Real prevalence of neural tube defects in Japan: How many of such pregnancies have been terminated?

The vital role of folic acid is to reduce the risk of having a neonate afflicted with neural tube defects. The prevalence of neural tube defects (myelomeningocele and anencephaly) has been reported in an incomplete form over the last 40 years in Japan. We aimed to evaluate the total number of neural tube defects including those delivered or terminated, to clarify the proportion of those terminated, and to internationally compare their prevalence. Through information on >311 000 deliveries obtained from 262 hospitals/clinics for 2 years of 2014 and 2015, we identified that the rate of total neural tube defects (termination of pregnancy, live births and stillbirths) was 8.29 per 10 000 deliveries for the year 2014 and was 8.72 for 2015, which were 1.5 and 1.6 times higher than the respective values (live births and stillbirths) reported. It is also observed that the ratio of the total number of myelomeningocele (termination of pregnancy, live births, and stillbirths) to that of anencephaly was approximately 1:1.2, that a half of pregnancies afflicted with neural tube defects were terminated, and that the proportion of termination of pregnancy due to myelomeningocele and due to anencephaly was 20% and 80%, respectively. Internationally, the real prevalence of neural tube defects in Japan was comparatively high, ranking fifth among the seven developed countries. In conclusion, the real prevalence of total neural tube defects was approximately 1.5 times higher than that currently reported by the Japan Association of Obstetricians and Gynecologists.

Spontaneous acute subdural haematoma and intracerebral haemorrhage in patient with HELLP syndrome: case report

HELLP (haemolysis, elevated liver enzymes, and low platelet count) syndrome can result in a fatal intracranial haemorrhage during the perinatal period. We report treatment of a 32-year-old primigravida who fell into a deep coma during labour with fetal distress, complicated by a spontaneous acute subdural haematoma and intracerebral haemorrhage. Simultaneous emergency operations, evacuation of the acute subdural haematoma and a caesarean section, were performed, during which a diagnosis of HELLP syndrome with disseminated intravascular coagulation was made. Both mother and infant recovered, though hemiparesis persisted in the mother. Patients with HELLP syndrome should be managed as high-risk, which requires an excellent working relationship of the physicians involved. Prompt recognition of intracranial haemorrhagic complications and neurosurgical intervention are particularly important.

Serum high-molecular weight adiponectin is related to early postprandial glycemic increases and gastric emptying in patients with type 2 diabetes mellitus

BACKGROUND

Postprandial hyperglycemia and hyperlipidemia are frequently associated with type 2 diabetes mellitus. The aim of the present study is to investigate the clinical determinants of postprandial glycemia and lipemia, especially serum high-molecular weight adiponectin.

METHODS

Twenty-seven diabetic patients treated with diet alone and 13 healthy volunteers took liquid test meal containing 53 g carbohydrate and 47 g lipid, dosed with nonradioactive isotope (13)C-acetate. Venous blood and breath samples were obtained for 180 min after the meal. Gastric emptying was evaluated by peak excretion time of (13)CO(2) in the breath samples. Delayed gastric emptying was defined as peak excretion time > 2.5 h (mean + 2 SD in the healthy volunteers).

RESULTS

Diabetic patients showed delayed insulin secretion, postprandial hyperglycemia and hyperlipidemia compared with control. Postprandial glycemic increases significantly correlated with enhanced gastric emptying. Serum high-molecular weight adiponectin correlated with postprandial glycemic increases at 30 and 60 min after meal (r = 0.42, p < 0.05; r = 0.37, p < 0.05, respectively). Serum high-molecular weight adiponectin also correlated with gastric emptying (versus peak excretion time r = - 0.58, p < 0.05). In addition, diabetic patients with delayed gastric emptying showed the suppressed postprandial glycemia with lower serum high-molecular weight adiponectin than those with normal gastric emptying. On the other hand, postprandial increases in serum triglyceride were not related to serum high-molecular weight adiponectin or gastric emptying, but significantly related to liver function test (serum transaminases) and body mass index.

CONCLUSIONS

Early postprandial glycemic increases were related to elevated serum high-molecular weight adiponectin, which might be associated with enhanced gastric emptying.

Poly(ethylene glycol) derivative of cholesterol reduces binding step of liposome uptake by murine macrophage-like cell line J774 and human hepatoma cell line HepG2

Liposome uptake by HepG2 human hepatoma cells was investigated in comparison with the uptake by J774 murine macrophage-like cells. HepG2 cells accumulated liposomes (egg yolk phosphatidylcholine (EPC)/Chol; 75/25, diameter 0.2 micron) at 37 degrees C comparably to J774 macrophage-like cells. Confocal microscopic observations revealed that J774 cells internalized EPC/Chol liposomes efficiently but HepG2 cells kept most of the liposomes bound on their plasma membrane surfaces. Poly(ethylene glycol) (PEG)-coated liposomes (0.2 micron) containing poly(ethylene glycol) cholesteryl ether (PEG-Chol) avoided cellular uptake at 37 degrees C by either cell line. In both cell lines, binding of PEG-coated liposomes was lower than that of EPC/Chol liposomes when incubation was carried out at 4 degrees C. To analyze the binding process at 37 degrees C, surface-bound liposomes were removed from the cells by pronase treatment. A reduction of the amount of bound-liposomes on cell surfaces was observed in the case of PEG-coated liposomes. Therefore, PEG-coating reduces direct binding of liposomes to the cell surfaces. The presence of apolipoprotein E (apoE) increased the uptake to EPC/Chol liposomes via its receptor in both cell lines. In contrast, cellular uptake of PEG-coated liposomes was not enhanced by treatment with apoE. Therefore, while apoE-mediated liposome uptake occurs in the case of EPC/Chol liposomes, it does not occur for PEG-coated liposomes; PEG-coating also inhibits protein-mediated binding to the cells. These results further imply that elusion from liver clearance of PEG-coated liposomes is not only due to the reduction of uptake by Kupffer cells but also by hepatocytes when liposomes are small enough to go through the fenestrates of the endothelial lining.

[A study on the maternal plasma C21 steroids concentration during pregnancy]

During pregnancy, C21 steroids such as progesterone (P4), and cortisol (F), have been reported to be closely involved in uterine contraction. To clarify the association between changes in steroid hormones and the onset of delivery, we measured the concentrations of six C21 steroids in maternal blood by high performance liquid chromatography. Changes in each steroid hormone were evaluated by analysis of variance during pregnancy. Pregnenolone, a source of C21 steroids, gradually increased during pregnancy. P4 and 17P4, its metabolite, reached a peak 3 weeks before delivery and noticeably decreased thereafter. Accompanying a decrease in P4 and 17P4, 20P4 and F, its metabolite, were noticeably increased. The association among these steroid hormones was also evaluated. The correlation between P4 and F was reversed after 3 weeks before delivery. These results suggest that steroid hormones in the maternal blood begin to change dynamically about 3 weeks before delivery. In particular, a decrease in P4 and an increase in F seem to be closely related to the onset of delivery.

The regulation of oxytocin receptor expression in human myometrial monolayer culture

Clarification of the mechanism of oxytocin (OT)-induced contraction of the uterus seems to be essential for the elucidation of the mechanism of the initiation of labor. Although it has been suggested that estradiol (E) and progesterone (P) are involved in the expression of oxytocin receptors (OTRs), no consensus opinion has been formed on this topic. Thus we recently assessed the effects of E and P on OTR expression using cultures of human uterine cells and we examined the changes in the expressed OTRs following treatment of the cell with exogenous OT. The following results were obtained: 1. The total cellular concentration of OTRs as measured in the myometrial crude membrane fraction (total OTR concentration) showed an increase dependent on the E concentration and on the length of the incubation period in the presence of E. This increase following treatment with E (10(-7) M) was suppressed by simultaneous treatment with P in a concentration-dependent manner; being suppressed by 50% when the concentration of P was 2.7 x 10(-6) M (E/P ratio = 0.037). When 1 nM OT was added to the culture, the total OTR concentration did not change within the first 30 minutes of incubation, but decreased by about 70% twenty-four hours after addition of OT. 2. The concentration of OTRs at the cell surface (surface OTR concentration), as measured in myometrial cells that adhered to the culture plate, did not change with time when the cells were cultured at 4 degrees C in the presence of 1 nM OT. However, when cultured at 37 degrees C, the surface OTR concentration showed decreases dependent on the concentration of OT added and the time after the addition of OT. This change was observed within 60 minutes after the addition of OT to the culture. This decrease in surface OTR concentration was suppressed by concanavalin A (ConA), an inhibition of the internalization of cell surface receptors. These results indicate that in humans also, the expression of myometrial OTRs is regulated by change in the E/P ratio. The present study also revealed that OTRs, once expressed, soon disappear from the cell surface in the presence of exogenous OT (due to internalization of OTRs, i.e., dislocation of OTRs from the cell surface to the inside of the cells), and that prolonged exposure to OT even leads to the disappearance of intracellular OTRs. The present study thus suggests that the expression of human myometrial OTRs is regulated by E and P, and that an agonist-induced desensitization mechanism at the receptor level, similar to that reported for beta-adrenergic receptors, is also operating in this receptor.

[A study on the effect of cortisol and progesterone on cytosolic arachidonic and palmitic acid concentrations in cultured human myometrial cells]

Glucocorticoids inhibit prostaglandin synthesis in several cell types, presumably by inhibiting arachidonic acid deacylation from phospholipids. We studied the effects of cortisol (F) and progesterone (P) on fatty acid release from cultured human myometrial cells. Confluent monolayer cultures of myometrial cells were adapted to steroids containing medium for 24 hours and the intracellular arachidonic acid and palmitic acid concentrations were determined. In the presence of fetal calf serum (FCS), the palmitic acid concentrations significantly decreased after the addition of 10(-7)M F. In the absence of FCS, the concentrations of both fatty acids were markedly increased after the addition of F. During oxytocin stimulation, the arachidonic acid concentration did not change but the palmitic acid concentration decreased slightly after the addition of F. A similar evaluation was done with P. The palmitic acid concentration decreased slightly after the addition of 10(-5)M P in the presence of FCS but increased markedly in the absence of FCS. During stimulation with oxytocin, the fatty concentrations of fatty acids decreased significantly in a dose-dependent manner. These results suggest that both F and P are implicated as regulatory factors in the activation of arachidonic acid cascade.

[Effect of progesterone, cortisol and dehydroepiandrosterone-sulfate on prostaglandin production by cultured human myometrial cells]

Prostaglandins (PGs) are considered to play important roles as contraction regulating factors in the mechanism of human uterine contraction. On the other hand, steroid hormones released in large amounts in late pregnancy appear to be closely related to the maintenance of pregnancy, fetal growth, and onset of delivery. To clarify the interactions between PGs and steroid hormones, we studied PGE2 and 6-keto-PGF1 alpha production on human myometrial cell culture. Cultures of myometrial cells from premenopausal patients with benign uterine diseases were established, and PG production in serum-free media and in the presence of various concentrations of progesterone (P), cortisol (F) and dehydroepiandrosterone-sulfate (DHAS) was studied. The following results were obtained: 1) The PGE2 and 6-keto-PGF1 alpha concentrations were 1,410.4pg/ml and 600pg/ml at 10 minutes after changing the medium, decreased transiently at 30-60 minutes, and increased thereafter. 2) When the cells were cultured with various concentration of P for 24 hours, PGE2 production was suppressed in the presence of P at 10(-7)M or above, but 6-keto-PGF1 alpha production showed a significant dose-dependent increase. 3) In the presence of F, PGF2 production shows a dose-dependent increase at high doses, but 6-keto-PGF1 alpha production markedly decreases at 10(-6)M or above. 4) In the presence of DHAS, PGE2 production increased markedly at 10(-6)M or above. These findings indicate that steroid hormones are regulatory factors in the production of PG by the myometrium.

[Effects of steroid hormones on change in [Ca2+]i and on PI response following oxytocin stimulation in cultured human myometrial cells]

In oxytocin (OT)-induced myometrial contraction, it is considered that Ca2+ release associated with activation of PI response is the main cascade. Steroid hormones such as dehydroepiandrosterone-sulfate (DHAS), progesterone (P), and cortisol (F), which show diverse changes during pregnancy, are considered to be involved in myometrial contraction at the onset of delivery. In this study, we examined changes in the intracellular Ca2+ concentration ([Ca2+]i) and PI response under OT stimulation. (1) After cultured human myometrial cells were incubated for 48 hours in a medium containing 10(-6) M of DHAS, P, or F, [Ca2+]i was measured with an OLYMPUS OSP3 by using the fluorescent Ca2+ indicator Fura2-AM. When the maximum change in [Ca2+]i under stimulation with 10(-8) M OT was regarded as 100% (control), it was increased significantly to 121.1 +/- 9.8% in the cells treated with F, but was reduced to 89.4 +/- 4% in those treated with P. It was increased to 107.5 +/- 6.9% in the cells treated with DHAS, but the difference was not significant. (2) After loading with 5 microCi 3H myo-inositol and various steroid hormones for 24 hours in the cells, the intracellular IP1-3 production under stimulation with 10(-8) M OT was examined. IP1-3 production and IP total production (IPn) were significantly increased in the cells treated with F as compared with the control, but IPn was reduced by about 40% in the cells treated with 10(-6) M P. And in the cells treated with DHAS, IPn was slightly increased.(ABSTRACT TRUNCATED AT 250 WORDS)

[The regulation of human myometrial oxytocin receptor expression by oxytocin]

Myometrial contraction induced by oxytocin (OT) is dependent on the OT concentration and the number of OT receptors (OTR) expressed. We previously reported that the number of myometrial OTR expressed is regulated by estradiol and progesterone in myometrial cell culture. In the present study, we evaluate the change in the number of OTR expressed on the cell surface after the addition of OT. After OT was added under various conditions to myometrial cells, we measured the number of OTR expressed on the cell surface (surface-OTR) and those in the plasma membrane (PM) (total-OTR). 1. After the addition of 1 nM OT, total-OTR was 25.78 fmol/mg protein in the OT-negative control and was 23.66 and 7.88 at 30 minutes and 24 hours. 2. Surface-OTR showed no changes after the addition of 1 nM OT at 4 degrees C, and the value after 60 minutes was 8.90 fmol/mg protein. At 37 degrees C, however, it become 5.53 and 1.72 fmol/mg protein 60 minutes after the addition of OT at 10pM and 10nM. This decrease in surface-OTR was suppressed by concanavalin A (ConA), which inhibits the internalization of receptors. Our study demonstrated that OTR expressed on the surface of myometrial cells decreased rapidly in the presence of OT due to internalization.

[The mechanism of beta-receptor desensitization in human myometrial culture cell]

Beta-adrenoceptor desensitization is considered to be primarily due to phosphorylation of receptors by protein kinase A (PKA) and beta-adrenaline receptor kinase (beta-ARK) and sequestration of receptors themselves. But in the human uterine muscle, the desensitization mechanism has been evaluated only as a phenomenon, and there are few studies on its mechanism. We evaluated cAMP production by beta-agonist and changes in the number of beta-receptors in cultured human myometrial cells. Uterine muscle cell were obtained from patients with benign disease before menopause and cultured. 1) At the confluent stage, dl-Isoproterenol Hydrochloride (ISP) was added under various conditions, and the intracellular cAMP concentration was determined by EIA. 2) After the addition of ISP (10(-6) M), plates were incubated at 37 degrees C, and beta-AR on the cell membrane surface (S beta-AR) and total beta-AR (T beta-AR) was measured in a binding assay with 125I-pindolol. The production of cAMP dose-dependently increased 30 minutes after the addition of ISP at 10(-6) M or higher, but rapidly decreased thereafter. T beta-AR was similar in the cells treated with ISP (10(-6) M) and the untreated cells. On the other hand, S beta-AR decreased by about 50% in the ISP treated cells. These result suggest the desensitization of beta-AR in human uterine muscle, and the involvement of the sequestration mechanism as its cause.

[The effect of oxytocin on production of free fatty acid in primary human uterine myometrial cell culture]

Oxytocin(OT) is considered to have several activities besides strongly inducing myometrial contraction by activating phosphatidilinositol-specific phospholipase C(PI-PLC). These include reconstructing the phospholipid constituents of the cell membrane and activating a variety of fatty acid producing systems. On the other hand, pregnancy-related steroid hormones which are produced by the fetus, placenta and mother are considered to be closely involved in the maintenance of pregnancy and the initiation of labor. In the present study with cultured myometrial cells, we examined what effect these steroid hormones might exert on the intramyometrial production of fatty acid by OT. Our results confirmed bi-phasic production of arachidonic acid(AA), linoleic acid(LA), palmitic acid(PA), and stearic acid(SA) by OT. Phase 1 was an increasing but transient phenomenon having its peak at 30 sec. It is considered to be derived from phosphatidylinositol bis-phosphate. Phase 2 was a persistent and increasing phenomenon which was initiated after 120 sec. It is considered to be mediated by Ca-dependent phospholipase. We also studied the effect of steroid hormones on the production of fatty acid. For AA, LA, and PA, we confirmed that dehydroepiandrosterone sulfate(DHAS) shortened the time taken in reaching the peak of Phase 1 to half of that of the control, and progesterone(P) extended the time 2-3 fold. These findings suggest that DHAS, P and F might modify the human myometrial construction mechanism as a factor which regulates the quantity and velocity of fatty acid production.

[The effect of steroid hormone on oxytocin receptor expression in primary human uterine myometrial cell culture]

In the present study, we have examined the steroid hormone effect on oxytocin receptor (OTR) expression in human myometrial monolayer culture. The myometrial cells were cultured for 24-72 hours in serum-free media with various concentrations of steroid hormones. The plasma membrane of the cultured cells was then collected. The 125I-oxytocin(OT) was employed for a binding assay and the mean binding and dissociation constant were evaluated by Scatchard analysis. 1. The OT binding values in the presence of estradiol free, 10(-8) M, and 10(-7) M at 72 hours were 19.85, 28.12, and 36.20pM/mg protein, respectively. 2. The OT binding values in the presence of estradiol (10(-7) M) at 24, 48, and 72 hours were 17.85, 23.72, and 36.20pM/mg protein, respectively. 3. Dehydroepiandrosterone sulfate (10(-5) M) exerted almost no effect on the OTR expression by estradiol (10(-7) M). Cortisol (10(-5) M) decreased the amount of OTR expressed by estradiol. 4. The changes in OTR expression caused by estradiol (10(-7) M) were inhibited according to the concentration by progesterone. The concentration of progesterone at which OT binding was reduced 50% was 2.7 x 10(-6) M (E/P ratio = 0.037). These results suggested that estradiol increased the amount of OTR discovered in human myometrial cells in a time and concentration dependent manner, while progesterone inhibited the changes in OTR expression by estradiol in a concentration dependent manner. Thus, it was indicated that the changes in the E/P ratio during pregnancy which regulate the OTR expression control the myometrial contraction.

[Effects of steroid hormones on change in [Ca2+]i following oxytocin stimulation in cultured human myometrial cells, and on myometrial oxytocin receptor]

It is considered that steroid hormones, the concentrations of which vary during pregnancy, play an important role in the initiation of delivery. In the present study, we measured intracellular Ca2+ ([Ca2+]i) change following oxytocin stimulation in cultured human myometrial cells with fura-2, a fluorescent Ca2+ indicator. We also studied the effect of the steroid hormones on changes in [Ca2+]i due to oxytocin stimulation. When the [Ca2+]i change due to 10(-6) M oxytocin reached 100%, the addition of 10(-6) M DHAS (dehydroepiandrosterone sulfate) just before the stimulation raised the [Ca2+]i level to 207%, whereas that of 10(-6) M progesterone dropped to 64%. Moreover DHAS accelerated the speed of increase until the maximum response of [Ca2+]i, while progesterone decelerated it. In another study, human myometrial plasma membrane was solubilized in 7.5mM CHAPSO solution and applied to a binding study. Oxytocin receptors of two different molecular weights, namely 350kD(OTR-1) and 39kD(OTR-2), were extracted from solubilized plasma membrane by employing a gel filtration column. Binding assays were performed for OTR-1 and OTR-2 in the presence of DHAS and progesterone (10(-5) M). The results showed that DHAS enhanced the binding affinity of the receptors, whereas progesterone reduced the maximum binding capacity. It is therefore considered that the steroid hormones added just before oxytocin stimulation might act on receptor levels and modify intracellular Ca2+ response over short periods.

[The effect of oxytocin stimulation on PGE2, 6keto PGF1 alpha production in human myometrial monolayer culture]

In order to clarify the mechanism by which oxytocin induces the generation of prostaglandin (PG) in human myometrial smooth muscle cell, we determined the concentration of PGE2 and 6ketoPGF1 alpha in the culture supernatant of human myometrial monolayer cells stimulated by oxytocin. PGE2 and 6ketoPGF1 alpha demonstrated a biphasic increasing curve when oxytocin was added. The first increase, phase 1, was a transient phenomenon with a peak at 20 seconds whereas the second increase, phase 2, was a continuous phenomenon starting at 120 seconds. Moreover, phase 1 was significantly inhibited by the DG lipase inhibitor, RHC80267. Phase 2 was significantly inhibited by the PLA2 inhibitor, Mepacrine. Phase 1 and 2 were dose dependent in the range 10(-10) to 10(-6) M. PG production at rest during which 6ketoPGF1 alpha was higher than PGE2, was reversed by oxytocin stimulation. These results suggest that oxytocin stimulation would actuate biphasic PG production, and this mechanism would probably regulate the myometrial construction in labor-pain initiation.

Haematopoietic cell lines capable of colonizing the thymus following in vivo transfer expressed T-cell receptor gamma-gene immature mRNA

To clarify the mechanism by which progenitor T (pro-T) cells recognize and enter the thymus, an attempt was made to produce haematopoietic cell lines by the fusion of BALB/c nude mouse bone marrow or foetal liver cells (gestation 14 and 15 days) with AKR thymoma BW5147, thereby immortalizing cells with potency to colonize the thymus, a characteristic of pro-T cells rarely found in adult bone marrow or foetal liver. The hybridomas thus produced were classified according to the phenotype of surface markers, T-cell receptor (TcR) gene configuration and expression. All hybridomas were negative in the surface expression of T-cell markers such as TcR alpha beta, TcR gamma delta, CD3, CD4 and CD8. They had TcR beta-, gamma- and delta-genes, each with a different status with respect to configuration and transcription. Some possessed partially rearranged TcR genes and others expressed immature TcR mRNA. The cell lines were examined for their capacity to colonize the thymus following intravenous injection into recipient mice. It was found that the cells with capacity of colonizing the thymus expressed immature TcR delta mRNA, while the cell lines lacking TcR delta-genes did not home to the thymus. These findings imply that the potency for migrating to thymus is closely associated with the particular stage of prethymic cell differentiation which could be estimated by the analysis of TcR genes, and that some cell lines with the expression of TcR delta-gene mRNA and the ability to colonize the thymus are derived from pro-T cells.

A novel ganglioside expressed by mouse hematopoietic cell lines

Mouse progenitor T cell-derived cell lines were established by fusion of cells of hematopoietic organs such as bone marrow and fetal liver with T lymphoma (BW5147) to determine their characteristic cell-surface components. The hybridomas with the phenotype of Thy-1+, CD3-, CD4-, CD8- and expression of T cell receptor gene mRNA (BM216 and FL339) were selected for progenitor T cell-derived cell lines, and their ganglioside compositions were studied. A ganglioside component with a mobility slightly faster than that of bovine brain GD1a on high-performance thin-layer chromatography was found in the cell extracts of these cell lines as one of the most abundant components and was absent in the extract of the parental cell line (BW5147). The structure of the ganglioside was determined to be: NeuAc alpha-Gal beta-Gal beta-Gal alpha-Gal beta-Glc beta-ceramide. Gangliosides with such a sequence have never been found before, suggesting the possibility that the ganglioside is expressed as a surface marker of the cells in hematopoietic organs committed to a specific cell lineage, presumably to T cell lineage. cells in hematopoietic organs committed to a specific

Presence of murine fetal liver cells capable of being induced to differentiate in vitro into T cell receptor-positive cells

Mouse fetal liver cells were analyzed for the surface expression of T cell markers. Fetal liver cells prepared from mouse embryos at 14.5 days of gestation contained a small number of CD4+ cells (1.4%), but virtually no cells positive for any other T cell markers such as CD8, CD3 and T cell receptor (TcR). When a fetal liver cell suspension prepared from BALB/c(male) x AKR(female) F1 embryos at 14.5 days of gestation was cultured in medium supplemented with culture supernatants of both WEHI-3 and concanavalin A-stimulated rat spleen cells, TcR alpha beta+ and CD4+ cells were generated, whereas CD8+ and TcR gamma delta+ cells were hardly detectable. Most of TcR alpha beta+ and CD4+ cells were H-2d+, thus clearly showing their fetal origin. Treatment with anti-CD4, anti-CD3 or anti-TcR alpha beta antibodies plus complement or electronic sorting to remove cells expressing these markers failed to inhibit the generation of T cell marker-positive cells following culture in vitro. On the other hand, depletion of Thy-1.2+ cells reduced their generation. These findings indicate the presence of some progenitor T cells in fetal liver with the Thy-1+, CD3-, CD4-, CD8-, TcR- phenotype, which can be induced to differentiate into TcR alpha beta+ cells in the presence of specific humoral supplements without the influence of the thymus.

The retarded rate of acid-catalyzed solvolysis of glycoside bonds between reducing-end glucose residue and ceramide in glycosphingolipids compared with that of glycoside bonds between hexopyranosides

Rates of acid-catalyzed solvolysis of glycoside bonds in glycosphingolipids were compared to establish a basis for conducting saccharide analysis. Permethylated globotetraosylceramide and asialogangliotriaosylceramide as model compounds for methylation and sugar composition analysis, respectively, were solvolyzed under acidic conditions and the sugar components thus obtained were determined at specified times by gas liquid chromatography, after they had been derivatized. Reducing-end glucose residues in both compounds were liberated more slowly than other sugar residues. Glycoside bonds between reducing-end glucose and ceramide in glycosphingolipids would thus appear to be more resistant towards acid-catalysed solvolysis than other glycoside bonds between hexopyranosides.

[Intraperitoneal (i.p.) chemotherapy in the management of ovarian cancer--pharmacokinetics and methods of sequential i.p. chemotherapy]

We studied the systemic efficacy of intraperitoneal (i.p.) chemotherapy which has been used as a locoregional chemotherapy for ovarian cancer. The following results were obtained. 1) The CDDP-based i.v. and i.p. regimen obtained a 90% response rate for ascites and a 35% response rate for measurable lesions. 2) According to the pharmacokinetic analysis of i.p.-chemotherapy, BH-AC showed a regional advantage because of a high AUC-ratio. Meanwhile CDDP and etoposide demonstrated a low AUC-ratio, that has direct effects in the abdominal cavity and anti-tumor effects from the vascular side of the tumor. 3) We performed sequential i.p.-chemotherapy using three types of drainage tubes according to the stage and the size of the residual tumor at operation. The abdomino-centesis using a peel-away introducer for the poor risk patients was very easy and this method could carry out sequential CDDP-i.p.. No patients had signs or symptoms of chemical peritonitis. 4) On the base of these date, we have designed a protocol of i.p. chemotherapy for patients with ovarian cancer.

[Pharmacokinetics of N4-behenoyl-1-beta-D-arabinofuranosylcytosine after intraperitoneal administration]

The patients with cartinomatous peritonitis were treated with the intraperitoneal administration (ip) of N4-behenoyl-1-beta-D-arabinofuranosylcytosineine (BH-AC: analogue of Ara-C), and the pharmacokinetics of BH-AC ip was studied. The following results were obtained (1) Immediately after ip administration, the concentration of BH-AC in ascites became as high as 10(6) ng/ml. At 24 hours following BH-AC ip, 10(4) ng/ml of BH-AC was detected in ascites. (2) Immediately after ip administration the concentration of Ara-C derived from BH-AC in ascites became as high as 10(3) ng/ml. At 24 hours, more than 10 ng/ml of Ara-C was detected in the ascites. (3) Ara-U in ascites was detected also soon after BH-AC ip was performed. Accordingly, it is expected that deaminase may be present in ascites. (4) As compared with in ascites, Ara-C in plasma showed very low level (less than 1 ng/ml). These findings indicate that BH-AC is suitable drug for intraperitoneal administration, because BH-AC revealed low peritoneal and high plasma clearances.

[A case report of advanced ovarian cancer with chronic renal dysfunction treated by CDDP i.p]

Reported in this paper is a case of a 56-year-old female patient who was diagnosed as having an ovarian cancer (stage T 4) with a renal dysfunction (CCr 30.5 ml/min). We instilled CDDP intra-peritoneally (CDDP-ip), taking into consideration the peritoneal clearance (CLp.). The administration of sodium thiosulphate also was combined. The low CLp. of this case (299.2 ml/h) made it possible to instill a high dose in the peritoneal cavity and a low dose in the plasma. This method provided enough of anti-tumor effect and kept the renal function safe. We believe that the CLp. is the most important factor in determining the effect and side effects of CDDp-ip.

[Steroids' action on dependence of outset, maintenance of gravidity and onset of labor]

Dependence of outset, maintenance of gravidity and onset of labor on different kinds of steroid hormones has long been the focus of debate with the underlying control mechanism of these hormones in question remaining left unestablished still in these days. Of author's particular concern in this paper was the two-sided aspect of steroid functions. In fact, the steroid may stimulate mother's organ, fetus and placenta to produce much amount of steroid hormone throughout gravidic interval, while at the same time it may control the two contradictory processes, namely the maintenance of gravity and onset of labor through one and the same route. With a view to solve the complexity referred to above an effort has been made through a series of experiments particularity in the term of: 1. Dependent of a system capable to simultaneously determine concentrations of a variety of steroid hormones using the high performance liquid chromatography (HPLC); 2. Profile-analysis to be made on behavior of different kinds of steroids observable over gravidic interval under a support of HPLC system; 3. Behavior of different kinds of hemogenic hormones subsequent to an active DHAS loading in both group with- and without labor pains; 4. Influence of DHAS and gestation on activity of 11 beta hydroxy steroid dehydrogenase in placenta; Some of the results brought by these experiments, which are of some value to speculate on the mechanism of labor-onset and growth of fetus, may be summarized below in line with the preceding items: 1. The measuring system incorporating HPLC made it possible to determine 8 kinds of steroid hormones under systems of C19 and C21 readily in approx. 45 min., even when pretreatment is made involved in the procedure. It was also demonstrably verified that the system shows an acceptable sensitivity combined with a higher correlation with the RIA-method. 2. Profile was successfully delineated of those steroids which would participate in controlling the labor pains inducing mechanism through a series of analytical works made on the behavior of steroid associated with the process of gravidism. With the approach of expected labor, it was seen that 5 kinds of steroid hormones comprising DHA, testosterone, pregnenolone, 20 alpha OH-progesterone, and cortisol showed a marked increase. In contrast, androstenedione and progesterone begin to fall abruptly ever since several days preceding the date of labor. 3. Gain of DHA, 17 alpha OH-progesterone, due to DHAS-loading was clearly identified in the group with onset of labor pains.(ABSTRACT TRUNCATED AT 400 WORDS)

[A case report of an advanced ovarian cancer (stage T4) treated with a total amount of 1815 mg of CDDP]

A case is reported of a 34-year-old female who complained of an adult head-sized tumor in the pelvis and was treated with a high dose of CDDP. On the first look operation, it was found impossible to perform reduction surgery because of severe adhesion and peritonitis carcinomatosa. To introduce a high concentration of an anti-cancer agent into the tumor tissue, we administered CDDP intravenously, intraperitoneally and intra-arterially to the total amount of 1815 mg. After this high dose combination chemotherapy, a second look operation was performed and the tumor was seen to be reduced. The patient is now in remission and is being followed up as an out-patient. The clinical course of this case had decided for us which route would be the most effective and would have the least side effect, also, how much of a dosage can be administered as a maximum adoptive dose of an anti-cancer agent, and what kind of a second-line chemotherapy is effective against resistant cancer cells.

[The study on human placental DHA-S transport mechanism (using placental microvillous membrane vesicles)]

To investigate the placental DHA-S (dehydroepiandrosterone sulfate) transport mechanism, the uptake of DHA-S into microvillous membrane vesicles prepared from human term placenta was studied using the rapid filtration technique. 1. The uptake of DHA-S into microvillous membrane vesicles was not dependent on both Na+ electrochemical gradient and membrane potential difference. 2. The uptake of DHA-S into microvillous membrane vesicles was dependent on temperature. The initial uptake rate of DHA-S at 37 degrees C was three times as great as at 4 degrees C. 3. The initial rate of DHA-S transport exhibited saturation kinetics with respect to the DHA-S concentration; an apparent Km of 0.067 mM and Vmax of 1.01 nmol/mg protein/20 sec were calculated. 4. The uptake of DHA-S into microvillous membrane vesicles was inhibited by DHA, but not by estriol. These results indicated that placental DHA-S transport was carrier mediated and a passive one.

[Intraperitoneal high-dose cisplatinum chemotherapy (CDDP-ip) in patients with carcinomatous peritonitis]

Immediately after CDDP-ip, the level of free Pt in ascites reached nearly 100 micrograms/ml, and the AUC (area under the curve) for ascites was 20-140 times greater than that for serum. The free Pt in serum following CDDP-ip administration was detected for several hours, and interestingly, the AUC for serum after ip therapy was 0.4-2.2 times greater than that after iv therapy. As a result, free Pt was found to act on cancer cells in the abdominal cavity directly at a high concentration. At the same time, the possibility of an antitumor effect from the vascular side of the tumor was also suggested. On the other hand, cases of ovarian cancer had various levels of peritoneal clearance (CLp), which depended on the severity of their carcinomatous peritonitis. The CLp had a great influence on the peak plasma concentration and on the AUC of free Pt in serum. In particular, the peak plasma concentration produced by CDDP-ip was 40-80% of the plasma concentration produced by CDDP-iv. These findings indicate that high-dose CDDP-ip is possibly effective and useful for advanced ovarian cancer, producing only very mild side effects.

[Nonenzymatic glucosylation of human placental trophoblast basement membrane collagen (relation to diabetic placenta pathology)]

Nonenzymatic glucosylation is a reaction in which glucose binds nonenzymatically to hemoglobin, serum protein and glomerular basement membrane collagen etc. It has been thought that nonenzymatic glucosylation results in functional and chemical changes in those substances (hemoglobin etc) and contributes to the pathological changes in diabetes mellitus. This time we investigated whether nonenzymatic glucosylation occurred in human placental trophoblast basement (TrBM) collagen or not. The ability of glucose to interact with TrBM collagen (nonenzymatic glucosylation of TrBM collagen) was examined by incubating TrBM collagen with 3H-D-glucose in vitro. As a result it was shown that nonenzymatic glucosylation occurred in TrBM collagen and nonenzymatic glucosylation of TrBM collagen depended on the glucose concentration, reaction time and reaction temperature. These results indicate that possibly hyperglycemia, via nonenzymatic glucosylation modifies the function and chemistry of TrBM collagen and is related to the placental pathological changes in diabetic pregnancy.

[The effect of inorganic mercury on placental amino acid transport using microvillous membrane vesicles]

To study the toxic effect of inorganic mercury on the placenta we elucidate the effect of inorganic mercury on placental amino acid transport using microvillous membrane vesicles isolated from human normal full term placenta. The transport of amino acids into microvillous membrane vesicles was studied by a rapid filtration technique using a millipore filter. The transport of L-alanine across placental microvillous membrane was Na+ electrochemical gradient dependent and 0.1 mM inorganic mercury inhibited 77% of this Na+ dependent L-alanine transport and 1 mM inorganic mercury inhibits 90% of this Na+ dependent L-alanine transport. The transport of L-lysine across microvillous membrane vesicles was sodium independent and 0.1 mM inorganic mercury inhibited 34% of this transport and 1 mM inorganic mercury inhibited 50% of this transport. These results indicated that one of the toxic effects of inorganic mercury on placenta-fetus unit was the inhibition of placental nutrient transport.