Urinary trypsin inhibitor levels in the urine of patients with haematological malignancies

The urinary trypsin inhibitor (UTI) levels in the urine of patients with various haematological malignancies were determined, using automated latex agglutination immunoturbidimetry. The mean UTI levels in urine in acute non-lymphocytic leukaemia, myelodysplastic syndrome, non-Hodgkin's lymphoma, and multiple myeloma groups were significantly elevated, compared with the normal control group. It was found that the UTI level in urine changed from an elevated value to a normal value with haematological improvement by chemotherapy in a patient with myelodysplastic syndrome included in a previous study. These results suggest tha

Effect of salt and heating on a mesoscopic structure composed of ovalbumin globules in aqueous solution

Mesoscopic structural changes of an ovalbumin solution by heating and adding NaCl have been investigated with a small-angle neutron scattering method. In the natural solution, a broad peak at q = 0.057 A(-1), which disappeared by adding NaCl, indicates the existence of an electrostatic long-range interaction between the ovalbumin globules. Along with the broad peak, a prominent intensity increase in a very small q region was observed on heating except for the initial and final stages, indicating the coexistence of a disordered structure of the denatured ovalbumin and a regular-interspacing structure of the natural ovalbumin globules. Though the macroscopic feature in the final stage, whether the solution forms a gel (10 wt %) or not (5 wt %), strongly depended on the concentration of the ovalbumin, the scattering profiles showed a common characteristic feature: the appearance of a new peak around q = 0.023 A(-1), which indicates the emergence of another regular structure.

Impaired glucose homeostasis and neonatal mortality in hepatocyte nuclear factor 3alpha-deficient mice

Hepatocyte nuclear factors 3 (HNF-3) belong to an evolutionarily conserved family of transcription factors that are critical for diverse biological processes such as development, differentiation, and metabolism. To study the physiological role of HNF-3alpha, we generated mice that lack HNF-3alpha by homologous recombination in embryonic stem cells. Mice homozygous for a null mutation in the HNF-3alpha gene develop a complex phenotype that is characterized by abnormal feeding behavior, progressive starvation, persistent hypoglycemia, hypotriglyceridemia, wasting, and neonatal mortality between days 2 and 14. Hypoglycemia in HNF-3alpha-null mice leads to physiological counter-regulatory responses in glucocorticoid and growth hormone production and an inhibition of insulin secretion but fails to stimulate glucagon secretion. Glucagon-producing pancreatic alpha cells develop normally in HNF-3alpha-/- mice, but proglucagon mRNA levels are reduced 50%. Furthermore, the transcriptional levels of neuropeptide Y are also significantly reduced shortly after birth, implying a direct role of HNF-3alpha in the expression of these genes. In contrast, mRNA levels were increased in HNF-3 target genes phosphofructo-2-kinase/fructose-2,6-bisphophatase, insulin growth factor binding protein-1, and hexokinase I of HNF-3alpha-null mice. Mice lacking one or both HNF-3alpha alleles also show impaired insulin secretion and glucose intolerance after an intraperitoneal glucose challenge, indicating that pancreatic beta-cell function is also compromised. Our results indicate that HNF-3alpha plays a critical role in the regulation of glucose homeostasis and in pancreatic islet function.

Specific fluorescence assay for advanced glycation end products in blood and urine of diabetic patients

Late rearrangement products that accumulate by glycation of proteins, known as advanced glycation end products (AGEs), have been implicated in the pathogenesis of complications related to diabetes. Circulating AGEs, especially in the form of a small peptide (AGE-peptide) of less than 10 kd, increase in the blood of diabetic patients with end-stage renal disease (ESRD). The aim of the study was to evaluate AGE-peptide levels by measuring AGE-specific fluorescence (excitation at 370 nm and emission at 440 nm) and to examine the relationship between AGE-peptide and diabetic nephropathy. AGE-specific fluorescence in serum and urine were examined in diabetic subjects with various levels of renal complications of varying severity: normoalbuminuria (N), microalbuminuria (Mi), macroalbuminuria (Ma), chronic renal failure (C), and hemodialysis (HD). We also assessed correlations among the AGE-peptide level and age, duration of diabetes, hemoglobin A1c (HbA1c), serum creatinine, and creatinine clearance. Serum and urine AGE-peptide levels in C and HD were significantly higher than in N, Mi, and Ma. Serum AGE-peptide levels were significantly correlated with serum creatinine (r=.866, P < .0001) and creatinine clearance (r=-.720, P < .0001) but not with duration of diabetes or age. There was a significant correlation between AGE-peptide levels measured by enzyme-linked immunosorbent assay (ELISA) and levels determined from the specific fluorescence intensity (r=.688, P < .0001). These findings suggest that renal function may play a greater role in the accumulation of AGEs than persistent hyperglycemia in diabetic patients. Measurement of AGE-specific fluorescence (ie, AGE-peptide) may serve as a simple and useful test to assess circulating AGE levels and monitor AGE excretion.

The role of advanced glycosylation end-products in the pathogenesis of atherosclerosis

Coronary artery disease and cerebrovascular disease due to the rapid progression of atherosclerosis is the principal cause of death in diabetes mellitus. Modification of low-density lipoproteins (LDL) by advanced glycosylation end-products (AGE) may play a central role in the development of atherosclerosis, especially in diabetic patients. An AGE-modified form of LDL (AGE-LDL) has been found to circulate in human plasma, and AGE modifications have been identified as being present on both the apoprotein (ApoB) and the phospholipid components of LDL. By utilizing an AGE-specific ELISA, we measured the AGE attached to the ApoB and lipid components of LDL from normal controls and diabetic patients with or without end-stage renal disease (ESRD), as well as lipid oxidation. AGE-ApoB, AGE-lipid and oxidized LDL (Ox-LDL) in diabetic patients were significantly higher than those in patients without diabetes. The correlation between AGE-ApoB and AGE-lipid were highly significant. An especially marked elevation of AGE-LDL was found in diabetic patients with ESRD. The correlation between the serum total cholesterol and the AGE-LDL (AGE-ApoB and AGE-lipid) was significant. In addition, based on the known biological properties of AGE-modified peptide (AGE-peptide), we have proposed that these chemically reactive circulating AGE-peptides contribute to tissue injury by reattaching to susceptible target proteins both within and outside the vasculature, and that this process accelerates vascular pathology in diabetic patients. These data indicate that AGE-modified LDLs may represent a particularly atherogenic form of LDL, and AGE-LDLs as well as AGE-peptides are likely to contribute to the development of atherosclerosis in diabetic patients.

Advanced glycation endproducts and diabetic nephropathy

Diabetic nephropathy is currently the single largest cause of endstage renal disease (ESRD) in the United States and many European countries. The primary cause for the development of diabetic complications (including diabetic nephropathy) is persistent exposure to hyperglycemia, although genetic and other incompletely understood factors also play an important role. Although much consideration has been given to the pathogenesis and genetics of the disease itself, the mechanisms by which persistent exposure to hyperglycemia cause biochemical and metabolic alterations have been very sketchily understood. Recently, a growing body of evidence has linked the accumulation of the late products of glucose-protein interaction to a variety of chronic complications, including diabetic nephropathy. The formation of irreversible advanced glycosylation endproducts (AGEs) resulting from the spontaneous reaction between glucose and proteins occur most noticeably on long-lived structural proteins. Recent studies demonstrate that the pathogenesis of diabetic nephropathy is caused by the hyperglycemia-accelerated formation of AGEs. Also, reactive AGE peptides in the circulation are thought to play a role as a new version of so called middle molecule toxic substances. This evidence is opening a new window for our understanding of the pathogenesis of diabetic nephropathy.

Peritoneal dialysis using a recycling system in dogs

In this study, Recirculation Peritoneal Dialysis (RPD) apparatus using a pump to circulate the dialysate was devised and its dialysis efficiency was investigated. In the experiment, 15 mongrel dogs with body weights of 6.6 +/- 0.7 kg were used. The surgery to induce azotemia was performed on the dogs, a disk catheter for drainage was placed between the liver and diaphragm, and a straight catheter for infusion was placed on the abdominal side of the bladder. RPD was conducted using 2 l of dialysate containing 1.3% glucose, and the dialysate was circulated by a pump through the peritoneal cavity and the dialysate chamber at the circulation rates of 30, 60, 90 and 120 ml/min. RPD was conducted for 3 hr and the clearances of urea nitrogen, creatinine, inorganic phosphorus and potassium were recorded every hour. The clearances in RPD became higher with an increase in the circulation rate. Although RPD requires two catheters in the peritoneal cavity, it has no appreciable technical difficulty in handling and is considered to be easier than hemodialysis. RPD enabled higher dialysis efficiency to be achieved in a short time compared with conventional peritoneal dialysis. It seems reasonable to conclude that RPD is a useful new dialysis technique for animals.

[Immunochemical determination of advanced glycation end products in erythrocyte peripheral-membrane proteins from diabetic patients]

Nonenzymatic glycation of protein leads to changes in protein structure and function, including browning, crosslinking and polymerization. There are several functional abnormalities in erythrocytes of diabetic patients. However, nothing definite is known about the relationship between these abnormalities and nonenzymatic glycation products, especially advanced glycation end products (AGEs). In this view, the present study was aimed to determine the amount of AGEs in diabetic erythrocyte peripheral-membrane proteins (EPMPs) by an ELISA system using AGE-specific antibodies. Erythrocyte membrane proteins from 19 control and 48 diabetic subjects were treated with 0.1 N-NaOH solution and then, the supernatants of each sample, containing EPMPs, were used to measure the amount of AGEs. The amount of AGEs in EPMPs was approximately 3 times greater in diabetic patients than in controls (70.7 +/- 51.8 AU vs. 22.5 +/- 7.7 AU (mean +/- SD), p < 0.001). There was a significant correlation between levels of AGEs in EPMPs and HbA1C (r = 0.779, p < 0.001). In SDS-PAGE analysis of EPMPs, two major bands, 221 kDa and 242 kDa were observed. These two bands were defined to be spectrin by immunoblotting with mouse monoclonal anti-human spectrin antibody. Based on these findings, it was speculated that the formation of AGEs in erythrocyte peripheral-membrane proteins is related to the functional abnormalities of erythrocytes, including reduced deformability and lowered membrane fluidity, frequently observed in diabetic patients.

Immunochemical detection of advanced glycation end products in renal cortex from STZ-induced diabetic rat

To reassess the accumulation of advanced glycation end products in diabetic renal cortex, we used a newly developed enzyme-linked immunosorbent assay to measure AGEs in renal cortex from STZ-induced diabetic and age-matched control rats. Kidneys and aortas were obtained from rats after 5 and 20 wk of STZ injection. At 5 wk of diabetes, the mean AGE content in collagenase-digested materials of renal cortex was > 16-fold higher in diabetic animals compared with controls (1044.4 +/- 151.8 vs. 64.3 +/- 5.7 arbitrary units, P < 0.01). At 20 wk of diabetes, it was > 45-fold higher in diabetic compared with control animals (3841.0 +/- 1077.3 vs. 83.8 +/- 12.8 AUs, P < 0.01). These increases were surprisingly large compared with the < 1.5-fold increase in the fluorescence levels both after 5 and 20 wk of diabetes. In control animals, neither the AGE content nor the fluorescence level increased during this period. Moreover, at 20 wk of diabetes, the AGE content was 39-fold higher in renal cortex compared with aorta. This study provided the first immunochemical evidence that collagenase-digested materials of renal cortex, as well as aorta, contained AGE products and that these products were present in much higher levels in diabetic animals than in control animals. With duration of diabetes, the AGE contents increased significantly both in renal cortex and aorta. The excessive accumulation of AGEs was most apparent in the diabetic kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

Efficient preparation of monospecific anti-canine C-reactive protein serum and purification of canine C-reactive protein by affinity chromatography

The canine C-reactive protein (CRP) fraction isolated from canine acute-phase serum on a phosphorylcholine-Sepharose 4B column was further subjected to Sephacryl S-300 gel filtration. A canine CRP fraction not containing IgM was then obtained. The antisera, obtained after several immunizations with this canine CRP fraction, contained nonspecific antibodies that reacted with albumin, transferrin and IgG in addition to CRP. This antiserum could be easily changed to monospecific canine CRP serum, when it was subjected to absorption for only 15 min using glutaraldehyde-insolubilized normal canine serum protein containing 3.5 micrograms ml-1 of CRP. Pure canine CRP was isolated with a recovery rate of 95% from canine acute-phase serum by affinity chromatography using specific anti-canine CRP antibody.

Immunochemical detection of advanced glycation end products in lens crystallins from streptozocin-induced diabetic rat

To reassess the significance of AGEs in cataract formation in diabetic animals, we measured amounts of AGEs in lens crystallins from STZ-induced diabetic animals with a newly developed ELISA. Lenses were removed at 5 and 20 wk after STZ injection. In 20-wk diabetic rats, all lenses were cataractous but not in control rats. In 20-wk diabetic compared with control rats, significant increases were observed in AGEs (172.3 +/- 18.3 vs. 14.3 +/- 1.7 AU, P < 0.01) and fluorescence (2.04 +/- 0.22 vs. 1.27 +/- 0.10 AU, P < 0.05). The amounts of AGEs in lens crystallins, measured by the ELISA, were > 12-fold higher in diabetic rats. In agreement with earlier studies, we found that fluorescence in lens crystallins increased by 61% in diabetic rats. In 5-wk diabetic rats, all lenses were noncataractous. In 5-wk diabetic compared with control rats, significant increases were observed in AGEs (84.1 +/- 7.7 vs. 9.4 +/- 1.5 AU, P < 0.01) and fluorescence (1.45 +/- 0.06 vs. 1.05 +/- 0.06 AU, P < 0.01). Analysis of the AGE content by ELISA showed that accumulation of AGEs in diabetic lens crystallins does markedly occur with time, and a large amount of AGEs exists in the diabetic (cataractous) lens crystallins. The disproportionate elevation of AGEs, measured by the ELISA, compared with fluorescence suggests that the actual levels of AGEs in cataractous lens crystallins from diabetic animals are higher than previously anticipated, and nonfluorescent AGEs may exist in diabetic lens crystallins.(ABSTRACT TRUNCATED AT 250 WORDS)

[Urinary trypsin inhibitor as an acute phase reactant]

Early in this century, trypsin inhibiting activity has already been recognized in patients with acute infection or renal disease. In addition to these, conditions such as coronary thrombosis, surgical operation, artificial fever by heat-killed bacilli, malignancy, leukemia, later stage of normal pregnancy, etc. have been known to cause the elevated excretion of UTI in urine. Typically, maximal excretion of UTI has been observed within one or two days after the onset. It appears that recent studies have overcome the complexity of UTI molecule. Automated measurement of urinary trypsin inhibitor (UTI) in urine sample was carried out by either enzymic or immunologic method. UTI as well as erythrocyte sedimentation rate and C-reactive protein enables us to monitor acute phase response, being confirmed in cases of abdominal surgery.

Characterization of antibodies to advanced glycosylation end products on protein

Antibodies directed against advanced glycosylation end products (AGEs) formed during a Maillard reaction have been generated and characterized. Since protein-bound AGEs recognized by the antibodies were labile to acid hydrolysis, the antibodies were further characterized by using the AGE-alpha-acetyl-L-lysine methyl ester (AGE-ALME) with a brown and fluorescent property as well as the AGE-proteins. The antibodies reacted with fluorescent compounds, rather than brown pigment compounds, in the AGE-ALME. The fluorescent compounds in the AGE-ALME were separated into four fluorescent compounds by reversed-phase thin layer chromatography (TLC). Of the fluorescent compounds tested, compound 3 (Rf = 0.63), as designated on a TLC plate, showed the highest affinity for the antibodies. In addition, the antibody recognition to the cross-linked oligomers with fluorescence in the AGE-protein was investigated by using bovine pancreatic ribonuclease A (RNase), which is known as a model protein for studying AGE-induced cross-linking. Fluorescence in the AGE-RNase existed in both of the oligomers and the monomer. The cross-linked oligomers exhibited higher affinity to the antibodies than did the monomer, which has a similar degree of fluorescent intensity. These results indicate that our antibodies against cross-linked protein-bound AGEs may serve as a useful tool to elucidate pathophysiological roles of advanced Maillard reaction in diabetic complications and aging processes.

Automated measurement of trypsin inhibitor in urine with a centrifugal analyzer: comparison with other acute phase reactants

Automated measurement of trypsin inhibitor in urine was performed with good precision using the COBAS FARA. Elevated levels of both trypsin inhibitor in urine and acute phase proteins in serum were shown in most cases of major abdominal surgery. We suggest that the automated assay of urinary trypsin inhibitor might be useful for the clinical diagnosis of acute phase response.

Production and characterization of antibodies to advanced glycation products on proteins

Antibodies directed against advanced glycation products formed during Maillard reaction have been generated and characterized. These antibodies reacted specifically with advanced glycation products in common among proteins incubated with glucose, but not early-stage compounds such as a Schiff base adduct and Amadori rearrangement products. Incubation of bovine serum albumin with glucose caused a time-related increase in immunoreactivity and a concomitant increase in fluorescence intensity. These antibodies may serve as a useful tool to elucidate pathophysiological roles of advanced Maillard reaction in diabetic complications and aging processes.

[Thirty-five cases of tuberculosis in childhood]

Thirty five children with tuberculosis admitted to the Hokkaido University Hospital from 1970 through 1984 wer reviewed. They were 7 cases of meningeal tuberculosis, 8 of military tuberculosis, 15 of primary tuberculosis and 5 of adult type pulmonary tuberculosis. Fifteen (43%) of the 35 cases were below 2 years, and over half of these younger cases were hematogenous spread such as meningeal and military types. Instead of hematogenic spread in these cases, erythrocyte sedimentation rate and CRP stayed in moderate values. Thirty one (91.2%) of the 34 cases having precise record had no history of BCG inoculation. Over half of the cases were infected from adults in the immediate household, and the sources of infection were found after the diagnosis of childhood tuberculosis in about half of these cases. Although incidence of the childhood tuberculosis are decreasing in recent years, childhood tuberculosis resulting hematogenous spread with poor prognosis in advanced state still exists, so it is important to remark the childhood tuberculosis at out patient clinics.

Epithelial dysplasia of the rabbit colon induced by degraded carrageenan

Colonic mucosal lesions, characterized by crypt abscesses and mononuclear cell infiltration, which resemble human ulcerative colitis can be induced in rabbits by short-term (7 to 8 weeks) administration of carrageenan according to our method. In this study experimental epithelial dysplasia of the colon was induced by the p.o. administration of lambda-degraded carrageenan for a much longer period of time. Fifteen rabbits, sensitized i.m. with the same substance 1 week before, were subjected to 12 or 28 months of treatment with 1% carrageenan solution in drinking water. Histological examination disclosed chiefly mild inflammatory changes of the colonic mucosa in all animals and a focal but high-grade dysplasia (nonpolypoid) involving the mucosal epithelium in three of the five animals treated for 28 months. The present observations suggested that epithelial dysplasia of the colon may be caused in association with inflammation and that the pathological condition produced by us can be a useful model of carcinoma in situ possibly resulting from inflammation.

[Studies on the interaction between cells infected with measles virus and anti-measles antibody. II. Production and application of monoclonal antibodies against measles virus]

Somatic cell hybrids which produced antibodies against measles virus were established by fusing the spleen cells of BALB/c mice immunizing with purified measles virus and the myeloma cell line P3.653 using polyethylene glycol 1,000. Mouse ascites were obtained by inoculating several hybridoma clones, and 2 ascites showed to have high HI titer antibodies. Location of the measles virus antigens on the cells infected with measles virus could be analysed by indirect immunofluorescence technique using these monoclonal antibodies. Reversed passive hemagglutination-inhibition (R-PHI) titers checked by chicken blood cells coated with 2 monoclonal antibodies were parallel with the HI tiers by African green monkey blood cells. These antibodies will be valuable for many virological investigation, for instance, for the detailed antigenic analysis of measles virus and for searching the location of measles virus antigens in the infected cells or tissues.

[Studies on the interaction between cells infected with measles virus and anti-measles antibody. I. Cytotoxic antibody activity of sera obtained from patients with natural measles and subacute sclerosing panencephalitis by use of chronically infected cell lines]

Sera obtained from patients with natural measles and subacute sclerosing panencephalitis (SSPE) showed cytotoxic activity in the presence of complement on cells persistently infected with either measles virus (Schwarz and TYCSA strains) or SSPE virus (Halle and Mantooth strains). The cytotoxic activity was demonstrated in both IgG and IgM fractions of measles convalescent sera, but only in IgG fraction of SSPE sera. Measles convalescent sera completely lost the cytotoxic activity to all carrier cell lines, when absorbed with any one of the cell lines, indicating that the viral surface antigens of these cell lines infected with measles or SSPE virus were identical. On the other hand, the cytotoxic activity of SSPE sera could not be readily absorbed with these cells. Thus, the affinity of SSPE sera for the viral surface antigens might be lower than that of measles convalescent sera.

Adult adrenal neuroblastoma with extension into inferior vena cava

An adult left adrenal neuroblastoma that extended into the left renal vein and inferior vena cava is reported. To the best of our knowledge, venous involvement of adrenal tumors has been reported in adrenal cortical carcinomas, but not in neuroblastomas. Differentiation of renal and adrenal tumors is also discussed.

[The prevalence of antibody to hepatitis A virus in different age groups of Hokkaido inhabitants (author's transl)]

Serum specimens drawn at random from Hokkaido inhabitants were tested for antibody to the hepatitis A virus (anti-HAV) by radioimmunoassay. The prevalence in different age groups was as follows, cord blood and newborn infants 44.4%, under one year 0%, 1-9 years 5.3%, 10-19 years 0%, 20-29 years 9.1%, 30-39 years 80%, 40-49 years 90%, and over 50 years 100%. This survey confirmed that antibody against HAV could pass through placenta and HAV had been very common virus by the 1950's in Hokkaido.

Complement-dependent cytotoxicity of sera obtained from subacute sclerosing panencephalitis patients

Human lymphoid cells (NC-37) persistently infected with either measles virus (Schwarz and TYCSA strains) or subacute sclerosing panencephalitis (SSPE) virus (Halle and Mantooth strains) were destroyed in the presence of complement by anti-measles sera as well as by sera from SSPE patients. The cytotoxic activity was demonstrated in both IgG and IgM fractions of measles convalescent sera, but only in IgG fraction of SSPE sera. Measles convalescent sera completely lost the cytotoxic activity to all the cell lines, when absorbed with any one of the cell lines, indicating that the viral surface antigens of these cell lines infected with measles or SSPE virus are identical. On the other hand, the cytotoxic activity of SSPE sera could not be readily absorbed with these cells. Thus, the affinity of SSPE sera for the viral surface antigens might be lower than that of measles convalescent sera.

Characterization of measles viruses in establishment of persistent infections in human lymphoid cell line

Human lymphoid cells (NC-37) were infected with attenuated measles vaccine virus (Schwarz, AIK-C, and CAM-70 strains), subacute sclerosing panencephalitis virus (Mantooth and Halle strains), neurovirulent TYCSA strain, and wild type virus (Edmonston and Toyoshima strains) at an input multiplicity of 0-01. These strains were divided into two groups by their capacity to establish carrier states. CAM-70, Toyoshima, and Edmonston strains did not set up persistent infections in NC-37 cells, whereas AIK-C strain induced chronic cyclic infection and the Schwarz, TYCSA, Mantooth and Halle strains could set up persistent infections and furthermore two types of persistent infections were recognizable. Cells persistently infected with Schwarz strain contained nucleocapsid structures in both nucleus and cytoplasm, and produced infectious virus of 10(4) to 10(5) p.f.u./ml over 100 days after the inoculation of the virus but the cap-formation of measles antigens on the cell membrane was seldom observed. However, in cells persistently infected with TYCSA strain, nucleocapsid structures were rarely observed in the nucleus, but the cap-formation of measles antigens on the cell membrane was often observed. The titre of carried virus was always higher than the number of cells in the range of 10(6) to 10(7) p.f.u./ml. Mantooth strain was similar to Schwarz strain and Halle strain was similar to TYCSA strain in the properties of their carrier states. These carrier states were stable and the cells grew normally for over one year.

A male infant with monosomy 21

A male infant with total monosomy 21 identified by Q-, G- and R-banding is described. His main symptoms are hypertonia, micrognathia, microphthalmus, imperforate anus, ambiguous external genitalia, floating and malopposed thumbs, overlying fingers, right clubfoot and growth retardation. Both parents are phenotypically as well as karotypically normal.