase) in patients with septic adult respiratory distress syndrome (ARDS), we examined the relationship between alpha-tocopherol, which has an antioxidant action, and PMN elastase. Serial blood samples were collected from 16 patients with septic ARDS. Serum levels of alpha-tocopherol were determined by HPLC. PMN elastase was determined by ELISA. The serum alpha-tocopherol level in a nonsurviving group was significantly lower than that in a surviving group at the time that septic ARDS was diagnosed (p = 0.0068). The level of PMN elastase in the nonsurviving group was significantly higher than that in the surviving group (p = 0.0058). A significant negative correlation existed between the serum levels of alpha-tocopherol and those of PMN-elastase (r = -0.659, p = 0.0043). Both the serum alpha-tocopherol level and the PMN elastase level appeared to be good indices of the severity of ARDS. The results suggested that an interaction between active oxygen and PMN elastase may increase the clinical severity of this disease.

Active oxygen species in formation of acute gastric mucosal lesions induced by thermal injury in rats

Active oxygen species generated by circulating leukocytes and released from the gastric mucosa were measured in the process of acute gastric mucosal lesion formation after thermal injury in rats. Alterations of luminol-dependent chemiluminescence activities generated by leukocytes obtained from the gastric vein and the inferior vena cava were approximately same. A decrease in chemiluminescence activity 15 min after thermal injury and a significant increase in chemiluminescence activity 5 hr after thermal injury were observed in leukocytes from both veins. From 15 min to 12 hr after thermal injury, luciferin-dependent chemiluminescence activities were significantly higher than that of the control group. Oral administration of rebamipide resulted in decreased mucosal lesion formation. Rebamipide, an antiulcer agent that protects the mucosa from damage in various animal models decreased chemiluminescence activities only released from the gastric mucosa but not from circulating leukocytes. These results suggest that two different pathways of active oxygen species formation may exist in the pathogenesis of acute gastric mucosal lesions after thermal injury.

[Endoscopic mucosal resection for radical treatment of esophageal cancer]

Clinico-pathological results of patients with superficial esophageal cancer was reviewed to determine the indications of endoscopic mucosal resection (EMR) for esophageal cancer as a radical treatment and to evaluate clinical results of EMR. The analysis on eighty-seven cases with superficial esophageal cancer who underwent esophagectomy revealed no lymph node metastasis in any 0% of case with cancer confined to the lamina propria mucosae, 10% of cancer reaching the muscularis mucosae and 43% of cancer infiltrating the submucosa. These results suggested that the endoscopic mucosal resection should be indicated for patients with esophageal cancer confined to the lamina propria mucosae. The accuracy rate for estimating depth of invasion of mucosal cancer of the esophagus was 96%. We early established "the double channel technique" for resection of mucosal lesion of the esophagus with a major part of the submucosa, we used it for sixty-nine cases, and all were eventually discharged. Immediate complications of EMR were noted in 12.9% of all cases (mediastinal emphysema: 2.9%, ulcer bleeding: 10%) and the late complication in 7.2% (esophageal stricture due to scar formation: 5.8% and ulcer bleeding 5 days after EMR: 1.4%). All cases who developed stricture had mucosal defect over 3/4 the circumference. The cumulative 5-year survival rate of patients with esophageal mucosal cancer treated by EMR (86%) showed no significant difference from those treated by esophagectomy (83.2%). We to conclude that endoscopic mucosal resection is indicated for the patient with mucosal cancer confined to the lamina propria mucosae. One can expect an excellent prognosis by less invasive treatment than esophagectomy.

[Two siblings of familial amyotrophic lateral sclerosis with multisystemic degeneration characterized by mild involvement of the middle root zone of the posterior column, Clarke's nuclei and spinocerebellar tract]

The aim of this study is to clarify the clinicopathological characteristics of the multisystem degeneration seen in two male siblings with familial amyotrophic lateral sclerosis (FALS). A similar neurological disorder affected their elder sister and paternal uncle, but not their parents. The older brother (case 1) developed muscular weakness at 50 years of age and the younger brother (case 2), at 42 years of age. The duration of illness was 19 months in case 1 and 31 months in case 2. The clinical picture was the common (suspended) form in case 1 and the pseudopolyneuritic form in case 2. Pyramidal tract sign was obscure in both cases and cerebellar sign, sensory disturbance, sphincter disturbance and oculomotor palsy were not observed in either case. Neuropathological examination revealed similar findings in the two cases: 1) marked loss of lower motor neurons in the spinal anterior horn and motor nuclei of the lower brain stem in both cases, with neuronal loss of Onuf's nuclei in case 2; 2) very mild involvement in Clarke's nuclei, the dorsal and ventral spinocerebellar tracts and the middle root zone of the posterior column; 3) relatively well preserved Betz cells in the upper motor cortex with the appearance of a few macrophages, and mild changes in the pyramidal tract of the spinal cord; and 4) mild degenerative changes in the pallidoluysian system and the dentatorubral system. The most characteristic pathological findings common to both cases were the extremely mild involvement of the middle root zone of the posterior column, Clarke's nuclei and spinocerebellar tracts. The pattern of lower motor neuron system degeneration paralleled the development of clinical features. Genetic studies demonstrated no mutations in exons 1, 2 and 4 of Cu/Zn-binding superoxide dismutase gene. We emphasized the existence of mild involvement of middle root zone of posterior column, Clarke's nuclei and spinocerebellar tract in FALS with multisystemic degeneration.

[Efficacy of combination chemotherapy with miconazole and G-CSF in deep mycosis accompanying hematological diseases]

In order to examine the efficacy of the combination chemotherapy with miconazole and G-CSF, patients with deep mycosis and suspected deep mycosis were divided into 3 groups. Group I: miconazole and G-CSF were administered simultaneously. Group II: miconazole was administered later during G-CSF administration. Group III: only miconazole was administered. Of a total of 117 cases 105 cases were analyzed including group I 37 cases, group II 39 cases and group III 29 cases, excluding 12 dropout and inadequate cases. Of the 105 cases, deep mycosis were 31 and suspected deep mycosis were 74, and underlying diseases were hematological malignancies such as leukemias. Efficacy judged mainly by the change of fever was 62.2% (23/37) in group I, 43.6% (17/39) in group II, and 41.4% (12/29) in group III, respectively. Efficacy was better in the patients whose neutrophil counts increased from less than 500/microliters to more than 500/microliters (group I 75.0%, group II 72.7%) than in the patients whose neutrophil counts were less than 500/microliters throughout the time of miconazole administration (group I 33.3%, group II 33.3%). Adverse effects were minimal in 3 groups (group I 15.4%, group II 17.4%, group III 15.6%). It is concluded that the combination with miconazole and G-CSF is effective in the treatment of deep fungal infections.

Alteration in the fluorescence polarization of rat plasma and liver cell membranes following bile duct ligation in rats

The fluorescence polarization levels of liver cell membranes and plasma were analyzed to determine membrane fluidity following bile duct ligation (BDL) in rats. Fluorescence polarization was measured with a spectrofluorophotometer equipped with polarizers, using 1,6-diphenyl-1,3,5-hexatrien (DPH) as a probe. After bile duct ligation, liver cell membrane fluidity decreased significantly for up to 14 days after surgery (P < 0.001 on 3rd and 7th days). The polarization of the plasma in rats with BDL slightly but significantly increased compared to the levels in the control animals over the 14-day period following BDL. In addition, a small but significant correlation in the polarization levels between plasma and liver cell membranes (r = 0.362, P < 0.02) was observed. The co-incubation of BDL plasma with normal liver cell membranes resulted in a decrease in membrane fluidity, which suggested that BDL rat plasma had a direct effect on membrane fluidity. After a 70% hepatectomy, the polarization of the membranes from remnant livers in the BDL rats remained elevated relative to the sham-operated controls. It is thus concluded that the membrane fluidity of the livers in BDL rats decreases following bile duct ligation and does not increase after a 70% hepatectomy, presumably due to the increased plasma level of bilirubin.

Adaptation of the resettled Kenyah Dayak villagers to riverine environment in east Kalimantan: a preliminary report

The Kenyah Dayak in East Kalimantan (Indonesia), who migrated from their mountainous homeland to a riverine village in the 1940s, have subsisted on slash-and-burn rice cultivation. To cope with rapidly increasing population, the villagers have not changed their farming practice to increase land productivity but instead have exploited fields in remote riverbanks, using motorized canoes.

Endoscopic assessment of invasion of colorectal tumors with a new high-frequency ultrasound probe

The present study was carried out to clarify the usefulness of and problems associated with a new ultrasound probe in the assessment of invasion of colorectal tumors. Normal colorectal wall of 23 resected specimens from colorectal cancer cases was examined in vitro with the probe. Fifty-one patients with colorectal carcinoma and 16 patients with rectal carcinoid tumor were presurgically examined using the probe via the biopsy channel of a conventional colonoscope. After endoscopic and ultrasonographic examination, 27 patients underwent endoscopic resection and 40 underwent surgical resection. The ultrasonographic findings were compared with histologic findings in all cases. Carcinomas and carcinoid tumors were visualized as an echo-poor region with the probe. The overall accuracy rate for depth of invasion was 76% (39/51) for colorectal cancer. The accuracy rates for tumors limited to the mucosa and tumors invading the submucosa were 83% and 90%, respectively; these rates were higher than those for tumors invading the muscularis propria (50%) and beyond the muscularis propria (73%). In all 16 cases of carcinoid tumor, the depth of invasion was accurately shown to be limited to the submucosa. This probe is useful to assess invasion of colorectal tumors, especially small and flat lesions limited to the mucosa or submucosa.

Repression of cell cycle progression by antisense HMG2 RNA

The expression level of the HMG2 gene during the cell cycle of rat fibroblast cell lines was analyzed. Northern analysis demonstrated that the level of HMG2 mRNA was markedly enhanced in the post-S phase and reached a maximum at G2 phase, suggesting that expression of the HMG2 gene is not coupled with DNA synthesis. Progression of the cell cycle of COS-1 cells was repressed during G1 to S phase by expression of the antisense RNA for HMG2, resulting in a decrease of cell growth. These results suggest that the fluctuation of the HMG2 message during the cell cycle is not a consequence of but a prerequisite for cell proliferation.

Age-dependent alterations in beta-adrenergic responsiveness of rat detrusor smooth muscle

The relaxant effects of norepinephrine (NE, 10(-7) to 10(-4) M.) and isoproterenol (ISO, 10(-9) to 10(-4) M.) on maximal KCl-induced tonic contractions and the relaxant effects of ISO on contractions induced by electrical field stimulation (EFS) were measured in detrusor muscle strips obtained from 22-25 day, 90-95 day and 22-month-old male Fischer 344 rats. The maximum relaxant response to NE and ISO on KCl-induced tonic contractions decreased significantly with increasing age. The ED50 values for ISO, but not NE, increased with age. The maximum relaxant response to ISO on EFS-induced contractions also was reduced significantly in the old bladders. The relaxation effects of forskolin (10(-6) to 3 x 10(-5) M.), dibutyryl cyclic AMP (DBcAMP, 10(-4) to 3 x 10(-3) M.) and cholera toxin (10 micrograms/ml.) were examined on maximal KCl-induced contractions of the muscle strips obtained from the three age groups. The relaxant responses to forskolin decreased significantly with increasing age, whereas DBcAMP relaxed the muscle strips from the three age groups equally. Cholera toxin (10 micrograms) attenuated KCl-induced phasic contractions, and this effect was impaired in the aged rat detrusor. The density of beta-adrenergic receptors, as determined by radioligand binding with [125I]iodopindolol ([125I]-PIN) decreased with increasing age. These data demonstrate an age-related decrease in the responsiveness of the bladder detrusor to beta-adrenergic stimulation that may be related to the decreased density of beta-adrenergic receptors and decreased cyclic AMP (cAMP) production.

Trichostatin A and trapoxin: novel chemical probes for the role of histone acetylation in chromatin structure and function

Reversible acetylation at the epsilon-amino group of lysines located at the conserved domain of core histones is supposed to play an important role in the regulation of chromatin structure and its transcriptional activity. One promising strategy for analyzing the precise function of histone acetylation is to block the activities of acetylating or deacetylating enzymes by specific inhibitors. Recently, two microbial metabolites, trichostatin A and trapoxin, were found to be potent inhibitors of histone deacetylases. Trichostatin A reversibly inhibits the mammalian histone deacetylase, whereas trapoxin causes inhibition through irreversible binding to the enzyme. The histone deacetylase from a trichostatin A-resistant cell line is resistant to trichostatin A, indicating that the enzyme is the primary target. Both of the agents induce a variety of biological responses of cells such as induction of differentiation and cell cycle arrest. Trichostatin A and trapoxin are useful in analyzing the role of histone acetylation in chromatin structure and function as well as in determining the genes whose activities are regulated by histone acetylation.

[Clinical evaluation of 99mTc-MAG3 as a radiotracer to assess the function of transplanted kidney: comparison with 123I-OIH]

99mTc-MAG3 (mercaptacetyl glycilglycilglycine) is a newly developed radiopharmaceutical for the functional imaging of kidneys. We evaluated the clinical usefulness of 99mTc-MAG3 in 12 cases (7 men and 5 women, aged from 18 to 57 years old) with transplanted kidney, and compared it with 123I-OIH (o-iodohippurate). Immediately after bolus injection of 300 MBq of 99mTc-MAG3, first pass images (1 frame/3 sec for 1 min) and dynamic renal images (1 frame/60 sec for 30 min) were recorded. In 10 of 12 cases, the same examination was carried out using 37 MBq of 123I-OIH within 2 weeks. Because of its larger dose and suitable gamma-ray energy, 99mTc-MAG3 provided much better images than 123I-OIH, particulary among first pass images. Effective renal plasma flow (ERPF) calculated from the clearance of 99mTc-MAG3 was less (about 70%) than that of 123I-OIH, however, a strong correlation (r = 0.98, p < 0.001) was observed between the ERPF values of the two radiotracers. No adverse effects were caused by 99mTc-MAG3. Our data suggested that 99mTc-MAG3 was a promising radiopharmaceutical with which to evaluate regional dynamic renal function.

Abnormal expression of apoptosis-related antigens, Fas and bcl-2, on circulating T-lymphocyte subsets in primary Sjögren's syndrome

OBJECTIVE

To clarify the pathological role of the apoptosis-related molecules expressed on peripheral blood (PB) lymphocyte subsets in primary Sjögren's syndrome (SS).

METHODS

The levels of apoptosis-regulating proteins, Fas and bcl-2, were determined in the PB lymphocyte subsets from 21 patients with SS and 14 healthy controls by 2-color flow cytometry.

RESULTS

In the PB from SS patients, lymphocytopenia, especially CD4+ cell-lymphocytopenia, was prominent. As observed in previous studies, the percentages of CD4+ CD45RA+ cells were lower in the SS patients than in the controls, while activated (DR+) cells were increased in CD4+ cells from the patients. Fas+ cells were also increased in the patients' CD4+ cells and CD8+ cells, but not in their B cells or natural killer cells. Furthermore, we observed several positive correlations among the percentages of activated cells (DR+ cells or CD45RA-cells) and Fas+ cells recognized in the CD4+ and/or CD8+ cells from the patients. On the other hand, intra-cellular bcl-2 proteins measured as mean fluorescence intensity were significantly diminished in the CD4+ cells, CD8+ cells, CD19+ cells, CD45RO+ cells and Fas+ cells from 14 SS patients compared with 12 healthy controls. In addition, the numbers and/or percentages of CD4+ cells and Fas+ cells positively correlated with their expression of bcl-2 in SS patients.

CONCLUSION

The abnormal balance between Fas and bcl-2 expression detected in the PB lymphocyte subsets from SS patients relates, at least partially, to the lymphocytopenia observed in the patients.