[A case of endodermal cyst in front of the pontomedullary junction]

We reported a rare case of an endodermal cyst on the posterior fossa. The patient was a 51-year-old woman with tinnitus, ear blockage and a mild swallowing disturbance. MR images revealed a cystic mass 5 cm in diameter in front of the pontomedullary junction. Gadolinium-enhanced images showed some spotty lesions in the cystic mass. The brain stem was compressed strongly by the mass. The left vertebral artery was involved in the mass. Total removal of the tumor was performed via the transcondylar approach. During the operation the lower cranial nerves, the bilateral vertebral artery and the vertebral union were recognized. The cystic mass consisted of a yellow colored thin wall and a watery fluid which contained some small hard lesions. Histopathological examination of the cyst wall revealed a single layer of ciliated columnar epithelium, and that of the small lesions showed histiocytes and granulation. Immunohistochemically, the cyst wall was stained by an epithelial membrane antigen and a carcinoembryonic antigen. From these histopathological findings, the final diagnosis of the cystic lesion was an endodermal cyst. Twenty such cases have been reported to date since Afshar reported a case of an endodermal cyst on the posterior fossa in 1981. There are many types of cystic lesions in the intracranial region, and immunohistochemical studies are necessary for diagnosis of these intracranial cysts.

Inhibition of theophylline metabolism by aciclovir

We report a case of side effects caused by the increase in plasma theophylline concentration after coadministration of aciclovir had been started during theophylline therapy. Interaction between theophylline and aciclovir has not previously been reported. Therefore, a study of the pharmacokinetic and metabolic interactions between theophylline and aciclovir was carried out in five healthy male volunteers. All subjects received a single oral dose of 320 mg theophylline (aminophylline, 400 mg) after they had taken oral aciclovir 800 mg five times daily for two consecutive days. The area under the curve from 0 to infinity of theophylline (AUC0-infinity) after coadministration of aciclovir was increased from 189.9 +/- 18.2 to 274.9 +/- 34.3 micrograms.h/ml (p < 0.01), and total body clearance was decreased from 28.4 +/- 2.9 to 19.8 +/- 2.5 ml/h/kg (p < 0.01). Further, there was a significant increase in urinary theophylline and decreases in urinary 1,3-dimethyluric acid and 1-methyluric acid after coadministration of aciclovir. The decrease in total body clearance is likely to have resulted from inhibition of metabolism via the oxidation pathway. The results indicated that with aciclovir therapy lower doses of theophylline might be necessary and careful monitoring of plasma concentrations was essential.

[Optimal administration in combination chemotherapy with 5-fluorouracil and cisplatin for gastric cancer]

To investigate an optimal administration method in combination chemotherapy with 5-fluorouracil (5-FU) and cisplatin (CDDP), the clinical results of this combination therapy are reviewed. The overall response rate of this combination is 30-50%, and these results are equivalent to those of conventional combination therapy for gastric cancer. It is expected that this combination will become the standard chemotherapy for gastric cancer. Although there are several schedules of 5-FU/ CDDP combination based on the biochemical modulation theory, there are no significant differences among the individual response rates. Therefore, the schedule of this combination should change depending on the clinical condition of the patient and so on. Low-dose CDDP administration is useful, because of fewer side effects. Bolus administration of 5-FU should be considered especially for gastric cancer.

Simultaneous observation of regional cerebral blood flow and event-related potential during performance of an auditory task

Reduced amplitude of the P300 component has been reported consistently in patients with neurological and psychiatric disorders. It is unclear, however, how such patients' cognitive dysfunction is related to their P300 abnormality. Further basic knowledge regarding neural substrates for P300 generation is required for gaining an understanding of the pathological significance of the P300 amplitude reduction. To determine the brain structures involved in P300 generation, we observed the event-related potential and the regional cerebral blood flow (rCBF) in 10 normal subjects performing an oddball discrimination of pure tones. The rCBF value was assessed quantitatively with the aid of single photon emission computed tomography using technetium-99m hexamethylpropylene amine oxime. During the task performance, significant activation was observed in the posterior superior temporal and inferior parietal regions of the right hemisphere. In addition, positive correlation of the task-related increase in rCBF with the simultaneously recorded P300 amplitude was observed in the right but not the left posterior superior temporal region. These findings indicate that activation of the right non-verbal auditory area might modulate P300 generation during pure-tone discrimination.

[Antigenicity tests of a new antineoplastic agent S-1]

The antigenicity was tested of a new antineoplastic agent S-1 (a combination of tegafur (FT), CDHP and potassium oxonate (Oxo)) in mice and guinea pigs. 1. Male BALB/c or C3H/He mice were sensitized with S-1, CDHP, Oxo, and conjugates of CDHP (or Oxo) and human serum albumin (HSA). S-1 was administered by oral gavage, and the other compounds were administered intraperitoneally with adjuvant (alum). In the heterologous passive cutaneous anaphylaxis (PCA) test, using Sprague-Dawley rats as recipients, no IgE antibodies against S-1, CDHP, or Oxo were detected to any serum obtained from the sensitized mice, and no eliciting antigenicities were seen for CDHP or Oxo. 2. Male Hartley guinea pigs were sensitized with S-1, CDHP, Oxo, and conjugates of CDHP (or Oxo) and HSA. S-1 was administered by oral gavage, and the other compounds were administered subcutaneously with Freund's complete adjuvant (FCA). The homologous PCA test, active systemic anaphylaxis test, and passive hemagglutination test showed no production of antibodies against S-1, CDHP, or Oxo in any sensitized guinea pig, and no eliciting antigenicities for CDHP or Oxo. 3. Female Hartley guinea pigs were sensitized with S-1 subcutaneously with FCA. The active cutaneous anaphylaxis test revealed that S-1 did not induce cell-mediated delayed type hypersensitivity. 4. These results indicated that S-1, Oxo, and CDHP were not antigenic in mice and guinea pigs.

[Mutagenicity study of a new antineoplastic agent S-1, and its components, CDHP, and Oxo]

S-1 is a new antineoplastic agent of a fluorinated pyrimidine derivative containing tegafur (FT), 5-chloro-2,4-dihydroxypyridine (CDHP) and potassium oxonate (Oxo) in a molar ratio of 1:0.4:1 with the aim of prolonging the effective plasma concentration of 5-fluorouracil (5-FU) and reducing its dose-limiting gastrointestinal toxicity. As a part of the safety evaluation of S-1, reverse mutation tests using bacteria and chromosomal aberration tests using cultured cells, CHL/IU, were conducted to test the in vitro mutagenicity of S-1, CDHP and Oxo. All S-1 doses are expressed as the content of FT. 1. The reverse mutation tests were carried out on S-1 at 1.02-520 micrograms/plate, on CDHP at 39.1-5000 micrograms/plate, and on Oxo at 78.1-5000 micrograms/plate using Salmonella typhimurium strains TA100, TA1535, TA98, and TA1537 and Escherichia coli WP2uvrA. None of the test compounds induced a significant increase over solvent controls in the number of mutant colonies in any tester strains in either system, with or without mammalian metabolic activation (S9 Mix). 2. For the in vitro chromosomal aberration tests, Chinese hamster lung cells (CHL/IU), were treated with S-1 at 27.5-220 micrograms/ml for 24 hr or at 6.88-27.5 micrograms/ml for 48 hr without S9 Mix, and at 110-880 micrograms/ml with S9 Mix, with CDHP at 365-1460 micrograms/ml (10 mM), and with Oxo at 122-1950 micrograms/ml (10 mM), with and without S9 Mix. S-1 with and without S9 Mix, and Oxo only for 48 h treatment without S9 Mix, induced chromosomal aberrations, while CDHP did not. 3. The present study indicates that S-1 was nonmutagenic in bacteria, but clastogenic in vitro. CDHP had no in vitro mutagenic or clastogenic activity. Oxo was positive in the in vitro chromosomal aberration test, but negative in the reverse mutation test.

[Immunotoxic effects of a new antineoplastic agent S-1 in mice--comparison with S-1, UFT and 5-FU]

The immunotoxicity of S-1, which is a new antineoplastic agent, was investigated in BALB/c mice. S-1 contains tegafur (FT), CDHP, and potassium oxonate (Oxo) in a molecular ratio of 1:0.4:1. 5-fluorouracil (5-FU) and UFT were used as reference drugs. S-1 and reference drugs were administered by oral gavage for 7 days. The high dose employed in this study was determined as the maximally tolerated dose of a 9-day repeated-dose study in sarcoma 180-bearing mice. Decreased body weight was observed in mice treated with 5-FU and UFT but not in those treated with S-1. A significant decrease in thymus and spleen weight was observed in S-1-, UFT- and 5-FU-treated mice, and the degree was same for the three drugs. Though the number of white blood cells decreased dose-dependently for the three drugs, S-1 had the weakest effect. The number of red blood cells also decreased, but the effect was not dose-dependent, and its magnitude was the same for the 3 drugs. S-1 induced a dose-dependent decrease in the IgM antibody PFC response to sheep erythrocytes. The delayed type hypersensitivity response used a footpad reaction method was significantly suppressed at the highest dose of S-1. 5-FU and UFT suppressed humoral and cell-mediated immunity in almost the same manner as S-1. The degree of suppressive effects was greater on the humoral immune response than on the cell-mediated immune response. The number of CFU-GM colonies was significantly decreased in the highest dose group of each drug and in a lower group as well in S-1-treated mice. This finding might reflect the fact that S-1 induced continuous high levels of 5-FU in the blood. Under these experimental conditions, S-1 induced immunosuppressive effects in BALB/c mice, and the degree of suppression was almost same as that induced by 5-FU and UFT.

A case of hepatocellular carcinoma effectively treated with epirubicin aqueous vesicles in monodispersed iodized poppy-seed oil microdroplets

A 64-year-old woman with a solitary mass (18 mm in diameter) of hepatocellular carcinoma underwent hepatic arterial infusion therapy with water-in-oil-in-water emulsion (W/O/W) prepared by the membrane emulsification technique using a controlled pore glass membrane. In the W/O/W, numerous microdroplets of iodized poppy-seed oil (IPSO), which contained many vesicles of aqueous solution of epirubicin, were suspended in the external aqueous phase. The mean diameter of the IPSO microdroplets was 30 microns. Seventeen milliliters of the W/O/W containing 40 mg of epirubicin and 5 ml of IPSO was infused into the proper hepatic artery. No severe side effects were encountered. Computed tomography taken 3 days after the treatment revealed a clearly defined deposition of IPSO within the tumor. Serum alpha-fetoprotein levels, 5.35x10(3) ng/ml, before treatment, decreased to 131 ng/ml on 38 days after treatment. The tumor was extirpated and histopathological examination revealed complete necrosis of the tumor.

Immunotoxic effect of low dose cisplatin in mice

The immunosuppressive effects of cisplatin at relatively low doses were investigated in CD-1 mice. Mice were injected intraperitoneally with 8, 40 and 200 micrograms/kg cisplatin for 10 days. A decrease in body and thymus weights was observed at 200 micrograms/kg. Though there were no dose-related effects on the IgM antibody response to sheep erythrocytes, a statistically significant reduction of the contact hypersensitivity response (CHR) was seen at 200 micrograms/kg. In vivo and in vitro effects of cisplatin on T- and B-lymphocyte function were assessed by proliferative response to concanavalin A and lipopolysaccharide, respectively. Cisplatin inhibited splenic T-lymphocyte function more than splenic B-lymphocyte function. These data indicate that a relatively low dose of cisplatin induce immunosuppressive effects in mice with a greater effect on T-lymphocytes than the B-lymphocytes.

Histamine augments VCAM-1 expression on IL-4- and TNF-alpha-stimulated human umbilical vein endothelial cells

Interaction between vascular cell adhesion molecule-1 (VCAM-1) on endothelial cells and CD49d molecules on eosinophils is thought to mediate the selective infiltration of eosinophils into inflamed tissues in allergic disease. IL-4 and TNF-alpha are associated with allergic conditions, and they have been shown to selectively augment VCAM-1 expression on endothelial cells, suggesting that they may be responsible for VCAM-1 expression in allergic disease. We used immunocytochemical staining analysis to examine the effect of chemical mediators, including histamine, leukotrienes and platelet-activating factor (PAF), on VCAM-1 expression in IL-4- and TNF-alpha-stimulated endothelial cells. Histamine, significantly augmented (p < 0.05 to p < 0.01) VCAM-1 expression in both IL-4- and TNF-alpha-stimulated endothelial cells. IL-4 and TNF-alpha were found to have a synergistic effect on endothelial cell VCAM-1 expression, when compared with the effect of stimulation with each of these cytokines separately, and the addition of histamine further increased VCAM-1 expression. This enhancing effect of histamine was inhibited by the presence of mepyramine and thioperamide but not by cimetidine. Another chemical mediator, PAF, failed to induce any increase in VCAM-1 expression, however, leukotrienes augmented it slightly in a narrow range of concentrations. The histamine-induced augmentation of VCAM-1 expression was reflected functionally by many more eosinophils attaching to endothelial cells than to cells stimulated with both cytokines. This attachment of eosinophils was inhibited by the presence of antibody to VCAM-1 and CD49d. Addition of histamine 10 h after stimulation with both cytokines still induced an increase in VCAM-1 expression. In addition, an inhibitor of RNA polymerase, alpha-amanitin, dose-dependently decreased this histamine-induced augmentation of VCAM-1 expression. These findings strongly suggest that histamine upregulates VCAM-1 expression at the transcriptional level through newly generated of mRNA in endothelial cells stimulated with IL-4 and TNF-alpha.

[Inhibition of proliferation by retinoic acid on adult T cell leukemia cells]

We observed the effects of the retinoic acid (13-cis retinoic acid; 13-cis RA, and all-trans retinoic acid; ATRA) for the cell growth and the expression of CD 25 on peripheral blood mononuclear cells (PBMC) from 17 patients with adult T cell leukemia (ATL). Fourteen had acute type, 1 had chronic type, and 2 had smoldering type of ATL. We divided those patient into 3 groups (hyper-sensitive, sensitive and resistant group) by determined with reduction rate of [3H]-thymidine incorporation obtained before and after treatment with 13 -cis RA or ATRA respectively. Growth inhibition was not observed in normal PBMC by 13 -cis RA or ATRA. However, no down-regulation of CD 25 expression was observed on PBMC in all patients and normal individuals after treatment with 13-cis RA or ATRA. In the aspect of growth inhibition on PBMC in ATL patients, we tried to clarify the mechanism of the phenomenon. In agarose gel electrophoresis, extracted genomic DNA from retinoic acid treated PBMC in hyper-sensitive and sensitive ATL patients showed multimer DNA fragmentation pattern. On the other hand, genomic DNA from PBMC after treatment with retinoic acid in resistant ATL patients and normal individuals showed high molecular DNA pattern without fragmentation. Taken together, it is suggested that retinoic acid could induce growth inhibition of PBMC in some ATL patients resulting in DNA fragmentation, apoptosis. We deeply consider that retinoic acid may be an useful agent for ATL patients in clinical aspect.

Clinical usefulness of serum cytokeratin 19 fragment as a tumor marker for lung cancer

Serum soluble cytokeratin 19 fragment (CYFRA) levels were measured in 251 patients with lung cancer and 139 patients with benign lung diseases to determine the clinical usefulness of CYFRA level determination in the diagnosis and monitoring of lung cancer. Serum levels of CYFRA were measured by a 2-step sandwich ELISA method. When the cut-off value was defined as 3.5 ng/ml, which was associated with a specificity of 95% for benign lung diseases, CYFRA had a high sensitivity (53%) in all patients with lung cancer. Both the serum level of CYFRA and its sensitivity increased significantly with the increase in clinical stage. A comparison of areas under receiver operating characteristic curves showed that CYFRA had the most power of discrimination in the diagnosis of lung cancer among markers including carcinoembryonic antigen, squamous cell carcinoma antigen, carbohydrate antigen 19-9, and neuron-specific enolase. A good correlation was found between serial changes in serum CYFRA levels during therapy and clinical responses for 18 patients who underwent chemotherapy and/or radiotherapy. Our findings suggest that CYFRA may be a marker of choice for screening and monitoring of lung cancer, particularly squamous cell carcinoma.

Prevalence of hepatitis C virus infection among female prostitutes in Fukuoka, Japan

To assess the risk of sexual transmission of hepatitis C virus (HCV), we surveyed female prostitutes to determine the prevalence of antibody to HCV (anti-HCV) and HCV RNA. Anti-HCV was examined with a second generation anti-HCV test employing a passive hemagglutination assay. HCV RNA was detected by two-stage polymerase chain reaction with primers deduced from the 5'-noncoding region of the HCV genome. All studies were performed in Fukuoka, Japan, from 1989 through 1992 and all subjects were Japanese and had no history of intravenous drug abuse. The prevalence of anti-HCV was significantly higher in the prostitutes (10.1%; 61/604) than in the controls (female blood donors; 0.8%; 52/6632) (P < 0.001). HCV RNA was found in 73.2% of the anti-HCV-positive prostitutes. The prevalence of anti-HCV among prostitutes increased with the number of years spent in prostitution (P < 0.05). Prostitutes with a history of syphilis had a higher prevalence of anti-HCV than those with no history of syphilis, irrespective of the number of years in prostitution. In a longitudinal study of 244 prostitutes, 2 of the 218 initially seronegative subjects showed anti-HCV and HCV RNA over the study period of 3 years. These two persons had no history of percutaneous exposure. Sexual transmission of HCV presents a risk for female prostitutes.

A fibrous histiocytoma with a polypoid pattern of growth in a major bronchus

A 47-year-old man was admitted to our hospital for abrupt onset of hemoptysis and dyspnea. Chest roentgenography revealed a left lower mass shadow with obstruction of the left main bronchus. However, on the third hospital day, he expectorated a coagulum-like substance which resembled bronchial tree, and his symptoms then dramatically subsided. Except for small amounts of bleeding from left B10a, the endobronchus was intact on bronchoscopic examination, and the pathologic diagnosis of the tumor using resected material was fibrous histiocytoma of low-grade malignancy. In addition, given the similarity in histologic findings between the expectorated substance and resected tumor, the expectorated substance was considered to be a part of the tumor which had grown along the endobronchial tree.

Three-dimensional brain visualization for metachromatic leukodystrophy

The basic understanding of many neurogenetic diseases requires study of the clinical, biochemical, and pathological aspects. To study the pathological aspects, the organs affected by the disease must be observed. We have used volume visualization techniques to create three-dimensional (3D) brain images of a patient with late infantile metachromatic leukodystrophy (MLD). The 3D brain images showed clearly, stereographically, and non-invasively the intracerebral lesion. This lesion, which indicated hyperintensity in magnetic resonance (MR) images, extended throughout the periventricular white matter. The 3D brain images are provided to integrate information. Volumetric ray-casting was useful in obtaining directly images of the entire brain and in allowing an intuitive understanding of the extension of the lesion in three dimensions and of the extent of the defects in the MLD brain. Isosurfacing facilitated a clear extraction of the lesion located by volumetric ray-casting. Each technique used in this study played a role in visualization and their use was complementary. 3D brain images will promote morphological investigation of neurogenetic diseases.

Angiotensin-converting enzyme gene polymorphism in hypertensive individuals with parental history of stroke

BACKGROUND AND PURPOSE

It has been suggested that the insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene is an independent risk factor for coronary artery disease, but its relation to stroke has not yet been proven. We investigated an association of ACE gene polymorphism with parental history of stroke (PHS) in patients with hypertension.

METHODS

We studied 70 hypertensive patients (ambulatory blood pressure > 140/90 mm Hg; age, 59 +/- 11 years) with (n = 27) or without (n = 43) PHS, defined as either one or both parents having had a stroke before 60 years of age. The ACE genotype was analyzed by polymerase chain reaction.

RESULTS

Casual blood pressure and mean ambulatory blood pressure levels were not significantly different between patients with and without PHS. The incidence of left ventricular hypertrophy also did not differ significantly between the two groups. However, the frequency of the D allele was significantly higher in patients with PHS (0.72) than in patients without PHS (0.52) (chi 2 = 5.472, P = .019). The frequency of the DD genotype of the ACE gene was also significantly higher in patients with than in those without PHS (DD, 63.0%; ID, 18.5%; II, 18.5% versus DD, 32.6%; ID, 39.5%; II, 27.9%; chi 2 = 6.395, P = .041).

CONCLUSIONS

The DD genotype of the ACE gene is associated with PHS in patients with hypertension, which is independent of blood pressure levels or presence of cardiac hypertrophy.

Primary lung cancer associated with diffuse granulomatous lesions in the pulmonary parenchyma

A 60-year-old man was admitted to our hospital for productive cough. Chest roentgenography and CT scan disclosed a left hilar tumor invading the mediastinum, with mediastinal lymphadenopathy and diffuse micronodular shadows in both lung fields. A biopsied sample of the tumor revealed squamous cell carcinoma, while noncaseating epithelioid cell granulomas were observed in the samples obtained by transbronchial lung biopsy. The granulomas in the pulmonary parenchyma were determined to be sarcoid reactions secondary to lung cancer, since there was no evidence of sarcoidosis. Combination chemotherapy was effective for the tumor, and the granulomas disappeared after completion of the chemotherapy. These findings suggest the presence of a relationship between sarcoid reactions and lung cancer in this case.

[Effects of intra-hepatic arterial injection of mitoxantrone for hepatocellular carcinoma]

Twenty patients with unresectable hepatoma, recurrent hepatoma or metastatic liver cancer were treated by intra-hepatic arterial injection of mitoxantrone, and its effectiveness and side effects were studied. In 35.5% of the patients, complete or partial responses were seen. The survival intervals after the beginning of therapy were from one to 21 months (mean, 9.4 months) and one-year survival ratio was 56.3%. Red blood cell, leukocyte, and platelet counts diminished significantly one week later after administration of mitoxantrone compared with the pre-administration levels. Severe hepatic dysfunction has not been experienced.

Sonochemical formation of gold particles in aqueous solution

Gold(III) ions in aqueous solutions of NaAuCl4 were reduced to form gold particles by ultrasonic irradiation. The rate of formation of gold particles was accelerated in the presence of certain organic additives such as surfactants, water-soluble polymers and aliphatic alcohols and ketones. The rates of formation of gold particles from 1 mM Au(III) ions in pure water were 3 microM min-1 under argon atmosphere and approximately zero under air, and in solutions containing additive the rates were 9-133 microM min-1 under argon and 8-40 microM min-1 under air. Surfactants stabilized the particles as colloidal state for more than several months. The rates of formation of both hydrogen atoms and hydroxyl radicals were estimated to be equal to 25 microM min-1 in the sonolysis of pure water under argon. Three reaction pathways leading to the reduction of metal ions were proposed: (1) reduction by hydrogen atoms; (2) reduction by reducing radicals formed via reactions of hydroxyl radicals or hydrogen atoms with the additives; (3) reduction by radicals formed from thermal reaction of the additives at the interfacial region between cavitation bubbles and bulk solution and/or in the cavities. The order of the contribution of these three pathways to the reduction of gold ions was (3) > (2) > (1) in most cases. The number averages of the size of gold particles formed in surfactant solutions under argon atmosphere were about 10 nm with a fairly narrow size distribution.

Phosphodiester amidates of allenic nucleoside analogues: anti-HIV activity and possible mechanism of action

Lipophilic phosphodiester amidates 2a, 2b, 4a, 4b, and 6 derived from anti-HIV agent adenallene 1a, 3a, inactive hypoxallene 1b, 3b, and 9-(4-hydroxy-2-butyn-1-yl)adenine (5) were synthesized and studied as inhibitors of HIV-1 in ATH8 cell system. All phosphodiester amidates were more biologically active than their parent nonphosphorylated compounds. Analogues 2a and 4a derived from (+/-)-adenallene 1a and (R)-enantiomer 3a are effective anti-HIV agents with EC50 approximately 0.88 and 0.21 microM, respectively. Both analogues are 16 and 28 times more effective than parent compounds 1a and 3a, respectively. Some anti-HIV activity of hypoxallene derivatives 2b and 4b was noted in the range of 0.1-10 microM but the dose-response relationship was poor. Phosphodiester amidate analogue 6 also exhibited anti-HIV activity in the range of 0.1-100 microM, but this effect was accompanied by cytotoxicity. Hydrolytic studies performed at pH 9.8 and with pig liver esterase at pH 7.4 have shown that analogue 2a gives adenallene 4'-phosphoralaninate (10a) as the major product. These results can be interpreted in terms of initial hydrolysis of phosphodiester amidates 2a, 2b, 4a, 4b, and 6 catalyzed by intracellular esterase(s) to give stable phosphomonoester amidate intermediates with a free carboxyl group. The results obtained with hypoxallene phosphoramidates 2b and 4b indicate that the aminosuccinate-fumarate enzyme system responsible for activation of AIDS drug ddIno (didanosine, Videx) can also, albeit less efficiently, activate hypoxallene 4'-phosphate (9b) and the respective (R)-enantiomer released inside the HIV-infected cells.

PIG-B, a membrane protein of the endoplasmic reticulum with a large lumenal domain, is involved in transferring the third mannose of the GPI anchor

Many eukaryotic cell surface proteins are bound to the membrane via the glycosylphosphatidylinositol (GPI) anchor that is covalently linked to their carboxy-terminus. The GPI anchor precursor is synthesized in the endoplasmic reticulum (ER) and post-translationally linked to protein. We cloned a human gene termed PIG-B (phosphatidylinositol glycan of complementation class B) that is involved in transferring the third mannose. PIG-B encodes a 554 amino acid, ER transmembrane protein with an amino-terminal portion of approximately 60 amino acids on the cytoplasmic side and a large carboxy-terminal portion of 470 amino acids within the ER lumen. A mutant PIG-B lacking the cytoplasmic portion remains active, indicating that the functional site of PIG-B resides on the lumenal side of the ER membrane. The PIG-B gene was localized to chromosome 15 at q21-q22. This autosomal location would explain why PIG-B is not involved in the defective GPI anchor synthesis in paroxysmal nocturnal hemoglobinuria, which is always caused by a somatic mutation of the X-linked PIG-A gene.

Prognostic factors for patients with advanced non-small cell lung cancer: univariate and multivariate analyses including recursive partitioning and amalgamation

In an attempt to determine the prognostic significance of pretreatment factors for patients with advanced non-small cell lung cancer (NSCLC), 24 pretreatment clinical variables were analyzed for 185 patients with NSCLC who underwent chemotherapy and/or radiotherapy between 1985 and 1994. Following univariate analysis, we applied two multivariate statistical techniques. In a Cox regression mode, independently significant factors influencing patient survival included performance status (PS), disease stage, hemoglobin level, and serum calcium level. Recursive partitioning and amalgamation (RPA) resulted in three distinct prognostic subgroups based on PS, stage, weight loss, and hemoglobin level. The best survival was observed for patients with a good PS and Stage III disease who had a hemoglobin level > 11 g/dl. The worst survival was observed for patients with a poor PS and presence of weight loss irrespective of stage. All other patients had an intermediate prognosis. Median survival times were 95.1 weeks, 17.1 weeks and 39.3 weeks, respectively (P < 0.00005). The results of our analyses show that three important prognostic subgroups could readily be discerned using RPA.

Elevated levels of soluble ICAM-1 in serum of patients with acute myeloid leukemia undergoing bone marrow transplantation

Serum soluble ICAM-1 concentrations were measured in 10 patients with or without chronic graft-vs.-host disease (GVHD) after allogeneic bone marrow transplantation. The serum soluble ICAM-1 levels in the patients with chronic GVHD were significantly higher than that in the patients without chronic GVHD. The data indicated that serum soluble ICAM-1 is a useful parameter for predicting chronic GVHD.

Inhibition of growth and induction of apoptosis by all-trans retinoic acid in lymphoid cell lines transfected with the PML/RAR alpha fusion gene

The interaction of an exogenous PML/RAR alpha fusion gene associated with acute promyelocytic leukaemia, with all-trans retinoic acid (ATRA) was examined in two lymphoid cell lines. L1210 and MOLT-4 cells were transfected with PML/RAR alpha cDNA in the expression vector pGD and stable transformants (L1210PML/RAR alpha and MOLT-4PML/RAR alpha) were selected with G418. ATRA inhibited the growth of these stable transformants, as assessed by [3H]thymidine incorporation, in a dose-dependent manner, but had no effect on the growth of control cells stably transformed with neomycin resistant gene alone. ATRA also induced apoptosis, as assessed by fragmentation of genomic DNA, in L121OPML/RAR alpha and MOLT-4PML/RAR alpha cells but not in control cells. The exogenous PML/RAR alpha fusion gene therefore probably mediates the effects of ATRA on cell growth and apoptosis in these cell lines.