Alterations in helper-specific circulating T lymphocytes and in the autologous mixed lymphocyte reaction in chronic hepatitis B

Defects in T lymphocyte subpopulations and in the functional characteristics of such cells have been thought to play a role in the evolution of chronic hepatitis B, but the precise nature of the alterations and their significance remains unresolved. We studied lymphocyte subsets in 27 patients with chronic hepatitis B utilizing standard monoclonal antibodies including Leu 1,2a,3a,7 and D1/12 (against the common determinant of the Dr molecule), as well as a newly described monoclonal antibody, "5/9," which is thought to characterize a unique subpopulation of T4 cells with specific helper/inducer function. These results were compared with those obtained using the autologous mixed lymphocyte reaction assay for the same patients in order to further delineate the lymphocyte alterations in chronic hepatitis B. A significant reduction in the mean number of Leu 3a (T4) positive cells was observed as well as a reduction in the number of 5/9 positive cells. These changes were most evident in those positive for HBeAg in serum. Reduction in Leu 3a cells was associated with a reduced autologous mixed lymphocyte reaction assay response, and was most marked in the HBeAg-positive individuals. These findings suggest that HBeAg-positive patients in whom active viral replication is occurring have a defect in T lymphocyte number and function, which may be due in part to reduced 5/9 positive cells. These alterations may be related to the persistence of virus in chronic active hepatitis B patients.

Cardiac myocyte hypertrophy is associated with c-myc protooncogene expression

The mechanism of hormonally induced cell hypertrophy is unknown. Stimulation of cardiac myocytes by alpha 1-adrenergic agents, phorbol esters, and serum induces an increase in the cell size of nondividing cardiac myocytes in primary culture. Expression of the c-myc gene, known to be increased in growth factor-induced cell division, was studied in this model of cell hypertrophy. The alpha-adrenergic agonist norepinephrine (0.002-20 microM) increased levels of c-myc-encoded mRNA to 10-fold over control levels. This increase was detectable at 30 min, peaked at 2 hr, and returned to baseline by 6 hr after stimulation. The norepinephrine response was abolished by the alpha 1-antagonist terazosin (2 microM) but was not affected by the beta-adrenergic antagonist propranolol (2 microM) and was only slightly (25%) attenuated by the alpha 2-adrenergic antagonist yohimbine (2 microM). Serum and the phorbol ester tumor promoter phorbol 12-myristate 13-acetate also enhanced c-myc expression in cardiac myocyte cultures. These findings show that the induction of cardiac myocyte hypertrophy is associated with enhanced expression of the c-myc gene and suggest that hormonally induced cell hypertrophy and cell division share common mechanistic pathways.

Measurement of a follicle-stimulating hormone-responsive protein of Sertoli cell origin using an enzyme-linked immunoblot assay

Many proteins secreted by Sertoli cell-enriched cultures are maximally stimulated by a combination of FSH and testosterone. Since very few are stimulated primarily by FSH, we thought it pertinent to identify such proteins. Sertoli cell-enriched cultures were prepared from testes of 20-day-old rats and grown in serum-free medium containing insulin, transferrin, and epidermal growth factor and in such medium supplemented with FSH, testosterone, or FSH plus testosterone. Media were fractionated using HPLC, and proteins were identified by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. A protein designated CMB-2, with an apparent mol wt of 22,000, was shown to increase in response to FSH. Antiserum was raised using denatured protein eluted from SDS-polyacrylamide gels as the antigen, and a specific immunoassay using a combination of SDS-polyacrylamide gel electrophoresis and Western blotting was developed. The production of CMB-2 by primary Sertoli cell-enriched cultures was found to increase in a dose-dependent manner in response to FSH (30-1000 ng/ml); secretion was not significantly affected by testosterone (2 X 10(-13) M). An investigation of the tissue distribution of CMB-2 showed that the puberty, CMB-2 is secreted into the rete testis and accumulates in the epididymis in high concentration. We conclude that CMB-2 will be a useful marker to study the action of FSH on the rat testis.

Refractory esophageal candidiasis associated with a low molecular weight plasma inhibitor of T-lymphocyte function

In a patient with chronic esophageal candidiasis due to C. tropicalis that was refractory to mycostatin and ketoconazole, a generalized cell-mediated immunodeficiency state was detected. Samples of plasma from this patient inhibited T-lymphocyte function, suppressing both rosette formation and mitogen responsiveness of T-cells derived from the patient and from normal individuals. Following plasma exchange, the patient's immune defect resolved and her candida infection disappeared. On further analysis, the plasma inhibitory factor was found to be of low molecular weight (less than 10,000) and heat labile. Preliminary studies suggested that this inhibitor was candida-derived, since it was removed from plasma by anti-candida antibodies in solid phase. Immunodeficiency in chronic candidiasis may be improved by removal of circulating inhibitory factors through plasma exchange.

Hepatotoxicity after long-term methotrexate therapy

To reassess the need for repeat liver biopsies in patients receiving long-term methotrexate therapy, we reviewed the results of 15 biopsies in 14 such patients seen from 1979 to 1984 at the Medical University of South Carolina. Significant changes in liver histology were found in seven patients. These findings did not correlate with biochemical abnormalities, presence of anemia or obesity, or age when methotrexate therapy was initiated. Four of the 15 biopsies (27%) showed grade III or IV histologic changes (fibrosis or cirrhosis), which led to discontinuance of treatment. The single most significant factor predisposing to toxicity appeared to be the duration of therapy, though the cumulative doses, no patient with grade III or IV histology had been treated for less than five years. Thus, surveillance liver biopsies at suitable intervals are advisable once the patient has been treated for five years or more. Conversely, liver biopsies within the first five years of treatment with methotrexate appear not to be necessary, though these results should be confirmed in a larger patient group.

Hepatic membrane antibodies: studies of prevalence and specificity

Using a newly developed assay for hepatic membrane-associated antibodies (HMA), we studied the prevalence and specificity of HMA in a variety of acute and chronic liver diseases to evaluate the usefulness of such an assay system. Sera were examined by indirect immunofluorescence on rat liver sections previously fixed in Bouin's fluid. As compared with a prevalence of 4% in 45 healthy controls, HMA were detected in 73% of 45 patients with chronic active hepatitis (CAH) (P less than 0.001) and in all 11 patients with primary biliary cirrhosis (PBC) (P less than 0.001). HMA were also present in 38% of 40 patients with acute viral hepatitis, 47% of 27 with alcoholic liver disease and 33% of 24 with other liver diseases not thought to be immunologically mediated. In 53 patients studied with other liver, gastrointestinal or autoimmune diseases, the prevalence of HMA was not increased over controls. Absorption studies showed that seven of 14 HMA positive sera contained specificities for polymerized human serum albumin (pHSA) or liver-specific protein (LSP) or both antigens. HMA positive samples reacted occasionally with rat kidney tubular epithelial membranes but did not appear to react with other tissues. These results demonstrate that HMA are present at higher prevalence in the autoimmune liver diseases than many previously described autoantibodies and are reactive in part to specificities on pHSA and LSP.

Augmented expression of normal c-myc is sufficient for cotransformation of rat embryo cells with a mutant ras gene

We studied the effect of altered c-myc structure and expression upon the ability of c-myc to promote the transformation of normal rat embryo cells when it was supplemented by EJras (the mutant c-H-ras1 gene from EJ/T24 bladder carcinoma cells). We tested several c-myc alleles cloned from normal and tumor tissues of chicken and human origin and found that only LL4myc (derived from a bursal lymphoma in which an avian leukosis virus long terminal repeat resides within the first c-myc intron in the same transcriptional orientation) had cotransforming activity. No activity was observed with normal chicken and human c-myc alleles, two other bursal lymphoma c-myc alleles (LL3myc and LL6myc), and two human c-myc genes (HSRmyc and DMmyc) from human neuroectodermal tumor cell line COLO320, in which c-myc is amplified. Some of these inactive alleles had the following alterations that are frequently found in tumor-derived c-myc: point mutations affecting the encoded protein (LL3myc); a truncated structure with loss of the first, noncoding exon (LL3myc and DMmyc); and proviral integration within or near the myc locus (LL3myc and LL6myc). The following two experimental approaches indicated that cotransforming activity was directly related to the transcriptional activity of the alleles in cultured rat cells: when cotransfected into Rat-2 cells, LL4myc was more highly expressed than the other (inactive) alleles; and augmented expression of HSRmyc, DMmyc, or normal human or normal chicken c-myc placed under the transcriptional control of retroviral long terminal repeats or increased expression of normal human c-myc under the influence of a retroviral enhancer element was accompanied by cotransformation activity. We concluded that augmented expression of even a normal c-myc gene is sufficient for cotransforming activity and that additional structural alterations frequently found in tumor-derived alleles are neither necessary nor sufficient for the gene to acquire rat embryo cell cotransforming properties.

c-myc gene expression is stimulated by agents that activate protein kinase C and does not account for the mitogenic effect of PDGF

The role of the phosphoinositide turnover-protein kinase C pathway in mediating PDGF-stimulated c-myc expression and cell proliferation was studied. Both direct activators of kinase C (e.g. phorbol ester analogues) and hormones that activate kinase C via receptor-mediated phosphoinositide turnover (e.g. PDGF, bradykinin, or vasopressin) elicited a rapid increase in c-myc mRNA expression. Desensitization of the kinase C pathway by prolonged exposure to phorbol abolished the induction of c-myc by subsequent phorbol challenge and attenuated c-myc induction by PDGF and bradykinin, but did not affect PDGF-stimulated mitogenesis. Bradykinin and phorbol esters stimulated the same magnitude of c-myc expression as PDGF but elicited less than one-tenth the PDGF-induced mitogenic response. We conclude that stimulation of c-myc expression is a common response to a diverse group of agents that elicit phosphoinositide turnover and activate protein kinase C, and that neither activation of protein kinase C nor enhanced c-myc expression is sufficient for the mitogenic action of PDGF.

Accurate quantitation of native Gc in serum and estimation of endogenous Gc: G-actin complexes by rocket immunoelectrophoresis

Complex formation between purified Gc and G-actin caused increased rocket height on immunoelectrophoresis with monospecific Gc antiserum, and artifactually high calculated Gc levels. The increase in rocket height varied in log: linear fashion with the amount of G-actin present, up to a plateau attained at equimolarity. The raw Gc values could therefore be corrected to within +/- 10% of known levels by addition of excess G-actin and use of standard plots obtained with Gc after saturation with G-actin. This also allowed quantitation of the percentage of Gc complexed with G-actin. In subsequent studies of whole human sera, comparison of normal controls with pregnant subjects and patients with liver disease showed evidence of differences both in absolute quantities of Gc and the relative proportion circulating as complex with G-actin. This appeared to be due to increased release of cellular actin into the extracellular space. These results show that rocket immunoelectrophoresis can be modified to provide accurate Gc levels, and also information concerning different molecular forms of this protein.

Decreased serum group-specific component protein levels and complexes with actin in fulminant hepatic necrosis

Monomeric G-actin has recently been shown to form high-affinity complexes with group-specific component protein (Gc), and this process might be expected to occur in vivo when hepatocyte necrosis with release of actin takes place. We therefore measured serum Gc levels and searched for evidence of actin-containing complexes of Gc in 147 sera from 21 normal subjects and 126 patients with acute and chronic liver diseases. Sera were examined for Gc concentration using an ELISA with purified Gc as standard. Gc levels were greatly diminished (less than 10 mg per dl) in 5 of 37 patients with acute hepatitis and 1 of 3 patients with subacute hepatic necrosis, and the mean values for these groups overall as well as those for chronic active hepatitis patients were significantly less than that observed in the normal controls (mean, 35.5 mg per dl). No significant alteration in Gc level was observed in the chronic disease categories studied. In contrast, Gc concentrations less than 10 mg per dl were found in 12 of 14 patients with fulminant hepatic necrosis, and the mean for this group (9.7) was significantly reduced (p less than 0.001). Sequential studies in 12 patients with acute hepatitis of moderate to marked severity but without a fulminant phase showed significant diminutions in initial Gc levels when these were compared with Gc levels obtained during recovery. Using analytical isoelectric focusing with print immunofixation, variable amounts of Gc:G-actin complexes could be demonstrated in virtually all sera examined, but the proportion of total Gc present as complex with G-actin appeared greater in fulminant hepatic necrosis sera.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatic rupture associated with pregnancy: treatment with transcatheter embolotherapy

Spontaneous rupture of the liver associated with pregnancy is a rare and very serious complication, usually occurring in association with eclampsia or preeclampsia. Survival has generally been dependent on early recognition of characteristic signs and symptoms and prompt surgical intervention. Even with surgery, maternal mortality approaches 40% and fetal mortality is even higher. The diagnosis can usually be firmly established based on the clinical and radiographic findings presented in this article. Reported is a patient with hepatic rupture successfully treated by transcatheter embolization of the hepatic artery. It is the authors' belief that if such a patient is clinically stable enough to undergo angiography, then transcatheter embolotherapy is a reasonable alternative to surgery.

Intercellular junctions in the hepatopancreas of the lobster Nephrops norvegicus

The hepatopancreas of the lobster has recently been found to be a rich source of material from which to isolate arthopod gap junctions biochemically (Finbow et al., 1983a; 1984). It has therefore been studied here to assess the features of these intercellular junctions and any others that may be present, in vivo. The tissue consists of columnar epithelial cells which possess apical microvilli and basal infoldings. In thin sections the lateral borders of these cells are characterized by desmosomes and smooth septate junctions as well as by gap junctions. The desmosomes exhibit no apparent freeze fracture profile but the septate junctions display parallel rows of ridges or aligned intramembranous particles (IMPs) with complementary grooves on the other membrane half; these IMPs shift in their preferential fracturing plane depending on whether the tissue has first been fixed, always remaining on the EF if unfixed. The IMPs or connexons, of which the gap junctions are composed, fracture onto the E face, leaving complementary pits on the P face, regardless of whether the tissue is fixed or not. At the base of the pancreatic cells, the lateral borders are thrown into interdigitating folds which display endocytotic profiles and possible internalization of junction-bearing membranes. This phenomenon, which is readily visualized both after tracer incubation and in replicas, may represent junctional degradation relating to membrane turnover.

Isolation and characterization of gangliosides from chronic myelogenous leukemia cells

Gangliosides isolated from the cells of three patients with chronic myelogenous leukemia (CML) were purified by Folch partitioning, diethylaminoethyl Sephadex, Florisil (acetylated gangliosides), and silicic acid chromatography and were structurally analyzed using thin-layer and gas-liquid chromatography, methylation analysis, enzyme degradation, and high-performance liquid chromatography. With these methods, the major gangliosides isolated were II3-alpha-N-acetylneuraminosyl-lactosylceramide, IV3-alpha-N-acetylneuraminosyl-neolactotetraosylceramide (sialosylparagloboside), and a ganglioside with the following structure: NeuAc alpha 2 leads to 3(Gal beta 1 leads to 4 GlcNac beta 1 leads to 3)2Gal beta 1 leads to 4Glc beta 1 leads to 1Cer. This ganglioside has previously been characterized as an "i" active compound. Like normal neutrophils, CML cells contain monosialogangliosides that belong to the lactosyl and neolacto family. However, our study shows that CML cells differed from normal neutrophils in that they contained less total ganglioside, and their major ganglioside species is II3-alpha-N-acetylneuraminosyl-lactosylceramide. Differences between gangliosides of CML and acute nonlymphoblastic leukemias are discussed.

Antibodies to hepatocyte membrane antigens in chronic liver disease: detection by immunofluorescence after Bouin's fixation

Using a modified indirect immunofluorescent (IF) technique in which cryostat tissue sections were fixed in Bouin's solution for ten minutes prior to reaction with sera under test, we have looked for antibodies to the hepatocyte membrane (HMA) in the sera of patients with chronic active hepatitis (CAH) and primary biliary cirrhosis (PBC). Samples were tested initially in parallel on unfixed and Bouin's-fixed rat composite blocks (kidney, stomach, liver) at a titer of 1:100 and those found to be positive were diluted further and reexamined. Conventional unfixed sections of rat composite block showed no liver membrane immunofluorescence although antinuclear (ANA), mitochondrial (AMA), and smooth muscle antibodies (SMA) were detected as anticipated. By contrast, prior Bouin's fixation abolished most of the fluorescence due to ANA, AMA and SMA but resulted in brilliant fluorescence of rat hepatocyte membranes in eleven of twelve patients with CAH (93%) and all ten patients with PBC. Only one of 22 normals (5%), one of 20 with collagen-vascular diseases (5%), and one of seven with nonimmunologic liver disease (14%) were positive for this hepatocyte membrane antibody. Bouin's fixation prior to IF is a simple technique which appears to alter the hepatocyte membrane so that HMA become detectable. The strong association of HMA with CAH and PBC suggests that this test might be of value and may contribute towards a further understanding of the pathogenesis of these conditions.

Membrane antigens in chronic active hepatitis: physicochemical and immunological studies of soluble liver homogenate fractions

Since the liver membrane components termed liver-specific protein (LSP) and liver membrane antigen (LM-Ag) have been implicated as target antigens in chronic active hepatitis (CAH), we performed physicochemical and immunological analyses of these and other fractions obtained from liver homogenates. Supernatants were prepared from homogenates of human and rabbit liver by centrifugation at 105,000 g for 1 hr; after gel filtration on Sepharose 6B, the LSP fraction was obtained as the excluded peak I and LM-Ag as an included fraction, peak IIB. Comparison by immunodiffusion with reference LSP and guinea pig antisera to LSP confirmed the similarity of our fractions to reference preparations. Upon SDS-polyacrylamide gel electrophoresis (SDS-PAGE), human and rabbit peak I were found to contain at least 25 distinct protein bands with a wide range of molecular weights (14,000- greater than 100,000) and the other peaks were found to be equally heterogeneous. Thin-layer polyacrylamide gel isoelectric focusing (PAGIF) revealed 35-40 separate bands in both peaks I and IIB with a wide range of isoelectric points (3.5-10.0). These results indicate that liver homogenate fractions such as LSP and LM-Ag can no longer be considered as single protein preparations, and are in fact highly complex mixtures of multiple proteins. Further separation and characterization of such fractions will facilitate identification of liver antigens for use in in vitro immunological assays.

Gangliosides of human chronic lymphocytic leukemia and hairy cells

Gangliosides were purified from the cells of two patients with hairy cell leukemia and one patient with chronic lymphocytic leukemia. Quantification of these compounds showed that these cells contain only 5-15% of the amount of lipid-bound sialic acid (gangliosides) per cell as normal lymphocytes. Structural characterization by gas-liquid chromatography, glycosidase treatment and high-performance liquid chromatography demonstrated that the major gangliosides of these leukemia cells were of the lactosyl type. Hairy cells contained monosialyllactosylceramide (II3NeuAc-LacCer), whereas chronic lymphocytic leukemia cells contained both monosialyl and disialyl lactosylceramide [II3(NeuAc)2-LacCer]. Chronic lymphocytic leukemia cell contained lesser amounts of three other gangliosides of the neolacto or lacto series as determined by endo-beta-galactosidase treatment. None of these leukemia cells contained detectable quantities of NeuAc-LcOse3Cer, a ganglioside found in normal leukocytes.

Potassium movement during sodium-induced motility initiation in the rat caudal epididymal spermatozoa

The sodium-induced sperm motility initiation of the rat cauda epididymal sperm has been studied in different potassium concentrations. High K+ inhibited motility initiation. At a K+ concentration of 50 mM (concentration found in the rat cauda epididymidis), sperm motility was inhibited by 80%. K+ movement across the sperm membrane has been followed by using 86Rb+ as a marker for K+. When the 86Rb+ preloaded sperm were suspended in a sodium-free medium, there was a little efflux of 86Rb+. However, if they were suspended in a sodium-containing medium, the efflux rate was greatly increased. This increase in 86Rb+ efflux rate was associated with an initiation of sperm motility. Both 86Rb+ efflux and motility initiation were triggered by a K+ ionophore 18-crown-6 (2 X 10(-3)M). However, the ionophore-induced 86Rb+ efflux and motility initiation only occurred in the presence of extracellular Na+. Tetraethylammonium (TEA) chloride, which blocks K+ channels, inhibited motility initiation in a dose-dependent manner. Changes in the membrane potential of sperm have been followed using the fluorescent dye diO-C6-(3) whose fluorescence in sperm suspension changes markedly with changes in sperm membrane potential. During motility initiation, there was a fall in fluorescence of the dye due to increased partition into sperm cells. This observation may indicate a hyperpolarization of the sperm membrane during motility initiation. It was concluded that sperm motility initiation is associated with a complex ionic event. Na+ enters sperm cells in exchange with H+ and K+. This change in the permeability of the sperm membrane to ions is reflected by a change in the sperm membrane potential.

Gangliosides of human acute leukemia cells

We characterized the gangliosides from cells of eight patients with different forms of acute leukemia (four lymphoblastic, four nonlymphoblastic) by thin-layer chromatography and high-performance liquid chromatography combined with glycosidase treatment. Our analysis indicated both quantitative and qualitative differences between the gangliosides of acute leukemia and those of normal leukocytes: 1, the absolute amount of ganglioside was decreased in the acute leukemia cells; 2, in general, acute leukemias had a more simplified ganglioside pattern in that they contained a greater proportion of the short-chain ganglioside, II3NeuAc-LacCer (GM#); 3, all of the acute leukemia cells contained reduced quantities of the ganglioside N-acetylneuraminosyl-lactotriaosylceramide, a compound previously found only in normal leukocytes; and 4, a disialylated ganglioside, II3(NeuAc)2-LacCer (GD3), which is not found in normal leukocytes, was isolated from the cells of one patient with acute nonlymphoblastic leukemia. These findings demonstrate important differences between the gangliosides of acute leukemia cells and normal leukocytes.

Candida infections in patients with acute leukemia: ineffectiveness of nystatin prophylaxis and relationship between oropharyngeal and systemic candidiasis

Ninety-three hospitalizations of 70 patients, who underwent induction chemotherapy for acute leukemia to determine the effectiveness of oral nystatin in preventing oropharyngeal and systemic candidiasis were reviewed. Sixty-two percent of patients who received prophylactic nystatin and 58% of patients who did not receive nystatin developed oropharyngeal candidiasis; 11% of patients who received prophylaxis and 21% of those who did not receive prophylaxis developed systemic candidiasis. The use of oral nystatin did not significantly diminish the risk of developing either type of Candida infection. Oropharyngeal candidiasis occurred more commonly in patients who had severe and prolonged leukopenia, had received more parenteral antibiotics, and had developed chemotherapy-induced mucositis. Systemic candidiasis developed almost exclusively in patients who had prior oropharyngeal candidiasis. Guidelines for the empiric use of amphotericin B in these patients are provided.

Hairy cell leukemia with bone marrow hypoplasia

This article reviews the authors' experience with hairy cell leukemia to determine the incidence of hypoplastic marrows in this disease and the utiity of embedding marrow biopsy specimens in plastic, which allows the sections to be stained for tartrate-resistant acid phosphatase (TRAP). It was found that the presence of hairy cells in the peripheral blood, marrow aspirate, or both established the diagnosis in eight of 11 patients; in the remaining three patients, the marrow biopsy specimen was necessary for definitive diagnosis. The bone marrow was markedly hypocellular in three patients, including one in whom the marrow morphologic results were essential for diagnosis. Embedding the marrow biopsy specimen in plastic and staining the sections for TRAP was noted to be a useful technique in establishing the diagnosis of hairy cell leukemia. In all cases in which this was performed, the authors found abundant TRAP-positive cells in the marrow biopsy specimen; even in those cases with markedly hypocellular marrows, this technique revealed the presence of hairy cells. In one patient, TRAP staining of the marrow biopsy specimen proved essential for definitive diagnosis. The authors concluded that the occurrence of marrow hypocellularity is not rare in patients with hairy cell leukemia and that TRAP-staining of plastic-embedded marrow biopsy specimens is a helpful and sometimes essential technique in diagnosing hairy cell leukemia.

Effects of spironolactone (aldosterone antagonist) on electrolyte and water content of the cauda epididymidis and fertility of male rats

It has previously been shown that the rat cauda epididymidis actively reabsorbs Na+ in exchange with K+. This coupled Na+/K+ transport is stimulated by aldosterone. These transport processes create a low Na+ and high K+ environment which appears to be (in part) responsible for sperm quiescence during storage. The effects of aldosterone antagonist, spironolactone, on the electrolyte and water content of the cauda epididymidis, sperm motility initiation and fertility of male rats were investigated in the present study. It was found that treatment of rats with spironolactone (10 mg/kg per day for 4 to 17 days) led to a significant fall in K+ (18%) and sperm (21.5%) concentrations in the cauda epididymal fluid. However, the Na+ concentration remained unchanged. The fall in sperm concentration may be taken to indicate an increase in fluid volume which is secondary to an inhibition of water absorption. When corrected for an increase in volume, there was no change in the amount of K+ in the fluid but the amount of intraluminal Na+ was increased. Despite a fall in K+ and sperm concentration, the capacity of the cauda sperm to initiate motility and fertility of the animals were apparently not affected by spironolactone treatment. It is concluded that the fertility capacity of spermatozoa is rather resistant to drugs which interfere with electrolyte and water transport across the caudal epididymal epithelium.

Carbon dioxide induced disassembly of gap-junctional plaques

When sheep ovarian follicle cells are maintained in an O2-rich environment their cells are metabolically coupled, as monitored by observing the exchange of [3H]choline; choline metabolites were detected up to 4 mm from the explant under these control conditions. When the tissues were placed in a CO2-rich environment the cells became uncoupled physiologically and choline metabolites were no longer exchanged. The cells in these two states, coupled and uncoupled, were examined by freeze-fracture. The initial controls were characteristic of ovarian follicular tissue exhibiting large macular plaques with regular outlines composed of PF intra-membranous particles (IMPs), which were arrayed in rows with IMP-free aisles. With uncoupling, the junctional plaques became irregular at the periphery, they became loosely packed and IMPs began to ‘stream’ out laterally across the membrane. Ultimately they were reduced to negligible IMP clusters or free IMPs. Analyses of the IMPs with an image analyser confirmed that in the uncoupled state the gap-junctional IMPs were dispersed over the membranes. On return to an O2-rich environment, the cells became recoupled as monitored by physiological criteria and in freeze-fracture replicas IMPs reclustered into macular, albeit smaller, plaques. These results support the contention that with uncoupling, gap-junctional particles are free to move and hence may become dispersed over the membrane face, with the possibility of being re-utilized to form junctions anew when conditions for coupling are re-established.

Fungal infections in patients with acute leukemia

We reviewed the records of 32 patients with acute leukemia and proved invasive fungal infections to determine the clinical and pathologic characteristics of systemic mycosis in patients undergoing intensive induction chemotherapy. The incidence of invasive fungal infections among our patients was at least 27 percent, and Candida and Aspergillus accounted for the majority of these infections. Patients with systemic candidiasis generally had prolonged severe neutropenia, fever refractory to antibiotics, and evidence of mucosal colonization by fungi. At autopsy, Candida was always widely disseminated. Patients with aspergillosis generally had neutropenia, fever, and pulmonary infiltrates at the time of admission to the hospital and, at autopsy, their infections were primarily confined to the lungs. Patients infected with both Candida and Aspergillus had clinical and pathologic findings that were a combination of the features of each type of infection. A diagnosis of invasive fungal infection was established before death in only nine of the patients, all of whom had systemic candidiasis. Four of these patients were successfully treated and survived their hospitalization. The reasons for frequently misdiagnosing and unsuccessfully treating systemic mycosis in patients with acute leukemia are examined, and suggestions are made for improved management of patients at high risk for these infections. These suggestions are based upon recognition of the clinical settings in which fungal infections occur, the aggressive use of invasive diagnostic procedures, and the early empiric use of amphotericin B.

High-performance liquid chromatography of long-chain neutral glycosphingolipids and gangliosides

We describe a method for analyzing the perbenzoyl derivatives of both neutral glycosphingolipids and gangliosides with a single high-performance liquid chromatography system. Use of this system, combined with endo- and/or exoglycosidase treatment of glycosphingolipids, provides a sensitive method for obtaining structural information on these compounds. This system has two advantages over previously published chromatography procedures: (i) it uses a commercially available column, and (ii) this single column can be used to analyze gangliosides and their neutral glycosphingolipid products generated by neuraminidase treatment. With this method, we have studied 24 different glycosphingolipids, containing one to ten sugars and one or two sialic acid residues, and have demonstrated its usefulness in evaluating the gangliosides present in human leukocytes.

Neutral glycosphingolipids of human acute leukemias

Neutral glycosphingolipids were isolated from the malignant cells of several patients with different types of acute leukemia. Analyses were performed by high performance liquid chromatography combined with enzymatic hydrolysis of glycosphingolipids using glycosidases (Escherichia freundii endo-beta-galactosidase, jack bean beta-galactosidase, and beef kidney beta-hexosaminidase). We found that acute leukemia cells contain very little or none of the more complex neutral glycosphingolipids that are found in normal leukocytes or chronic leukemia cells. Lymphoblasts, in particular, are rich in neutral glycosphingolipids with only 1 or 2 carbohydrate units. The most significant finding of our study was that, in contrast to normal leukocytes and chronic leukemia cells which have a single predominant tetraosylceramide species, acute leukemia cells (9 out of 10 patients analyzed) were found to have significant amounts of both globo (GalNAc beta 1 leads to 3Gal alpha 1 leads to 4Gal beta 1 leads to 4Glc beta 1 leads to 1ceramide) and neolactotetraosylceramide (Gal beta 1 leads to 4GlcNAc beta 1 leads to 3Gal beta 1 leads to 4Glc beta 1 leads to 1ceramide). These results indicate that the composition of neutral glycosphingolipids in acute leukemia cells differs significantly from that found in normal or chronic leukemia cells.

Glycosphingolipids of normal and leukemic human leukocytes

We have reviewed the studies on neutral glycosphingolipids and gangliosides of normal and leukemia human leukocytes. In this review, we examine (a) the glycosphingolipid composition of various leukocyte populations, (b) the differences in glycosphingolipids found among subsets of these cells, (c) the possible use of these compounds as markers of differentiation, and (d) the changes in glycosphingolipid composition that occur with leukemogenesis.

Gastrin-secreting tumor of the duodenum (G-cell apudoma) associated with secondary biliary cirrhosis

A middle-aged woman with evidence of chronic cholestasis of several years and no previous abdominal surgery was initially thought to have primary biliary cirrhosis. Clinical evaluation disclosed a well-developed secondary biliary cirrhosis apparently caused by extrahepatic obstruction due to a 1 X 2 cm neoplasm of the periampullary duodenum. Electron microscopy and immunofluorescent studies showed the neoplasm to be a G-cell adenoma. Wide local excision has resolved the biliary obstruction. Bening or slow-growing duodenal tumors, if they involve the ampulla of Vater, may produce prolonged partial extrahepatic obstruction and secondary biliary cirrhosis.

Isolation and characterization of glycosphingolipids from human leukocytes. A unique glycosphingolipid pattern in a case of acute myelomonoblastic leukemia

Neutral glycosphingolipids and gangliosides were isolated from the malignant cells of a patient with acute myelomonoblastic leukemia. Structural analyses were performed by gas-liquid chromatography and by high-performance liquid chromatography combined with enzymatic hydrolysis of glycosphingolipids using glycosidases. We found that, in contrast to normal leukocytes and chronic leukemia cells which have only a single tetraosylceramide species, these acute myelomonoblastic leukemia cells have approximately equal amounts of both globo- and neolactotetraosylceramide. This is the first population of human leukocytes in which we found two families of neutral glycosphingolipids to be present. The ganglioside fraction was composed of appreciable quantities of both NeuAc alpha 2 leads to 3Gal beta 1 leads to 4Glc beta 1 leads to 1Cer (GM3, hematoside) and NeuAc alpha 2 leads to 3Gal beta 1 leads to 4GlcNAc beta 1 leads to 3Gal beta 1 leads to 4Glc beta 1 leads to 1Cer (sialoparagloboside). These cells did not have the 'leukocyte-specific' N-acetylneuraminosyllactotriaosylceramide found in normal human lymphocytes and neutrophils. These results are discussed in relation to normal leukocyte differentiation and acute leukemia. The present study also illustrates the usefulness of combining enzymatic degradation with high-performance liquid chromatography for glycosphingolipid structural determination.

The supply of oxygen to the flight muscles of insects: a theory of tracheole physiology

In the flight muscles of insects, virtually every mitochondrion is in contact with or is encircled by terminal tracheoles which reach them by following the channels formed by the invaginated plasma membrane of the muscle fibres, the T-system tubules. In musca, Calliphora and Drosophila (Diptera), Apis (Hymenoptera) and Tenebrio (Coleoptera) the terminal tracheoles are smooth-surfaced tubes with a lumen of about 50 nm. In Pieris (Lepidoptera) the terminal tracheoles occupy the regular transverse tubular system which runs between the mitochondria and across the fibrils on either side of the H zone. They are smooth tubules of 80-200 nm diameter. Preliminary observations suggest the same arrangement in Ischnura (Odonata). In Rhodnius and other Hemiptera the transverse T-tubule system forms large cavities among the mitochondria: these cavities in Rhodnius are occupied by smooth-walled tracheole endings. In the nature adult of Schistocerca (Orthoptera) T-tubules of varying size are utilized by terminal tracheoles (diameter 50-100 nm). The terminal tracheoles of the flight muscles are highly permeable to myrcene and kerosene. They commonly fill with liquid during rest and this liquid is resorbed during activity. It is suggested that these adaptations increase the efficiency of respiration in the flight muscles by ensuring that, when it is most needed, gaseous oxygen extends to the surface of the mitochondria, from which it is separated by a very permeable barrier.

Effects of antifertility drugs on epididymal protein secretion, acquisition of sperm surface proteins and fertility in male rats

The possibility that alpha-chlorohydrin, 6-chloro-6-deoxyglucose (6CDG) and cyproterone acetate (CPA) might affect epididymal protein secretion or acquisition of sperm surface proteins as the cause of their antifertility action in male rats was investigated. Daily administration of 9 mg/kg alpha-chlorohydrin for 7--14 days and 24 mg/kg 6CDG for 14--21 days induced sterility in male rats and imparied the capacity of the cauda epididymal spermatozoa to initiate motility. Treatment with CPA (30 mg/kg/day) for 21--28 days, however, was found to have no effect on fertility and initiation of sperm motility, although the epididymis of the treated animals underwent a loss in weight. The antifertility effects of alpha-chlorohydrin or 6CDG did not seem to be attributed to an interference with epididymal protein secretion. The cauda epididymal fluids of the alpha-chlorohydrin, 6CDG and CPA treated animals have similar protein patterns compared to those of the control animals. However, when the surface proteins of the spermatozoa were labelled with radioactive iodine, the sperm surface proteins alpha-chlorohydrin and 6CDG treated animals were found to differ from those of the control animals. Two peaks (MW 32 000 and 70 000) and one peak (70 000) were significantly reduced in the alpha-chlorohydrin treated and 6CDG treated animals, respectively. Additional bands appeared on the surface of the treated (infertile) animals. In contrast, CPA treatment did not affect the surface protein pattern of the epididymal spermatozoa. It was concluded that the antifertility affects of alpha-chlorohydrin and 6CDG are not due to an interference with epididymal secretion of specific proteins but to an intervention of the subsequent acquisition of these proteins by epididymal spermatozoa. This results in a decrease in the capacity of the epididymal sperm to initiate motility and hence a loss of fertilizing capacity.

Neutral glycosphingolipids in hairy cell leukemia

The neutral glycosphingolipids of hairy cells from a patient with hairy cell leukemia were chemically analyzed by thin-layer and gas-liquid chromatography, mass spectrometry, combined gas chromatography-mass spectrometry, and glycosidase treatment. These cells were found to have compounds containing one to four sugars with the following structures: Glc1 leads to 1Cer Gal beta 1 leads to 4Glc1 leads to 1Cer Gal alpha 1 leads to 4 Gal beta 1 leads to 4Glc1 leads to 1Cer GalNAc beta 1 leads to 3Gal alpha 1 leads to 4Gal beta 1 leads to 4Glc1 leads to 1Cer These compounds belong to the globo series of neutral glycosphingolipids and are similar to those found in human lymphocytes and chronic lymphocytic leukemia cells. They differ from the neutral glycosphingolipids found in human neutrophils and chronic myelogenous leukemia cells which are of the lactoneo and gala type. Neutral glycosphingolipids may be useful in classifying leukemias of uncertain origin.

Effects of divalent and lanthanide ions on motility initiation in rat caudal epididymal spermatozoa

1 Sperm motility initiation of rat caudal epididymal spermatozoa in vitro has been studied.2 Spermatozoa flushed out from the cauda epididymis with a sodium-free medium exhibited a transient motility which decreased progressively. At 40 min, the forward motility was completely suppressed. However, if they were resuspended in a sodium containing medium their motility was completely restored to normal within 15 min.3 This initiation of sperm motility required the presence of extracellular calcium. Maximal stimulation was obtained at a calcium concentration of 10(-3)M. Above this concentration, further increase in calcium produced a fall in motility and at 10(-2)M, motility initiation was completely suppressed.4 The initiation of sperm motility has been shown to depend closely on sodium. Sperm motility initiation alters in a curvilinear fashion with extracellular sodium concentration showing saturation kinetics. High calcium (above 10(-3)M) was found to depress motility initiation induced by sodium, without affecting the apparent affinity constant for sodium.5 The effect of Ca(2+) on sperm motility initiation could be mimicked by Sr(2+) but not by Mg(2+), La(3+) or Eu(3+).6 In the presence of extracellular calcium (1.27 or 2.54 mM), La(3+) and Eu(3+) exerted a dose-dependent inhibition of sperm motility initiation. The IC(50) values for both ions were about 5 x 10(-5)M.7 The possible mechanism of inhibition by lanthanide ions is discussed.

Isolation and structural characterization of human lymphocyte neutral glycosphingolipids

The neutral glycosphingolipids of human peripheral blood lymphocytes and of the lymphoid cells from a patient with B cell chronic lymphocytic leukemia were chemically analyzed. Four neutral glycosphingolipids were chemically analyzed. Four neutral glycosphingolipids were isolated from each of these two sources and studied by gas chromatography, methylation analysis, and electron impact--desorption mass spectrometry. The results of these studies indicate that the compounds have the following structures: Glc1 leads to 1Cer Gal1 leads to 4Glc1 leads to 1Cer Gal1 leads to 4Gal1 leads to 4Glc1 leads to 1Cer GalNAc1 leads to 3Gal1 leads to 4Gal1 leads to 4Glc1 leads to 1Cer These compounds, belonging to the globo series, were the only neutral glycosphingolipids found in the lymphoid cells. The ceramide (Cer) moiety of all these compounds contained 4-sphingenine with C16:0, C24:0, and C24:1 as the major fatty acid species. There were no structural differences in the neutral glycosphingolipids of peripheral blood lymphocytes compared to those of chronic lymphocytic leukemia cells. Peripheral blood lymphocytes contained more di- than monohexosylceramide whereas the reverse was true of the chronic lymphocytic leukemia cells. The proportion of tri- and tetrahexosylceramide was less than 10% for both types of cells. The results of our analyses did not support the existence of any differences in the major neutral glycosphingolipids among T, B, and chronic lymphocytic leukemia cells.

Origin of the luminal fluid proteins of the rat epididymis

Using a combined microperfusion and high resolution gel electrophoresis technique, the origin of the epididymal fluid proteins of the rats has been investigated. Some proteins originate from the testis, others are secreted by the epididymis or are released by spermatozoa. Of particular interest is a 32 000 dalton protein found to be actively secreted by the caput epithelium in situ and concentrated in the lumen. The cauda epididymis contained the highest concentration of this protein. Radioactive labelling of the sperm surface proteins revealed that this protein was present on the surface of the mature cauda but not on the immature caput or corpus sperm, suggesting its acquisition by the sperm surface during epididymal transit. Another sperm surface protein of interest (MW 40 000) is present only on the plasma membrane of the cauda but not on that of the caput or corpus sperm. Since this protein was not identified in the epididymal perfusates or luminal fluids, its presence may result from some modification events taking place in the sperm membrane during maturation.

The effects of sodium and amiloride on the motility of the caudal epididymal spermatozoa of the rat

The forward motility of the rat caudal epididymal spermatozoa has been studied in different Na+ concentrations. When spermatozoa were suspended in a completely Na+-free solution, the forward motility suffered a progressive fall and after 3 h was completely suppressed. This effect was fully reversible on resuspending the spermatozoa in a solution containing Na+. Amiloride caused a fall in motility and the effect was similar to that of Na+ removal. The inhibition by amiloride of the motility was concentration dependent and the dose response curve showed an IC50-value of about 5 x 10(-5) M. The role of Na+ influx in the maintenance of sperm motility was discussed.

Secretion of the rat cauda epididymidis

A method has been developed to study the mechanism of epididymal secretion in the anesthetized rat in vivo. Secretion of the cauda epididymidis was affected by altering the intraluminal calcium ion concentration. Removal of calcium caused a rise and high calcium (10 X normal) caused a fall in the rate of secretion. Exocytosis did not seem to be operative in the epididymidis. The perfusate collected from the cauda epididymidis stimulated the forward motility of the washed caudal epididymal spermatozoa. This effect was concentration-dependent. At low concentration the perfusate stimulated the forward motility and at high concentration it caused a fall. A similar relationship between concentration and effect was noted for the epididymal plasma. When the diluted perfusate was used as the stimulant, there was a time lag of 15 min before any stimulation of forward motility was observed. However, the effect of the diluted epididymal plasma was immediate. The effect of the perfusate but not the plasma was inhibited by pretreatment of the sperm with cyclohexamide (10(-4) M). This difference in the action of the two fluids was discussed in relation to the proteins present in the fluids as revealed by SDS polyacrylamide gel electrophoresis.

Evans blue dye. Accumulation in swine aortic intimal cell collections and atherosclerotic lesions

A two-part study concerned the accumulation of intravenously injected Evans blue dye in the abdominal aorta of swine. In normolipidemic swine weighing up to 90 kg each, Evans blue accumulated predominantly in areas of the aorta that were the site of intimal smooth muscle cell collections. The second part of the study dealt with Evans blue accumulation in swine with advanced atherosclerosis. The extent of blue staining in these animals was not significantly different than in normolipidemic, nonatherosclerotic swine of the same size. The dye showed a predilection for raised atherosclerotic lesions, but only one quarter of the surface of these lesions was stained. Histologic studies of the uppermost portion of blue and nonblue lesion areas showed that the dye preferentially accumulated in regions with lower concentrations of foam cells. Injected isotopic cholesterol tended to accumulate in the blue rather than the nonblue areas.

Effect of intraluminal ion concentrations on the secretion of the rat cauda epididymidis in vivo

It has been shown that the rat epididymis secretes proteins and organic compounds which may play a role in sperm maturation and storage. A method has been described to study caudal epididymal secretion in anaesthetized rats in vivo. The cauda epididymidis was luminally perfused with Krebs bicarbonate solution. The perfusate collected at the vas deferens was allowed to flow through a microcell and absorption at 280 nm was monitored and displayed on a recorder. Secretion as measured by this method was found to be independent of perfusion rate ranging from 2.8 to 25 microliter/min and was maintained over a period of 8 h. Removal of Na+ ions from the perfusion fluid had no effect on the secretion rate. Removal of Ca2+ by perfusion of the duct with a Ca2+-free EGTA (1.5 mM) solution caused a rise in the secretion rate as revealed by an increase in absorption of the perfusate. High potassium produced similar results. Analysis of the perfusates showed that the Ca2+-free EGTA solution caused an increase in the secretion of non-protein materials whilst high potassium stimulated the release of proteins. Luminal application (0.5 mg/ml) or intraperitoneal injection (30 or 80 mg/kg) of cycloheximide had no effect on secretion during the 6 h post-treatment period. These results are discussed in relation to the possible mechanism of secretion in the epididymis.