[The relationship between complement C3 receptors (CR1, CR3) on polymorphonuclear leukocytes and complement fragments during hemodialysis]

The expression of complement receptor type 1 (CR1) and type 3 (CR3) on polymorphonuclear leukocytes (PMNs) and generation of complement fragments, C3a, C5a, C4d, iC3b and Bb, were studied in patients during hemodialysis using cuprammonium rayon (Cu) membranes. Furthermore, the relation between the expression of CR1 and CR3 on PMNs from healthy donors and complement fragments was investigated. The expression of CR1 and CR3 on PMNs increased during hemodialysis. Plasma C3a, C5a and iC3b levels increased in the first 15 minutes and then decreased at 120 minutes of dialysis. But plasma Bb level remained high until the end of hemodialysis. Purified Bb had no effect on the expression of CR1 and CR3 on PMNs, but C5a augmented those expression in vitro. Nafamostat mesilate, an artificial proteinase inhibitor, inhibited augmentation of complement receptors on PMNs in concentration dependent fashion. C5a generated through the activation of complement was thought to take an important role in the increased expression of CR1 and CR3 on PMNs.

[Chemoembolization with degradable starch microspheres for liver metastases of colorectal cancer]

Transcatheter chemoembolization using degradable starch microspheres (DSM) was performed in 17 patients with liver metastases of colorectal cancer. DSM, 45 microns in diameter, which are easily degraded by serum amylase, and therefore obstruct arterial blood flow temporarily at the arteriolar capillary bed. DSM mixed with mitomycin C were administered through the catheter introduced by Seldinger's method in 13 cases, and through subcutaneously implanted drug delivery system (Port-A-Cath) in 4 cases. The treatment was repeated 5 times on the average at intervals of 2 to 4 weeks. The therapeutic effect of this chemoembolization was evaluated by the change in tumor size measured by angiography or computed tomography. Tumor regression of over 50% was observed in 9 of 17 cases (53%). Elevated serum CEA levels (greater than 10 ng/ml) decreased in 10 of 15 cases (67%). One-year survival rate was 48% in 17 cases, and among them it was 100% in 7 cases with the extent of several liver metastases (H2). Extrahepatic metastasis was observed in 3 of 17 cases (18%) before the treatment, and in 8 cases (47%) after the treatment. Abdominal pain occurred in 36% of the cases by the administration of DSM, but the pain disappeared within 2 hours. No major side effects such as bone marrow suppression or hepatotoxicity were observed. Our results suggest that chemoembolization using DSM is effective and safe in the treatment of liver metastases from colorectal cancer.

[Kinetics of immune complex deposition and influence of decomplementation on their clearance in cationized antigen induced acute serum sickness]

Using a murine acute serum sickness model caused by cationized bovine gamma-globulin (CBGG), the histological findings, accumulation of CBGG in the organs and the effect of decomplementation for the clearance of immune complex (IC) were investigated. The accumulation of CBGG increased in the lungs in the presence of anti-CBGG antibody 1 hour after injection of CBGG, but did not change in the kidneys. This suggests that CBGG forms IC in situ in the kidneys, and that circulating IC accumulates in the lungs. Decomplementation did not influence the uptake of CBGG immediately after challenge but delayed the clearance of CBGG in the kidneys, lungs, liver and spleen. A beneficial role of the complement system in the clearance of IC even for those formed in situ was recognized. Histological changes, cellular infiltration and microvascular destruction, evoked in the lungs in this experimental model immediately after challenge, were not seen in the kidney, suggesting the different modes of complement activation in these organs.

Vascular alterations in Fukuyama type congenital muscular dystrophy

Blood vessels in muscle biopsy specimens from 6 Fukuyama type congenital muscular dystrophy (FCMD) patients were examined by electron microscopy and compared with ones in non-diagnostic biopsy specimens from age-matched controls and patients with childhood neuromuscular disorders. The most striking feature was the blister-like swelling of vascular endothelial cells in the biopsied muscle specimens from 5 of the 6 patients with FCMD. Morphometric analysis of capillaries in biopsied muscles showed the extremely greater capillary, endothelial and pericyte areas in the FCMD patients than in controls. These phenomena are quite similar to those found in Duchenne muscular dystrophy (DMD) at the preclinical stage and suggest an as yet undetermined process in blood vessels in FCMD as well as DMD. An immunohistochemical study involving dystrophin antibodies showed positive staining in FCMD.

Infantile osteopetrosis complicating neuronal ceroid lipofuscinosis

An autopsy case of infantile osteopetrosis complicating neuronal ceroid-lipofuscinosis is reported. Autopsy revealed generalized sclerosis and thickening of cortical and spongy bones, formation of mineralized cartilagenous tissues, and narrowing of the marrow cavities associated with decreased hematopoietic cell components. Around the thickened bone trabecles, osteoclasts lacked a ruffled border and clear zone along the cell membrane facing the bone matrix surface. The brain was markedly atrophic with neuronal cell loss and focal gliosis, and the remaining neuronal cells accumulated brown granular pigments, which were confirmed histochemically and electron-microscopically to be ceroid and lipofuscin. In the cerebral medulla, the development of myelin sheaths was extremely poor. Also, the occurrence of Lex type glycolipids and GM3 and the apparent absence of cerebroside and cerebroside sulfate were proved by biochemical analysis, suggesting that the brain was still in a stage of embryonic development or still in the process of differentiation. Except for one suggestive case, this is the first case of complicating neuronal ceroid-lipofuscinosis in infantile osteopetrosis.

[A simplified method for the assessment of C1 esterase inhibitor function]

From the result that the activated form of C1-s(C1-s) prolonged the kinetics of hemolysis via complement, this assay was applied to assess C1 esterase inhibitor (C1INH) function. In the kinetic assay, the complement hemolytic activity was evaluated by the time which required to cause 50% reduction of the initial turbidity of sensitized sheep erythrocytes, and was expressed as T1/2. (1) T1/2 of pooled normal human sera (p-NHS) showed dose-dependent prolongation by the addition of various amounts of C1-s. (2) Preincubation of various amounts of functionally pure C1INH with the constant amounts of C1-s inhibited dose-dependently the prolongation of T1/2 by C1-s. (3) The C1INH activity of NHS was 840 +/- 80 units/ml (n = 6) and that of the C1INH deficient serum was 80 units/ml, which were calculated from the standard curve established by the addition of various amounts of purified C1INH. This test requiring only C1-s and sensitized sheep erythrocytes is simple technically and high in sensitivity, and seems to be useful for the routine assay for C1INH function of human sera.

[Role of active oxygen species and lipid peroxidation in liver injury induced by ischemia-reperfusion]

The role of superoxide and lipid peroxidation in liver injury induced by ischemia-reperfusion was investigated in rats. Ischemic condition of the liver was created by applying small clamps to the right branch of portal vein and the right hepatic artery for 15 min. Clamping of hepatic artery and portal vein could decrease the hepatic blood flow to about 30% of that measured before the clamping. Levels of serum GPT and thiobarbituric acid (TBA) reactive substances in the liver tissue were significantly increased 30 min after the reperfusion following 15 min of ischemia. The increase in serum GPT and TBA reactants in the liver tissue was significantly inhibited by the treatment with superoxide dismutase combined with catalase. The treatment with allopurinol significantly inhibited the elevation of serum GPT levels and showed a tendency to inhibit the increase in TBA reactants in liver tissue. These results suggest that active oxygen species and lipid peroxidation may play an important role in the pathogenesis of ischemia-reperfusion injury in the liver, and hypoxanthine-xanthine oxidase system may be one of the main sources of active oxygen species.

Role of oxygen-derived free radicals in the pathogenesis of gastric mucosal lesions in rats

The role of oxygen-derived free radicals and lipid peroxidation in the pathogenesis of acute gastric mucosal erosion was investigated in rat models produced by burn shock stress, by treatment with regional hyperthermia, platelet activating factor, and compound 48/80, and by ischemia-reperfusion. In all experimental models, the increase in the gastric erosions and in TBA reactants in the gastric mucosa were significantly inhibited by the treatment with superoxide dismutase (SOD) and/or catalase. Pretreatment with allopurinol, a competitive inhibitor of xanthine oxidase, prevented considerably the gastric injury (a) induced by burn shock, (b) produced by treatment with compound 48/80, and (c) caused by ischemia-reperfusion. By the treatment with anti-rat neutrophil antibody, the gastric mucosal injuries induced by regional hyperthermia, platelet activating factor, and compound 48/80 were significantly inhibited; however, burn shock and ischemia-reperfusion injuries were not inhibited. These results suggest that oxygen-free radical and lipid peroxidation contribute to the formation of gastric mucosal lesions, and that the sources of oxygen radicals seem to be different among these experimental models.

[Plasma levels of complement fragments during hemodialysis in patients with chronic renal failure]

The kinetics of hemodialysis-induced leukopenia and generation of complement fragments including C3a, C5a, C4d, iC3b and Bb were investigated in 14 patients during hemodialysis using cellulose acetate (CA), cuprophan (Cu) and ethylenevinyl alcohol (EVA) membranes. A marked leukopenia in the first 15 minutes was observed in CA and Cu. Plasma C3a levels were higher in CA than in Cu and EVA. Plasma C5a levels were higher in CA and Cu than in EVA. There was a negative correlation between the white blood cell counts and plasma C5a levels at 15 minutes (gamma = -0.85, p less than 0.001). Plasma C4d levels showed no increase in all membranes. Plasma iC3b levels were higher significantly in Cu than in CA and EVA. Plasma Bb levels in the first 15 minutes increased significantly in all membranes, and furthermore continued to increase till the end of hemodialysis in CA and Cu. This study revealed that all the membranes tested activated the complement via the alternative pathway to produce Bb, iC3b, C3a and C5a. C5a was thought to take an important role in transient leukopenia. Furthermore, Bb was accumulated during hemodialysis in CA and Cu, and its biological effects on patients undergoing hemodialysis should be studied.

[Role of free radicals and lipid peroxidation in gastric mucosal injury induced by ischemia-reperfusion in rats]

Ischemia and reperfusion is of the greatest importance in the pathology of various diseases. This study was designed to investigate the role of oxygen-derived free radicals and lipid peroxidation in gastric mucosal injury induced by ischemia-reperfusion in rats. Clamping of the celiac artery in rats reduced the gastric mucosal blood flow to 10% of that measured before the clamping. Gastric mucosal injury, such as spotty and linear hemorrhagic erosions, was seen in rats 60 min of the reperfusion following 30 min of ischemia. Thiobarbituric acid (TBA) reactants in the gastric mucosa were increased after the reperfusion. The increase in gastric mucosal lesions and TBA reactants were significantly inhibited by the treatment with SOD+ catalase and allopurinol. These results suggest that oxygen-derived free radicals and lipid peroxidation may play an important role in the pathogenesis of acute gastric mucosal lesions induced by ischemia-reperfusion.

[Two siblings with interstitial deletion of chromosome 14 [46 XX, del (14) (q12 q13.3)]]

Two siblings with interstitial deletion of chromosome 14 not associated with ring formation were reported. Clinical features of the patients included failure to thrive, severe mental retardation, microcephaly, round face, hypertelorism, micrognathia and high-arched palate. They were common also in five previously reported cases. Other peculiar finding was hyperthyrotropinemia in their neonatal periods; mild hypothyroidism was found in the elder sister, and hyperthyrotropinemia was only transient in the younger sister. By a high-resolution G-banding analysis, the maternal origin of the chromosome with the deletion was noted.

Molecular-genetic study of Duchenne and Becker muscular dystrophies: deletion analyses of 45 Japanese patients and segregation analyses in their families with RFLPs based on the data from normal Japanese females

This study consisted of 1) molecular deletion analyses in patients with Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) using the entire cDNA for the DMD gene as hybridization probes, 2) RFLP analyses in a large number of Japanese normal women using 11 DMD-linked cloned DNAs as probes, and 3) segregation analyses with these RFLP data in 17 DMD families in which prenatal or carrier diagnosis was required. The deletion study showed that 18 (43%) of 42 male DMD patients had a deletion within the DMD gene, while no detectable deletion was found in 3 BMD patients. These deletions were preferentially observed at the 5' end of the DMD gene, while no deletion was found in the 3' portion of the gene. Of a total of 15 RFLPs detected with the 11 probes, one was a new RFLP (probe/enzyme: P20/MspI). In 6 RFLPs, the allele frequencies in the Japanese were statistically different from those in the Caucasian. Based on the RFLP data combined with the result of the deletion study, an estimated diagnostic rate for prenatal diagnosis and/or carrier detection in the Japanese DMD families was 63%. The real diagnostic rate obtained from the prenatal and carrier diagnoses, which were practically performed in 17 families, corresponded to the estimation. A protocol useful for the diagnosis in Japanese DMD families is presented.

[Changes of complement in immune complex glomerulonephritis induced by cationized antigen]

Complement system takes an important role in the pathogenesis of immune complex glomerulonephritis. In this study the precise changes of serum complement and its deposition in the glomeruli were investigated in the mice models induced with cationized bovine gamma-globulin (CBGG). Balb/c mice preimmunized with CBGG were injected intravenously with CBGG three times every 24 hours. Proteinuria and hypoalbuminemia have developed from day 3 until the death on day 9-13 of progressed azotemia. This nephritis resembled to mesangial proliferative glomerulonephritis histopathologically. Immunofluorescent study revealed granular deposits of CBGG, IgG, A, M and C3 along the glomerular capillary loop. Serum C3 decreased to about 50% of normal controls within 1 hour after challenge of antigen and plasma C3 conversion evaluated by crossed-immunoelectrophoresis, occurred in accordance with C3 reduction and then decreased. Immunofluorescent study showed a big difference in the mode of deposition among IgG, CBGG and C3. The most intense deposits of C3 in the glomeruli were seen 12 hours after challenge of CBGG, and then gradually decreased until the next challenge. IgG and CBGG antigen deposited most intensely soon after the challenge of antigen, and gradually decreased. These results led us to conclude that there existed two phases of complement activation in this immune complex induced mice glomerulonephritis; an early phase activation of complement by antigen-antibody complexes in the circulation and later phase activation of complement by immune complexes after deposition of them in situ glomeruli.

[Chemoembolization with degradable starch microspheres for liver metastases in colorectal cancer]

Transcatheter chemoembolization using Degradable Starch Microspheres (DSM) was performed in 17 patients with liver metastases of colorectal cancer. Mitomycin C mixed with DSM was injected into the proper hepatic artery. Tumor regression of over 50% was observed in 9 of 17 cases (53%). Elevated serum CEA levels (greater than 10 ng/ml) decreased in 10 of 15 cases (67%). One-year survival rate was 50% in 17 cases. One-year survival rate was 100% in 7 cases with several liver metastases (H2). Abdominal pain occurred in 36%, mostly disappearing within 2 hours. No major side effects such as bone marrow suppression or hepatotoxicity were observed. Our results suggest that chemoembolization using DSM is effective and safe in the treatment of liver metastases from colorectal cancer.

[Binding of K-18 on the surface of tumor cells--flowcytometrical analysis in vitro]

After K-18 was contacted with various kinds of tumor cell lines in vitro, the binding pattern was examined. K-18 bound on the surface of K-562 cells showed the maximum levels 1 hr later and maintained the binding activity for 24 hrs in the analysis by flowcytometry. K-18 also bound to HeLa S3, KB, RPMI8226, P815, YAC-1 and L1210 cells. Fluorescent intensity on K-562 cells was stronger with whole molecules of K-18 than with F(ab')2 conjugated with melphalan. Normal human IgG could bind more on the surface of K-562 cells than F(ab')2 of IgG. These results suggest that K-18 might bind on tumor cells via IgG Fc receptors on their surface.

[Chemo-embolization using degradable starch microspheres and regional hyperthermia in unresectable hepatocellular carcinoma]

Antitumor effects and prognosis of the patients with unresectable hepatocellular carcinoma were investigated in the treatment of chemo-embolization using degradable starch microspheres (DSM) and regional hyperthermia. Twenty-six cases were treated with chemo-embolization using DSM alone (Group A) and eighteen cases were treated with combination of chemo-embolization and hyperthermia (Group B). Tumor regression rates over 50% were 42% (11/26) and 56% (10/18) in Group A and Group B, respectively. In the patients with tumors over 7 cm in diameter, no favorable response was obtained in Group A (0/11), but the response rate was increased to 56% (5/9) by the combination of hyperthermia. In the patients with arterio-portal shunt, therapeutic effects were observed in 17% (1/6) and 50% (1/2) of Group A and Group B, respectively. In the patients with portal invasion (Vp2 and Vp3), no favorable response was demonstrated in Group A (0/4), but tumor response was demonstrated in one out of 3 cases in Group B. One- and two-year survival rates were 59% and 53%, respectively, in Group A, and 93% and 45%, respectively, in Group B. The DSM, temporary embolus, is suitable for the combination of hyperthermia because chemo-embolization using DSM can be performed many times. Therefore, these results suggested that chemo-embolization using DSM should be beneficial as combination therapy for unresectable hepatocellular carcinoma.

[Influences of anti-allergic drugs on superoxide generation from the hypoxanthine-xanthine oxidase system or polymorphonuclear leukocytes]

The influences of anti-allergic drugs on superoxide generation from the hypoxanthine-xanthine oxidase system or polymorphonuclear leukocytes (PMN) were studied by an electron spin resonance assay using 5,5-dimethyl-1-pyrroline-N-oxide (DMPO) as a spin trapper. The intensity of DMPO-OOH signal generated from the hypoxanthine-xanthine oxidase system was not influenced by the presence of azelastine, ketotifen, disodium cromoglycate, mequitazine, or methylprednisolone, but it decreased in the presence of AA-673. A kinetic study showed that the second order rate constant for reaction between AA-673 and superoxide anion at pH 7.4 was 2.9 x 10(8)M-1S-1. The relative intensity of DMPO-OOH spin adduct generated from PMN stimulated with phorbol myristate acetate (PMA) or opsonized zymosan (OZ) significantly decreased in the presence of azelastine: from the PMN-PMA system, with 10.7 microM concentration of molar concentration causing 50% reduction of the signal intensity (IC50), while from the PMN-OZ system, with 10.5 microM concentration of IC50, and also decreased in the presence of mequitazine: from the PMN-PMA system, with 10.8 microM concentration of IC50, while from the PMN-OZ system, less than 2.0 microM concentration of IC50. These results suggest that some anti-allergic drugs may have anti-inflammatory and anti-oxidative actions due to scavenging superoxide radicals or due to inhibiting superoxide production.

[Strategy for molecular diagnosis of Duchenne muscular dystrophy: alleles frequency in RFLPs detected with X-linked probes in normal Japanese]

Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder. Recently it has been suggested that the protein named "dystrophin" is not produced in the DMD muscle because of their mutant of defective DMD gene. Recent molecular studies using subclones from the DMD-cDNA as probes revealed a DNA deletion in about a half of the DMD patients. Since not all patients showed deletion, segregation analysis with restriction fragment length polymorphisms (RFLPs) is still necessary and important for diagnosis not only patients but female carriers as well. Therefore, we tried to detect RFLPs with the use of many probes localized within and/or flanked with the DMD gene and made a protocol for the diagnosis with our RFLP data. Among 50 normal Japanese females, the frequencies of rare alleles which identified with enzyme/probe combinations in each were as follows (RFLPs practically available for diagnosis are underlined): 0.38 for p782/EcoRI; 0.14 for p99-6/Pst I: 0.45 for pJ66-HI/Pst I: 0.16 for pERT87-30/Bgl II; 0.44 for 87-15/Xmn I: 0.07 for 87-15/Taq I; 0.33 for 87-8/Taq I; 0.44 for 87-1/Xmn I; 0.45 for 87-1/Mva I; 0.43 for Xj-1.1/Taq I; 0.34 for 754-11/EcoR I; 0.41 for 11.28/Taq I. Some of our results were different from the Caucasian both on the allele frequencies and the restriction fragment length. We proposed a diagnostic protocol of DMD and it's carriers in Japan. Firstly, segregation analysis should be performed with five different combinations of double probe/enzyme, such as Yj-1,.1/L1.28/Taq I, ERT87-1/87-15/Xmn I, 87-1/Mva I, J66-HI/99-6/Pst I, and 782/754-11/EcoR I.(ABSTRACT TRUNCATED AT 250 WORDS)