[A prospective study of septic episodes due to Staphylococcus aureus and the background of the patients]

From January 1983 to December 1991, 94 cases of Staphylococcus aureus septicemia were identified at Matsue Red Cross Hospital and were evaluated. Methicillin-resistant Staphylococci aureus counted 49%. Seventy two percent of the patients were 60 years or over in age. Intravascular catheters were the most common foci (33%), respiratory infections in 25% and so on. Administration of antibiotics before isolation of Staphylococcus aureus were thought to be the most significant factor in producing the methicillin-resistant septicemia, used in 41% of MSSA and 91.3% of MRSA cases. Especially, the trend of unproper usage of the 3rd generation cephems derivative antibiotics had a major role in producing multi-drug resistant bacteria. No significance was seen in the clinical background, underlying diseases, primary site of infection in between the two groups of methicillin resistant and sensitive cases. Mortality due to septicemia was 47.9% in the MSSA group of patients, while it was much higher in cases of MRSA (73.9%). In conclusion, as the administration of antibiotics even in non-infectious episodes is common in daily clinical activities in some out-patient clinics, the indications should be restricted, in order to prevent the further MRSA infections.

Identification of a new serine kinase that activates NF kappa B by direct phosphorylation

A novel serine kinase, named nuclear factor kappa B (NF kappa B) kinase, has been shown to be associated with the NF kappa B.I kappa B complex in the cytosol of human primary T lymphocytes. It activates the DNA binding activity of NF kappa B by directly phosphorylating its p65 and p50 subunits. There is no evidence that it phosphorylates I kappa B. Experiments with inhibitors and antisera showed that it is distinct from other known serine kinases such as mitogen-activated protein kinase or Mos. It has an apparent molecular size of 43 kDa determined by the substrate binding assay. This kinase might have a central role in mediating various signals to NF kappa B.

CD7, CD4 and myeloid antigen-positive acute lymphoblastic leukemia

We report a case of acute lymphoblastic leukemia (ALL, FAB-L2) with unique cellular characteristics. Leukemic cells were negative for various cytochemical stainings except acid phosphatase. Immunophenotypic studies revealed CD7+, CD4+, CD8-, CD2+, CD3-, CD13+, CD25+, CD33+ and CD34+. The immunoglobulin heavy chain and T-cell receptor beta, gamma and delta chain genes were germline configurations. This patient had a karyotype of complex abnormalities involving Nos. 5 and 7. Leukemic cells showed a prominent response to interleukin-3, granulocyte macrophage colony stimulating factor (GM-CSF) and G-CSF with partial granulocytic differentiation in a colony assay. A binding assay confirmed the presence of both high and low affinity receptors for GM-CSF. These findings suggest that CD7+CD4+CD8-CD3- putative T-cell precursors may retain the capacity to differentiate to myeloid lineage.

[A case of intercostal neuropathy (Th 2-9) due to sarcoidosis]

Neurosarcoidosis is a disorder which presents in 5 percent of cases of general sarcoidosis, in only 10% of which the peripheral nerves are involved. A patient who complained of numbness of the abdomen and back associated with paralytic motion of intestines was admitted. The patient was diagnosed as having neurosarcoidosis of the intercostal nerves (Th2-9) on the basis of abnormality of somatosensory evoked potentials (SEP) and reduced conduction velocity, and evident disease of intrathoracic lesions confirmed by biopsy. Corticosteroid was administered, with relief of symptoms and active response on SEP. Somatosensory evoked potentials and VC were of great value in the diagnosis and follow up of peripheral neuropathy due to sarcoidosis.

Three-dimensional cytoarchitecture of complex branched fibers in soleus muscle from mdx mutant mice

Three-dimensional cytoarchitecture and types and features of muscle fibers were examined in soleus muscles from mdx mutant mice at different stages of development. In the 2-week-old mice, no abnormal muscle fibers were observed light microscopically, whereas in the 4-week-old animals, disrupted fibers were frequent in light microscopy and scanning electron microscopy. Muscle fibers fused with several short fiber branches appeared at the sixth week after birth and increased in number until the tenth week. In the 1-year-old mice, approximately ten or more muscle fibers were seen fused together. They had many complex branches forming an "anastomosing syncytial reticulum." Muscle fibers with irregular diameters and aggregations of the same type fibers were also observed. Our results demonstrated that these complex branched fibers might be formed by long term repetition of the degeneration and regeneration cycle during the development of soleus muscles, indicating that the characteristic features of muscle fibers with irregular diameters and aggregations of the same type fibers are certainly dependent on the existence of the complex branched fibers.

A case-control study of colorectal cancer and its relation to diet, cigarettes, and alcohol consumption in Saitama Prefecture, Japan

A case-control study of colorectal cancer in relation to dietary, smoking, and drinking habits was undertaken in Saitama Prefecture, Japan. The study was based on 181 newly diagnosed cases of adenocarcinoma of the colorectum at a single institution and 653 general population controls. Dietary habits were investigated on the basis of the intake of 12 foods and 12 food groups in a food intake frequency questionnaire, together with individual food preferences. Preference for salty foods was positively related to the risk of both colon and rectal cancer, and the consumption of seaweed was inversely related to these cancers, both with a dose-response relation. Cigarette smoking was inversely related to colon cancer risk, but not to rectal cancer risk. Alcohol intake tended to be associated inversely with colon cancer, but not with rectal cancer. In the multiple logistic regression, preference for salty foods (positively) and the consumption of seaweed (inversely) were independently related to both colon and rectal cancer risks.

Chromosome 3p deletion in a renal cell carcinoma cell line established from a patient with von Hippel-Lindau disease

von Hippel-Lindau disease (VHL) is an autosomal dominant inherited disease, frequently accompanied by occurrences of renal cell carcinoma (RCC). Both the VHL gene and tumor suppressor genes for RCC have been mapped to the short arm of chromosome 3, although the genes have not yet been identified. An RCC cell line, KC12, was established from a VHL patient. Molecular genetic analyses in conjunction with cytogenetic studies revealed that the short arm of chromosome 3 distal to the D3S4 locus at 3p11 was lost in the RCC cell line as a result of an unbalanced translocation between chromosomes 3p and 5q. Structural and numerical aberrations, including those on chromosome 3p, were not detected in T-lymphocytes from the patient, suggesting that the inherited mutation of the VHL gene at 3p25-26 in this patient was too subtle to be detected by either Southern blot or karyotype analysis. Since no permanent RCC cell line has been established from a VHL patient, this cell line will be a useful source for analyzing the VHL gene at 3p25-26 and tumor suppressor gene(s) at 3p13-21.

Biologic characteristics of acute leukemia after myelodysplastic syndrome

Ten patients with acute leukemia after primary myelodysplastic syndrome (MDS-AL) were examined to clarify the biologic nature of the leukemic cells in comparison with that of de novo acute myelocytic leukemia (AML). The morphologic and cytochemical features of the leukemic cells from all these patients corresponded well to those of de novo AML, and they were diagnosed with MDS-AML. Phenotypically, the frequent expression of the lymphocyte activation antigens, CD25 and CD30, was characteristic in MDS-AML. The in vitro response of MDS-AML cells to various growth factors was similar to that of de novo AML cells. Transforming growth factor beta 1 (TGF beta 1) suppressed growth factor-dependent colony formation by normal bone marrow cells, MDS bone marrow cells, and de novo AML cells, but did not inhibit colony formation by MDS-AML cells. The number of TGF beta 1 high-affinity binding sites of MDS-AML samples (< 5 to 47 sites/cell) was markedly lower than that in de novo AML samples (120 to 221 sites/cell). Our results indicate that the reduced TGF beta 1 may represent disregulation of the proliferation system in MDS-AML cells. This is thought to occur during the MDS phase, and may be related to the poorer response shown to conventional chemotherapy of AML.

Acute renal failure after exercise in a child with renal hypouricaemia

We describe a 12-year-old boy with renal hypouricaemia who presented with acute renal failure after a 6-h sports training session. Back and loin pain were noted at presentation. Although serum creatinine and blood urea nitrogen were elevated, the serum uric acid concentration was normal (2.6 mg/dl). This decreased to 0.3 mg/dl after recovery. The pyrazinamide and probenecid tests revealed that the cause of renal hypouricaemia in this patient was totally defective uric acid reabsorption. Acute renal failure after exercise is a rare but serious complication in paediatric patients with renal hypouricaemia.

Isolation of camelliaside C from "tea seed cake" and inhibitory effects of its derivatives on arachidonate 5-lipoxygenase

A new flavonol glycoside, camelliaside C, was isolated from "tea seed cake" prepared from the defatted seeds of Camellia sinensis O. Kuntze. The structure was determined as kaempferol 3-O-beta-D-galactopyranosyl-(1-->2)-beta-D-glucopyranoside by spectroscopic methods (FAB-MS, UV, IR, 1H- and 13C-NMR) and the enzymatic transformation of camelliaside C to astragalin. Camelliaside C showed an inhibitory effect on the arachidonate 5-lipoxygenase of RBL-1 cells (IC50:1.4 x 10(-4)M) as did camelliaside A and B isolated from the same product.

Absolute configuration of L-methionine sulfoximine as a toxic principle in Cnestis palala (Lour.) Merr

An unusual amino acid, L-methionine sulfoximine (1), has been isolated from the fresh seeds of Cnestis palala (Lour.) Merr. [Connaraceae]. The absolute configuration of the natural sulfoximine (1) was confirmed to be 2(S)-methionine S(S)-sulfoximine [(2S,SS)-2-amino-4-(S-methylsulfonimidoyl)-n-butanoic acid] by comparison of the [alpha]D value and IR spectrum with those of authentic samples obtained through the optical resolution of synthetic materials. Acute toxicity of the seeds of C. palala in a beagle dog was also studied.

Precise analyses of DNA structure by NMR

Novel 1H NMR techniques were developed and applied to the analyses of the DNA structure. They distinguished the base proton signals of cytosine (uracil) from those of the other bases. Two dimensional experiments were also performed by using these techniques, and were found to be useful for signal assignments. Moreover, the (2'R)-[2'-2H]-labeled DNA 10-mer and 17-mer were synthesized to be used for the determination of precise structures. These stereoselective [2'-2H]-labeling made possible explicit stereospecific assignments and exact determination of the vicinal coupling constants, 3JHH, and thus the conformation of each deoxyribose ring was accurately determined.

A feasible method for expansion of peripheral blood lymphocytes by culture with immobilized anti-CD3 monoclonal antibody and interleukin-2 for use in adoptive immunotherapy of cancer patients

Cultivation of T lymphocytes with immobilized anti-CD3 monoclonal antibody and human recombinant interleukin-2 induced a rapid proliferative response. This procedure was applied to expansion culture of peripheral blood lymphocytes obtained from cancer patients for use in adoptive immunotherapy. Peripheral blood mononuclear cells were separated from 20 ml of blood and cultured in anti-CD3 coated flasks with rIL-2 for 6 days, then transferred to a gas-permeable culture bag and culture continued for an additional 8 days with an increasing volume of medium. Cell numbers increased about 2000-fold during this 2-week culture. The final population contained about 30% CD4+ and 60% CD8+ cells, and all were CD3+ & HLA-DR+. NK cells comprised less than 5%. In clinical trials involving 12 cases receiving 35 infusions, the mean number of harvested T cells after 14 days culture was 3.5 x 10(10) (R = 1.6-6.8 x 10(10)), and the mean expansion index was 1560-fold (R = 409-4091). This method could be of benefit not only in immunotherapy but also for obtaining somatic cells from a small volume of blood for use in molecular or genetic analysis instead of having to perform EB virus transformation of B cells.

[A new lupin alkaloid, (-)-leontalbinine N-oxide, in Sophora flavescens var. angustifolia seeds and its synthesis by biomimetic transformation from (+)-matrine N-oxide]

The possibility of the biomimetic transformation of (+)-matrine N-oxide, a main alkaloid in Sophora flavescens var. angustifolia, under various oxidative conditions was examined by the use of several metallic ions. When (+)-matrine N-oxide was warmed with FeSO4, or Fe(COOH)2 in MeOH-H2O at 40 degrees C, (-)-7, 11-didehydromatrine [(-)-leontalbinine], a minor alkaloid in the same plant, was obtained along with (+)-matrine. This selective formation of (-)-leontalbinine seems to be specific to the reaction of (+)-matrine N-oxide with ferrous reagents. In addition, the structure of the newly isolated minor lupin alkaloid from the seeds of S. flavescens. was determined as (-)-leontalbinine N-oxide from its spectral comparison with the authentic sample.

Regulation of differentiation and proliferation of rat hepatocytes by lactose-carrying polystyrene

We noticed that hepatocytes recognize the structure of oligosaccharides via asialoglycoprotein receptors and synthesized lactose-carrying styrene polymer (PVLA) as an asialoglycoprotein model. We found that the regulation of differentiated function and proliferation of hepatocytes that were cultured on polystyrene dishes can be achieved by varying the amount of PVLA coated on the dishes. The 3H-thymidine uptake of cultured hepatocytes is low for cells cultured on dishes coated with high amounts of PVLA in which the hepatocytes are round and is highest for those cultured on dishes with a low PVLA coating level in which the hepatocytes are spread in shape. Moreover, bile acid release as a typical differentiated function of hepatocytes was maintained at higher levels in hepatocytes attached on dishes coated with a high level of PVLA. Our results indicated that regulation of differentiated function and proliferation in hepatocytes could be achieved by specific ligand-mediated recognition of microscopic surface structure. Thus, it may be possible to regulate proliferation and differentiation of hepatocytes by design of the culturing substrata.

[Expansion of peripheral blood lymphocytes by culture with immobilized anti-CD3 antibody and IL-2]

Peripheral blood lymphocytes separated from about 20ml of blood were cultured with immobilized anti-CD3 antibody and IL-2. Total T lymphocytes in the culture expanded about 2,000 times by 2 weeks culture. Expanded T lymphocytes were infused to cancer patients, and safety and feasibility was confirmed. This method will be applicable for prevention of cancer recurrence.

Multivariate analyses of CT findings in typical schizophrenia and atypical psychosis

In order to investigate the brain morphological differences between typical schizophrenia and atypical psychosis, the brain CTs of 41 patients with typical schizophrenia, 27 patients with atypical psychosis (ATP), and 20 controls were examined. The schizophrenics had larger values for 9 CT indices, i.e., interhemispheric fissure (IHF) index, VBR, 2 lateral ventricles (L-V) and 3rd ventricle (III-V) indices, and 4 sylvian fissure (SF) indices, while the values of ATP patients for 3 SF indices were greater than for the controls. Moreover, the schizophrenics had greater III-V and L-V indices than the ATP patients. The correlation matrix of CT indices indicates that the III-V index correlated well with the other CT indices, whereas the VBR, IHF and right SF indices did not. Therefore, it was speculated that there might be 3 subgroups, each of which has a main focus of alteration in the above-mentioned regions. Therefore, all the cases were divided by means of a cluster analysis into 5 groups. Group I, which contained mainly normal controls, and Group II, which consisted mainly of atypical psychosis patients, had no abnormal CT findings. Group III, which comprised mainly ATP patients and paranoid type schizophrenics, had right SF enlargement. Group IV, which showed significant IHF enlargement, and the residue group, which had larger VBR and significant left SF enlargement, consisted mostly of schizophrenics. Thus, our results suggest that the classification by CT data corresponds on the whole to our clinical diagnosis, according to which schizophrenic psychosis is divided into typical schizophrenia and atypical psychosis, and that each of the two psychosis groups may be further classified into distinct subgroups.

[Intraoperative radiotherapy for local recurrence of intrapelvic malignancies]

From 1986 to 1992, seventeen patients with recurrent intrapelvic malignancies have been treated with intraoperative radiotherapy (IOR) in Saitama Cancer Center. They were 8 males and 9 females. The age ranged 44 to 83 (mean:61.6). The primary organs involved were rectum in 7, urinary bladder in 5, uterine cervix in 3 and ovary in 2. Invasion of recurrent disease into bony pelvis was noted in all but one patient. A total of 27 IORs were done on 18 occasions for 17 patients. The mean radiation dose was 25.6 Gy (range: 12-30). The cones used were 4 to 7 (mean: 5.4) cm in diameter. Debulking surgery was performed in 13 patients just before IOR. Chemotherapy and/or external radiotherapy were done in addition to IOR in most of the cases. As of May 1992, 14 patients had died with a mean survival time of 10 months (range:0.5-29.8). IOR seems to be useful in controlling the intrapelvic recurrent disease and may warrant further investigation.