[Acute promyelocytic leukemia relapse as leukemia cutis shortly after complete remission with all-trans retinoic acid]

A 56-year-old man was admitted to our hospital in September, 1996. Chromosomal translocation (15; 17) and a PT-PCR study for PML-RAR alpha mRNA were positive in bone marrow aspirates, and acute promyelocytic leukemia was diagnosed. After CR was obtained with all-trans retinoic acid (ATRA) followed up with chemotherapy, the RT-PCR became negative. When he was readmitted in April, 1997, skin eruption on his chest and extremities were observed. Specimens taken for biopsy revealed leukemia cutis, and RT-PCR became positive in the same specimen. Bone marrow PT-PCR was also positive without abnormal promyelocytes. Although he was treated with oral ATRA 80 mg/day again, no significant improvement in leukemia cutis was noted. After combined therapy with Ara-C and acularubicin, skin eruption disappeared and bone marrow RT-PCR became negative. A second CR was then obtained. Although it is unknown whether the administration of ATRA is related to extramedullary relapse or not, we recommend combined chemotherapy for such cases.

Influence of selenium deficiency on vital functions in rats

To clarify the relationship between selenium (Se) deficiency and functional disorders, the authors determined the Se concentration, anti-oxidant enzyme activity, and other parameters in rats fed a Se-deficient diet. Rats fed the Se-deficient diet showed a decrease in Se concentration and glutathione peroxidase (GSH-Px) activity in plasma, erythrocytes, heart, liver, and skeletal muscle from the first week after the initiation of the diet, an increase in heart lipid peroxide concentration from the second week, and an increase in liver glutathione S-transferase activity from the fourth week. From the twelfth week, a decrease in the growth rate in the rats fed the Se-deficient diet was observed. In spite of this growth impairment, no changes in electrocardiogram, muscle tone, degree of hemolysis, plasma biochemistry, or hematological values were detected. In summary, the authors found that a reduction of body Se is easily induced, but that the appearance of functional disorders following Se deficiency is difficult to detect in rats.

Tumor growth inhibition and nutritional effect of D-amino acid solution in AH109A hepatoma-bearing rats

We examined the inhibitional and nutritional effects of total parenteral nutrition (TPN) containing D-amino acids (D-phenylalanine, D-Phe; D-valine, D-Val; D-leucine, D-Leu; D-methionine, D-Met) on tumor growth in AH109A hepatoma-bearing rats. Five experimental groups were examined: a control amino acid solution group (control group), D-Phe group, D-Val group, D-Leu group and D-Met group. The analysis of tumor volume and weight revealed significant tumor growth inhibition in the D-Val group as compared with the control group. In the D-Val group, decreases of DNA and protein contents in the tumor tissues were also observed. The D-Leu and D-Met groups showed a tendency toward tumor growth inhibition. The protein content in the liver tissues of these two groups was significantly higher as compared with the control group. The DNA content in the liver tissue was also significantly higher in the D-Met group. The body weight including the tumor (on the final day of TPN) was significantly lower in the D-Val group as compared with the control group, but there was no significant difference in the groups for body weights not including tumors (carcass body weight). The hematocrit and hemoglobin values, indicators of anemia, were significantly higher in the D-Val group as compared with the control group. From these results, regarding tumor growth inhibition, the D-Val solution had the strongest inhibitory effect with no negative influence on the host, and improvement of nutritional status was also suggested in the rats that received the D-Leu or D-Met solutions.

Comparison of glucose and fat as energy sources in peripheral parenteral nutrition in rats

Glucose is usually chosen as the energy source for total parenteral nutrition. However, the optimal glucose:fat ratio for peripheral parenteral nutrition has not been examined sufficiently. We compared glucose:fat ratios in hypocaloric nutrition. Male SD rats were given hypocaloric parenteral nutrition (approx. 190 kcal/kg/d) for 5 d after laparotomy. The hypocaloric solutions used contained 0, 33, 50, 67 or 100% of the non-protein energy in the form of fat. Body weight change, nitrogen balance, organ weights, and hepatic, splenic and plasma biochemistries were assessed. Body weight increase in the 67 and 100% fat groups was significantly greater than that in the 0% fat group. Nitrogen balance was the same in all groups. Hepatic glycogen content was significantly lower in the 100% fat group than that in the 0% fat group. The weight of epididymal fat deposits was significantly lower in the 0% fat group than in the 50 and 67% fat groups. On the other hand, tissue triglyceride content and plasma lipid levels in the 100% fat group were significantly higher than in the 0% fat group, and were also higher than in the control group. It is suggested that combinations of glucose and fat have sparing effects on body fat and hepatic glycogen. Combinations of glucose and fat as non-protein energy sources were superior to glucose or fat alone for hypocaloric parenteral nutrition.

Development and biochemical characterization of a 2'-C-cyano-2'-deoxy-1-beta-D-arabino-pentofuranosylcytosine (CNDAC)-resistant variant of the human fibrosarcoma cell line HT-1080

2'-C-Cyano-2'-deoxy-1-beta-D-arabino-pentofuranosylcytosine (CNDAC) is an antitumor nucleoside with a novel chemical structure that exerts potent antitumor activity against various human tumor cells in vitro and in vivo. In order to be active it needs to be phosphorylated by deoxycytidine (dCyd) kinase. We induced resistance to CNDAC in the human fibrosarcoma cell line HT-1080 by exposure to increasing concentrations of CNDAC. The resistant cells showed over 560 times higher resistance as compared to that of the parental HT-1080 cells and were cross-resistant to the other 2'-deoxycytidine derivatives. The dCyd kinase mRNA expression of the resistant cells decreased and there was the expression of aberrant mRNA of dCyd kinase which contained a 116-nucleotide deletion within the coding region, corresponding to the fifth exon of the gene. The dCyd kinase enzymatic activity of the resistant cells was deficient. The initial uptake of CNDAC into the resistant cells was similar to that of the parental cells. However, the incorporation of CNDAC into the DNA fraction of the resistant cells was significantly less than that of the parent cells. These results led us to conclude that the acquired resistance to CNDAC can be attributed to a deficiency of dCyd kinase activity, which should be based on a remarkable decrease in mRNA expression and genetic mutation of the dCyd kinase gene, but not on cellular CNDAC accumulation.

Stereospecificity of 6'-C-neplanocin A analogues as inhibitors of S-adenosylhomocysteine hydrolase activity and human immunodeficiency virus replication

The R- and S-isomers of 6'-C-neplanocin A analogues, which are all known as inhibitors of S-adenosylhomocysteine (AdoHcy) hydrolase, were studied for their inhibitory effects on Human Immunodeficiency Virus type 1 (HIV-1) replication and HIV-1 Tat-mediated transactivation. The R-isomers showed much greater activity against AdoHcy hydrolase than the S-isomers. The same differential activity was observed against the HIV-1 replication and the Tat transactivation.

[Effects of folic acid supplementation on hyperhomocysteinemia in CAPD patients: effects on unsaturated fatty acids]

Hyperhomocysteinemia has been recognized as one of the risk factors for atherosclerosis and premature vascular disease. Patients on dialysis and end-stage renal disease also manifest high plasma concentrations of homocysteine. We performed this study to evaluate the effects of folic acid supplementation on hyperhomocysteinemia in CAPD patients. Twenty-three CAPD patients (8 males, 15 females, 49.1 +/- 14.2-years-old) dialyzed for 22.7 +/- 19.2 months participated in the study. Daily 5-mg doses of folic acid supplementation for 4 weeks significantly reduced plasma concentrations of total homocysteine (p < 0.01) and serine (p < 0.001). This observation suggests that the reduction of plasma concentrations of total homocysteine results from activation of homocysteine remethylation to methionine. On the other hand, folic acid supplementation also revealed significant correlations between changes in serum concentrations of both dihomo-gamma-linolenic acid and arachidonic acid and changes in plasma concentrations of total homocysteine (r = -0.517, p < 0.05, r = -0.451, p < 0.05, respectively). In addition, serum concentrations of both dihomo-gamma-linolenic acid and arachidonic acid in 11 CAPD patients with hyperhomocysteinemia (> or = 35 micromol/litter) were significantly lower than those of 12 CAPD patients with normohomocysteinemia (< 35 micromol/litter) (p < 0.05, p < 0.05, respectively). Serum concentrations of both dihomo-gamma-linolenic acid and arachidonic acid in CAPD patients with hyperhomocysteinemia increased significantly (p < 0.01, p < 0.05, respectively) and reached similar levels of CAPD patients with normohomocysteinemia, while plasma concentrations of total homocysteine decreased after folic acid supplementation. These findings suggest that correction of hyperhomocysteinemia in patients on dialysis produces an increase in unsaturated fatty acids.

Nucleosides and nucleotides. 170. Synthesis and properties of oligodeoxynucleotides containing 5-[N-[2-[N,N-bis(2-aminoethyl)- amino]ethyl]carbamoyl]-2'-deoxyuridine and 5-[N-[3-[N,N-bis(3-aminopropyl) amino]propyl]carbamoyl]-2'-deoxyuridine

The synthesis of oligodeoxynucleotides (ODNs) containing 5-[N-[2-[N,N-bis(2-aminoethyl)amino]ethyl]-carbamoyl]-2'-deoxyuridine (BAE) and 5-[N-[3-[N,N-bis(3-aminopropyl)amino]propyl]carbamoyl]-2'- deoxyuridine (BAP) is described. The thermal stabilities of duplexes containing these ODNs and either the complementary DNA or RNA strand and of triplexes consisting of these ODNs and the target duplex were studied by thermal denaturation. ODNs containing BAE or BAP stabilize duplex formation with either the complementary DNA or RNA strands but destabilize triplex formation with the target duplex. Furthermore, the resistance of these ODNs to nuclease hydrolysis was studied by using snake venom phosphodiesterase (a 3'-exonuclease) and nuclease S1 (an endonuclease). It was found that ODNs containing either BAE or BAP were more resistant to nucleolytic hydrolysis by either of the nucleases than the unmodified ODN.

[Effects of various Ringer's solutions on acid-base balance in rats in hemorrhagic shock and with hepatic dysfunction]

We investigated the effects of bicarbonated Ringer's solution (BR) on arterial blood acid-base balance, and compared these with the effects of lactated Ringer's solution (LR) and acetated Ringer's solution (AR) in rats in hemorrhagic shock. Rats underwent 70% reduction of hepatic blood flow and blood shedding of 1.5% of body weight. Each solution was infused through the femoral vein at a rate of shed blood volume x 8.hr-1 for 30 min under urethane anaesthesia. After the blood shedding, arterial blood pH and HCO3-decreased but plasma lactate concentration increased. These parameters improved significantly in the BR group compared with those in the LR group. However, the LR group showed the lowest blood pH and the highest plasma lactate concentration among the groups. These results suggest that BR has superior effects on the arterial blood acid-base balance and glucose metabolism in rats in hemorrhagic shock and with hepatic dysfunction.

[Characteristics of home parenteral nutrition and effectiveness of 3 way valved PICC in regional medical care]

Home medical care is becoming a greater matter of concern along with the increasing population of elderly persons. The various difficulties in home care are also found in regional care, and it could be said that in Japan regional care serves as an "advanced model" for home medical care. Ohya Town is located in the mountains of northern Hyogo Prefecture. It has a population of about 5,000 of which 32% is elderly people. There is no railroad, and it takes around 30 minutes to travel to the central hospital from the area. The three town clinics are in contact with each other and with the central hospital concerning medical information. The characteristics of Home Parenteral Nutrition in this underpopulated district are discussed and reported in reference mainly to cases in which the 3 way valved peripherally inserted central venous catheter (Groshong Catheter) is used, in comparison with HPN cases in the city university hospital.

[Effects of establishing a special smoking area in the office of an electronic factory]

Measurements of concentrations of suspended particles and a questionnaire survey at the office of an electronic factory were conducted before and after the establishing of a special smoking area. Compared with the previous conditions where smoking had been allowed during a specified time, the suspended particle concentration has decreased to less than one fifth of the previous condition. Both smokers and non-smokers are satisfied with the establishment of the smoking area. All were convinced that the separation of the smoking permissible area and non-smoking area was more effective than the time restriction on smoking.

Magnetic resonance imaging patterns in patients with multiple myeloma

Sixty-one consecutive patients with multiple myeloma were studied with magnetic resonance (MR) imaging of the spine. Sagittal T1-weighted and short inversion time (TI) inversion recovery (STIR) images were obtained. The MR patterns of the bone marrow were classified as diffuse (D) (n=26), nodular (N) (n=11), D+N (n=13) or normal (n) (n=11). Abnormal patterns were seen in 50 (82%) of the 61 patients. Correlations were found between the MR imaging patterns and some laboratory findings (WBC, haematocrit, platelet count, serum albumin, and percentage of marrow plasmacytosis). The survival of the patients with abnormal MRI patterns was significantly poorer than that of the patients with normal patterns. However, the survival of patients with a nodular pattern did not differ from those with a normal pattern. The MR imaging pattern of the bone marrow in patients with multiple myeloma is a useful factor in the assessment of prognosis.

A homozygous missense mutation of the sodium/iodide symporter gene causing iodide transport defect

Iodide transport defect is a disorder characterized by an inability of the thyroid to maintain an iodide concentration difference between the plasma and the thyroid. The recent cloning of the sodium/iodide symporter (NIS) gene enabled us to characterize the NIS gene in this disorder. We identified a homozygous missense mutation of A-->C at nucleotide +1060 in NIS complementary DNA in a male patient who was born from consanguineous marriage, had a huge goiter, and lacked the ability to accumulate iodide but was essentially euthyroid. The mutation results in an amino acid replacement of Thr354-->Pro in the middle of the ninth transmembrane domain. COS-7 cells transfected with the mutant NIS complementary DNA showed markedly decreased iodide uptake, confirming that this mutation was the direct cause of the disorder in the patient. Northern analysis of thyroid ribonucleic acid revealed that NIS messenger ribonucleic acid level was markedly increased (> 100-fold) compared with that in the normal thyroid, suggesting possible compensation by overexpression.

Correlation between intravenously supplied energy level and zinc metabolism in laparotomized rats

We investigated the relationship between intravenous energy loading and zinc status in laparotomized rats. One of three test solutions consisting of 3% amino acid, the same amount of electrolytes (excluding zinc) and different concentrations of glucose were infused through the jugular vein for 5 d. The total energy was 109, 191 and 273 kcal/kg/d, respectively. Significantly positive correlations were observed between infusion energy and rat body weight changes (% of initial value) and between infusion energy and cumulative nitrogen balance. Regarding the zinc status, a negative correlation was found between infusion energy and plasma zinc concentration, and a positive correlation was observed between infusion energy and urinary zinc excretion. There was no significant relationship between infusion energy and hepatic zinc content. These results indicate that the zinc requirement might be increased when infusion energy is elevated and the nutritional status is improved. Zinc supplementation in the post-operative period should be considered in light of not only catabolism but also anabolism. Anabolism may be more important than catabolism in regard to zinc metabolism under relatively mild stress.

Neplanocin A, a potent inhibitor of S-adenosylhomocysteine hydrolase, potentiates granulocytic differentiation of acute promyelocytic leukemia cells induced by all-trans retinoic acid

Several neplanocin A analogs were synthesized and their growth-inhibiting and differentiation-inducing activities on myelogenous leukemia cells were examined. An adenosine kinase-ineffective analog of neplanocin A was effective in inducing differentiation, suggesting that phosphorylation of the nucleoside is not essential for inducing the differentiation of leukemia cells. Neplanocin A induced functional and morphological differentiation of HL-60 cells, but did not effectively induce differentiation of NB4, a cell line derived from a leukemia patient with t(15;17). However, these cells have been known to undergo granulocytic differentiation upon treatment with all-trans retinoic acid (ATRA), and are used as a model for differentiation therapy in acute promyelocytic leukemia. Preexposure of NB4 cells to low concentrations of neplanocin A greatly enhanced the ATRA-induced differentiation of the cells, whereas representative antileukemic drugs such as cytosine arabinoside and daunomycin did not enhance this differentiation. A clinical strategy that combines intermittent treatment with neplanocin A analogs and a low dose of ATRA may increase the clinical response and decrease the adverse effects of ATRA.

Differential expression of maf-1 and maf-2 genes in the developing rat lens

PURPOSE

To examine the expression of maf-1 and maf-2 protocogenes in the developing rat lens.

METHODS

Maf-1 and maf-2 transcripts were assayed in rat lenses on embryonic days 13 and 16 (E13 and E16) by in situ hybridization using single-stranded RNA probes. Proteins encoded by the maf-2 gene were assayed immunocytochemically in embryonic (E12, 13, 16, 19) and postnatal day 14 and 90 (P14 and P90) lenses.

RESULTS

In embryonic lenses, we detected maf-1 messenger RNA (mRNA) in the lens epithelium and maf-2 mRNA diffusely distributed in the lens fiber cells. By immunocytochemistry, Maf-2 was detected on E12 in the nuclei of almost all lens pit cells. On days E13, E16, and E19, however, lens epithelial cells showed no immunoreactivity, but nuclei of fiber cells reacted strongly. On P14, nuclei containing Maf-2 protein were confined to the equator of the lens, but at 3 months of age, no Maf-2 could be detected in the rat lens. Western blotting showed that the anti-Maf-2 antiserum reacted with a single protein, of molecular weight approximately 39 kDa, in rat lens.

CONCLUSIONS

Results showed the spatial and temporal regulation of maf gene expression and suggest that these genes participate in transcriptional regulation during the development of the lens in the rat.

Inhibition by aminosalicylates of lipid peroxidation in large intestinal mucosa after mesenteric ischemia/reperfusion in the rat

To clarify the mode of action of aminosalicylates, which are generally used as therapeutic agents for ulcerative colitis, we investigated the effect of some of the aminosalicylates on lipid peroxidation in the large intestinal mucosa after mesenteric ischemia/reperfusion in the rat. Lipid peroxidation was assessed by measuring the level of thiobarbituric-acid-reactive substances. It was found that aminosalicylates dose-dependently inhibited the elevation of the level of thiobarbituric-acid-reactive substances in the large intestinal mucosa after ischemia/reperfusion. This effect may partly contribute to the therapeutic actions of aminosalicylates in ulcerative colitis.

Selenium level and glutathione peroxidase activity in plasma, erythrocytes and platelets of healthy Japanese volunteers

The purpose of this study was to determine both the selenium (Se) level and glutathione peroxidase (GSH-Px) activity in plasma, erythrocytes and platelets from 51 healthy Japanese individuals. The Se levels (mean +/- SD) of plasma, erythrocytes and platelets were 117.4 +/- 15.7 micrograms/L, 0.954 +/- 0.159 microgram/g hemoglobin, and 4.93 +/- 1.52 ng/mg protein, respectively, and GSH-Px activity was 318 +/- 50 U/L, 18.0 +/- 5.0 U/g hemoglobin, and 0.142 +/- 0.035 U/mg protein, respectively. There was a negative correlation between age and the platelet Se level in men (r = -0.761, p < 0.001), and a positive correlation between the plasma and platelet GSH-Px activities in women (r = 0.663, p < 0.001).

Effects of 5-(N-aminohexyl)carbamoyl-2'-deoxyuridine on endonuclease stability and the ability of oligodeoxynucleotide to activate RNase H

To evaluate an endonuclease resistance property of oligodeoxynucleotides (ODNs) containing 5-(N-aminohexyl)carbamoyl-2'-deoxyuridines (Hs) and to elucidate whether a duplex consisting of the ODN analogue and its complementary RNA induces RNase H activity, the ODNs containing the deoxyuridine analogues, Hs, at intervals of one, two, three, four and five natural nucleosides were synthesized. From partial hydrolysis of these ODNs with nuclease S1 (an endonuclease), it was found that the ODNs became more stable towards nucleolytic hydrolysis by the enzyme as the number of H increased. Furthermore, to examine whether the duplexes composed of the ODNs containing Hs and their complementary RNAs are substrates for RNase H or not, the duplexes of these ODNs and their complementary RNA strands were treated with Escherichia coliRNase H. It was found that cleavage of the RNA strands by the enzyme was kinetically affected by the introduction of Hs into the duplexes.

Bone marrow patterns in patients with aplastic anaemia and myelodysplastic syndrome: observations with magnetic resonance imaging

Bone marrow magnetic resonance imaging (MRI) was obtained in 48 patients with myelodysplastic syndrome (MDS) (35 cases) or aplastic anaemia (AA) (13 cases). The lower thoracic and lumbar spine were evaluated on sagittal plane using a 1.5 Tesla superconducting MR unit with a surface coil. Pulse sequence of STIRs (TR 2000 msec, TI 160 msec, TE 20 msec) were applied. Four distinct patterns of signal intensity (SI) on the STIR images were classified as follows: pattern 1, homogeneously low SI; 2, marginally high SI; 3, heterogeneously high SI; 4, homogeneously high SI. In all 13 patients with AA, STIR images initially revealed pattern 1. In 25 of 35 cases with MDS patients, the STIR images were initially classified as pattern 3. The STIR images of 6 AA and 5 MDS patients with a clinical response to treatment showed pattern 2 similar to that of normal marrow distribution. The STIR images of MDS patients showed an abnormal distribution of SI. Significant signal changes in the STIR images can be observed in successive examinations of the patients, thus facilitating follow-up of the disease and treatment. MRI of the bone marrow provides a noninvasive means of grossly examining a large fraction and is a useful technique in patients with aplastic anaemia or myelodysplastic syndrome.