[Study of serial bronchoalveolar lavage in patients with aspergilloma: cell reaction at the affected sites and penetration of miconazole and flucytosine into the lesion]

We have performed serial bronchoalveolar lavage (BAL) examination in two patients with asperigilloma and compared that of total cell count and cell population with control groups (5 non-smokers, 10 smokers) and other pulmonary infectious diseases: 7 each with mycoplasmal pneumonia and pulmonary tuberculosis, 6 with bacterial pneumonia, and 5 with chlamydial pneumonia. Miconazole (MCZ) by drip intravenous infusion of 400 mg/day and flucytosine (5-FC) by oral intake of 4.5 to 6.0 g/day were administered to one patient with aspergilloma, and we studied the serum and BALF concentration about 5 hours after administration. The followings results were obtained: 1. In aspergilloma, the cell population of neutrophils in BALF increased compared with control groups (p < 0.01) and other pulmonary infectious disease. 2. The serum and BALF levels of MCZ ranged from 0.1 to 0.3 micrograms/ml, < 0.1 14.4 micrograms/ml, respectively. On the other hand, the serum and BALF levels of 5-FC ranged from < 0.2 to 9.3 micrograms/ml, and < 0.4 to 1.5 micrograms/ml, respectively. From these results, we consider that neutrophils play the main role in the immune host defense in aspergilloma, and the combination of intracavitary infusion of MCZ and oral administration of 5-FC should be the treatment of choice.

Peroxidase activity and cell differentiation in developing salivary glands of the rats

Peroxidase (PO) activity-positive cells were found to develop in both the sublingual and submandibular glands of the rat on day 19 of gestation. The PO activity in the nuclear envelope (NE), endoplasmic reticulum (ER), Golgi apparatus (G) and secretory granules (SG) of these cells were enhanced day by day. However, no PO activity was detected in the parotid gland on the same day. In the parotid gland PO-positive cells were detected first on postnatal day 1. After birth the PO activity in the SG of both the sublingual and submandibular glands gradually diminished in intensity and disappeared, whereas the activity persisted in the parotid gland. From postnatal day 1 to 14, the NE and ER of the cells in the parotid and sublingual glands exhibited intense PO activity, while cells containing mucous SG appeared. The cells were identified as mucoserous acinar cells. These mucoserous cells later differentiated into different cell types: serous cells in the parotid gland and mucous cells in the sublingual gland. As the submandibular gland developed, PO activity-positive serous cells also differentiated into mucoserous cells and the activity in the G and SG disappeared. The parotid, sublingual and submandibular glands of perinatal rats have clearly showed varied growth, with the advent processes of PO activity and cell differentiation, whereas PO activity in the G concomitantly occurred with SG activity.

Early ultrastructural glomerular alterations in neonatal nephrotic mice (ICGN strain)

ICGN is a strain of mice with hereditary nephrotic syndrome of an unknown cause. In this study, early glomerular alterations in newborn ICGN mice were observed with electron microscopy to gain a better insight into the onset of the disease. Development of the glomeruli was normal until fusion of epithelial and endothelial basement membranes in the developing capillary stage. From the maturing glomerulus stage onward, the fused glomerular basement membrane (GBM) increased in thickness by excessive accumulation of the basement membrane material secreted from the epithelial cells. This accumulation was followed by overall loss of epithelial foot processes in the glomeruli. These findings indicate that the disease in ICGN mice is caused by some defect(s) in the GMB maturation process, which may be crucial for the generation of the glomerular permselectivity.

A recurrent case of spontaneous mediastinal emphysema

The first case of spontaneous mediastinal emphysema was reported by Hamman et al. in 1939. It is a rare condition that primarily occurs in young adults. In many instances, spontaneous mediastinal emphysema is caused by yelling, shouting or active exercise, but the cause is often unknown. It is rare for cases of spontaneous mediastinal emphysema to recur. Recently, we experienced a recurrent case of spontaneous mediastinal emphysema in a patient with a duodenal ulcer. Vomiting appeared to be the cause of the recurrence in our patient. Of the 58 patients with spontaneous mediastinal emphysema who have been reported in Japan so far, recurrences were documented only in our patient and two others.

[Highlateral approach to the lesions around the upper cervical vertebrae and foramen magnum]

In the present paper, we describe the surgical techniques of high lateral cervical approach and its feasibility for the excision of tumors located in the ventral or lateral aspect of the upper cervical vertebrae and of the craniovertebral junction. The patient is positioned laterally on the operating table, but the operator's position and the skin incision are slightly altered depending on the location of the tumor. When the lesion is situated below C1, the ipsilateral shoulder is pulled down toward the back. The operator stands rostral to the head. The attachment of the sternocleidomastoid muscle to the mastoid is detached and reflected anteriorly through a retroauricular curved skin incision. The posterior cervical muscles such as the splenius capitis, longissimus capitis, semi-spinalis capitis are detached from the occipit and retracted posteriorly. At this point, the transverse process of C1 and the articular facet of the vertebrae of C2-C4 are identified by palpation. According to the tumor location, the muscles attached to the relevant transverse processes and facets are divided and reflected posteriorly. Through careful dissection, the cervical nerve roots and the vertebral artery are exposed. The root sleeves as well as thecal sac may be exposed by resecting the posterior two-thirds of the superior and inferior articular facets and the adjacent laminae of the vertebrae. In case the whole facet was removed, an iliac bone graft is placed between the remaining transverse processes and the laminae above and below for fixation.(ABSTRACT TRUNCATED AT 250 WORDS)

Morphological studies on the kidney of the spontaneous nephrotic (ICGN) mice in the late stage

Spontaneous nephrotic (ICGN) mice develop proteinuria, hypoproteinemia and hypercholesterolemia. These symptoms steadily progress to chronic renal failure. Details of the changes of the kidney, in the late stage (more than 5 months old) were investigated by both light and electron microscopy. The kidney exhibited a slightly whitish, granular surface and the cortex became thinner and contained fibrous lesions, in which clusters of unaffected and occluded renal tubules were randomly scattered. In the juxtamedullary and outer medullary zone, there were highly dilated renal tubules, which sometimes contained urinary casts. The glomerulus exhibited basement membrane thickening in the capillary loops and the capillary lumen was narrowed in size and sometimes occluded. No detachment of the podocyte from the basement membrane was observed and the podocyte foot-processes were extensively fused, causing their characteristic slits to be lost. The thickened basement membranes were found both in the glomerulus and around the occluded renal tubules, while the basement membrane in the dilated renal tubule appeared normal. Therefore, the basement membranes of the glomerulus and renal tubules appear to react differently in the pathogenesis of the condition. In conclusion, ICGN mice are a good model for not only the nephrotic syndrome but also for chronic renal failure.

ATP-evoked membrane current in guinea pig adrenal chromaffin cells

Adenosine 5'-triphosphate (ATP) evoked an inward current in whole-cell voltage-clamped adrenal chromaffin cells of the guinea pig. The reversal potential (Erev) of ATP-evoked current was about 0 mV in normal external solution and was shifted towards negative potentials by substituting Tris+ or sucrose, but not Ca2+, for the extracellular Na+. This current was mediated by the activation of non-selective cation channels and had some different properties from nicotinic current. It is suggested that these channels may function as a part of the ATP-induced Ca2+ influx pathway in guinea pig chromaffin cells.

[Perinodal cryomodification for supraventricular tachycardia]

The perinodal cryomodification procedure ablates the surrounding tissue of atrioventricular node, as a consequence, eliminates atrioventricular nodal reentrant tachycardia (AVNRT) and reduces the ventricular response during atrial fibrillation. We performed the procedure in 4 patients: 2 patients with AVNRT, 1 patient with atrioventricular reciprocating tachycardia utilizing a left side accessory pathway and atrioventricular node dual pathways, and 1 patient with tachycardic atrial fibrillation. The concomitant procedures include a closure of atrial septal defect and a mitral valve replacement. All the patients survived the procedure and cured the tachycardia. Post operative electrophysiological studies showed that the retrograde conduction over the atrioventricular node was eliminated while the antegrade conduction was preserved in the patients with atrioventricular node dual pathways. The perinodal cryomodification is a safe and effective procedure to cure the tachycardia, particularly in the patients with a structural heart disease.

Localization of various forms of the gamma subunit of G protein in neural and nonneural tissues

For a study of the localization of various forms of the gamma subunit of G proteins, antibodies were raised in rabbits against peptides that corresponded to partial amino acid sequences of bovine gamma 2, gamma 3, gamma 5, and gamma 7. Affinity-purified antibodies against gamma 2, gamma 3, and gamma 5 reacted specifically with gamma 2, gamma 3, and gamma 5, respectively, but the antibody against gamma 7 reacted with gamma 2, gamma 3, and a novel gamma subunit, designated gamma S1, as well as with gamma 7. Because these antibodies reacted with the respective forms of the gamma subunit from rat brain, we investigated the localization of gamma subunits in the rat. gamma 2 and gamma 3 were abundant in all regions in the brain, whereas the concentration of gamma 5 and gamma 7 was relatively low with the single exception being a high concentration of gamma 7 in the striatum. The concentration of gamma 2 was consistently high during ontogenic development in the rat brain, whereas gamma 3 appeared about a week after birth and their concentrations then increased until a month after birth. In tissues other than the brain, gamma 3 was observed only in the pituitary gland, whereas gamma 2, gamma 5, and gamma 7 were found in a variety of tissues. In addition, most tissues contained relatively high concentrations of some other gamma subunit, which was detected with an antibody against a gamma 7-derived peptide and appeared to be gamma S1. Among cloned cells tested, gamma 3 was detected only in PC12 pheochromocytoma cells.(ABSTRACT TRUNCATED AT 250 WORDS)

[Study on tumor accumulation property of 99mTc-HM-PAO and 99mTc-MIBI in rabbits bearing VX-2 cancer]

Each of blood flow imaging agents has a potential usefulness as an agent for tumor scintigraphy. The usefulness for tumor scintigraphy of two agents, i.e. cerebral blood flow scintigraphy agent 99mTc-HM-PAO and myocardial blood flow scintigraphy agent 99mTc-MIBI, was comparatively studied using rabbits bearing VX-2 cancer. From then to twenty days after the implantation of VX-2 cancer into the femoral region of five rabbits, tumor to soft tissue accumulation ratio (T/S ratio) of each agent was calculated in early images (5 min after injection) and in late images (50 min after injection). Compared with 99mTc-MIBI, the T/S ratio of 99mTc-HM-PAO was higher and, moreover, the washout was delayed. These results suggest that there is a difference in tumor accumulation property between these two agents.

Rare association of human papillomavirus DNA with esophageal cancer in Japan

To examine whether human papillomavirus (HPV) DNA is associated with esophageal cancer, frozen and paraffin-embedded neoplasms of the upper aerodigestive tract, including esophageal cancer, were investigated. DNA obtained from frozen specimens and cell lines were analyzed by both polymerase chain reaction (PCR) and Southern blot hybridization. DNA from paraffin-embedded samples were analyzed strictly by PCR. DNA of HPV types 6 and 11 was detected in papillomas of the upper respiratory tract at > 50%. However, HPV DNA was infrequently detected in specimens from the upper digestive tract (31 esophageal cancers and 2 esophageal carcinoma--derived cell lines), even by PCR at a sensitivity of 0.1 copy number per cell. These results suggest that the etiologic significance of HPV infection in esophageal cancer is negligible.

[Anterior transcallosal approach for the mass lesions in and around the third ventricle: with particular reference to the method of enlarging the foramen of Monro]

Enlargement of the foramen of Monro is an essential maneuver to obtain an appropriate surgical view when large, solid lesions in and around the third ventricle are to be removed via the anterior transcallosal approach (ATA). For this purpose, three methods, i.e., the subchoroidal, transchororidal, and transfornicial approaches have so far been reported. However, since the locations and the pathological natures of space occupying lesions in this region are widely variable, the indication as well as the feasibility of each approach has remained rather unclear. The present paper deals with our surgical experience with six patients (2 gliomas, 1 angioma, 1 AVM, 1 plexus papilloma, 1 basilar top aneurysm) operated on using the ATA in which variable methods of enlarging the foramen of Monro were employed. Aiming at complete removal or clipping of the lesion, the seemingly best among the above three approaches was determined preoperatively, considering the size, location, and pathological nature of the lesion. The shape of the choroid plexus of the roof of the IIIrd ventricle as revealed by MRI was also taken into account. The subchoroidal, transchoroidal, and the transfornicial approaches were employed in 3, 2, and 1 cases, respectively. Except for one glioma which ended up being removed extensively, all the tumors and AVM were totally removed and the aneurysm successfully clipped. From the above experience, the merits and demerits of each approach for different types of lesions are discussed in view of their suitability for achieving total removal.(ABSTRACT TRUNCATED AT 250 WORDS)

Evidence for a free N-acetylneuraminic acid-hydroxylating enzyme in pig mandibular gland soluble fraction

The activity of a free N-acetylneuraminic acid (Neu5Ac)-hydroxylating enzyme which converted Neu5Ac into N-glycolyl-neuraminic acid (Neu5Gc) was demonstrated in the soluble fraction of pig mandibular gland. The hydroxylation was possible only with NADPH as the electron donor. The apparent Km was 4.5 mM Neu5Ac. At 0.5 mM monovalent cations had no effect on the hydroxylation of Neu5Ac whereas bivalent cations gave varied inhibition capacities ranging from 14 to 75%. EDTA gave a time-dependent enhancement of activity. It was concluded that the enzyme does not require an exogenously added inorganic cofactor. Results from salt fractionation of the soluble fraction and the use of inhibitors such as mercurials suggested that the hydroxylation of Neu5Ac to Neu5Gc may involve other, as yet unknown, component(s) and the possibility of electrons donated by NADPH being transferred to activated molecular oxygen (second substrate). We propose to name this enzyme N-acetyl-neuraminic acid hydroxylase.

Gastrointestinal motor inhibition by exogenous human, salmon, and eel calcitonin in conscious dogs

Effects of synthetic eel (E-), salmon (S-), and human (H-) calcitonin (CT) on gastrointestinal motility were studied in conscious beagle dogs, which had been implanted with strain gauge force transducers. Intramuscular administration of E-, S-, or H-CT interrupted gastric migrating motor complexes, digestive pattern, and gastric emptying. The order of potency was E-CT = S-CT > H-CT. Motor inhibition induced by CT occurred independently of plasma immunoreactive motilin levels or hypocalcemia. In addition, E-CT and S-CT induced vomiting without a retrograde giant contraction (RGC) during the postprandial state. Apomorphine or CuSO4 initiated RGC prior to vomiting. RGC induced by apomorphine was inhibited by pretreatment with E-CT as well as hexamethonium, atropine, or surgical vagotomy. E-CT showed no inhibitory effect on nicotine stimulated contraction of isolated guinea-pig ileum. These results suggest that peripherally administered CT inhibits canine gastrointestinal motility at the central nervous system level by lowering vagal activity.

Isolation of extracellular 28- and 42-kilodalton beta-1,3-glucanases and comparison of three beta-1,3-glucanases produced by Bacillus circulans IAM1165

Bacillus circulans IAM1165 produces three major extracellular beta-1,3-glucanases (molecular masses, 28, 42, and 91 kDa) during the stationary phase of growth. The 28- and 42-kDa enzymes were purified to homogeneity from the culture supernatant in this study. The properties of these two enzymes were examined, together with those of the 91-kDa enzyme previously isolated. The enzymatic properties of the 28- and 42-kDa beta-1,3-glucanases closely resemble each other. The enzymes belong to a category of endo type 1,3-beta-D-glucan glucanohydrolases. The enzymes were active at pH 4.0 to 7.0. The optimum temperature of the reactions was 60 degrees C when laminarin (a soluble beta-1,3-glucan) was used as the substrate at pH 7.0. The enzymes hydrolyzed barley glucan and lichenan (beta-1,3-1,4-glucans) more effectively than laminarin. Of the three enzymes, the 42-kDa enzyme lysed fungal cell walls the most effectively.

Mitochondrial diabetes mellitus--glucose-induced signaling defects and beta-cell loss

Japanese diabetic patients whose mothers were also diabetic were screened, using peripheral leukocytes, for an A to G transition at nucleotide pair 3243 of the mitochondrial gene, a tRNA(Leu)(UUR) mutation. This mutation was identified in four pedigrees from among 300 unrelated patients. Diabetes mellitus cosegretated with the mutation, except in 1 young subject, and was maternally inherited. Long-term follow-up revealed that the underlying disorder in affected members is a progressive impairment of insulin secretion. In accord with this finding, this mutation was found to be highly prevalent in a subset of diabetes mellitus called slowly progressive IDDM; the mutation was identified in 3 of 27 Japanese patients enrolled in the prospective study of islet cell antibody (ICA)-positive, initially non-insulin-dependent diabetic patients, who are very likely to become insulin dependent in several years. The histologic characteristics of slowly progressive IDDM include loss, though incomplete, of pancreatic beta-cells. Mitochondrial gene defects in beta-cells could therefore cause glucose-induced signaling defects as well as beta-cell loss, which explains the wide range of diabetic phenotypes, from NIDDM phenotype to IDDM, in patients with this mitochondrial gene mutation.

The G-protein G(o) in mammalian cardiac muscle: localization and coupling to A1 adenosine receptors

To investigate the functional relevance of the G-protein G(o) to adenosine-induced effects in the heart, we studied the localization of G(o) and its interaction with A1 adenosine receptors. Concentrations of G(o) in various mammalian hearts differed markedly between the atrial and the ventricular muscle, as well as among species. In most species examined, the concentration of G(o) was much higher in the atrium than in the ventricle. The highest levels of G(o) in atria and ventricles were found in the ferret heart. An immunohistochemical study of the ferret heart with G(o) alpha-specific antibodies showed that G(o) was localized throughout the membranes of cardiac myocytes, including the intercalated disks. In addition, G(o) was densely distributed in the nerve fibers and Purkinje fibers. Analyses of G(o) alpha subtypes showed that bovine atrium mainly contained G(o)A alpha, while bovine ventricle contained only G(o)B alpha. By contrast, ferret ventricle contained both subtypes of G(o) alpha. To study the coupling of G(o) to A1 adenosine receptors, receptors in ventricular membranes of ferrets, which had been pretreated with pertussis toxin, or purified receptors were reconstituted with purified G(o)A and G(o)B. The reconstitution experiments indicated that both subtypes of G(o) coupled with A1 adenosine receptors. These results suggest that the effect of adenosine is mediated by both G(o)A and G(o)B in membranes of ferret cardiac myocytes.

Characterization of interactions between transducin alpha/beta gamma-subunits and lipid membranes

The gamma-subunits of heterotrimeric guanine nucleotide-binding regulatory proteins (G-proteins) are isoprenylated and alpha-carboxyl methylated at their COOH-terminal cysteine residues. These modifications are necessary for membrane attachment of the beta gamma complex, but a requirement of an additional factor has been proposed for the stable binding. We explored a possible contribution of the blocked amino terminus of beta-subunits of bovine photoreceptor G-protein, transducin (T alpha/T beta gamma = Gt alpha/beta 1 gamma 1), and of three beta gamma complexes (beta 1 gamma 2, beta 1 gamma 3, and beta 1 gamma 7) purified from bovine brains. Structural analyses revealed that every beta 1-subunit has an N-acetylated serine, which is unlikely to contribute to the membrane association. Since neither protease nor heat treatment of photoreceptor membranes affected the membrane binding of T beta gamma, it seems unlikely that rhodopsin (or other membrane proteins) serves as an anchor protein for accepting T beta gamma. In fact, T beta gamma bound to phospholipid large unilamellar vesicles (LUVs), of which the polar head groups strongly influenced the binding: T beta gamma alone showed 2-fold higher binding for negatively charged phosphatidylserine-LUVs than for neutral phosphatidylcholine (PC)-LUVs, while the affinity of T alpha/T beta gamma complex for the phosphatidylserine-LUVs was lower than that for the PC-LUVs. These results indicate that 1) an ionic interaction between T beta gamma and membrane surface plays an important role in the stable membrane association, and 2) the domain(s) of T beta gamma responsible for the association would be different between trimeric and dissociated states. We also found that synthetic peptides corresponding to the COOH-terminal region of T gamma inhibited T alpha-T beta gamma interaction only when the peptides were isoprenylated. This suggests that the isoprenyl moiety is located at the contact site between the subunits, not at the membrane-binding domain, when T beta gamma is complexed with T alpha.

CD3-negative lymphoproliferative disease of granular lymphocytes in a girl with an unusual pattern of anti-Epstein-Barr virus antibodies

We describe an 11-year-old girl who initially had mild hepatosplenomegaly and then presented with abnormal expansion of CD3-negative granular lymphocytes in peripheral blood and Epstein-Barr virus (EBV) genome in the DNA obtained from the peripheral blood mononuclear cells (PBMNC). After approximately 3 years, she developed oedema, ascites, marked hepatosplenomegaly, and pancytopenia, and showed both a profile of anti-EBV antibodies of reactivated infection and a high titre of anti-cytomegalovirus antibody. Although she was treated with antibiotics, ganciclovir, and prednisolone, she died of hepatic failure.

CONCLUSION

Careful clinical observation, periodic examination of anti-EBV antibodies, and the analysis of EBV genome from PBMNC are needed in young patients with CD3-negative lymphoproliferative disease of granular lymphocytes.

Synthesis and human immunodeficiency virus (HIV)-1 protease inhibitory activity of tripeptide analogues containing a dioxoethylene moiety

Tripeptide analogues 2 and 3 containing a dioxoethylene moiety were designed based on the characteristic structure of the naturally occurring human immunodeficiency virus (HIV)-1 protease inhibitors RPI-856 A, B, C and D (1). The compounds (2, 3) prepared showed high inhibitory activity, comparable to that of RPI-856 A, against HIV-1 protease in vitro.

High frequency of cancer patients with abnormal assembly of the T cell receptor-CD3 complex in peripheral blood T lymphocytes

Structural abnormality of T cell receptor (TCR)-CD3 complex on the cell surface was investigated in peripheral blood lymphocytes (PBL) from 55 cancer patients. In 24 of the 68 tests done on these patients, the CD3 zeta chain was not detected by immunoprecipitation with anti-CD3 epsilon monoclonal antibody (mAb), but was observed with anti-CD3 zeta mAb, suggesting that a high frequency of cancer patients possesses abnormal T cell receptor (TCR) complex in PBL. On the other hand, the total zeta chain was missing in several advanced cases. During follow-up of several patients, the zeta chain became undetectable after two or three months of cancer progression. It appears that immunosuppressive status can be monitored by analyzing the TCR-CD3 complex on the cell surface of PBL.