First Report of Guinea Grass Smut Caused by Conidiosporomyces ayresii in Japan

Guinea grass (Panicum maximum Jacq.) is an important C-4 perennial plant that grows in southern Japan. In March 2010, a smut disease was found in grass that is cultivated in the Ishigaki Islands, Okinawa, in southernmost Japan. Spikelets of susceptible cultivars were swollen and filled with gray spore masses and seed production was substantially reduced. Two single-spore isolates of a smut fungus were obtained from infected spikelets and deposited at the NIAS Genebank, Japan as MAFF511519 and 511520. The 28S rDNA sequences of the isolates were analyzed as described by Boekhout et al. (1). The 28S rDNA sequence (GenBank Accession No. AB647346) of isolate MAFF511519 matched that of Conidiosporomyces ayresii (GenBank Accession No. AY819017) isolated from P. maximum with 99.8% similarity. Spores were pale brown to brown, globose to subglobose, verrucose, and 14 to 16 × 15 to 18 μm in diameter with relatively thick walls of 2 to 3 μm. With scanning electron microscopy, warts appeared dense and short with pointed tips. Spores germinated under wet conditions and produced masses of basidiospores. Basidiospores were aseptate, long, cylindrical, straight to slightly curved, 20 to 37 × 2 to 3 μm, and often germinated into Y-shaped conidia. This description matches previous descriptions (3) of C. ayresii (Berk.) Vánky (Tilletia ayresii Berk.) of the smut pathogen of guinea grass (2). The smut fungus was identified as C. ayresii on the basis of morphology and molecular phylogenetic analysis. To produce inoculum, the isolates were grown on potato dextrose agar at 25°C in the dark for 7 days. Two plants of cv. Ryukyu 5-gou with half-flowering heads were grown in a greenhouse for approximately 1 month and then inoculated by atomizing them with conidial suspensions of each isolate (10⁶ conidia/ml). A plant sprayed with sterilized distilled water served as the control. Inoculated heads were covered with plastic bags for 48 h at 25°C. After 30 days, all inoculated plants were symptomatic with swollen spikelets releasing gray spores. Controls remained asymptomatic. The smut fungus was reisolated from released gray spores, confirming Koch's postulates. To our knowledge, this is the first report of smut caused by C. ayresii on guinea grass in Japan. References: (1) T. Boekhout et al. Stud. Mycol. 38:175, 1995. (2) J. M. Lenné and P. Trutmann. Diseases of Tropical Pasture Plants. CAB International, Wallingford, UK, 1994. (3) K. Vánky and R. Bauer. Mycotaxon 43:427, 1992.

First Report of Pestalotiopsis microspora Causing Leaf Spot of Hidcote (Hypericum patulum) in Japan

Hidcote, Hypericum patulum Thunb. ex Murray, is a deciduous shrub that is cultivated as an ornamental in landscape gardens and courtyards in Japan. In early August 2008, severe leaf spotting was observed on plants growing in a courtyard in Nasushiobara, Tochigi, Japan. More than 30% of the leaves on five shrubs exhibited leaf spot symptoms. Small, round, pale brown lesions were initially observed. Later, they expanded to 5 to 12 mm in diameter, round to irregular-shaped with pale brown centers and dark brown margins. Under continuously wet or humid conditions, black acervuli developed on the leaf lesions. Conidia were straight or slightly curved, fusiform to clavate, and five-celled with constrictions at the septa. Conidia ranged from 17 to 21 × 5 to 8 μm with hyaline apical and basal cells. Fifteen percent of apical cells had two and the rest had three appendages (setulae) ranging from 10 to 21 μm long. The basal hyaline cell tapered into a 2 to 4 μm pedicel. The three median cells ranged from light or dark brown to olive green. These morphological characteristics matched those of Pestalotiopsis microspora (Speg.) G.C. Zhao & N. Li (1,2). The identity of the fungus was confirmed by DNA sequencing of the internal transcribed spacer (ITS) region (GenBank Accession No. GU908473) from single-spore isolates, which revealed 100% homology with those of other P. microspora isolates (e.g., GenBank Accession Nos. FJ459950 and DQ456865). Koch's postulates were confirmed using leaves of three detached branches of a field-grown asymptomatic plant of H. patulum. Thirty leaves of each branch were inoculated by placing mycelial plugs obtained from the periphery of 7-day-old single-spore cultures on the leaf surface. Potato dextrose agar plugs without mycelium served as controls. Leaves on branches were covered with plastic bags for 24 h to maintain high relative humidity in a greenhouse (approximately 24 to 28°C). After 5 days, all inoculated leaves showed symptoms identical to those described above, whereas control leaves remained symptom free. Reisolation of the fungus from lesions on inoculated leaves confirmed that the causal agent was P. microspora. To our knowledge, this is the first report of leaf spots on H. patulum caused by P. microspora in Japan. Management options may have to be developed and implemented to protect Hidcote plants in areas where leaf spot cannot be tolerated. References: (1) P. A. Saccardo. Sylloge Fungorum III:789, 1884. (2) G. C. Zhao and N. Li. J. Northeast For. Univ. 23(4):21, 1995.

First Report of Blast of Guinea Grass Caused by Pyricularia sp. LS-Group in Japan

Guinea grass (Panicum maximum Jacq.) is an important C-4 perennial herbage in the southern part of Japan. In February 2002, a blast disease was found on the grass cultivated on the Okinawa Islands, the southern most region of Japan. Early symptoms appeared as small, round or ellipsoid lesions on leaves. Lesions later expanded to 2 to 5 × 1 to 2 mm and were spindle shaped and grayish white in the central area with dark brown margins. We obtained three single-conidia isolates of a Pyricularia-like fungus from the lesions and deposited them in the NIAS Genebank, Japan as MAFF306662, 306671, and 306672. The isolates were grown under near-UV light on V8 juice agar for 7 days to produce conidia, and guinea grass plants of the seven- to eight-leaf stage grown from seeds in a green house, five plants for each isolate, were inoculated by atomizing them with the conidial suspension of 10⁵ conidia/ml. The same number of plants sprayed with sterilized distilled water served as the control. The experiments were repeated twice. All plants were covered with plastic bags for 24 h at 25°C to maintain high relative humidity. After 7 days, all inoculated plants showed symptoms identical to those observed in the field. Controls remained symptom free. The Pyricularia-like fungus was reisolated from lesions on inoculated leaves. The morphologies of the isolates were observed and described from the colonies grown under the condition described above. Conidiophores were pale brown, emerging singly or in small groups, straight or flexuous, geniculate toward the apex, and 36 to 197 × 2 to 5 μm. Conidia were obpyriform, straight, colorless to pale brown, smooth, and 19 to 30 × 5 to 10 μm with two to three septa. The morphologies were the same as those of the description of the genus Pyricularia. Previously, all Pyricularia isolates from Gramineae had been identified as P. grisea, except for those from rice (3,4). However, a new taxonomy of Pyricularia spp. based on DNA analyses was proposed by Couch and Kohn (1). Only the isolates from Digitaria were classified as P. grisea and those from C-3 grasses classified as P. oryzae. However, the species names for the isolates from the other C-4 grasses were not described. We analyzed the sequences of the rDNA-ITS region (ITS1-5.8s-ITS2) and β-tubulin gene of the isolates from guinea grass following Couch and Kohn (1). The sequences of rDNA-ITS (GenBank Accession No. AB512785) and β-tubulin (AB512786) of the isolate MAFF306672 matched the sequences of those of the Pyricularia sp. LS-group (AB274426 and AB274458, respectively) isolated from Leersia oryzoides. Hirata et al. (2) reclassified Pyricularia isolates from Gramineae by multilocus phylogenetic analysis and showed that non-P. oryzae and non-P. grisea isolates could be classified into two groups of the Pyricularia sp., a LS- and a CE-group, corresponding to those isolated from Leersia spp. and Setaria spp. or Cenchrus spp. of grasses, respectively. Since no Magnaporthe teleomorph was produced by the crossing tests using the isolates, we identified the isolates from guinea grass as the Pyricularia sp. LS-group on the basis of their morphology and the molecular phylogenetic analysis. To our knowledge, this is the first report of blast on guinea grass in Japan. References: (1) B. C. Couch and L. M. Kohn. Mycologia 94:683, 2002. (2) K. Hirata et al. Mycol. Res. 111:799, 2007. (3) K. D. Hyde. Australas. Plant Pathol. 22:73, 1993. (4) R. Sprague. Diseases of Cereals and Grasses in North America. Ronald Press Company, New York, 1950.

First Report of Alternaria panax Causing Leaf Spot of Aralia cordata in Japan

Udo, Aralia cordata Thumb, Araliaceae, is a traditional Japanese perennial vegetable and used in Chinese herbal medicines. During the last 10 days of July 2008, before the period of flower, leaf spots were observed on udo growing under pine trees in Nasushiobara, Tochigi, Japan. Leaf spots affected more than 40% of the plants. Early symptoms appeared as small, round or irregular, water-soaked, dark brown lesions on the leaves. These areas expanded to 15 to 30 mm in diameter, were irregular and pale brown in the central area and the margin of the lesions were water soaked and dark brown. Later, some lesions coalesced. In continuously wet or humid conditions, conidiophores with conidia appeared on the surface of leaf spots. Conidiophores were medium brown and simple (approximately 70 to 160 × 6 to 8 μm). Well-developed conidia were long-obclavate, base obtuse, straight, yellowish brown, smooth walled, with six to nine transverse septa and three to five longitudinal or oblique septa, constricted at some main septa, some cells easily swelled, conidium body was 72 to 100 × 19 to 34 μm, and the rostra extension was 40 to 90 × 4 to 5 μm. The pathogen was identified as Alternaria panax on the basis of the morphology and sequence of ITS1-5.8s-ITS2 of rDNA. The sequence (GenBank Accession No. FJ607183) exactly matched the sequences of two A. panax (e.g., GenBank Accession Nos. AY898639 and AY898640) (2-4). The fungus was isolated on V8 agar from a single conidium found on symptomatic leaf tissue. Colonies of A. panax were gray-to-black and did not easily produce conidia on the agar. Koch's postulates were performed with the leaves of three branches on a field plant of Aralia cordata. Leaves were inoculated with a mycelial plug harvested from the periphery of a 7-day-old colony; an equal number of leaves on the same plant inoculated with plugs of V8 medium served as the control. All test leaves were covered with plastic bags for 24 h to maintain high relative humidity and incubated at a natural temperature (approximately 24 to 28°C). After 7 days, all inoculated leaves showed symptoms identical to those observed in natural conditions, whereas the controls remained symptom free. Reisolation of the fungus from lesions on inoculated leaves confirmed that the causal agent was A. panax. This species has been previously reported on Aralia cordata in Korea (1). To our knowledge, this is the first report of leaf spots caused by A. panax on Aralia cordata in Japan. References: (1) W. D. Cho and H. D. Shin. List of Plant Diseases in Korea. 4th ed. Korean Society of Plant Pathology, 2004. (2) E. G. Simmons. Mycotaxon 14:17, 1982. (3) E. G. Simmons. Alternaria: An Identification Manual. CBS Fungal Biodiversity Centre, Utrecht, the Netherlands, 2007. (4) T. Y. Zhang et al. Flora Fungorum Sinicorum: Alternaria. Vol. 16. Science Press (in Chinese), Beijing, 2003.

First Report of Botrytis cinerea Causing Leaf Spot of Aquilegia vulgaris in Japan

European columbine, Aquilegia vulgaris L., Ranunculaceae, is an herbaceous flower widely used in gardens, parterres, and courtyards and is a traditional herbal plant. During the summer of 2008, leaf spots were observed on a plant cultivated along a roadside area in Nasushiobara, Tochigi, Japan. In some courtyards, the leaf spot affected more than 60% of the plants. Early symptoms appeared as small, round or elliptic, brown lesions on the leaves. Lesions expanded to 5 to 15 × 4 to 10 mm, irregular spots that were dark brown to black in the middle, with pale yellow-brown or purple-brown margins. In continuously wet or humid conditions, thick, gray mycelium and conidia appeared on the surface of leaf spots. Conidiophores were melanized at the base and hyaline near the apex, branched, and septated (approximately 3 mm × 16 to 18 μm). Conidia were hyaline, aseptate, ellipsoidal to obovoid, with a slightly protuberant hilum, and ranged from 9 to 14.5 × 5.5 to 6.5 μm. The pathogen was identified as Botrytis cinerea Pers.:Fr on the basis of morphology and sequence of ITS1-5.8s-ITS2 region of rDNA. The sequence (GenBank Accession No. FJ424510) exactly matched the sequences of two Botryotinia fuckeliana (anamorph Botrytis cinerea), (e.g., GenBank Accession Nos. AY686865 and FJ169666) (2). The fungus was isolated on potato dextrose agar (PDA) from a single conidium found on the symptomatic leaf tissue. Colonies of B. cinerea were first hyaline and later turned gray to black when the spores differentiated. Koch's postulates were performed with three whole plants of potted aquilegia. Leaves were inoculated with mycelia plugs harvested from the periphery of a 7-day-old colony; an equal number of plants were inoculated with the plugs of PDA medium only and served as controls. All plants were covered with plastic bags for 24 h to maintain high relative humidity and incubated at 25°C. After 8 days, all mycelium-inoculated plants showed symptoms identical to those observed on leaves from A. vulgaris infected in the field, whereas controls remained symptom free. Reisolation of the fungus from lesions on inoculated leaves confirmed that the causal agent was B. cinerea. B. cinerea has been previously reported on A. vulgaris in the United States and China (1,3). To our knowledge, this is the first report of leaf spots caused by B. cinerea on A. vulgaris in Japan. References: (1) Anonymous. Index of Plant Diseases in the United States. USDA Agric. Handb. No 165, 1960. (2) M. B. Ellis. Dematiaceous Hyphomycetes. Commonwealth Mycological Institute, Kew, England, 1971. (3) Z. Y. Zhang. Flora Fungorum Sinicorum. Vol. 26. Botrytis, Ramularia. Science Press, Beijing, 2006.

Proliferative defect and embryonic lethality in mice homozygous for a deletion in the p110alpha subunit of phosphoinositide 3-kinase

Phosphatidylinositol 3,4,5-trisphosphate is a phospholipid signaling molecule involved in many cellular functions including growth factor receptor signaling, cytoskeletal organization, chemotaxis, apoptosis, and protein trafficking. Phosphorylation at the 3 position of the inositol ring is catalyzed by many different 3-kinases (classified as types IA, IB, II, and III), but the physiological roles played by each of the different 3-kinase isozymes during embryonic development and in homeostasis in animals is incompletely understood. Mammalian type IA kinase isozymes are heterodimers that are active at 37 degrees C when the catalytic 110-kDa subunit interacts through an amino-terminal binding domain with a regulatory 85- or 55-kDa subunit. Using gene targeting in embryonic stem cells, we deleted this binding domain in the gene encoding the alpha isoform of the 110-kDa catalytic subunit (Pik3ca) of the alpha isozyme of the type IA kinases, leading to loss of expression of the p110 catalytic subunit. We show that Pik3cadel/del embryos are developmentally delayed at embryonic day (E) 9.5 and die between E9.5 and E10.5. E9. 5 Pik3cadel/del embryos have a profound proliferative defect but no increase in apoptosis. A proliferative defect is supported by the observation that fibroblasts from Pik3cadel/del embryos fail to replicate in Dulbecco's modified Eagle's medium and fetal calf serum, even with supplemental growth factors.

Prenatal diagnosis of Lowe syndrome by OCRL1 messenger RNA analysis

Prenatal screening of oculo-cerebro-renal syndrome of Lowe (OCRL; McKusick 309000) was performed using cultured amniocytes. Following identification of defective mRNA expression in the OCRL; gene of the proband's fibroblasts, the mRNA size and quantity of the cultured amniocytes were compared. Based on this analysis, the fetus was diagnosed as being normal and was subsequently delivered as a healthy boy. This is the first reported successful prenatal screening of OCRL using a comparison with defective mRNA of OCRL1 from affected subjects.

[TNM classification--pediatric tumors]

The clinical and postsurgical TNM classifications (cTNM and pTNM) for neuroblastoma (NB), nephroblastoma (WT) and soft tissue sarcomas were presented in 1982 by the TNM Committee in UICC in collaboration with SIOP. The Japanese TNM Committee proposed new pTNM systems (J-pTNM) for NB and WT, and new cTNM and pTNM system for primary liver carcinoma in infants and children (HT). These pTNMs were based on the staging systems developed by the Malignant Tumor Committee of the Japanese Society of Pediatric Surgeons. The proposal of subdivision of M category in NB was presented for testing the new telescopic ramifications of TNM. The TNM for HT was added as a new classification recommended for testing. The effectiveness of these TNM systems was assessed using NB, WT and hepatoblastoma (HB) cases which were registered in collaborating institutes. The analyses suggested that pTNM, especially the J-pTNM system in NB, WT and HT were effective for the assessment of prognoses, although cTNM systems were not enough to assess the extent of the disease.

Unique presentation of heterotopic pancreatic tissue arising from small-bowel mesentery

Heterotopic pancreatic tissue in the small-bowel mesentery is an extremely rare anomaly: no such case has been reported in the English literature. We report a 5-year-old boy in whom the aberrant tissue formed a retroperitoneal cyst. The condition was further complicated by a ventral pancreatic duct defect. The unique clinical manifestations and difficulty in making the diagnosis are discussed.

Prevention of visual field defect progression with brovincamine in eyes with normal-tension glaucoma

PURPOSE

A prospective investigation of the effect of brovincamine fumarate, a Ca2+-channel blocker, on visual field changes in normal-tension glaucoma (NTG).

METHODS

A total of 28, age- and field-matched, patients with NTG were allocated randomly to either brovincamine fumarate (20 mg 3 times daily) or placebo (3 times daily). The patients were followed at least every 4 months for a minimum of 2.5 years, and visual field examinations were carried out at least every 6 months. The mean follow-up periods (+/-standard deviation) were 39.1 +/- 8.7 months in the brovincamine-treated group and 37.9 +/- 10.1 months in the placebo group. Stepwise discriminant analyses were performed to separate the patients who showed improvement of their visual fields from those who failed to improve in the brovincamine-treated group, and to identify factors that may determine the visual field prognosis of all patients with NTG enrolled in the study.

RESULTS

In the brovincamine-treated group, six patients showed visual field improvement, whereas none showed improvement in the placebo group using the Statpac 2 linear regression analysis. Discriminant analyses identified better cold recovery rate and higher initial systolic blood pressure to be significantly contributory to a favorable outcome in the brovincamine-treated group, and the use of brovincamine, better cold recovery rate, and higher initial systolic blood pressure were identified to be significantly contributory to a favorable prognosis in all subjects.

CONCLUSION

Brovincamine seems to have a favorable effect on visual field in at least some patients with NTG.

Identification and chromosomal mapping of the mouse inositol polyphosphate 1-phosphatase gene

A mouse inositol polyphosphate 1-phosphatase (Inpp1) cDNA fragment (348 bp) was amplified by means of the polymerase chain reaction using a mouse cDNA library as template with primers designed from published human and bovine cDNA sequences. We isolated a 1623-bp full-length Inpp1 cDNA from a mouse brain cDNA library using this amplified cDNA fragment as probe. Amino acid sequences of mouse, human, and bovine inositol polyphosphate 1-phosphatase are highly conserved. Northern blot analysis shows a major transcript of 1.65-kb mRNA and several higher molecular weight mRNAs that are expressed in a variety of mouse tissues. Utilizing the Jackson Lab backcross DNA panel map service, we mapped Inpp1 to chromosome 1, 1.06 cM proximal to Ctla4.

Biological characteristics of neuroblastoma with spontaneous tumor reduction: a case report

The authors examined the biological characteristics of a neuroblastoma with spontaneous tumor reduction. A 6-month-old boy with a pelvic neuroblastoma underwent surgical extirpation of the tumor 1 month after diagnosis. The size of the tumor reduced spontaneously while he was awaiting operation. The low proliferative activity of the tumor cells and the presence of apoptosis in the tumor tissue were shown by an immunohistochemical method using anti-PCNA antibody and a DNA fragmentation analysis, respectively. These results suggest that the spontaneous tumor reduction seen in this patient may well be caused by the overwhelming apoptosis of tumor cells.

[Hypotonous maculopathy following trabeculectomy with mitomycin C]

We retrospectively studied incidence, prognosis and predictive factors of hypotonous maculopathy following trabeculectomy with adjunctive mitomycin C. The subjects were 208 cases (208 eyes) with various types of glaucoma with clear media, who were followed up for at least three months postoperatively. The follow up periods ranged from 3 to 44 months with a mean of 21.1 months. The incidence of the maculopahy was 9.1% (19/208). The postoperative intraocular pressures (IOPs) varied between 1 and 6 mmHg in the presence of maculopathy. The maculopathy disappeared in 14 eyes (74%) spontaneously or following ocular hypertensive therapy including application of trichloracetic acid and subconjunctival injection of autologous blood. The final visual acuity deteriorated two lines or more in 8 eyes (42%). A discriminant analysis showed that age, history of intraocular surgery, preoperative maximum IOP, and mean deviation are the predictive factors for maculopathy. As compared with the hypotonous eyes without maculopathy, those with maculopathy tended to be younger and to have less severe visual field changes.

Autologous bone marrow transplantation in children with advanced neuroblastoma

BACKGROUND

Encouraging results have been reported with high dose chemotherapy and total body radiation followed by bone marrow autotransplantation in children with advanced neuroblastoma; however, relapse remains a significant problem.

METHODS

The authors treated 22 children with advanced neuroblastoma with high dose chemotherapy, surgery, intraoperative radiation, and a bone marrow autotransplant (treated in vitro to remove tumor cells) followed by 13-cis-retinoic acid.

RESULTS

The 3-year relapse rate was 25% (95% confidence interval [CI], 6-44%). The 3-year disease free survival rate was 72% (95% CI, 52-92%). Toxicities included hemolytic uremic syndrome, herpes infection, and hepatic venoocclusive disease.

CONCLUSION

These data suggest that this treatment strategy offers an increased rate of 3-year disease free survival. The nonrandomized nature of this study and its use of multiple modalities precludes the analysis of the specific contribution of each treatment component and comparison with conventional therapy.

[Methylmalonic acidemia with bilateral MRI high intensities of the globus pallidus]

We report a patient with methylmalonic acidemia who developed an acute extrapyramidal disorder after severe ketoacidosis. The neurologic findings resulted from bilateral destruction of the globus pallidus. A 10-year-old girl was the term product of an uncomplicated pregnancy and delivery. Poor feeding and vomiting were noted after one month. She was hospitalized at 6 months of age with vomiting, coma and tachypnea. Analysis of urinary organic acids revealed a massive amount methylmalonic acid. She was not vitamin B 12-responsive and was maintained on a low-protein diet. At 33 months of age, she was able to walk and speak, but she developed acute severe ketoacidosis. Involuntary movements and spastic paraplegia became evident two days after admission. Subsequently, the patient has had metabolic ketoacidosis once or twice a year. Her intelligence quotient was 47. Neurologic examination revealed spastic paraplegia and generalized hypotonicity with mild dystonia. Some relief from dystonic symptoms has been obtained through the use of L-dopa. A brain CT scan at 5 years of age disclosed bilaterally symmetric lucencies of the globus pallidus. T2-weighted brain MRI at 8 years of age showed bilateral symmetric high intensities of the globus pallidus.

Cloning of human and bovine homologs of SNF2/SWI2: a global activator of transcription in yeast S. cerevisiae

We performed positional cloning of genes carried on yeast artificial chromosomes that span a human translocation breakpoint associated with a human disease and isolated by chance human and bovine genes with strong homology to the S. cerevisiae genes, SNF2/SWI2 and STH1, and the D. melanogaster gene brahma. We report here sequence analysis, expression data, and functional studies for this human SNF2-like gene (hSNF2L) and its bovine homolog (bovSNF2L). Despite strong homology at the amino acid level, hSNF2L is not capable of complementing the yeast mutations snf2 or sth1 in S. cerevisiae. Furthermore, in contrast to SNF2 itself, a fusion protein consisting of the DNA binding domain of LexA and hSNF2L did not transactivate a reporter gene downstream of LexA binding sites in a yeast expression system. The strong similarity between hSNF2L and these yeast and drosophila genes suggest that the mammalian genes are part of an evolutionarily conserved family that has been implicated as global activators of transcription in yeast and fruitflies but whose function in mammals remains unknown.

The Lowe's oculocerebrorenal syndrome gene encodes a protein highly homologous to inositol polyphosphate-5-phosphatase

Lowe's oculocerebrorenal syndrome (OCRL) is a human X-linked developmental disorder of unknown pathogenesis and has a pleiotropic phenotype affecting the lens, brain and kidneys. The OCRL locus has been mapped to Xq25-q26 by linkage and by finding de novo X; autosome translocations at Xq25-q26 in two unrelated females with OCRL. Here we use yeast artificial chromosomes with inserts that span the X chromosomal breakpoint from a female OCRL patient in order to isolate complementary DNAs for a gene that is interrupted by the translocation. We show that the transcript is absent in both female OCRL patients with X; autosome translocations and that it is absent or abnormally sized in 9 of 13 unrelated male OCRL patients with no detectable genomic rearrangement. The open reading frame encodes a new protein with 71% similarity to human inositol polyphosphate-5-phosphatase. Our results suggest that OCRL may be an inborn error of inositol phosphate metabolism.

[Prevention of stomatitis in patients with acute myelogenous leukemia using PVP-iodine (Isodine) gargle]

From November 1987 to October 1990, we investigated the efficacy of povidine iodine gargle solution (Isodine Gargle) for preventing stomatitis in 26 patients (19 males and 7 females; mean age 53.2 years) with acute myelogenous leukemia (AML). The patients were given a concentrated preparation of the gargle solution which they had to dilute 50 times, and were asked to use it 8 times/day for one year. Twenty patients (76.9%) frequently suffered from stomatitis despite the gargling. Therefore, in the second year they were instructed to use the gargle solution at a higher concentration (30-fold dilution). On the third year, they were asked to increase the frequency of gargling to 10 times/day; this resulted in a significant decrease in frequency of the episodes of stomatitis. Severe and painful stomatitis no longer occurred. Gargling with povidine iodine gargle solution was thus considered effective for preventing stomatitis in AML patients.

Therapeutic significance of surgery in advanced neuroblastoma: a report from the study group of Japan

The role of surgery was evaluated in 19 stage III and 102 stage IV neuroblastoma patients, all of whom were treated with intensive induction chemotherapy by the Study Group of Japan between January 1985 and March 1990. For stage III neuroblastoma, surgical intervention at the primary site was performed in 18 of the 19 patients, 9 during and 9 after the first three cycles of A1 regimen, consisting of high-dose cyclophosphamide, vincristine, THP-adriamycin, and cis-platinum. Gross complete resection of primary tumor and regional lymph nodes was feasible in 17 of the 19 patients (89%), and the survival rate for the 17 patients were 79%, 70%, and 70% at 2 years, 3 years, and 4 years, respectively. For stage IV, surgical intervention at the primary site was performed in 92 of the 102 patients (90%): 30 cases during the first 3 cycles of A1 chemotherapy and 62 cases after that, with gross complete resection accomplished in 81 of the 102 patients (79%). The 81 patients with gross complete resection achieved had a better prognosis than those 11 patients with partial resection (P less than .05). Overall survival rate was 62% at 2 years for 27 patients who underwent complete resection after 3 cycles of A1 when resolution of all metastases was obtained, whereas the survival was 52% at 2 years for 31 patients who similarly underwent complete resection but when evidence of persistent metastases was present. Patients in whom the ipsilateral kidney was preserved at surgery had an outcome superior to that of those with associated nephrectomy (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Isolation of cDNA sequences around the chromosomal breakpoint in a female with Lowe syndrome by direct screening of cDNA libraries with yeast artificial chromosomes

The Lowe oculocerebrorenal syndrome (OCRL; McKusick 309000) is an X-linked disorder characterized by congenital cataracts, muscular hypotonia, mental retardation, and Fanconi syndrome of the renal tubules. A pair of yeast artificial chromosomes (YACs) that span the Xq25-q26 translocation breakpoint in a female with OCRL were used as probes to screen cDNA libraries made from bovine lens and human kidney. The methods used to prepare the YACs as probes and to screen the libraries are presented in detail. Two different transcripts were found that map to the region around the Xq25-q26 breakpoint. These transcripts are now being studied to determine whether one or the other is a candidate gene for OCRL.

Ultrasonography of ovary, uterus and breast in premature thelarche

We studied 17 girls with the complaint of premature breast development. Enlarged breast tissue was confirmed in 15 patients by sonography. Pelvic and breast sonography were also performed in these patients. The sizes of most uteri and ovaries were within the normal range. Nine of the 15 patients (60%) showed follicular cysts in the ovaries. These cysts were ovoid with diameters of up to 10 mm. No relationship was found between the thickness of breast tissue and the ovarian findings. Pelvic sonography was also performed in normally developing girls under 6 years of age. Four of 47 girls (4%) showed small follicular cysts in the ovaries. In summary a high percentage of patients with premature thelarche have relatively large follicular cysts, with normal sized ovaries and uteri. Breast sonography is useful to distinguish swollen subcutaneous tissue from breast development.

[Experience of multimodal therapy for advanced neuroblastoma]

The prognosis of advanced neuroblastoma is extremely poor. We treated 5 patients with advanced neuroblastoma, older than 3 years, with multimodal therapy including intraoperative irradiation and autologous bone marrow transplantation. Elevated serum NSE and ferritin level and unfavorable histology according to the Shimadas histological classification, all of which are indicators of poor prognosis, were found in all of them. N-myc oncogene was amplified in 3 cases. After preoperative intensive induction chemotherapy, delayed primary operation and intraoperative irradiation (10-15 Gy) were performed. The postoperative lethal dose chemotherapy and total body irradiation (33 Gy x 3 days) were followed by autologous bone marrow transplantation. Tumor cells were purged using immunomagnetic beads method. Two cases showed recurrence (brain; 1, bone and bone marrow; 1) and a metastatic brain tumor was extirpated completely. All of them are alive during the follow up period from 6mo. to 4y8mo. (mean; 2y5mo.) with no evidence of disease except one. It may be concluded that our multimodal therapy is effective in achieving better results for advanced neuroblastoma.

[On factors related to the width of anterior chamber angle--multivariate analysis of biometrically determined values]

Primary angle-closure glaucoma (PACG) is associated with certain biometric ocular features such as shallow anterior chamber, axial hyperopia, increased thickness of the lens and small corneal diameter. The vast majority of previous studies on PAGG has shown that females are affected more frequently than males. In an attempt to study the relationship between the angle width and ocular dimensions, we carried out gonioscopic examination and biometric measurements (corneal diameter, corneal radius, anterior chamber depth, lens thickness, relative lens position and axial length) in 1,169 eyes of 585 adult subjects who participated in the glaucoma screening in Gifu Prefecture. It was found that the angle width significantly correlated with each biometric value. The coefficient of determination calculated by multiple regression analysis was 0.41, suggesting that factors other than these are involved in determining the angle width. When the angle width of females was compared to that of males with identical refractive errors and biometric values, the angle width of females was significantly narrower than that of males. Hence, the difference in ocular dimensions does not adequately explain the higher incidence of narrow angle in females. Increased asymmetry of angle width between a pair of eyes with aging appeared to be related to asymmetry of lens thickness, anterior chamber depth and lens position.

[An epidemiological study on the prevalence of the narrow chamber angle in Japanese]

Primary angle-closure glaucoma (PACG) has been reported to be more prevalent in Orientals than in Caucasians. However, our knowledge about the epidemiology of narrow angle and PACG in Orientals is still extremely limited. To determine the prevalence of narrow angle and PACG in Japanese, we carried out gonioscopic and oculometric examinations as a part of the first nationwide, multicenter glaucoma survey in Japan. We also estimated the angle width by means of van Herick's method to assess the efficacy of this method in detecting narrow angle. Of 1,979 inhabitants 40 years or older of a town in Gifu Prefecture, 585 (29.6%) participated in the study and underwent tonometric, gonioscopic and oculometric examinations. The width of the angle was estimated by van Herick's method prior to gonioscopy. Of the group tested, the prevalence of grade 0 to 2 angles (Shaffer's classification) was found in 8.0%, which was significantly more frequent than among Caucasians. The prevalence of grade 1 or narrower angle and PACG was 2.6% and 0.3%, respectively, neither of which was significantly different from rates reported among Caucasians. Using the gonioscopic determination as a gold standard, van Herick's method was noted to have a sensitivity of 77% and a specificity of 94% in identifying eyes with the angle of grade 2 or narrower, while both the sensitivity and specificity of this method were above 90% in detecting an angle of grade 1 or narrower. It was concluded that van Herick's method was useful in detecting the extremely narrow angle.

Proposal and assessment of Japanese tumor node metastasis postsurgical histopathological staging system for neuroblastoma based on an analysis of 495 cases

In 1971, the Japanese Society of Pediatric Surgeons' Committee on Malignancies proposed new criteria for neuroblastoma staging. It was fundamentally, based on the system of Evans et al. described in 1971. The main difference was the separation of stage IV disease into stages IV-A, with metastases to bone, orbita, distant lymph nodes and viscera other than liver, IV-B, the primary tumor extending over the midline and with metastases to bone marrow, liver and skin, and IV-S, which was the same as that of Evans et al. The new criteria did not include the resectability of the primary tumor, assessment of regional lymph node involvement or any other disease assessment resulting from therapeutic intervention. For the purpose of international usage, the Japanese system has been newly formulated and proposed as the Japanese Tumor Node Metastasis (TNM) Postsurgical Histopathological Classification for Neuroblastoma. In the present report, 495 neuroblastomas, registered between 1970 and 1985, were analyzed retrospectively according to the International Union Against Cancer (UICC) TNM classification and the proposed Japanese TNM system. The analyses suggested that the Japanese system reflected both the extent of tumor invasion and its biological neuroblastoma characteristics better than the UICC TNM classification based on statistical analysis.

Current urinary mass screening for catecholamine metabolites at 6 months of age may be detecting only a small portion of high-risk neuroblastomas: a chromosome and N-myc amplification study

We studied 96 infants and children with untreated neuroblastomas. Chromosomes of tumor cells were analyzed in 68, and N-myc copy numbers were determined in 67 patients. Patients found by a mass screening program for 6-month-old infants (group A1, 39 patients) or those less than 12 months of age found clinically (group A2, 13 patients) were rarely in the disseminated stage (A1, three of 39; A2 one of 13); their tumors usually had near-triploid (3n) or hypertetraploid (greater than 4n) karyotypes (A1, 28 of 37; A2, nine of 11), and never had N-myc amplification (A1, zero of 34; A2, zero of 11). In contrast, children 12 months or over (group B, 27 patients) were usually in the disseminated stage (19 of 27) (P less than .0001); their tumors usually had near-diploid (2n) or near-tetraploid (4n) karyotypes (16 of 20) (P = .0027), and often had N-myc amplification (nine of 22) (P less than .0001). Of the 40 clinically found patients (A2 and B), six had undergone the screening with a negative result at the age of 6 months. Two of the six patients had N-myc amplification in the tumors. Most tumors found by the screening showed known characteristics predicting a good prognosis, and the majority of tumors showing characteristics predicting a poor prognosis were found in patients aged between 12 and 36 months. Our chromosome and N-myc amplification studies suggest that a low-risk tumor does not usually evolve to a high-risk tumor. Thus, the current mass screening program may be detecting only a small portion of highly malignant neuroblastomas at the earliest stage. Infants should be screened twice, at 6 months as well as at 12 months of age, for the early detection of high-risk neuroblastomas.

[Present status of neuroblastoma mass screening in Japan. Neuroblastoma-Committee of the Japanese Childhood Cancer Society]

In 1973, mass screening program for 6-month old infants for early detection of neuroblastoma using a VMA spot test of a urine sample was initiated in Kyoto. In 1985, nation wide mass screening was initiated throughout the entire country and the Government has given the financial support to each district. In 1988, the Government recommended the institution of mass screening by quantitative measurements of VMA, HVA and creatinine using HPLC (high performance liquid chromatography), instead of the qualitative test of VMA alone. From 1974, at the time of initiation of mass screening for neuroblastoma to the end of October, 1989, 383 cases with this tumor have been discovered throughout the screening program. Three hundreds eighty three cases (88%) of them had been registered to the Neuroblastoma Committee of the Japanese Society of Pediatric Oncology. In this paper, the mass screening program was introduced and the 337 cases with this tumor detected by 6-month old screening were analyzed their clinical symptoms, findings, urinary VMA and HVA levels, primary sites, weights of primary tumor, histology, stages at diagnosis, metastatic sites, and the results of the treatment. Three hundreds twenty eight cases (97%) of them are expected to be cured. And we discussed clinical problems related to mass screening program for neuroblastoma, such as an increase of the incidence of infantile neuroblastomas detected by this program and the spontaneous regression.

Treatment of advanced neuroblastoma with emphasis on intensive induction chemotherapy. A report from the Study Group of Japan

One hundred nine newly treated patients with advanced neuroblastoma were entered in this study between January 1985 and May 1989. The eligible patients included infants younger than 12 months of age with Stage IVA disease (bone cortex, distant lymph node, and/or remote organ metastases) and patients aged 12 months or older with Stage III or IV disease (IVA plus IVB with tumor crossing the mid-line and with metastases confined to bone marrow, liver, and skin). The patients first received six cyclic course of intensive chemotherapy (regimen A1), consisting of cyclophosphamide (1200 mg/m2), vincristine (1.5 mg/m2), tetrahydropyranyl adriamycin (pyrarubicin; 40 mg/m2), and cisplatin (90 mg/m2). Original tumors and the regional lymph node metastases were removed some time during these first six cycles of chemotherapy. The patients were further divided into three groups. Patients in course 1 received alternating treatment by regimen B (cyclophosphamide and ACNU) and intensified regimen A1, and those in course 2 were treated with alternating administration of regimen C (cyclophosphamide and DTIC) and intensified A1. Patients in course 3 were treated with bone marrow transplantation (BMT) preceded by high-dose preconditioning chemotherapy. Survival rates were 77% in Stage III and 54% in Stage IV at 2 years, and 70% in Stage III and 45% in Stage IV at 3 years. The major toxicities encountered were bone marrow suppression with leukocyte counts down to 100/mm3, mild cystitis, and hearing impairment. The 2-year survival rate was 78% in 21 patients who underwent BMT when complete remission was achieved. We concluded that our intensive induction chemotherapy is of significant value in increasing the rate of complete response, and in widening the indications for and achieving improved results of treatment with BMT.

[Investigation on clinical efficacy and passage into ascites of cefminox in diffuse peritonitis associated with infantile acute appendicitis]

Cefminox (CMNX), one of newly developed cephamycin antibiotics, was administered to 7 cases of diffuse peritonitis associated with infantile acute appendicitis to determine its concentrations in the blood, the appendiceal tissue and the purulent ascites and simultaneously to investigate its clinical efficacy. CMNX was intravenously injected at a dose of 20 mg/kg (at a maximum amount of 1.0 g/body) before operation and intravenously by bolus injection or by drip infusion twice daily after operation for 3 to 11 days in a total dose of 2.36 to 14.06 g. Fourteen strains of bacteria were isolated from the purulent ascites: Escherichia coli was isolated from 6 cases but superinfections in 5 cases. MICs of CMNX against these isolated organisms were at or lower than 3.13 micrograms/ml for 12 out of 14 strains. CMNX penetrated into the appendiceal tissue and the purulent ascites very well. The concentrations in the pus reached higher than those in the tissue in about 1 hour after administration and were found to reach as high as 9.63 micrograms/ml in 5 hours after administration. Its clinical efficacies were excellent in 4 cases, good in 2 cases and poor in 1 case. No subjective or objective adverse reactions were observed nor any abnormalities were found in laboratory examinations.

Ultrasonography and magnetic resonance imaging in Leigh disease

An infant with Leigh disease, who was the younger sister of a similarly affected infant, had been examined before the onset of the disease. Ultrasonography revealed hyperechoic lesions in the putamen and caudate nucleus during the preclinical stage. At onset, these changes extended into the cerebral cortex and medulla. These lesions were also detected by T2-weighted magnetic resonance imaging (MRI) as areas of increased signal intensity. Her brother demonstrated the same ultrasonographic results; cranial computed tomography disclosed low-density areas in the basal ganglia which were detected as hyperechoic lesions by ultrasonography. These findings suggest that ultrasonography is useful in detecting early intracranial lesions in Leigh disease.

Frequent loss of heterozygosity on chromosome 14q in neuroblastoma

Using 29 polymorphic DNA markers which detect allelic deletion of genes at specific loci on 19 different chromosomes, we analyzed 14 neuroblastomas for possible loss of chromosomal heterozygosity. The incidence of loss of heterozygosity was high at the D14S1 locus on chromosome 14q, being detected in six of 12 patients (50%). In spite of the cytogenetic finding suggesting high frequency of chromosome 1p deletion, loss of heterozygosity at the MYCL locus on 1p32 was detected only in two of nine patients (22%). It was also found in two of 11 patients (18%) on 13q, but not on chromosomes 2, 3, 5, 6, 7, 8, 9, 10, 11, 12, 15, 16, 17, 18, 19, and 20. The present results indicate that recessive genetic changes involving sequences on chromosome 14q may play an important role in the development of neuroblastoma.

Copper deficiency in the mitochondria of cultured skin fibroblasts from patients with Menkes syndrome

The mitochondrial copper concentrations and cytochrome C oxidase activity of the fibroblasts from the patients with Menkes syndrome were investigated. Both the mitochondrial copper concentrations and cytochrome C oxidase activity of fibroblasts from patients with Menkes syndrome were lower than those of the control fibroblasts. These data indicate that the mitochondria of fibroblasts from patients with Menkes syndrome are in a state of copper deficiency. The activity decline of cytochrome C oxidase, a mitochondrial cuproenzyme, seems to be caused by copper deficiency in the mitochondria.

Does CSF copper level in Wilson disease reflect copper accumulation in the brain?

The levels of copper and ceruloplasmin in the cerebrospinal fluid (CSF) of patients with Wilson disease were investigated. Ceruloplasmin concentrations in the CSF of all patients were almost the same but were lower than those of the controls. CSF copper concentrations in patients without neurologic signs were within the normal range, 22 +/- 6 ng/ml. In contrast, CSF copper concentrations in patients with neurologic signs (69-98 ng/ml) were significantly higher than the normal levels before and at the beginning of the treatment with D-penicillamine; it gradually decreased in response to treatment. These results suggest that the appearance of neurologic manifestations in Wilson disease is not related to the CSF ceruloplasmin concentration. The CSF copper concentration in this disease appears to reflect copper accumulation in the brain and may be useful as a marker for monitoring therapy.

Assessment of the percentages of maximum static pressure in the anal canal for postoperative continence in patients with imperforate anus

The maximum static pressure in the anal canal was measured using an open-tip manometric method with a continuous infusion system. The values obtained from 49 postoperative patients with imperforate anus were expressed as a percentage of those values obtained from 108 aged-matched controls. The value was observed to be 50 per cent or more in those patients with translevator type, showing normal defecation, 30-50 per cent in those with supralevator type, showing normal defecation or constipation, and 30 per cent or less in those with supralevator type, showing incontinence, and 30 per cent or less in those who had undergone surgery on the anal area at another hospital and required re-operation at our department, showing normal continence or incontinence.

Different karyotypic patterns in early and advanced stage neuroblastomas

Of 23 untreated and 7 treated (relapsed) neuroblastomas, 14 (11 untreated, 3 treated) had modal chromosome numbers in the diploid (45 to 51), 9 (8 untreated, 1 treated) in the triploid (60 to 77), and 6 (3 untreated, 3 treated) in the hypotetraploid (81 to 88) range, and one (untreated) had hypertetraploidy (100). The near-or-pseudodiploid and hypotetraploid tumors were characterized by numerous structural abnormalities, most frequently of 1p, and frequent presence of double minutes or homogeneously staining regions. The near-triploid tumors were characterized by three almost complete haploid sets of chromosomes, and few structural abnormalities. N-myc amplification was found in five of the near-or-pseudodiploid or hypotetraploid tumors but in none of the near-triploid tumors. Most near-triploid tumors were found in infants at stage I or II, and the near-or-pseudodiploid or hypotetraploid tumors in children at stage II or IV mostly 1 year old or older. Among the untreated patients, all 8 with a near-triploid tumor were alive with no evidence of the disease, and the 11 with a near-or-pseudodiploid tumor had a median survival of only 376 days (P less than 0.05), 7 of the 11 being dead. Thus, the near-triploid patients had well recognized favorable prognostic factors and an excellent prognosis, and the near-or-pseudodiploid patients had unfavorable prognostic factors and a dismal prognosis. The hypotetraploid tumors seemed to have karyotypic and clinical features in common with the near-or-pseudodiploid tumors. We presume that the near-triploid tumors and the near-or-pseudodiploid or hypotepraploid tumors may constitute distinctly different subcategories within neuroblastomas.

Renal effects of dichloroacetate in vivo

We have investigated the effect of dichloroacetate (DCA) on the urinary excretion of lactate and pyruvate in a patient with congenital lactic acidosis and in healthy human controls. DCA administered orally in doses of 50 mg/kg and 30 mg/kg decreased plasma lactate and pyruvate of both the patient and the controls, while the urinary excretion of lactate and pyruvate was increased. However, these urinary increments were too small to contribute to the decrease of plasma lactate and pyruvate.