A Novel 29-kDa Crystal Protein fromBacillus thuringiensisInduces Caspase Activation and Cell Death of Jurkat T Cells

Bacillus thuringiensis, the most successful and most widely used microbial insecticide, produces crystal proteins. The physiological significance of the crystal proteins is poorly understood except for the potent insecticidal activity. In this paper, we report a novel biological activity of the crystal protein. A 29-kDa crystal protein, p29, produced by B. thuringiensis subsp. coreanensis A1519, was toxic to Jurkat, a cell line from human leukemic T cells. Upon treatment of the Jurkat cells with p29 at a lower concentration, translocation of phosphatidylserine to the external cell surface, release of cytochrome c and Smac/DIABLO from the mitochondria, and activation of caspase-9 were induced. These cellular events were followed by activation of caspase-3, cleavage of poly (ADP-ribose) polymerase (PARP), and chromatin condensation. Peak activation of caspase-9 was prominent and preceded that of caspase-8. Depletion of Bax from the cytosol was observed as the progress of p29-induced cell death. At a higher concentration of p29, the cells showed similar and accelerated morphological change, but neither externalized phosphatidylserine nor caspase-3 activation was observed. These results suggest that p29 at the lower concentration induced cell death of Jurkat accompanied by apotosis-like cellular events, and that mitochondria played a major role in p29-induced cell death.

Tunable high-energy ion source via oblique laser pulse incident on a double-layer target

The laser-driven acceleration of high quality proton beams from a double-layer target, comprised of a high-Z ion layer and a thin disk of hydrogen, is investigated with three-dimensional particle-in-cell simulations for an obliquely incident laser pulse. The proton beam energy reaches its maximum at a certain incidence angle, where it can be much greater than the energy at normal incidence. The proton beam propagates at some angle with respect to the target surface normal and with some tilt around the target surface, as determined by the proton energy and the incidence angle.

Parasporin-2Ab, a Newly Isolated Cytotoxic Crystal Protein from Bacillus thuringiensis

A novel crystal protein that exhibited potent cytotoxicity against human leukemic T-cells was cloned from the Bacillus thuringiensis TK-E6 strain. The protein, designated as parasporin-2Ab (PS2Ab), was a polypeptide of 304 amino acid residues with a predicted molecular weight of 33,017. The deduced amino acid sequence of PS2Ab showed significant homology (84% identitiy) to parasporin-2Aa (PS2Aa) from the B. thuringiensis A1547 strain. Upon processing of PS2Ab with proteinase K, the active form of 29 kDa was produced. The activated PS2Ab showed potent cytotoxicity against MOLT-4 and Jurkat cells and the EC(50) values were estimated as 0.545 and 0.745 ng/mL, respectively. The cytotoxicity of PS2Ab was significantly higher than that of PS2Aa reported elsewhere. Although both cytotoxins were structurally related, it was thought that the minor differences found were responsible for the different cytotoxicities of PS2Ab and PS2Aa.

Flexibility and strictness in functional replacement of domain III of cry insecticidal proteins from Bacillus thuringiensis

Cry1C, one of the lepidopteran-specific insecticidal proteins from Bacillus thuringiensis, exhibits potent cytotoxicity against Sf9, an insect cell line. Cry1Aa and Cry4A, which are lepidopteran- and dipteran-specific insecticidal proteins, respectively, show no cytotoxicity against Sf9. When domain III of Cry1C was replaced with that of Cry1Aa or Cry4A, the hybrid Cry1C protein retained the cytotoxicity. These results suggest that domain III of Cry1C is not crucial in determining the cytocidal specificity of Cry1C against Sf9.

Laser ion-acceleration scaling laws seen in multiparametric particle-in-cell simulations

The ion acceleration driven by a laser pulse at intensity I= 10(20)-10(22) W/cm(2) x (microm/lambda)(2) from a double layer target is investigated with multiparametric particle-in-cell simulations. For targets with a wide range of thickness l and density n(e), at a given intensity, the highest ion energy gain occurs at certain electron areal density of the target sigma = n(e)l, which is proportional to the square root of intensity. In the case of thin targets and optimal laser pulse duration, the ion maximum energy scales as the square root of the laser pulse power. When the radiation pressure of the laser field becomes dominant, the ion maximum energy becomes proportional to the laser pulse energy.

Electron, positron, and photon wakefield acceleration: trapping, wake overtaking, and ponderomotive acceleration

The electron, positron, and photon acceleration in the first cycle of a laser-driven wakefield is investigated. Separatrices between different types of the particle motion (trapped, reflected by the wakefield and ponderomotive potential, and transient) are demonstrated. The ponderomotive acceleration of electrons can be largely compensated by the wakefield action, in contrast to positrons and positively charged mesons. The electron bunch energy spectrum is analyzed. The maximum upshift of an electromagnetic wave frequency during reflection from the wakefield is obtained.

Functional analysis of two processed fragments of Bacillus thuringiensis Cry11A toxin

The 70-kDa protoxin of Cry11A, a dipteran-specific insecticidal protein, was processed by trypsin into 36- and 32-kDa fragments. To investigate the potent function of the two processed fragments, a GST (Glutathione-S-transferase) fusion protein of each polypeptide was constructed. While neither the 36- nor the 32-kDa fragment was toxic to Culex pipiens larvae, coexpression of the two fragments restored the insecticidal activity. Furthermore, the coprecipitation experiment demonstrated that the 36-kDa fragment was associated with the 32-kDa fragment. It was, therefore, shown that the coexistence of the two processed fragments of Cry11A was essential for the toxicity. The mutant of the 36-kDa fragment lacking the region from Gly(257) to Arg(360) bound to the 32-kDa fragment but the coexpression with the 32-kDa fragment resulted in no toxicity, suggesting that this region was involved in insecticidal activity.

The cytotoxicity of Bacillus thuringiensis subsp. coreanensis A1519 strain against the human leukemic T cell

A novel cytotoxic protein was isolated from the crystal produced by Bacillus thuringiensis subsp. coreanensis A1519 strain. Upon treatment of the crystal proteins by proteinase K, the significant cytotoxicity toward the leukemic T cell, MOLT-4, was exhibited. The microscopic observation indicated that the cell death was accompanied by no extensive rupture of the cell membrane. It was, therefore, suggested that the cell death of MOLT-4 was induced through a mechanism other than the colloid-osmotic swelling and cell lysis as caused by hitherto known B. thuringiensis crystal proteins. The 29-kDa polypeptide proved to be an active component of the proteinase K-digested A1519 crystal proteins. EC(50) of the purified 29-kDa polypeptide was 0.078 microg/ml. The N-terminal amino acid sequence of the 29-kDa polypeptide shared no significant homology with all the known proteins, suggesting that this polypeptide belong to a new family of B. thuringiensis crystal proteins. In the ligand blotting analysis, specific binding proteins for the 29-kDa polypeptide were detected from the cell membrane of MOLT-4.

Binding properties of Bacillus thuringiensis Cry1C delta-endotoxin to the midgut epithelial membranes of Culex pipiens

The Cry1C delta-endotoxin from Bacillus thuringiensis is toxic to both lepidopteran and dipteran insect larvae. To analyze the dipteran-specific insecticidal mechanisms, we investigated the properties of Cry1C binding to the epithelial cell membrane of the larval midgut from the mosquito Culex pipiens in comparison with dipteran-specific Cry4A. Immunohistochemical staining of the larval midgut sections from Culex pipiens showed that Cry1C and Cry4A bound to the microvilli of the epithelial cells. The Cry1C binding to brush border membrane vesicles from the mosquito larvae was specific and irreversible, and did not compete with Cry4A. By ligand blotting analyses, we detected several Cry1C-binding proteins, the Cry1C binding to which did compete with excess unlabeled Cry4A. These results suggested that Cry1C and Cry4A recognized the same binding site(s) on the epithelial cell surface but that their interaction with the target membrane differed.

Active form of dipteran-specific insecticidal protein cryllA produced by Bacillus thuringiensis subsp. israelensis

The nucleotide sequence of the cry11A gene from Bacillus thuringiensis subsp. israelensis strain HD522 was analyzed and the molecular characterization of CryllA toxin was done. The 70-kDa CryllA protoxin was processed in vitro into 36- and 32-kDa fragments by trypsin and into 34- and 32-kDa fragments by gut proteases from C. pipiens. These two processed fragments are associated together to form the heterodimer. The results of the binding assay with BBMV and the bioassay toward C. pipiens larvae suggested that the heterodimer was biologically as active as the non-digested CryllA toxin and the intramolecular cleavage did not promote the insecticidal activity. These results suggested that a probable complex of the 36- or 34-kDa and 32-kDa fragments was also one of the possible active forms of Cry11A, and that the biological functions of CryllA was not essentially affected by the intramolecular cleavage of the 70-kDa protein.

Binding properties of Bacillus thuringiensis Cry4A toxin to the apical microvilli of larval midgut of Culex pipiens

Cry4A is a dipteran-specific delta-endotoxin produced by Bacillus thuringiensis, and toxic to Culex pipiens (mosquito) larvae. The immunohistochemical staining of the midgut sections of C. pipiens larvae revealed that Cry4A bound in vitro and in vivo to the microvilli of the epithelial cells of posterior midgut and gastric caecae. The binding of digoxigenin-labeled Cry4A (DIG-Cry4A) to the apical microvilli was almost abolished in the presence of excess unlabeled Cry4A, suggesting that the binding of Cry4A to the microvilli was specific. Several Cry4A-specific binding proteins were detected using the ligand blotting technique with DIG-Cry4A. Moreover, an insertion assay was done, where the binding of DIG-Cry4A to the BBMVs was completely irreversible and did not compete with excess unlabeled Cry4A. On the basis of these results, we propose a schematic interpretation for the binding process of Cry4A.

[Relationship between intensity of annoyance due to throat discomfort and psychological test results]

For 87 male and 100 female patients (average age of 58.5 years) with throat discomfort, we investigated the relationship between the intensity of annoyance caused by throat discomfort and psychological distress. We asked patients to assess their throat discomfort using a 100-mm horizontal visual analogue scale (VAS) which defined the left end (0) as no annoyance and the right end (100) as overwhelming annoyance attributed to throat discomfort. The extent of their psychological distress was evaluated by 3 tests: Cornell Medical Index-Health Questionnaire (CMI), Self-rating Depression Scale (SDS) and Self-rating Questionnaire for Depression (SRQ-D). Our results indicate that the increase in intensity of annoyance caused by throat discomfort was significantly related to the increase in somatic symptoms (Spearman's rho = 0.164, p = 0.025), symptoms connected to autonomic nerve dysfunction (rho = 0.203, p = 0.006) as measured by CMI and neurotic condition as classified by Fukamachi's diagnostic method for CMI (p = 0.049 by Kruskal-Wallis test). The increase in intensity of annoyance caused by throat discomfort was significantly related to the increase in depressive condition as measured using SRQ-D (rho = 0.263, p < 0.001), but not to that measured using SDS (rho = 0.097, p = 0.185). The results obtained from the present study indicate that VAS is a useful tool for measuring annoyance caused by throat discomfort, yielding valuable information about the intensity of patients' somatic and psychological complaints.

Ion explosion and multi-mega-electron-volt ion generation from an underdense plasma layer irradiated by a relativistically intense short-pulse laser

Ion acceleration and expansion in the interaction of a relativistically intense short-pulse laser with an underdense plasma layer are investigated. Ion and electron dynamics are studied by a two-dimensional particle-in-cell simulation with the real mass ratio. It is shown that the longitudinal electric field induced by electron evacuation due to a large ponderomotive force or light pressure can accelerate ions to several MeV in the direction of the laser propagation. It is after the laser completely passes through the plasma layer that the ion explosion starts to be significant.

Activation process of dipteran-specific insecticidal protein produced by Bacillus thuringiensis subsp. israelensis

Dipteran-specific insecticidal protein Cry4A is produced as a protoxin of 130 kDa in Bacillus thuringiensis subsp. israelensis. Here we performed the in vitro processing of Cry4A and showed that the 130-kDa protoxin of Cry4A was processed into the two protease-resistant fragments of 20 and 45 kDa through the intramolecular cleavage of a 60-kDa intermediate. The processing into these two fragments was also observed in vivo. To investigate functional properties of the two fragments, GST (glutathione S-transferase) fusion proteins of the 60-kDa intermediate and the 20- and 45-kDa fragments were constructed. Neither the GST-20-kDa fusion protein (GST-20) nor the GST-45-kDa fusion protein (GST-45) was actively toxic against mosquito larvae of Culex pipiens, whereas the GST-60-kDa intermediate fusion protein (GST-60) exhibited significant toxicity. However, when the two fusion proteins GST-20 and GST-45 coexisted, significant toxicity was observed. The coprecipitation experiment demonstrated that the two fragments associated with each other. Therefore, it is strongly suggested that the two fragments formed an active complex of apparently 60 kDa. A mutant of the 60-kDa protein which was apparently resistant to the intramolecular cleavage with the midgut extract of C. pipiens larvae had toxicity slightly lower than that of GST-60.

Nasal passage patency in patients with allergic rhinitis measured by acoustic rhinometry: nasal responses after allergen and histamine provocation

We investigated nasal passage patency after allergen and histamine provocation in patients with allergic rhinitis by acoustic rhinometry. In total, 75 outpatients with allergic rhinitis were studied. The threshold of nasal hypersensitivity to histamine was measured by the 10 microliters instillation of serial 10-fold dilution in the ipsilateral nasal cavity. Nasal provocation testing to specific antigen was applied to the anterior part of inferior turbinate in bilateral sides in sitting position. Measurement of nasal patency by acoustic rhinometry was repeated three times in each nasal cavity. The minimal cross-sectional area and total volume of nasal cavity were measured in an individual subject. The minimal cross-sectional area and total volume in the histamine challenged-side significantly decreased on the 10(-2), 10(-1), 10(-0) of end point, and up to 30 min after challenge with the threshold dose, but not in the unchallenged side. This means acoustic reflection technique is sensitive at least 100-fold in comparison with classical method like findings by anterior rhinoscopy and symptom scores. Nasal passage patency after bilateral allergen provocation showed predominant in the unilateral side, suggesting the cross over-reflex effects. It was concluded that acoustic rhinometry is one of the highly quantitative and sensitive method which can observe the change of nasal congestion.

Identification of a second transcriptional start site for the insecticidal protein gene cryIVA of Bacillus thuringiensis subsp. israelensis

Expression of cryIVA, one of the insecticidal protein genes of B. thuringiensis subsp. israelensis, is regulated at the transcriptional level. The cryIVA gene is specifically transcribed during the stationary phase of this bacterium. As shown in our previous report [Yoshisue et al. (1993a)], the transcription from the -364 position of the cryIVA gene is conducted by the major promoter P1 that is functional during middle stages of the stationary phase of B. thuringiensis. In the present study, we have identified a second transcriptional start point P2 for the cryIVA gene in addition to P1, the major transcriptional start point. The transcription from P2 of the cryIVA gene occurred later than that from P1, during later stages of stationary phase of B. thuringiensis subsp. israelensis. The -10 and -35 nt sequences upstream from P2 of cryIVA are similar to those of the omega 28-specific promoters of B. thuringiensis genes and of the omega K-specific promoters of B. subtilis genes. It is most likely that the region upstream from P2 of cryIVA contains the nt sequences that determine the omega 28-specific promoter, the second one, for the cryIVA gene.

Acoustic evaluation of the efficacy of medical therapy for allergic nasal obstruction

Acoustic rhinometry (AR) was used for objective measurements of nasal cavity dimensions in conjunction with a 100-mm horizontal visual analogue scale (VAS) for simultaneous subjective assessments of nasal sensations of airflow. Studies were conducted on 45 patients with perennial allergic rhinitis before, during and after a 2-week period of treatment with oral emedastine difumarate, azelastine hydrochloride, and xiao qing long tang (a homeopathic decongestant), as well as intranasal fluticasone propionate aqueous nasal spray. During the treatment period, there was a significant increase in the right and left minimum cross-sectional areas (MCA) of the nose and/or nasal cavity volumes (NCV) in all groups. The average increase in MCA ranged from 21-39% after 1 week of treatment and 16-39% after 2 weeks, whereas that in the NCV ranged from 16-24% and 19-24%, respectively. Post-treatment measurements were not significantly different from the corresponding pre-treatment ones. These findings were in close agreement with that obtained with VAS, demonstrating that AR can be used to validate the application of VAS in the evaluation of nasal airflow during medical therapy.

[Abnormal sensation in the throat and autonomic nerve dysfunction symptoms]

Abnormal sensations, such as a lump, itchiness or choking, in the throat (AST) may develop as symptoms of autonomic nerve dysfunction (AND). If this is true, the subjects with AST should show more subjective symptoms and objective signs of AND than those without AST. We classified 500 otolaryngological and neurological patients [172 males and 328 females, age 58.4 +/- 14.0 years (mean +/- SD)] with various signs and symptoms suggesting autonomic nerve dysfunction into 2 groups: 370 patients with AST (AST group) and 130 without AST (non-AST group). For the subjective evaluation of AND symptoms, we calculated the number of positive answers to 33 questions concerning AND symptoms which appear in the Cornell Medical Index (Health Questionnaire). Objective evaluation of AND was done by analyzing the coefficient of variation (%) of 100 R-R intervals on electrocardiograms [CV R-R (%)], as previous studies by others have shown that CV R-R (%) decreases with age and/or with the severity of autonomic nerve dysfunction. The following results were obtained in the comparison between the two groups. 1) There were significantly more complaints of AND symptoms in the AST group (7.3 +/- 5.5, mean +/- SD) than in the non-AST group (5.3 +/- 4.4) (p < 0.0005 by Wilcoxon test). 2) The relative CV R-R (%) value calculated by dividing the CV R-R (%) actually obtained by the formula [5.13 - 0.0419 x age of subject (years)] was significantly smaller in the AST group (0.98 +/- 0.40) than in the non-AST group (1.06 +/- 0.39) (p < 0.05 by Wilcoxon test).(ABSTRACT TRUNCATED AT 250 WORDS)

Nasal cavity dimensions in the newborn measured by acoustic reflections

The acoustic reflections technique was used to measure nasal cavity dimensions in 27 newborns. The results were expressed in terms of curves describing cross-sectional area as a function of the distance into the nose. From these curves, a mean curve with 95% confidence limits, nasal cavity volumes between the nostril and 4.5 cm into the nasal cavity (V45 = 1.05 (0.24) cm3), the cross-sectional area at the narrowest site (Amin = 0.114 (0.033) cm2), and the distance from the nostril to Amin (DAmin = 1.14 (0.47) cm), expressed as mean and SD were calculated. There was a weak correlation between Amin and length and weight at birth, but otherwise nasal cavity dimensions did not correlate with sex, race, birth weight, birth length, head circumference, or duration of gestation. Comparison of the curves from the newborns with curves from adults showed a facial growth in vertical/transverse directions (area) of 600% and anterior/posterior directions of 120%. The technique of acoustic rhinometry is noninvasive, and can be performed rapidly, and is therefore eminently suitable for pediatric application. Further investigations are needed to demonstrate the value as a diagnostic tool in pathological cases.

[Evaluation of throat discomfort with visual analogue scale (VAS)]

We adopted a visual analogue scale (VAS) to evaluate discomfort like the sensation of a choking lump in the throats of 92 patients (24 male and 68 female, 17-80 years of age) who consulted us complaining of the sensation. The VAS consisted of a 100 mm long horizontal straight line defined by anchors with verbal labels: the left end point (0 mm) indicated no throat discomfort, the right end point (100 mm) overwhelming throat discomfort. We determined the VAS score (1 mm = 1) by measuring the distance from the left end point to the mark made by the patient. On the first day of the study, the patients evaluated the sensation with the VAS alone. One, two and three weeks later they evaluated the sensation with the scale, and at the same time, they were asked to compare the strength of the existing sensation with that on the first experimental day and to express the percent change in the sensation. The latter data were used for calculation of the predicted VAS score. It was neither difficult nor time-consuming for the patients, some of whom were fairly elderly, to display the strength of the sensation on the scale. The VAS score on the first day of the study for each patient ranged from 6-92, and the mean and the standard deviation were 44.6 and 21.0, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhalation of diethylamine--acute nasal effects and subjective response

Adult volunteers were exposed to 25 ppm (75 mg/m3) diethylamine in a climate chamber for 15 min in order to study the acute nasal reactions to an exposure equivalent to the present threshold limit value-short-term exposure limit. Changes in nasal volume and nasal resistance were measured by acoustic rhinometry and by rhinomanometry. Acute change in nasal volume, usually seen as acute nasal mucosa response to thermal stimuli, was not observed, nor was an acute change in nasal airway resistance. In a subsequent experiment, the aim was to measure acute sensory effects. Exposure to a concentration increasing from 0 to 12 ppm took place for 60 min, equal to an average concentration of 10 ppm (30 mg/m3). A moderate to strong olfactory response and distinct nasal and eye irritation were observed. In spite of considerable individual variation, the results were in agreement with sensory effect estimates obtained from animal studies.

A simple measurement of parotid salivary flow using material quick absorber

We applied Material Quick Absorber (Inami Co Ltd, Tokyo, Japan), a small triangular paper strip made mainly from viscose and used for fluid absorption during surgery, to collect right resting parotid saliva directly from Stensen's orifice and estimated nonstimulated parotid salivary flow by weighing the saliva absorbed in a given period of time. We assayed this method in 53 patients with dry mouth and/or throat and in 115 healthy young and elderly control subjects. The median salivary flow rates in male and female patients were 18 mg/min (almost equal to 0.018 mL/min) and 11 mg/min, respectively, significantly lower (P less than .05 for men, P less than .01 for women) than those obtained from young male (36 mg/min) and female (34 mg/min) controls and consistent with previously reported physiologic flow rates obtained by means of the "cup method." Although the median flow rate for elderly male controls (35 mg/min) was rather close to that of young male or female controls, there was no significant difference in flow rates between elderly male controls and male patients. On the other hand, in female control subjects, a significant decrease (P less than .05) in salivary flow was shown with aging. Repeated 3-minute measurements (eight times at 5- to 6-minute intervals) with this method in 10 healthy younger male volunteers showed that the coefficient of variance in the same subject ranged from 14.1% to 57.2% and that the larger the mean flow rate the smaller the coefficient of variance (P less than .05 by simple regression analysis).(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of recognition of head and neck malignancies on patients' psychosomatic condition and personality]

In order to elucidate the effect of recognition of head and neck malignancies on patients' psychosomatic condition and personality, we applied the Cornell Medical Index Health Questionnaire (CMI) and the Maudsley Personality Inventory (MPI) and collected medical and psychological data from 35 male (42-78 years of age; average 62.5) and 15 female (20-76 years of age; average 54.7) patients with malignant head and neck tumors (10 nose and paranasal, 8 oral, 8 pharyngeal, 14 laryngeal, 6 thyroid gland and 4 others). The two tests were done twice for each patients; at first immediately before hospitalization for treatment of the tumors at Mie University Hospital and secondly just before discharge from the hospital. The period of hospitalization ranged 1 to 13 months, average 3.3 months. At the end of hospitalization doctors and nurses who had mainly taken care of the patients estimated the patients' recognition of their malignancy by analyzing behavior and information mainly from their family and classified patients into three groups; Group R (Patients who recognized that they were patients with head and neck malignancies) comprised 22 patients, Group N (who did not recognize the condition) comprised 15 and Group U (who could not be classified into Groups R or N) comprised 13. Comparison among the three groups revealed the followings. 1) Patients in Group R were relatively young (average 56.3 years) and extrovert (estimated by MPI) and their somatic and psychological complaints registered on the CMI were less than those in other 2 groups. Psychosomatic condition after recognition that they had been patients with malignant tumors was better than before.(ABSTRACT TRUNCATED AT 250 WORDS)

[Ala1,3,11,15]endothelin-1 analogs with ETB agonistic activity

A linear peptide analog of endothelin (ET)-1, [Ala1,3,11,15]ET-1 (4AlaET-1), and its truncated peptide analogs were synthesized to study the structural requirements of ET-1 for the recognition of ETs-nonselective ETB receptors. ET-1 exhibited sub-nanomolar binding to two distinct ET receptor subtypes (ETA and ETB), but 4AlaET-1 bound to ETB with an affinity 1,700 times higher than that seen during binding to ETA. The truncated linear peptides 4AlaET-1(6-21), 4AlaET-1(8-21) and N-acetyl-4AlaET-1(10-21) still had high affinity for ETB, whereas 4AlaET-1(6-20) and 4AlaET-1(11-21) displayed remarkably reduced affinity for ETB. Therefore, ET-1 requires the Glu10-Trp21 sequence for ETB binding, but not the disulfide bridges. These ETB-binding peptides elicit endothelium-dependent vasorelaxation of porcine pulmonary arteries in parallel with the binding affinity for ETB, suggesting that they are ETB agonists.

[Psychological states and personality as factors in the morbidity of head and neck malignant tumors]

Many publications have repeatedly indicated that there seems to be a correlation between neoplastic disease and certain types of psychological situations. However, such studies subjected malignant tumors in head and neck region are scanty so far. We applied Cornell Medical Index Health Questionnaire (CMI) and Maudsley Personality Inventory (MPI) to collect medical and psychiatric data from 86 patients (56 males and 30 females) with head and neck malignant tumors and 115 control patients (73 males and 42 females) with head and neck diseases other than malignant tumors. Analysis of CMI data using Diagnostic Sheet, Fukamachi's method and Modification of Abe's method, and analysis of each of Extroversion-Introversion scale scores, Neuroticism scale scores and Lie scale scores of MPI led the following conclusion. 1) Both male and female patients with head and neck malignant tumors showed to be more depressive than their control patients were. Especially, between the two patient groups in males, there was a statistically significant (p less than 0.05) difference. 2) Regarding neurosis, autonomic nerve dysfunctioning and extroversion-introversion, none of these factors seemed to be related with the morbidity of head and neck malignant tumors. Further exploration of this issue, with a special attention to the relationship between depression and head and neck malignancy should be conducted, if possibly, from a prospective point of view.

Estrogen regulates peptidylarginine deiminase levels in a rat pituitary cell line in culture

A Nonidet P-40 extract of growth hormone-producing rat pituitary MtT/S cells was found to contain peptidylarginine deiminase (EC 3.5.3.15), which was indistinguishable from an enzyme preparation from rat muscle in Western immunoblotting and immunoprecipitation. This enzyme was immunocytochemically detected in the cytoplasm but was not secreted into the medium during the cultivation. When the cells were cultured for 2 days with various concentrations of 17 beta-estradiol (E2), the enzyme activity increased in a dose-dependent manner, reaching a maximum level (four- to fivefold higher than control) at about 10(-9) M. This increase in the enzyme activity was evident by 14 hr of culture and became relatively stable after 24 hr. It correlated well with the increase in the amount of the muscle type enzyme per cell as analyzed by Western immunoblotting. Estriol and a synthetic estrogen, diethylstilbestrol, also increased the enzyme activity, whereas testosterone, progesterone, and corticosterone were without effect. An antiestrogen, tamoxifen, which by itself was inactive, partially suppressed the effect of E2. Exposure of MtT/S cells for 14 hr to E2 increased incorporation of 35S-labeled amino acids into the immunoprecipitable peptidylarginine deiminase. This increase was dependent on the concentration of E2, attaining a maximum level (about tenfold higher than the control) at about 10(-9) M. These results indicate that estrogen effects the increase in peptidylarginine deiminase content in the pituitary cells by stimulating enzyme synthesis.

[Clinical effects and toxicity of chemotherapy with cisplatin for head and neck cancer--the multi-institutional joint research in Tokai district]

We investigated the clinical effects and toxicity of chemotherapy with Cisplatin (CDDP) for head and neck cancer as the third joint research project of the Tokai Meeting for Head and Neck Tumors. The cases were examined at the cooperating institutions from September 1986 to March 1988. The subjects were 93 cases consisting of 66 patients (intravenous infusion: 47 cases; intraarterial infusion: 19 cases) of PP therapy (CDDP + PEP), 16 cases of PF therapy (CDDP + 5-FU) and 11 cases of PPV therapy (CDDP + PEP + VCR). The regimens of PP therapy were: CDDP 50-100 mg/body x 1 day, PEP 5 mg/body x 5 days (i.v.), and CDDP 10-20 mg/body x 5 days, PEP 5-10 mg/body x 5 days (i.a.). In the regimen of PF therapy, CDDP 80-100 mg/body x 1 day and 5-FU 750-1,000 mg/body x 5 days were administered. In the regimen of PPV therapy, CDDP 80-100 mg/body x 1 day, PEP 5 mg/body x 5 days and VCR 1 mg/body x 1 day were administered. As a rule, two courses of each of the regimens were performed. The total dose of CDDP in intraarterial infusion of PP therapy was significantly less than in intravenous infusion. The major results were as follows: 1) Total response rate was 57.0% on the average, and this was not significantly different among the regimens. 2) The response rate of intraarterial infusion of PP therapy was as high as that for intravenous infusion in spite of the lower CDDP dose. 3) The response rate of oral cavity was significantly higher than that of nasal cavity and paranasal sinuses. 4) In the squamous cell carcinoma, the response rate of the well differentiated type was significantly higher than that of the poorly differentiated type. 5) The leukocyte counts significantly decreased with the intravenous infusion of PP therapy, PF therapy and PPV therapy. 6) The platelet counts significantly decreased with PPV therapy. 7) There were no significant changes with time with Ccr and PaO2 of PP therapy. 8) The frequency of toxicities such as nausea and vomiting was high in the intravenous infusion of PP therapy, PF therapy and PPV therapy. However, the frequency of toxicity was low in the intraarterial infusion of PP therapy.

Endotoxin and lysosomal protease activity in acute and chronic otitis media with effusion

Endotoxin levels and lysosomal protease (collagenase, cathepsin B, and lysozyme) activity were measured in 104 middle ear effusions (MEEs) from patients with otitis media with effusion (OME). The MEE samples were classified into four groups: pediatric serous, mucoid, and acute, and adult serous. Endotoxin levels and lysosomal protease activity in MEEs were significantly different in the following order: adult less than serous less than mucoid less than acute groups, indicating that both endotoxin and lysosomal proteases are more closely related to the pathogenesis of pediatric chronic OME than to adult OME. In pediatric serous and mucoid effusions, endotoxin level had a significant correlation with activity of the lysosomal proteases. In conclusion, endotoxin enhances leukocyte infiltration into the middle ear, and lysosomal proteases released from leukocytes damage the middle ear mucosa and thereby prolong mucosal inflammation, which may be responsible for delayed recovery from acute OME.

Evaluation of the effect of localized skin cooling on nasal airway volume by acoustic rhinometry

Ten healthy subjects (four men and six women) were subjected to localized skin cooling by submersion for 5 min of both feet and, in another experiment, one hand and forearm into ice-cold water. Repeated measurements of nasal cavity volumes by a new method, acoustic rhinometry, showed characteristic patterns ranging from marked increases in volumes lasting the entire exposure period to transient monophasic or biphasic responses to no change at all. The pattern in individual subjects was reproducible with the two methods of cooling, and it could be characterized by five types when related to baseline measurements during the preexposure period. Because of large minute-to-minute variations, probably determined by local differences and fluctuations in blood flow in tissues through the nose, evaluation of induced changes in the nasal cavity volume cannot be based on single measurements as has frequently been done in the past by using rhinomanometry as the experimental method. The mechanisms behind the characteristic patterns in immediate human nasal response to local skin cooling challenge remains to be explored.

[Effect of Impletol injection into paratonsillar tissue on abnormal sensation in the throat]

If the abnormal sensation, such as a lump or choking, in the throat was mainly caused by inflammatory changes in the palatine tonsils or their surrounding tissues and conveyed via vagal nerve branches distributing there, the sensation might be reduced by topically injected Impletol (Procaine and caffeine in saline solution), i.e. Impletol test for focal tonsillitis. One hundred patients with abnormal sensation in the throat were injected Impletol (Impletol group), 50 patients were injected saline solution alone (Saline group) and 50 patients had injection needle simply inserted into the peritonsillar tissues (Needle group). The Impletol group showed the best result and was followed by Saline group and then Needle group. Namely, the degree of sensation reduced by 80% or more in 38% of the Impletol group and by 50% or more in 62% of them. Those rates were 26% and 60% for Saline group and 28% and 52% for Needle group, respectively. Though the results were indicative of the effectiveness of the Impletol injection for the abnormal sensation in the throat, the difference among these three groups was not statistically significant.

[Psychosomatic aspect of a choking lump sensation in the throat]

In order to elucidate the relationship between a choking lump sensation in the throat and psychosomatic status, the authors subjected 339 in-patients above 17 years of age with various kinds of otorhinolaryngologic diseases and evaluated their psychosomatic conditions by means of two questionnaires: Cornell Medical Index Questionnaire (CMI) and Maudsley Personality Inventory (MPI). According to the answer to one of the CMI questions "Do you often feel a choking lump in your throat?", the patients were divided into two groups: "Yes" group and "No" one. "Yes" group comprised 51 males (56.1 +/- 15.6 years old of mean +/- SD age) and 34 females (57.9 +/- 13.9 years old) and "No" group 170 males (57.7 +/- 14.3 years old) and 84 females (47.8 +/- 15.8 years old). The data were analysed for comparison between the two groups and the following results were obtained. Patients with benign and malignant oral, pharyngeal and laryngeal diseases were included in the "Yes" group with a significantly higher rate when compared to the patients with benign and malignant ear or nasal diseases. Patients in "Yes" group made significantly more complaints and judged to be significantly more neurotic and autonomic nerve dysfunctioning than those in "No" group. Therefore, diseases in the pharyngolaryngeal region more likely produces abnormal sensation in the throat as well as many other symptoms relating to the autonomic nerve function.

Structure-activity relationships of airway irritating aliphatic amines. Receptor activation mechanisms and predicted industrial exposure limits

Sensory irritation due to inhalation of diethyl-, triethyl-, dibutyl-, tributyl- and cyclohexylamine was estimated from the decrease in respiratory rate in normal mice (American Standard Method E981-84). The concentration-effect relations followed Michaelis-Menten equations, except for diethylamine, for which a threshold was found. The concentrations depressing the respiratory rate by 50% (RD50) for diethyl-, triethyl-, dibutyl- and cyclohexylamine were 184, 186, 81 and 27 ppm, respectively. For tributylamine the maximum response was too low to achieve a RD50 value. Pulmonary irritation was estimated from the decrease in respiratory rate in tracheal-cannulated mice. The respective concentrations depressing the respiratory rate by 50% (tRD50) were 549, 691, 101, 96 and 78 ppm for diethyl-, triethyl-, dibutyl-, tributyl- and cyclohexylamine. Only minor or no effects on the tidal volumes were found at the lower exposure concentrations. The trigeminal and pulmonary receptors are believed to be activated directly by the amines, and the receptor environments are believed to be lipophilic. Structure-activity analysis was made by comparing the effects of the amines with the effects of previously investigated primary n-alkylamines. Occupational exposure limits (TLV) were estimated for both effects. Finally, the sensory irritation effect was found to be an important part of the odour sensation, also below the TLVs.

[Clinical study of HCFU in combination with irradiation therapy in squamous cell carcinoma of the head and neck]

Sixty-two patients with squamous cell carcinoma of the head and neck were administered a mean total dose of 75.9 g carmofur (HCFU) in combination with a mean total dose of 49.0 Gy irradiation therapy. The primary sites of cancer were: larynx 29 cases, oral cavity 11 cases, nasal and paranasal cavity 7 cases, hypopharynx 5 cases, nasopharynx 5 cases, epipharynx 3 cases, and others 2 cases. The clinical stages were: stage I II cases, stage II 15 cases, stage III 17 cases, and stage IV 19 cases. In 57 evaluable patients having measurable lesions, overall response rate, including 26 complete responses (CR) and 16 partial responses (PR), was 73.7%. Average doses of HCFU were 13.1 g at PR, 27.8 g at CR, and those of irradiation were 27.7 Gy at PR, 48.5 Gy at CR. The median duration of PR was 44.8 weeks and that of CR was 47.0 weeks, the overall response interval being 47.7 weeks. Of the 62 patients, 25 (40.3%) complained of side effects including pollakisuria (9 cases), appetite loss (6 cases), stomatitis (5 cases), and so on.

[Adenoid cystic carcinoma of the head and neck--a clinical study of 27 cases]

Adenoid cystic carcinoma (ACC) is frequently seen in the salivary glands, but may occur at other sites in the head and neck. We report 27 patients with ACC treated at the Department of Otorhinolaryngology, Mie University School of Medicine, for 15 years. The survival rate dropped from 78% at five years to 36% at 10 years. This suggests that the long-term prognosis of ACC is poor. According to Batsakis, we classified ACC according to histopathology and emphasize that the solid cellular pattern had the worst prognosis.

Aneurysm of the extracranial carotid artery

Aneurysms of the extracranial carotid artery are rare vascular lesions. These aneurysms usually present to the otolaryngologist or vascular surgeon as a cervical or parapharyngeal pulsatile mass. Rupture and hemorrhage are unusual complications. Central nervous system symptoms secondary to embolism or thrombosis, however, are relatively common. Because of these serious complications, surgical resection of the aneurysm with restoration of arterial continuity is the treatment of choice. We describe herein three cases of the extracranial carotid aneurysm treated at the Mie University Hospital, Tsu, Japan, in the past two years. Surgical treatments include end-to-end anastomosis, saphenous vein autograft replacement, and direct closure utilizing an internal shunt, respectively, after resection of the aneurysm. In all patients, the postoperative course was uneventful, and angiography six weeks after the operation demonstrated good blood flow through the repaired artery.

[A statistical analysis of multiple primary malignant tumors]

The authors analyzed 32 patients with multiple primary malignant tumors treated in the Department of Otolaryngology, Mie Univ. from 1965 to 1984 and reviewed the literature. Of 1149 malignant head and neck tumors in our clinic in the same period, 32 cases (2.79%) were multiple primary malignant tumors. In this series, quadruple and triple malignancies were found in one case each and double ones in the others. The average age of these 32 patients was 67.5 years for the men and 52.7 for the women. The male: female ratio was 4.3:1. The average interval between the first and second tumor was 35 months, and in 17 cases (56.7%), they were synchronous. Laryngeal cancers were the most frequent double-primary lesions and cancers in the head and neck were most commonly associated with stomach cancers in this study.

Sensation elicited by mechanical stimuli to the oropharyngeal mucosa

An inaccurate localization of the site of stimulus, a higher two-point threshold for touch than those at lower lip or soft palate mucosae, and reference of touch sensation to the submaxillary cervical region following mechanical stimuli to the posterior oropharyngeal wall or lateral pharyngeal band were observed in the present study on otolaryngologists, medical students and patients with abnormal sensations in the throat. These results indicated that not only the somatic but also the visceral nervous system might contribute to the elicitation of sensation from the oropharyngeal structures behind the soft palate.

Chondrosarcoma of the ethmoid sinus extending to the anterior fossa

A 27-year-old women with chondrosarcoma of the ethmoid sinus extending to the anterior fossa had initial symptoms of blurred vision on the left and slight proptosis. Neuroradiological examination, however, disclosed that the tumor extended not only to the anterior cranial fossa, but also to the orbit, nasal cavity, and maxillary sinus. It is difficult to predict the biological behavior of chondrosarcoma by means of histological examination. The effectiveness of radiotherapy, chemotherapy, or both is also a matter of controversy. Clinical aspects of chondrosarcoma are briefly discussed.

Congenital stridor caused by redundant arytenoid mucosa

Two cases of congenital stridor caused by merely unusual redundancy of the mucosa covering the arytenoids are reported in this paper. The stridor was noted only when the patients were awake, and was not affected by postural changes of patients. The patients who did not reach their full mental and physical development had congenital abnormalities: cleft palate in one case, and hypertrichiosis, short palpebral fissures of camptodactyly in the other. No abnormalities were revealed in the patients on examinations of chromosomes, thyroid hormones and brains using the techniques of computerized axial tomographic scanning and electroencephalography. The diagnosis of these cases should be confirmed by a direct laryngoscopy or a laryngofiberscopy. Although the etiology of redundant arytenoid mucosa is not known, it may be suggested that this condition is incidental to other congenital abnormalities.

Interaction of upper airway reflexes on protective laryngeal closure

Reflex responses evoked in the adductor branches of recurrent laryngeal nerve (RLN) by stimulation of the afferent nerves in the upper respiratory tracty were studied on anesthetized cats for the purpose of elucidating the mechanisms of the protective laryngeal closure reflex. A single pulse stimulation to each of the infraorbital branch of the trigeminal nerve (ION), the glossopharyngeal nerve (GPN) and the superior laryngeal nerve (SLN) elicited reflex responses in RLNs on both sides. The frequency-dependent attenuation of reflex responses in right RLN elicited by repetitive stimulation of ipsilateral SLN began at frequencies of 40-50/sec; on the other hand, that elicited by repetitive stimulation of ipsilateral GPN or ION was attenuated at frequencies of 5-10/sec. Furthermore, interactions among the reflexes in right RLN elicited by stimulation of ipsilateral ION, GPN and SLN were observed by using the technique of double shock stimulation (the "conditioning-testing" technique). The effect of conditioning stimulation of ION was a short facilitation followed by a long-lasting inhibition of RLN reflex responses elicited by test stimulation of SLN and GPN. conditioning stimulation of GPN elicited a similar effect on RLN reflex responses evoked by test stimulation of SLN. These results indicate an important role of the interactions among upper airway afferent activities for the performance of laryngeal defense action.