[Treatment of promyelocytic blast crisis of chronic myelogenous leukemia with all-trans-retinoic acid]

This paper describes the treatment of promyelocytic blast crisis of chronic myelogenous leukemia with all-trans-retinoic acid (ATRA). The patient, a 22-year-old male, was diagnosed to have APL and had been treated with busulfan and then with three and half years interferon (IFN) alpha in the chronic phase. A cytogenetic study of blast cells showed the t(1;17) (p11;q11) translocation as the second chromosomal abnormality without morphological abnormality of chromosome 15. Molecular analysis showed cells to have a chimera gene consisted of PML and retinoic acid receptor alpha genes. Though maturation and differentiation of leukemic cells were seen after ATRA therapy, hematological complete remission did not occur. The ineffectiveness of ATRA may be dut to different pathological conditions from de novo APL, or progressive reduction in plasma ATRA concentration as reported by Muindi et al. When our case was compared with a similar case reported by Wiernick et al., both cases were treated with IFN alpha in the chronic phases, had no t(15;17) translocation involving No.1 chromosome abnormality and did not develop complete remission after ATRA therapy.

Expression of basic fibroblast growth factor receptor messenger RNA in the periinfarcted brain tissue

The present study examined whether expression of basic fibroblast growth factor receptor (bFGFR) messenger ribonucleic acid (mRNA) was upregulated by focal ischemia. We have studied the in situ hybridization autoradiography for bFGFR mRNA in the rat model of middle cerebral artery (MCA) occlusion. Male Wistar rats were used for occlusion of the left MCA, and were sacrificed 1, 3, 7 and 14 days after MCA occlusion. In situ hybridization was performed on the brain sections of these animals and sham controls by using 35S-labeled antisense and sense (control) RNA probes for rat bFGFR. Expression of bFGFR mRNA was observed in the periinfarcted area of the rats within 1-14 days after MCA occlusion. Expression was evident in the whole hemisphere of the infarcted side, especially at 1 and 3 days after ischemia, but no expression was detected in the contralateral side. On microautoradiograms, the signals of bFGFR mRNA were detected in both neurons and non-neural cells located in the periinfarcted area. Upregulation of bFGFR mRNA detected in the periinfarcted brain tissue suggests that receptor-mediated action of bFGF may be related to preservation of neurons injured by ischemia.

Cloning, sequence and characterization of the polyphosphate kinase-encoding gene (ppk) of Klebsiella aerogenes

Polyphosphate kinase (PPK) catalyzes the formation of polyphosphate (polyP). The PPK-encoding gene (ppk) has been cloned from Klebsiella aerogenes ATCC9621. The gene possessed an open reading frame of 2055 bp capable of encoding a putative polypeptide with a deduced M(r) of 80,157. This polypeptide showed 93% similarity to the Escherichia coli PPK. The nucleotide sequence of the promoter region of K. aerogenes ppk differed from that of the previously sequenced E. coli ppk. A putative pho box sequence was found in the promoter region of K. aerogenes ppk. The expression of lacZ from the ppk promoter was increased in E. coli MV1184 under conditions of phosphate (Pi) limitation, but not in E. coli ANCS3 (phoB-), indicating that the ppk promoter is regulated by the phoB product. Increased levels of specific PPK activity were shown by expressing the cloned ppk at high levels, resulting in increased accumulation of polyP in E. coli.

[A case of marked eosinophilia in peripheral blood induced by rhGM-CSF]

A 53-year-old man underwent chemotherapy (CDDP, VDS, MMC) for treatment of lung cancer. He was given 125 micrograms/m2 of GM-CSF subcutaneously every day for 8 consecutive days, in order to prevent neutropenia. Three days after starting GM-CSF therapy, marked eosinophilia in peripheral blood was observed. The maximum eosinophil count was 89% of leukocytes. Nine days after stopping the treatment with GM-CSF, the number of eosinophils had normalized spontaneously. There were no clinical symptoms except for slight fever, up to 37.5 degrees C. Moreover, there was no relationship between the number of eosinophils and the serum levels of cytokines (IL-3, IL-5, GM-CSF), although we observed minimal but significant elevation of serum ECP level. This case indicates that GM-CSF may induce marked eosinophilia rather than widely stimulating granulocytes and monocytes.

Reproduction of progressive retinal degeneration (bright blindness) in sheep by administration of ptaquiloside contained in bracken

The process of occurrence of bright blindness, progressive retinal degeneration (PRD), in sheep was observed using two Suffolk ram lambs fed on a diet containing bracken powder. The first sign of the bright blindness was detected 4 months after the start of experiment. Based on these preliminary results, the amount of bracken powder necessary to induce PRD was estimated (experiment I). In the following experiment, ptaquiloside (PT), a norsesquiterpene glucoside of the illudane type isolated from bracken, which is a bracken carcinogen and a causative principle of cattle bracken poisoning was administered to two Suffolk ram lambs. It was clearly demonstrated in this experiment (experiment II) that PT present in bracken is also a causative principle of PRD.

IGF-II producing hepatic fibrosarcoma associated with hypoglycemia

A 67-year-old male was admitted with the complaint of weakness at hunger early in the morning, when blood glucose was less than 40 mg/dl. The abdominal ultrasonogram and computerized tomogram demonstrated a huge tumor in the right liver lobe. Hypoglycemia disappeared after transcatheter arterial embolization. Then hepatic lobectomy was performed. The tumor was histologically shown to be a fibrosarcoma. Insulin-like growth factor-II was intensely stained in the Golgi area of the tumor cells, suggesting its role in the mechanism of hypoglycemia.

Kinetics and mechanism of heterogeneous hydrolysis of poly[(R)-3-hydroxybutyrate] film by PHA depolymerases

The kinetics and mechanism of enzymatic degradation on the surface of poly[(R)-3-hydroxybutyrate] (P[(R)-3HB]) film have been studied using three types of extracellular poly(hydroxyalkanoate) (PHA) depolymerases from Alcaligenes faecalis, Pseudomonas picketti and Comamonas testosteroni. The monomer and dimer of 3-hydroxybutyric acid were produced during the course of the enzymatic degradation of P[(R)-3HB] film, and the rate of production was determined by monitoring the increase in absorbance at 210 nm on a spectrophotometer. The rate of enzymatic degradation increased to a maximum value with the concentration of PHA depolymerase, followed by a gradual decrease. The kinetic data were accounted for in terms of a heterogeneous enzymatic reaction, involving enzymatic degradation on the surface of P[(R)-3HB] film via two steps of adsorption and hydrolysis by a PHA depolymerase with binding and catalytic domains. The kinetic results suggest that the properties of the catalytic domains are very similar among the three PHA depolymerases, but that those of the binding domains are strongly dependent on the type of depolymerase.

Neuropharmacological characterization of voltage-sensitive calcium channels: possible existence of neomycin-sensitive, omega-conotoxin GVIA- and dihydropyridines-resistant calcium channels in the rat brain

We attempted to characterize the functional roles of subtypes of voltage-sensitive calcium channels in the brain. The maximal number of [125I]omega-conotoxin GVIA (omega-CTX) binding sites in rat brain associated with N-type calcium channels (N-channels) was approximately 10 times more than that of [3H]-PN200-110 associated with L-type calcium channels (L-channels). [125I]omega-CTX binding was inhibited by aminoglycoside antibiotics, neomycin and dynorphin A(1-13), but not by various classes of L-channel antagonists. A 6-hydroxydopamine-induced lesion of the striatum resulted in a marked reduction of both [125I]-omega-CTX and [3H]PN200-110 binding. Kainic acid-induced lesion of the striatum reduced [3H]PN200-110 binding by 57%, but did not reduce [125I]omega-CTX binding. Omega-CTX produced a small (18%) but significant reduction of potassium-stimulated Ca2+ influx into rat brain synaptosomes, although it produced a concentration-dependent inhibition in chick brain synaptosomes. Neomycin inhibited Ca2+ influx in both preparations in a concentration-dependent manner. Both omega-CTX and neomycin inhibited potassium-stimulated [3H]dopamine (DA) release from rat striatal slices. The L-channel antagonists had no effect on either Ca2+ influx or [3H]DA release. These results suggest that DA release in the striatum is regulated by Ca2+ influx through N-channels located in presynaptic nerve terminals, and that the most of the Ca2+ influx in rat brain appears to be governed by neomycin-sensitive, omega-CTX- and DHP-resistant calcium channels.

[Pathogenesis of idiopathic pulmonary fibrosis--is hepatitis C virus involved?]

Hepatitis C virus (HCV) is a new virus discovered in 1989. Since HCV is known to cause fibrotic changes in the liver, we studied whether HCV is involved in the pathogenesis of idiopathic pulmonary fibrosis (IPF). Firstly, we assessed anti-HCV antibodies by enzyme-linked immunosorbent assay (ELISA) in the sera obtained from 66 IPF patients (46 males and 20 females; mean age +/- SEM, 61.5 +/- 10.1). We observed a significantly high prevalence of anti-HCV antibodies in IPF compared with 9,464 age-matched controls (28.8% vs 3.66%, p < 0.05). To confirm the results, recombinant immunoblotting assay (RIBA) was conducted on the 19 ELISA-positive sera, and 8 sera (12.2%) were found to be definitely positive. Secondly, we searched for HCV in the blood of IPF patients by reverse transcription-polymerase chain reaction. As preliminary data, four out of 28 cases (14.3%), all of which were pathologically diagnosed as UIP, were positive for HCV. In conclusion, although further investigation is required, a high prevalence of anti-HCV antibodies and the existence of HCV itself in the blood may suggest the possibility that HCV infection plays an important role in the pathogenesis of IPF.

[Detection of HIV-1 proviral DNA in peripheral leukocytes by AMPLICOR HIV-1 test kit]

AMPLICOR HIV-1 test kits, which had been developed as an HIV-1 provirus detection test by PCR method, have been evaluated for its clinical diagnostic application. Sixty-six of HIV-1 antibody positive and 67 of HIV-1 antibody negative blood samples derived from hemophiliacs, who had received blood products, have been tested by AMPLICOR HIV-1. All of the results from AMPLICOR HIV-1 were consistent with those from antibody test and clinical aspects. Thirty-nine of HIV-1 antibody positive samples have been tested by AMPLICOR HIV-1 and virus isolation (culture method). Twelve of 39 (30.8%) were positive by virus isolation, and 39 of 39 (100%) were positive by AMPLICOR HIV-1. Two of new born infants from HIV-1 sero-positive mothers were tested by AMPLICOR HIV-1, and the result suggested that the kit would be useful for diagnosis of infants from sero-positive mothers. Based on these studies, AMPLICOR HIV-1 is considered as useful clinical diagnostic for HIV-1 proviral DNA detection.

Evaluation of masked neurological disorders in the chronic stage after middle cerebral artery occlusion in rats--methamphetamine-induced rotation and regional glucose metabolism in basal ganglia

Neurofunctional changes in rats in the chronic stage of focal cerebral ischemia induced by left middle cerebral artery (MCA) occlusion were examined. Neurological disorders and behavioral changes were observed with or without methamphetamine administration. Metabolic changes in the basal ganglia following methamphetamine intraperitoneal injection were evaluated by [14C]deoxyglucose autoradiography 30 days after occlusion. Neurological examination revealed persistent spontaneous rotation to the lesioned side in two of 18 rats, and forelimb flexion to the lesioned side in nine of 18 rats during a 28-day observation period after occlusion. Intraperitoneal administration of methamphetamine (4 mg/kg) induced full 360 degrees rotation toward the lesion side in 14 of 17 rats. The number of rotations was inversely correlated with the size of the intact striatum on the lesion side, especially in rats with cerebral infarct located only in the striatum. Rats with extensive cortical lesion in addition to striatal lesion did not demonstrate this relationship. Deoxyglucose autoradiography in methamphetamine-untreated rats showed symmetrical local cerebral glucose utilization in the basal ganglia except for the subthalamic nucleus, striatum and sensorimotor cortex. Autoradiography in methamphetamine-treated and MCA-occluded rats showed a remarkable increase in glucose utilization in the anterior striatum, entopeduncular nucleus, substantia nigra pars reticulata, and sensorimotor cortex contralateral to the occlusion side, but not on the lesioned side. Rotational movements observed in methamphetamine-treated rats are related to lack of stimulation of the basal ganglia system on the ischemic side.(ABSTRACT TRUNCATED AT 250 WORDS)

Treatment of severe localized cerebral vasospasm following recurrent hemorrhage from middle cerebral artery aneurysm--case report

A 52-year-old female presented with localized but severe cerebral vasospasm induced by recurrent aneurysmal subarachnoid hemorrhage. The middle cerebral artery (MCA) aneurysm was clipped and the subarachnoid hematoma evacuated 1 day after recurrent hemorrhage. The cerebral vasospasm, localized in a region near the MCA aneurysm, was reduced by papaverine and nicardipine vasodilating agents delivered via an Ommaya cerebrospinal fluid reservoir placed at craniotomy.

Effect of an ultraviolet light-activated coating material on reduction of the leaching of methyl methacrylate and formaldehyde from denture acrylic resins

Effect of glazing with an ultraviolet light-activated coating material on reduction of the leaching of methyl methacrylate and formaldehyde from denture acrylic resins was quantitatively evaluated. Disks prepared from auto-polymerized resins were painted with the material and radiated with ultraviolet light. The disks were immersed in artificial saliva and the concentrations of methyl methacrylate and formaldehyde leached were determined by high-performance liquid chromatography and flow injection analysis. Compared to untreated controls, the glaze significantly decreased concentrations of both leachable substances. Treatment with an ultraviolet light-activated coating material is effective in suppressing the leaching of methyl methacrylate and formaldehyde from acrylic resins as well as in smoothing the denture surfaces.

Nitric oxide and nitric oxide synthase mRNA induction in mouse islet cells by interferon-gamma plus tumor necrosis factor-alpha

It has been shown that nitric oxide (NO) is involved in islet cell damage induced by interleukin-1 (IL-1). Here we show that interferon-gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha) synergistically induced NO production and inducible NO synthase (iNOS) mRNA expression in mouse islet cells. Cycloheximide (CXH) did not prevent the iNOS mRNA expressions. The combination of IFN-gamma and TNF-alpha, which is highly cytotoxic to mouse islet cells, failed to destruct islet cells in the absence of L-arginine or in the presence of NG-monomethyl-L-arginine (NMMA). These observations suggest that NO is a primary effector in islet cell damage caused by IFN-gamma plus TNF-alpha.

Genetic improvement of Escherichia coli for enhanced biological removal of phosphate from wastewater

The ability of Escherichia coli MV1184 to accumulate inorganic phosphate (Pi) was enhanced by manipulating the genes involved in the transport and metabolism of Pi. The high-level Pi accumulation was achieved by modifying the genetic regulation and increasing the dosage of the E. coli genes encoding polyphosphate kinase (ppk), acetate kinase (ackA), and the phosphate-inducible transport system (pstS, pstC, pstA, and pstB). Acetate kinase was employed as an ATP regeneration system for polyphosphate synthesis. Recombinant strains, which contained either pBC29 (carrying ppk) or pEP02.2 (pst operon), removed approximately two- and threefold, respectively, more Pi from minimal medium than did the control strain. The highest rates of Pii removal were obtained by strain MV1184 containing pEP03 (ppk and ackA). However, unlike the control strain, MV1184 (pEP03) released Pi to the medium after growth had stopped. Drastic changes in growth and Pi uptake were observed when pBC29 (ppk) and pEP02.2 (pst operon) were introduced simultaneously into MV1184. Even though growth of this recombinant was severely limited in minimal medium, the recombinant could remove approximately threefold more Pi than the control strain. Consequently, the phosphorus content of this recombinant reached a maximum of approximately 16% on a dry weight basis (49% as phosphate).

Nosocomial outbreak of Pseudomonas cepacia respiratory infection in immunocompromised patients associated with contaminated nebulizer devices

From May 1990 to August 1991, 36 patients admitted to the Department of Internal Medicine in a medical school hospital with hematological malignancies or solid tumors, developed respiratory tract colonization with Pseudomonas cepacia. Sixteen (44.4%) of these patients developed pneumonia, and four (11.1%) died of respiratory failure due to P. cepacia pneumonia. Extensive survey of the hospital environment as well as equipment showed that nebulizer devices used by the patients for inhalation were contaminated with P. cepacia. Phenotypic characteristics, (production of hemolysin and extracellular enzymes [lipase, lecithinase and protease]), the Analytical Profile Index 20 NE pattern, and the pattern of DNA fingerprinting by pulse-field gel electrophoresis in clinically isolated strains and strains derived from nebulizer devices were compared. The strains of P. cepacia obtained from patients in the Department of Internal Medicine were indistinguishable from each other and also from those isolated from nebulizer devices, but were different from those isolated from patients in other departments at the same time. These results demonstrated that the outbreak of P. cepacia respiratory colonization in immunocompromised patients was a nosocomial acquisition, and probably occurred by transmission through contaminated nebulizer devices.

Beta 0-thalassemia trait (IVS-I-1 G-->T) in a Japanese family

Three subjects in a family with microcytic and hypochromic anemia were studied; red blood cell morphology indicated aniso-poikilocytosis and hypochromasia. Target and tear-drop cells were also noted. In all three cases evaluated, there was an increase in HbA2 levels and a decline in the beta/alpha synthesis ratio. Direct cloning and DNA sequencing identified a point mutation (G-->T) at position 1 of intervening sequence I. The resulting reduction of beta-globin chain synthesis is considered to give rise to beta 0-thalassemia phenotype. This point mutation is to our knowledge, the first case in Japan.

The inhibitory effects of salmon calcitonin on intrathecally-injected N-methyl-D-aspartate-induced aversive behavior in mice

The effects of salmon calcitonin (SCT) on intrathecally-injected N-methyl-D-aspartate (NMDA)-induced aversive behavior were investigated to clarify the involvement of the NMDA receptor/ionophore complex on the analgesic effects of SCT. Intracerebroventricular (i.c.v.) injection of SCT significantly inhibited acetic acid-induced writhing. Intrathecal (i.t.) injection of NMDA (0.25-1.0 nmol/mouse) dose-dependently induced aversive behavior such as scratching and tail biting. SCT at the doses of 0.01 and 0.1 IU/mouse (i.c.v.) significantly inhibited the NMDA-induced aversive behavior. This inhibitory effects of SCT on NMDA (i.t.)-induced aversive behavior were neither potentiated nor antagonized by i.c.v. injection of MK-801 and NMDA, respectively. Further, MK-801 (i.c.v.) and NMDA (i.c.v.) themselves did not affect the NMDA (i.t.)-induced aversive behavior. These results suggest that the NMDA receptor/ionophore complex in the brain is not directly involved in the antinociceptive effects of intracerebrally-injected SCT.

[Sinus thrombosis during CDDP and VP-16 (PE) therapy for suprasellar germ-cell tumor: case report]

A case of sinus thrombosis occurring during combination chemotherapy with CDDP and VP-16 (PE) for a suprasellar germ-cell tumor is presented. A 5-year-old girl developed polyuria, polydipsia and headache in April, 1991 and became unconscious on May 10, 1991, when MRI and CT demonstrated a suprasellar tumor and marked hydrocephalus. After a ventriculo-peritoneal shunt operation, radiotherapy and two courses of PE therapy were carried out. During the second course of PE therapy, diabetes insipidus became quite difficult to control and severe hypovolemic hypernatremia developed. While it was being treated, the patient developed a clonic convulsion of her left extremities and visual disturbance. CT scan demonstrated a right parietal hemorrhagic infarction and IV-DSA suggested thrombosis of the superior sagittal sinus. Laboratory data disclosed DIC. The main cause of sinus thrombosis in this patient was considered severe dehydration. It is also possible that cisplatin and steroid played a role. In addition to these, dysfunction of hypothalamus, which is one of the regulatory centers of the plasma concentration of factor VIII, may have contributed to the acceleration of blood coagulation. This case re-emphasized the importance of preventing dehydration and monitoring the blood coagulation fibrinolytic system during PE therapy in patients with a suprasellar germ-cell tumor accompanied with diabetes insipidus.

How to ventilate lungs as small as 12.5% of normal: the new technique of intratracheal pulmonary ventilation

We wished to determine in a laboratory animal model how much residual lung was needed to sustain total gas exchange. In a series of young, healthy lambs weighing approximately 10 kg that were sedated and paralyzed, we progressively excluded from gas exchange all the left lung (a total of 43%), plus the right lower and cardiac lobes (81%), plus the right middle lobe (87.5%). In some studies, the respective lobes were surgically removed; in others, the bronchi and the pulmonary arteries to the respective lobes were ligated. We provided pulmonary ventilation using the pressure control mode (Servo 900 C) at a tidal volume of 20 mL/kg multiplied by the fraction of the remaining lungs, a respiratory rate up to 120/min, a peak inspiratory pressure of 12-15 cm H2O, and a positive end-expiratory pressure of 3 cm H2O. Those lambs with at least both the right upper lobe (RUL) and right middle lobe remaining (19% of total lungs) were weaned to room air on mechanical ventilation within 48 h. Ventilating RUL (12.5% of remaining lung) with the same ventilator required a substantially higher tidal volume and peak inspiratory pressure to result in adequate alveolar ventilation but led to respiratory failure and death within 8 h. We then applied a newly developed system of intratracheal pulmonary ventilation to ventilate the RUL (12.5% of remaining lung) alone. A continuous flow of humidified mixture of air and oxygen was directly passed into the trachea at the level of the carina through a diffuser at a tidal volume of 2.5 mL/kg. A single valve controlled expiration and respiratory rate.(ABSTRACT TRUNCATED AT 250 WORDS)

[Airway inflammatory cell dynamics during late asthmatic reactions induced by toluene diisocyanate in guinea pigs. II. Histological study]

We investigated airway inflammatory cell dynamics during late asthmatic reactions (LAR) induced by toluene diisocyanate (TDI) in a guinea pig model developed by K. Tanaka et al. (Bull. Chest Dis. Res. Inst. Kyoto Univ. 1983: 16: 1-9). For sensitization, 10% TDI solution was applied once daily to the bilateral nasal mucosa of 41 guinea pigs for 7 consecutive days. One week after the sensitization, the animals were challenged with 5% TDI solution once a week. In addition, metyrapone (50 mg/kg) was injected intraperitoneally 24 h, and 30 min before the challenge, respectively. Airway tissue specimens (large bronchi and bronchioles) were obtained from the 41 guinea pigs at each time point (30 min, 3, 6, 24 and 168 h) after the challenge. Airway inflammatory cell dynamics were evaluated with regard to the onset and persistence of LAR. As a control, 7 guinea pigs were only exposed to ethyl acetate (a solvent for TDI) and sacrificed 6 h afterward. A histological examination of the airways revealed remarkable infiltration of eosinophils but failed to demonstrate infiltration of other inflammatory cells, including neutrophils, in the mucosal tissues of the bronchi and bronchioles during LAR at any time point (3, 6 and 24 h) after the challenge. Therefore, we conclude that eosinophils, but not neutrophils, play an important role in LAR in our model, a contrast to previous reports on human TDI-induced LAR in which neutrophils were also involved.