Prophylactic effect of rikkunshito, an herbal medicine, for chemotherapy-induced nausea in thoracic cancer patients receiving carboplatin-based chemotherapy

Rikkunshito has been shown to improve upper gastrointestinal symptoms and anorexia. The aim of this study was to evaluate whether rikkunshito improves chemotherapy-induced nausea in thoracic cancer patients receiving carboplatin (CBDCA)-based chemotherapy. A retrospective before-and-after comparison study was conducted in patients with thoracic cancer receiving the first cycle of CBDCA-based chemotherapy. Among 61 eligible patients, 34 received standard antiemetic therapy with a combination of 5-hydroxytryptamine-3 receptor antagonist and dexamethasone from September 2012 and June 2013 (standard group), while the other 27 received the standard antiemetic therapy plus oral rikkunshito from July 2013 and December 2014 (rikkunshito group). The rates of no nausea showed no significant difference between the standard and rikkunshito group (Overall phase: 64.7 % for standard group vs 74.1 % for rikkunshito group, p = 0.579). Subgroup analysis indicated that, in female patients, the rates of no nausea in rikkunshito groups was significantly higher than in standard group (overall phase: 44.4 % vs 100 %, p = 0.034). Rikkunshito did not demonstrate an additional prophylactic effect on standard antiemetic therapy for nausea in patients with thoracic cancer receiving CBDCA-based chemotherapy, but showed a prophylactic effect of nausea in female patients.

Unilateral ablation of trunk superficial neuromasts increases directional instability during steady swimming in the yellowtail kingfish Seriola lalandi

Detailed swimming kinematics of the yellowtail kingfish Seriola lalandi were investigated after unilateral ablation of superficial neuromasts (SNs). Most kinematic variables, such as tail-beat frequency, stride length, caudal fin-beat amplitude and propulsive wavelength, were unaffected but lateral amplitude at the tip of the snout (A0 ) was significantly increased in SN-disrupted fish compared with sham-operated controls. In addition, the orientation of caudal fin-tip relative to the overall swimming direction of SN-disrupted fish was significantly deflected (two-fold) in comparison with sham-operated control fish. In some fish, SN disruption also led to a phase distortion of the propulsive body-wave. These changes would be expected to increase both hydrodynamic drag and thrust production which is consistent with the finding that SN-disrupted fish had to generate significantly greater thrust power when swimming at ≥1·3 fork lengths (LF ) s(-1) . In particular, hydrodynamic drag would increase as a result of any increase in rotational (yaw) perturbation and sideways slip resulting from the sensory disturbance. In conclusion, unilateral SN ablation produced directional instability of steady swimming and altered propulsive movements, suggesting a role for sensory feedback in correcting yaw and slip disturbances to maintain efficient locomotion.

Angiopoietin 2 displays a vascular endothelial growth factor dependent synergistic effect in hepatocellular carcinoma development in mice

BACKGROUND

Orchestration of two major classes of angiogenic factors-namely, vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2)-has been shown to play a pivotal role in tumour angiogenesis, including hepatocellular carcinoma (HCC). However, few studies have focused on the direct interaction of these factors on in vivo tumour development and angiogenesis.

AIM

To examine the interaction between both factors in murine HCC.

METHODS

We examined the combination effect of VEGF and Ang-2 overexpression by means of a combination of a retroviral tetracycline (tet) regulated gene manipulating system in vivo, by providing tet in the drinking water, and a conventional plasmid gene expression system.

RESULTS

Neither Ang-2 nor VEGF overexpression induced proliferation of HCC cells in vitro. In vivo, although overexpression of Ang-2 did not increase tumour development, simultaneous expression of Ang-2 and VEGF synergistically augmented tumour growth and angiogenesis in murine HCC. Ang-2 plus VEGF induced tumour development was markedly attenuated by treatment with neutralising monoclonal antibodies against VEGF receptors. Ang-2 plus VEGF overexpression significantly increased the activities of matrix metalloproteinase (MMP)-2 and MMP-9 in the tumour. Suppression of intratumoral VEGF almost completely abolished this augmentation of MMPs.

CONCLUSIONS

These results suggest that Ang-2 synergistically augments VEGF mediated HCC development and angiogenesis. This proangiogenic activity was exerted only in the presence of VEGF, at least partly mediated via induction of MMP-2 and MMP-9 in the tumour.

Two cases of colonic tuberculosis presenting with massive melena

The clinical symptoms of colonic tuberculosis are variable, among which massive melena is extremely rare. Herein, we report two cases of colonic tuberculosis representing with massive melena, both of whom never had active pulmonary tuberculosis. The first case was a 55-year-old woman. Although her emergency colonoscopic setting suggested colonic tuberculosis, no evidence of tuberculosis could be found at that time. We performed a therapeutic trial and observed a drastic regression of the initial changes with 4-week treatment using antituberculous agents. The second case was a 37-year-old man. His emergency colonoscopy showed lesions mimicking colon carcinoma. However, the histological examinations did not indicate malignancy. The polymerase chain reaction of colonic biopsy specimen was positive for Mycobacterium tuberculosis. Similar to the first case, a significant improvement of the initial lesions was observed after 4-week treatment using antituberculous agents. Collectively, although the massive melena is a rare manifestation, tuberculosis of the colon should be suspected in the patients with such symptom.

Successful treatment of acute Budd-Chiari syndrome with percutaneous transluminal angioplasty

A 26-year-old man developed progressive, massive ascites and hematemesis due to rupture of esophageal varices. Combination diagnostic modalities of color doppler ultrasonography, enhanced computed tomography, and magnetic resonance imaging led to the case being diagnosed as acute Budd-Chiari syndrome with severe stricture of the intrahepatic inferior vena cava. Percutaneous transluminal angioplasty this resulted in great improvement of the clinical manifestations.

Vascular endothelial growth factor and receptor interaction is a prerequisite for murine hepatic fibrogenesis

BACKGROUND

It has been shown that expression of the potent angiogenic factor, vascular endothelial growth factor (VEGF), and its receptors, flt-1 (VEGFR-1) and KDR/Flk-1 (VEGFR-2), increased during the development of liver fibrosis.

AIMS

To elucidate the in vivo role of interaction between VEGF and its receptors in liver fibrogenesis.

METHODS

A model of CCl(4) induced hepatic fibrosis was used to assess the role of VEGFR-1 and VEGFR-2 by means of specific neutralising monoclonal antibodies (R-1mAb and R-2mAb, respectively). R-1mAb and R-2mAb were administered after two weeks of treatment with CCl(4), and indices of fibrosis were assessed at eight weeks.

RESULTS

Hepatic VEGF mRNA expression significantly increased during the development of liver fibrosis. Both R-1mAb and R-2mAb treatments significantly attenuated the development of fibrosis associated with suppression of neovascularisation in the liver. Hepatic hydroxyproline and serum fibrosis markers were also suppressed. Furthermore, the number of alpha-smooth muscle actin positive cells and alpha1(I)-procollagen mRNA expression were significantly suppressed by R-1mAb and R-2mAb treatment. The inhibitory effect of R-2mAb was more potent than that of R-1mAb, and combination treatment with both mAbs almost completely attenuated fibrosis development. Our in vitro study showed that VEGF treatment significantly stimulated proliferation of both activated hepatic stellate cells (HSC) and sinusoidal endothelial cells (SEC). VEGF also significantly increased alpha1(I)-procollagen mRNA expression in activated HSC.

CONCLUSIONS

These results suggest that the interaction of VEGF and its receptor, which reflected the combined effects of both on HSC and SEC, was a prerequisite for liver fibrosis development.

Penetration of minocycline hydrochloride into lung tissue and sputum

Penetration of minocycline hydrochloride (MINO) into lung tissue and sputum was investigated. MINO (100 mg) was intravenously infused over 30 min to 14 patients before lung surgery: the concentration of MINO was determined in 16 lung tissue samples which were collected between 0.25 and 5.0 h after infusion. The mean concentration of MINO in lung tissue sample was 2.92 +/- 1.43 microg/g, and the mean lung tissue/plasma ratio of MINO concentration was 3.71 +/- 2.36. MINO was infused intravenously over 60 min twice daily to 5 patients with a chronic respiratory disease for 3-7 days. The concentration of MINO in sputum and in serum was determined on day 3. The mean maximum concentration of MINO in sputum sample was 2.12 +/- 2.20 microg/g, and the mean sputum/serum ratio of MINO concentration was 0.56 +/- 0.47. The concentration of MINO in sputum showed little time-related variation and remained as high as 0.74 microg/g until 10 h after infusion. The concentration of MINO in sputum and in serum after intravenous drip infusion was about twice as high as that after oral administration at the same dose. The breakpoint was 1.88 for MINO, as calculated by the formula established by the Japan Society of Chemotherapy.

[A comparative study of the prognosis for Japanese patients with idiopathic interstitial pneumonia or BOOP based on histopathologic subsets]

We explored the prognosis for 123 patients with either idiopathic interstitial pneumonia (IIP) or bronchiolitis obliterans organizing pneumonia (BOOP). All patients underwent either open lung biopsy or thoracoscopic lung biopsy procedures. The histopathologic diagnosis of IIP included patients with usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), and desquamative interstitial pneumonia with respiratory bronchiolitis-associated interstitial lung disease. The prognosis was poorest for patients with a histologic diagnosis of UIP, and excellent for those who received a diagnosis of BOOP. Although the prognosis is generally considered to be good for patients with NSIP, some NSIP patients in our study died. Histopathologic diagnosis based on surgical lung biopsy is useful in evaluating the prognosis for patients with IIP.

Identification and characterization of a deletion mutant of DNA topoisomerase I mRNA in a camptothecin-resistant subline of human colon carcinoma

In previous studies, we established two camptothecin (CPT)-resistant sublines, HT-29 / CPT and St-4 / CPT, from the human colon cancer cell line HT-29 and the human stomach cancer cell line St-4, respectively. Cellular contents of DNA topoisomerase I (topo I) in the resistant cells were eight-fold less than those in the corresponding parental lines. In this study, we have shown expression of two species of the TOP1 mRNA in HT-29 / CPT. The longer mRNA (4.0 kb) is the wild-type TOP1 mRNA, and the shorter mRNA (3.3 kb) proved to have a deletion of 672 bp (nucleotides 58 - 729 or 59 - 730) that caused the in-frame deletion of amino acids 20 - 243 of human topo I. The deleted region is identical to exons 3 - 9 of the TOP1 gene. The expression level of the 3.3-kb mRNA was similar to that of the wild-type mRNA in HT-29 / CPT. St-4 / CPT expressed only the wild-type TOP1 mRNA in lesser amounts than did St-4. Mouse NIH3T3 cells transfected with the wild-type TOP1 cDNA showed higher sensitivity to CPT than the parental cells, whereas those transfected with the deleted TOP1 cDNA showed levels similar to those of the parental cells. Expression of the exogenous TOP1 mRNA was confirmed; however, expression of the truncated topo I was not detected in cells transfected with the deleted TOP1 cDNA. These results suggest that the expression of the deleted TOP1 mRNA led to the low expression of CPT-sensitive topo I in the resistant cells.

Selection of specific phage from display libraries: monoclonal antibody against VCS M13 helper phage coat protein III (gIIIp)

Screening of specific phage is often hampered by nonspecific binding either of the VCS M13 helper phage to the solid phase absorbent or to the polyclonal antibodies used for selection. The former is improved by increasing the stringency for selection. However, the available polyclonal anti-VCS M13 antibodies often react with immobilized antigen nonspecifically, making it difficult to distinguish between positive and negative clones. To improve this selection process, a monoclonal antibody (MAb) was produced which recognizes ligand-coat protein three (gIIIp) on the helper phage VCS M13. This MAb is highly sensitive and specific, and it is useful for selecting relevant clones. This reagent should find widespread application in identifying interactive clones from a variety of phage display libraries.

Retroviral expression of a mutant (Gly-533) human DNA topoisomerase I cDNA confers a dominant form of camptothecin resistance

In previous studies, we isolated a mutant DNA topoisomerase I cDNA from a camptothecin (CPT)-resistant human T-lymphoblastic leukemia cell line, CPT-K5, and demonstrated that an amino acid change from Asp to Gly at residue 533 is responsible for the CPT resistance of the enzyme. In the present study, we have constructed a bicistronic retroviral vector, Ha-TM1-IRES-neo, that carries the mutant (Gly-533) TOP1 cDNA (TM1) and a neomycin-resistance gene to examine the effect of mutant DNA topoisomerase I (topo I) expression on CPT resistance of cells. HeLa S3 cells were transduced with Ha-TM1-IRES-neo, and the transduced cells were selected with G418. Two independently isolated populations of the G418-resistant cells and 2 clones showed 1.7- to 1.8-fold higher resistance to CPT than the control cells. Integration and expression of the exogenous TOP1 were confirmed by genomic and RT-PCR analyses. The topo I enzyme (mixture of mutant and wild-type) expressed in the transduced cells showed 3-fold resistance to CPT in cleavable-complex-formation assay and DNA-relaxation assay. Mutant topo I activity in the transduced cells was as much as 10% that of the endogenous enzyme. Our results clearly show that expression of Gly-533 topo I confers a dominant form of CPT resistance in cells expressing wild-type topo I. The mutant TOP1 could be used for the protection of normal bone marrow cells of cancer patients from the severe hematotoxicity of CPT-derivative anti-tumor agents.

[Percutaneous drainage of a bulla with tuberculous infection in a patient]

A 63-year-old man complaining of low grade fever and dry cough was admitted to our hospital. Chest X-ray showed infiltrative shadows and a bulla with a fluid level in the left upper lung field. Bacteriological examination of sputum and bronchoalveolar lavage fluid did not yield any diagnostic results. Percutaneous aspiration of the bulla under fluoroscopy was performed. Bulla with tuberculous infection was considered because a high ADA level was detected in the fluid of the bulla. A culture of the bulla fluid was positive for mycobacterium tuberculosis (TB), which was sensitive to all anti-mycobacterial drugs. The fluid in the bulla gradually increased, and occupied the entire space of the bulla three months later. Percutaneous aspiration of the bulla was performed again and a fluid smear was positive for TB. It was thought that systemic administration of anti-mycobacterial drugs had been ineffective, so percutaneous drainage and subsequent injection of anti-mycobacterial drugs into the bulla was performed. The fluid in the bulla subsequently disappeared and the bulla shrank gradually. Percutaneous drainage of a bulla with tuberculous infection should be considered in those who do not respond to medical management.

Receptor-mediated cellular entry of nuclear localizing anti-DNA antibodies via myosin 1

A unique subset of anti-DNA antibodies enters living cells, interacts with DNase 1, and inhibits endonuclease activity, before their nuclear localization and subsequent attenuation of apoptosis. We now report that endocytosis of these immunoglobulins is mediated by cell surface binding to brush border myosin (myosin 1). Cellular entry and internalization via this unique receptor provides initial contact for entry and sorting these immunoglobulins to translocate to the nuclear pore and enter the nucleus, interact with DNase 1 within the cytoplasm, or recycle back to the cell surface. This internalization pathway provides clues to the translocation of large proteins across cell membranes and the functional effects of intracellular antibodies on cytopathology. This is the first demonstration that brush border myosin functions as a specific cell surface receptor for internalization of large proteins.

[Two cases of tubercle bacilli infected pulmonary bulla]

Two cases of tubercle bacilli infected bulla are reported. Case 1; A 78-year-old man visited our hospital complaining of fever and chest pain. The chest radiograph revealed the bulla with air fluid level in the left upper lung field. Mycobacterium tuberculosis was detected in the fluid obtained by percutaneous lung aspiration. He was treated with anti-mycobacterial drugs and showed improvement. Case 2; A 66-year-old man visited our hospital complaining of fever, chest pain and dry cough. The chest radiograph revealed the bulla with air fluid level in the left upper lung field. A diagnosis of tubercle bacilli infected bulla was considered because of high level of ADA in the fluid obtained by percutaneous lung aspiration, and anti-mycobacterial drugs were administered. His symptoms were improved and the frequent chest radiograph showed gradual absorption of the fluid. It is suggested that ADA and bacteriological examinations of the fluid obtained by percutaneous lung aspiration are useful for early diagnosis of tubercle bacilli infected bulla.

Nuclear proteins involved in cell division in the ciliate, Tetrahymena

For the purpose of clarifying the presence of nuclear proteins which may induce cell division, we conducted experiments using ciliate Tetrahymena which can be synchronized at the G2 phase in the cell cycle easily by periodic heat shock treatment (HST): We obtained proteins from the nuclei isolated from the cells grown at the early mid log-phase, at the G2 phase (60 min) and at the G1 phase (150 min), after HST. The proteins were studied by comparing the spots separated by isoelectric point, 10-20% gradient SDS two-dimensional electrophoresis. As a result, in comparison with the intranuclear protein at the log-phase, the proteins at the G2 phase showed a marked increase, but with no great change in the electrophoretic pattern. Meanwhile, the proteins at the G1 phase differed greatly from those at the G2 phase not only in the quantitative changes, but in the electrophoretic patterns. It is considered that the level of the accumulation of the nuclear proteins which should be closely involved in cell division must increase markedly at the G2 phase and decrease at the G1 phase. We confirmed the presence of four proteins: pI 5.8 MW 68 kDa, pI 6.1 MW 75 kDa, pI 8.6 MW 48 kDa and pI 6.6 MW 57 kDa, and then prepared monoclonal antibodies using these nuclear proteins as antigens. Among them, the antibody (IgM) against the pI 8.6 MW 48 kDa polypeptide (p48) was recognized the nuclei by indirect immunofluorescence in ancellular system at the S, G2 and the mid-M phases. However, nuclei at the late M and G1 phases were not stained.(ABSTRACT TRUNCATED AT 250 WORDS)

A subgroup of murine monoclonal anti-deoxyribonucleic acid antibodies traverse the cytoplasm and enter the nucleus in a time-and temperature- dependent manner

BACKGROUND

The capacity of lupus autoantibodies to enter living cells and bind to molecules for which they have intrinsic affinity is not well appreciated. In previous studies, we identified a subgroup of three murine monoclonal IgG anti-DNA antibodies, derived from lupus-prone MRL-lpr/lpr mice, that localized within nuclei of cells in multiple organs and induced functional perturbations, in vivo, after passive transfer to normal mice. To examine the mechanisms of this phenomenon, we now extend these observations, using the same monoclonal anti-DNA antibodies and cultured cell lines.

EXPERIMENTAL DESIGN

Multiple experimental approaches were utilized to track nuclear localization of anti-DNA antibodies, including direct immunofluorescence, confocal microscopy and immunoelectron microscopy. The requirements for nuclear localization were further evaluated quantitatively, in nuclei isolated from co-cultures of cells and 125I-Ig, under varying experimental conditions.

RESULTS

Nuclear localization was observed with the same subset of anti-DNA antibodies that localized within nuclei in vivo; it was dependent on the antigen-binding region of the molecule; and it was not found with other anti-DNA antibodies. At progressive intervals, the Ig were observed: at the cell surface, within the cytoplasm, clustered at the nuclear pore, and within the nucleus. Nuclear localization of Ig was found to be a time- and temperature- dependent process, specific for a subset of anti-DNA antibodies and dependent on the antigen binding region of the Ig.

CONCLUSIONS

This is the first demonstration that monoclonal autoantibodies can traverse both the cell and nuclear membranes to localize within the nuclei of cultured cells. Furthermore, nuclear localization of Ig was regulated in a manner analogous to that of other large cytoplasmic proteins that enter the nucleus. This confirms and extends our results using the same antibodies in whole animals, and it provides the basis to further examine the underlying mechanisms and consequences of this phenomenon.

[A case of primary amyloidosis with diffuse alveolar hemorrhage]

A 58-year-old man was admitted complaining of hemoptysis and dyspnea. Chest roentgenogram demonstrated bilateral alveolar infiltrates in the middle and lower lung fields. Diffuse alveolar filling shadows were seen on standard chest CT images. His symptoms and pulmonary infiltrates gradually resolved after administration of high-dose corticosteroids and erythromycin. Immunoelectrophoresis showed increased IgM of lambda type. Transbronchial lung biopsy specimens revealed amyloid deposits in the alveolar septa and blood vessel walls. Cervical lymph node biopsy specimen also showed amyloid deposits. The amyloid in this case stained positively with anti-A lambda type amyloid antibody. A diagnosis of primary systemic amyloidosis was made.

Erythema multiforme: pathomechanism of papular erythema and target lesion

Skin lesions of erythema multiforme show time-dependent changes from early papular erythema to the late target lesion which consists of a peripheral elevated erythematous area and a central depressed area. We investigated the pathomechanism of erythema multiforme, by examining the papular erythema and target lesion separately. In the early papular erythema, a small number of polymorphonuclear leukocytes and nuclear debris were seen intermingled with mononuclear cells around the slightly swollen blood vessels, on which immunoglobulin and complement components were deposited. Circulating immune complex levels were occasionally elevated. Sera from the patients generated high levels of reactive oxygen species and nitroblue tetrazolium test revealed positive reaction on the infiltrating cells around the blood vessels. These findings suggest that the papular erythema develops via incomplete type III allergic reaction, followed by damage through reactive oxygen species. In the target lesion, the activity of histamine-N-methyltransferase, which is the major histamine-degrading enzyme, was markedly decreased in the peripheral elevated erythematous area and it was recovering in the central clearing area. ICAM-1 and HLA-DR antigens were expressed on the surfaces of the keratinocytes. An increased number of epidermal Langerhans cells and CD4 cell infiltration were observed in the peripheral elevated erythematous area, while a decreased number of epidermal Langerhans cells and CD8 cell infiltration in the central depressed area were observed. These findings suggest that impaired histamine metabolism and cellular allergic reactions play important roles in the development of the target lesion.

[Clinical efficacy of ceftriaxone when administered once daily for respiratory tract infections in patients with advanced ages]

Ceftriaxone (CTRX), a new third generation cephalosporin, was investigated upon once daily administration for its clinical efficacy and safety on respiratory tract infections in patients with advanced ages. The results are summarized as follows: 1. Clinical responses to CTRX of 48 cases of advanced age patients with respiratory tract infections were good with an efficacy rate of 89.6%. 2. Adverse reactions to CTRX were mainly exanthema in 7 cases (14.6%). 3. Serum levels of CTRX were determined in 4 cases after intravenous drip infusion of 2 g CTRX. Serum levels were analyzed by one-compartment model. There was no evidence of accumulation of CTRX in the patients with advanced ages.

Asymptomatic urinary abnormalities found via the Japanese school screening program: a clinical, morphological and prognostic analysis

Clinicohistopathologically, we observed 109 patients with asymptomatic urinary abnormalities found via the Japanese school medical screening process. Follow-up was for a mean period of 9.3 +/- 4.0 years. More than 80% of the patients had either IgA nephropathy (IgAN, 47 cases, 43.1%), thin membrane disease (TMD; 21 cases, 19.3%) or normal glomerulus (NG; 20 cases, 18.3%). Complete remission appeared in 60.0% of the NG cases, 14.3% of the TMD cases and in 19.1% of the IgAN cases, and remission was significantly high in the NG group (p less than 0.01). No patient with TMD and NG ever progressed to the extent of pronounced proteinuria or renal failure. One patient deteriorated and required hemodialysis, and 2 patients developed renal insufficiency in IgAN. All of these cases possessed severe glomerular sclerotic change when the initial biopsies were performed. All IgAN cases that went into remission, however, had minor glomerular abnormalities. A positive family history of urinary abnormality was observed in 14.1% of both the IgAN group and the NG group, whereas we observed 71.4% in the TMD group, which was significantly high (p less than 0.01). Other cases included 4 each with non-IgA proliferative glomerulonephritis, focal segmental glomerular sclerosis, membranoproliferative glomerulonephritis and Alport's nephritis. It was concluded that the majority of patients (80.7%) with urinary abnormalities found via the school screening program had IgAN, NG or TMD. 74.5% of the IgAN group and 85.7% of the TMD group had long histories of urinary abnormalities extending into adulthood with no deterioration of the renal function.

[Glomerular ultrastructures and prognosis of the patients with urinary abnormalities found by school screening program]

Detailed histopathological study were performed and compared with clinical features in 120 children with serial renal biopsies who were found by school screening program. 41 cases (34.2%) of IgA nephropathy (IgAN), 26 cases (21.7%) of thin membrane disease (TMD) and 22 cases (18.3%) of normal glomeruli [( Normal]) accounted for 74.2% of all biopsies. 81 cases (67.5%) were revealed to be minor glomerular abnormalities by light microscopy and which contained 26 cases (32.1%) of TMD, 22 cases (27.2%) of [Normal] and 19 cases (23.4%) of IgAN. The frequency and the severity of proteinuria was significantly higher in IgAN than in TMD and [Normal] (P less than 0.01, P less than 0.05). Hematuria was significantly greater in [Normal] than in IgAN. In the 71 follow-up cases, no patient went to renal insufficiency, moreover, urinary abnormalities had disappeared in 25.4% of the patients including IgAN, TMD, [Normal], nonIgA proliferative glomerulonephritis, incomplete foot process disease and MPGN. [Normal] consisted of stationary or exercised urinary abnormality.

[Correlations among the renal parenchymal components and renal function with IgA-GN; age related changes]

To clarify and evaluate the changes by aging to renal parenchyma of IgA nephropathy with normal renal function (serum creatinine levels less than or equal to 1.5 mg/dl), we compared morphological findings and renal function in 100 adult patients with IgA nephropathy similarly distributed in each decade of age including over 60 y.o.. The following histological parameters were investigated; glomerular sclerotic index calculated a mean for total glomeruli, tubulointerstitial damage or interstitial volume measured by the point-counting method, luminal narrowing index by intimal thickening of arterioles determined morphometry. Tubulointerstitial damages were significantly correlated to aging with a direct linear worsening. Luminal narrowing of arterioles rapidly worsened with age after 40 y.o. who were frequently associated with chronic hypertension. The patients over 60 y.o. had a significant correlation between luminal narrowing of arterioles and glomerular sclerotic index, though those were statistically no related in patients less than 60 y.o.. Glomerular sclerotic index was significantly related with tubulointerstitial damage at all decades except for thirtieth decade. Serum creatinine level was well correlated with glomerular sclerotic index and tubulointerstitial damage, respectively; increase of those indices may indicate poor prognosis. We concluded that ischemic glomerular sclerosis by mean narrowing of afferent arterioles may appear after 60 y.o., probably due to insufficiency of autoregulation for glomerular circulation. Luminal narrowing of arterioles in patients less than 60 y.o. may not reflect to be a main cause for ischemic damage of glomerulus. Therefore it may not be a indicator for renal prognosis in patients with IgA nephropathy less than 60 y.o.

The effect of sevoflurane on somatically induced sympathetic reflexes

The effects of various inspiratory concentrations of sevoflurane anesthetics on the sympathetic reflex responses evoked in the left inferior cardiac nerve branch following an electrical stimulation to the ipsilateral superficial peroneal nerve were investigated in cats. At a 2.0% inspiratory concentration of sevoflurane, two components of the somato-sympathetic reflexes with two different latencies were recorded. The early component was due to an activation of myelinated A afferent fibers (referred to as the A-reflex), while the late component was due to an activation of unmyelinated C afferent fibers (referred to as the C-reflex). The increase in the concentration of sevoflurane from 2.0% to 3.0% resulted in about 50% attenuation of both the A- and C-reflexes. A further increase in the concentration of sevoflurane to 4.0% resulted in further suppression of both reflexes.

Efficient cleavage by alpha-thrombin of a recombinant fused protein which contains insulin-like growth factor I

The gene for insulin-like growth factor I (IGF-I) was constructed from chemically synthesized deoxyoligonucleotides and expressed in Escherichia coli, under the control of a trp promoter, as a set of fusion proteins which were connected with a portion of human growth hormone through the recognition sequence for a sequence-specific protease, either blood coagulation factor Xa or alpha-thrombin. Upon induction with 3-indoleacrylic acid, fusion proteins accumulated with a yield of 10-30% of the total protein. A fusion protein connected through a tetradecapeptide (Asp-Asp-Pro-Pro-Thr-Val-Glu-Leu-Gln-Gly-Leu-Val-Pro-Arg) was efficiently and correctly cleaved by alpha-thrombin, and the purified IGF-I possessed somatomedin-like activity, as determined by the enhancement of sulfation of glycosaminoglycans in cultured costal chondrocytes from rabbits.

Inquiries into the structure-function relationship of ribonuclease T1 using chemically synthesized coding sequences

The genes for ribonuclease T1 and its site-specific mutants were chemically synthesized and introduced to Escherichia coli. All enzymes were fusion products produced by joining the synthetic gene at specific restriction sites to the synthetic gene for human growth hormone in a plasmid containing the E. coli trp promoter. The fusion protein from this plasmid contained 66% of the amino-terminal sequences of the human growth hormone, which were recognizable immunologically. RNase T1 or its mutants were cleaved from the fusion protein with cyanogen bromide. The synthetic RNase T1 endowed with the revised wild-type triad Gly-Ser-Pro, residues 71-73, was fully functional, readily hydrolyzing pGpC bonds, whereas a mutant enzyme having the originally reported, erroneous triad Pro-Gly-Ser was totally inactive. Various amino acid substitutions were also introduced to the guanosine recognition region comprised of residues 42-45, Tyr-Asn-Asn-Tyr. Substitution of either of the tyrosine residues noted above with phenylalanine had no dramatic effect on the enzyme's function. Replacement of asparagine-43 with arginine or alanine also caused only a small change in the hydrolyzing activity--a mutant enzyme maintained greater than 50% of the wild-type activity. In sharp contrast, when aspartic acid or alanine was substituted for asparagine-44, the activity was dramatically reduced to a few percent of the wild-type activity.

Lupus vulgaris: demonstration of circulating and tissue-bound immune complexes

2 cases of lupus vulgaris are reported. In both cases, the deposition of IgG, IgM and/or C3 were detected at the dermo-epidermal junction of the lesional skin. In case 1 the circulating immune complexes, as determined by the C1q-binding test, were elevated at the first visit, suggesting that the circulating immune complexes were deposited in the skin.

Studies on protein nutrition of Papua New Guinea highlanders: nitrogen balance and hematological studies

Studies were made in August 1978 on the N-balance and hematological characteristics of 18 men living in the village of Kalugaluvi (altitude: 1,500m) near Lufa, which is 60km from Goroka, in the Eastern Highland Province of Papua New Guinea. The average daily protein intake on 3 consecutive days was 95.2 +/- 29.3 mgN/kg (35.2 +/- 10.7 g protein/day), and 32.6 +/- 18.7% of the total protein intake was in the form of animal proteins. The calculated nutritional value of the dietary protein, scored according to the 1973 FAO/WHO pattern, was 83.7 +/- 10.6. Urinary and fecal N excretions during the same period were 81.9 +/- 18.7 and 26.3 +/- 11.8 mgN/kg, respectively, giving a nitrogen balance of -13.5 +/- 24.9 mgN/kg. From N-balance data on individuals, the N-intake for maintenance of a zero N-balance was estimated as 116.3 +/- 48.6 mgN/kg (mean 95% confidence interval). Hematological data showed normal or rather high values for hemoglobin (16.90 +/- 1.05 g/100 ml) and serum proteins (8.05 +/- 0.40 g/100 ml). The increased level of serum proteins was associated with an increased globulin level.

Increased hydroxyl radical generation by normal polymorphonuclear leukocytes incubated in sera from patients with leukocytoclastic vasculitis

The effect of sera from patients with untreated leukocytoclastic vasculitis was investigated on the generation of oxygen intermediates by normal polymorphonuclear leukocytes. Sera from untreated patients induced increased hydroxyl radical generation, which is one of the most potent oxidants capable of causing tissue damage. It is suggested that vascular injury may be mediated in part by enhanced production of hydroxyl radical by polymorphonuclear leukocytes. Circulating immune complexes in the sera of the patients are considered to be one of the factors responsible for enhanced generation of hydroxyl radical.

Demonstration of circulating and tissue-fixed immune complexes in cutaneous necrotizing vasculitis

Simultaneous demonstration of circulating and tissue-fixed immune complexes was attempted in 22 patients with cutaneous necrotizing vasculitis (7 anaphylactoid purpura, 9 cutaneous allergic vasculitis, 2 livedo reticularis, 1 thrombophlebitis, 2 erythema elevatum diutinum and 1 acute generalized pustular bacterid). In 16 out of the 22 patients, particularly patients with anaphylactoid purpura and cutaneous necrotizing vasculitis, there was a high Clq-binding activity. Decreased levels of C3 and C4 were seen in 2 and 3 patients, respectively. In 11 out of 16 skin lesions, the granular deposits of immunoglobulins and/or complement were demonstrated in the blood vessel walls of the dermis. IgA deposit was seen in anaphylactoid purpura, and IgM deposit in other types of vasculitis. C3 deposit was the most frequently noted. There was no definite correlation between Clq-binding activity and tissue deposits.

Immune complexes in patients with drug eruptions: the relationship between skin lesions and circulating immune complexes

The relationship between skin lesions and immune complexes was studied in sixty-two patients with exanthematic drug eruptions. By means of C1q-binding, conglutinin-binding and platelet aggregation tests, immune complexes were detected in a considerable number of sera from these patients. Patients with widespread maculopapular drug eruptions were found to show a relatively high serum level of immune complexes. There was a close association between the disease activity and the amount of the circulating immune complexes. By immunofluorescence, six of seventeen patients with drug eruptions were shown to have deposits of IgG, IgM, IgA or C3 in the skin lesions. These results suggest that certain immune complexes may play a role in some types of drug eruption as a pathogenetic factor.

Vibrational modes of flavin bound to riboflavin binding protein from egg white. Resonance Raman spectra of lumiflavin and 8-substituted riboflavin

The resonance Raman (RR) spectra of 8-halogenated-riboflavin, 8-demethyl-riboflavin(8-H-RF), 8-amino-riboflavin(8-NH2-RF), 8-methoxy-riboflavin(8-OCH3-RF), lumiflavin, and 3-methyl-lumiflavin were observed. The Raman lines with the highest frequency are at 1624, 1620, and 1615 cm-1 for 8-chloro-riboflavin, 8-bromo-riboflavin, and 8-iodo-riboflavin, respectively. This systematic shift confirms that the 1631 cm-1 line of riboflavin is derived from the benzene part of isoalloxazine. Substitution at the 8-position by an amino or methoxy group, which has a large influence on the electronic structure of isoalloxazine, changes the RR spectrum markedly in comparison with that of 8-halogenated riboflavin. The 1583 cm-1 line of riboflavin, which involves the vibrational displacement of N(5) and C(4a) atoms of isoalloxazine, is shifted to the low frequency side by substitution at the 8-position with an amino or methoxy group. The corresponding line of 8-H-RF, on the contrary, shifts to the high frequency side. The RR spectrum of lumiflavin is very different from that of riboflavin in the range from 1200 to 1300 cm-1. Although the pi-electronic structure is little affected by the substitution at the 10-position, the Raman spectrum of lumiflavin in this region is very sensitive.