Murine bone morphogenetic protein-4 gene: existence of multiple promoters and exons for the 5'-untranslated region

A murine genomic clone of about 16 kilobases encompassing putatively entire bone morphogenetic protein (BMP)-4 gene has been isolated. Comparison with the cDNA clones revealed the existence of at least five exons on the 3' side of the clone. There are two alternative transcriptional start sites, one is for the first exon the other for the second, the resulting exon organization in mRNA is I-III-IV-V and II-III-IV-V, respectively. The coding region is dispersed between exons IV and V. Both promoter regions carry no canonical TATA box but carry GC rich sequences.

Cutaneous reactions induced by calcium channel blocker: high frequency of psoriasiform eruptions

Fifteen cases with cutaneous reactions to calcium channel blockers (Ca-antagonist), dihydropiridine (including nicardipine, nifedipine, nisoldipine), verapamil, and diltiazem are reported. The patients from Yokohama City University Hospital and affiliated hospitals included 4 males and 11 females with cardiovascular diseases. Their average age was 64.7 (54 to 82) years. They had been taking Ca-antagonists for an average of 95 days (7 days to 10 years) before they developed dermatitis. The frequency of reactions to Ca-antagonists was high with diltiazem (5/16:31.25%) and dihydropyridine (7/16:43.75%), including nifedipine (4/7), nisoldipine (1/7), and nicardipine (2/7). Stevens-Johnson syndrome (MCOS) was associated only with verapamil. A notable type of eruption was the psoriasiform type, including exacerbation of psoriasis, which was resolved or easily controlled after discontinuation of the drug. Provocation tests verified the Ca-antagonist as the cause in 7 cases of psoriasiform eruption. The frequency of positive patch tests to Ca-antagonists was low except for diltiazem. Patch tests with diltiazem showed positive reactions in 54% (7 of 13 patients), based on our experience and papers published in Japan. Ca-antagonists are occasional causes of a wide spectrum of cutaneous reactions and should also be considered as causative factors in patients who develop psoriasiform eruptions or in patients whose psoriasis is exacerbated while using these drugs.

Acute electrolyte disturbances in coronary sinus during left coronary arteriography in man

Electrolyte disturbances, particularly reduction of ionized calcium, induced by iodinated contrast media (CM) are important considerations in coronary arteriography. A study was conducted in 24 patients to evaluate the acute electrolyte alterations in the coronary sinus during left coronary arteriography. During left coronary arteriography, coronary sinus blood was withdrawn for measurement of electrolytes. The CM used were diatrizoate, ioxaglate, iohexol, and iopamidol. The hematocrit was decreased moderately by all 4 CM used at 5 s and returned to the control level at 15 s. The level of ionized calcium was decreased by all CM at 5 s. Prolonged reduction of ionic calcium was observed with diatrizoate and ioxaglate at 15 s. The level of potassium was almost unchanged by diatrizoate and ioxaglate in spite of hemodilution, which may lead us to a hypothesis that potassium can be released from the intracellular spaces such as red blood cells and vascular endothelial cells. Thus the depression of left ventricular function might be caused not only by reduction of ionized calcium, but also by a relative increase in the level of serum potassium.

Protective effect of R(-)-1-(benzo[b]thiophen-5-yl)- 2-[2-(N,N-diethylamino)ethoxy]ethanol hydrochloride (T-588), a novel cerebral activator, against experimental cerebral anoxia

Effects of R(-)-1-(benzo[b]thiophen-5-yl)-2-[2- (N,N-diethylamino)ethoxy]ethanol hydrochloride (T-588) on normobaric hypoxia, histotoxic anoxia by KCN and complete ischemia by decapitation were investigated in mice. T-588 (30-100 mg/kg, p.o.) showed a significant and dose-dependent prolongation of the survival time in all of the models studied. Bifemelane (100-300 mg/kg, p.o.) was also protective against all the models. Tacrine was protective against hypoxia but had no effect on anoxia and ischemia. Imipramine was protective against anoxia, but shortened the survival time of hypoxic mice. It had no effect on ischemia. The anti-hypoxic effect of T-588 was completely inhibited by pretreatment with scopolamine (1 mg/kg, i.p.), while the anti-anoxic effect was partially inhibited. Its effect on the ischemia was not affected by scopolamine. Hypoxia decreased the cerebral contents of ATP, phosphocreatine and glucose and increased the contents of lactate in mice. T-588 had no effect on these changes. Bifemelane prolonged pentobarbital-induced sleeping time in mice with the doses inducing anti-anoxic action, but T-588 did not. These results suggest that the activation of the CNS cholinergic system is involved as one of the mechanisms for the anti-anoxic action of T-588.

Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma

A novel hypotensive peptide was discovered in human pheochromocytoma by monitoring the elevating activity of platelet cAMP. Since this peptide is abundant in normal adrenal medulla as well as in pheochromocytoma tissue arising from adrenal medulla, it was designated "adrenomedullin". The peptide, consisting of 52 amino acids, has one intramolecular disulfide bond and shows slight homology with calcitonin gene related peptide. It was found to elicit a potent and long lasting hypotensive effect. The peptide circulates in blood in a considerable concentration, but it was not found in brain. These data suggest that adrenomedullin is a new hormone participating in blood pressure control. Occurrence of adrenomedullin indicates the possible existence of a novel system for circulation control.

[A case report of mediastinal teratoma complicated with cardiac tamponade]

A 10-year-old Japanese boy was admitted to our hospital with complaints of the sudden and severe chest pain having occurred when he caught a ball on his chest. A chest X-ray film and MRI made a diagnosis of cardiac tamponade caused by perforation into the pericardial sac of a mediastinal teratoma and pericardial drainage was carried out. Pericardial effusion showed cloudy yellow and CA 19-9 level in the effusion was 6, 538.2 U/ml. The tumor was extirpated after recovery of his general condition. The tumor was consisted of solid material (5 x 6 x 3 cm) and of cystic part (4 x 6 x 0.8 cm) involving of viscous yellowish fluid. Microscopic sections showed ulcer with bleeding, granulation and pancreatic tissue. Histopathological diagnosis was benign mature teratoma. Including this case, fourteen cases of mediastinal teratomas with cardiac tamponade have been reported and this is the youngest case. Pancreatic tissue were observed histopathologically in most cases and it was thought that autodigestion by digestive enzyme from pancreas was major cause of perforation of the tumor into the pericardial sac.

[Clinical application of new cytokines]

Recent progress of molecular biology and gene technology has developed a novel approach of clinical treatment. Several recombinant cytokines are already applied to clinical field. In this symposium, I introduced clinical application of some cytokines including GM-CSF, interleukin (IL)-1 and IL-3. The clinical benefits of IL-1 are; 1) IL-1 has an anti-tumor effect especially on cutaneous lymphoma and brain tumors, and 2) IL-1 has a function as hematopoietic growth factor for very immature hematopoietic stem cells. In the clinical Phase I/II study, IL-1 has been shown to have anti-tumor effect on cutaneous T-lymphoma via immune mechanisms. The side effects of IL-1 were variable including fever, fatigue, skin redness and so on, but they were all tolerable. The clinical phase studies of GM-CSF and IL-3 are now on going. The preliminary studies show that GM-CSF has granulo-poietic activity but not thrombo-poietic activity, and that IL-3 has multi-hematopoietic activity. These cytokines may be useful for treatment of disorders of hematopoietic stem cells such as aplastic anemia and myelodysplastic syndrome. The side effects of both cytokines are resemble, but all are tolerable.

[Granulocyte-colony stimulating factor and clinical laboratory]

The effects of granulocyte-colony stimulating factor (G-CSF) on the white blood cell count and the morphology of peripheral white blood cells were studied during the period of leukocytopenia following chemotherapy in patients with non-hematological malignant tumors (solid tumor group) and those with lymphatic hematological diseases (lymphocytic malignancy group). Cell surface markers were also analyzed to evaluate the usefulness of G-CSF in peripheral stem cell transplantation. After G-CSF administration, the white blood cell count showed remarkable changes beyond the physiologic range; the increase and decrease were 5.0 times and 0.3 times previous values, respectively, in the solid tumor group, and 11.0 times and 0.2 times, respectively, in the lymphocytic malignancy group. Concerning the morphology of peripheral white blood cells, immature leukocytes increased markedly to 133.0 times the previous value. The frequency of immature cells with morphological abnormalities was 0.5 percent in the solid tumor group, but 1.6 percent in the lymphocytic malignancy group. These findings suggest that administering G-CSF affects precision control and microscopic findings in routine laboratory blood tests and that information about whether the patient was treated with G-CSF should be obtained from the clinical staff. A cell surface marker, c-kit, was analyzed to clarify whether stem cells useful for peripheral stem cell transplantation appear in peripheral blood after administration of G-CSF. The incidence of c-kit-positive cells was at 1-10% in 3 of 5 patients in the solid tumor group administered G-CSF and in all 6 patients in the lymphocytic malignancy group.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhanced lymphatic delivery of monoclonal antibody following OK432 pretreatment

The effect of OK432 on the lymphatic delivery of monoclonal antibody (Mab) was investigated by injecting [125I]-Mab A7 into BALB/c mice pre-treated with OK432, and measuring the radioactivity in the regional lymph nodes. The [125I]-Mab A7, when administered subcutaneously to the foot pad, preferentially accumulated in the ipsilateral popliteal and para-aortic lymph nodes. Treatment with OK432 prior to antibody injection significantly enhanced the accumulation of Mab A7 in these regional lymph nodes. These findings suggest that pretreatment with OK432 may constitute a promising method of enhancing the lymphatic delivery of Mab, and improving the efficacy of therapy directed against lymphatic malignancies.

Endoscopic local injection of a new drug-delivery format of peplomycin for superficial esophageal cancer: a pilot study

BACKGROUND

A new drug-delivery format comprising activated carbon particles adsorbing peplomycin (PEP-CH) was developed for the treatment of superficial esophageal cancer.

METHODS

The drug distribution was measured in rats that received subcutaneous injections of PEP-CH or peplomycin aqueous solution. In 6 patients with superficial esophageal cancer, peplomycin as PEP-CH, 5-10 mg once a week for 4-10 weeks (total, 40-100 mg/patient) was injected endoscopically into primary lesions.

RESULTS

Rats given PEP-CH had significantly higher peplomycin levels in the regional lymph nodes and the injection site than rats given aqueous solution. Five patients have survived to the present or died without cancer after 27-72 months. The remaining patient has survived without cancer for 8 months after a second course of PEP-CH against recurrence.

CONCLUSIONS

PEP-CH therapy seems to have a good therapeutic effect on superficial esophageal cancer, although the present clinical study may have been biased by patient selection.

Dimeric form of calcitonin gene-related peptide in the porcine thyroid gland

In this study we investigated peptides that increase rat platelet cAMP in porcine thyroid gland. Gel filtration of extracts from porcine thyroid gland showed high and low molecular weight activity. Low molecular weight activity contained peptides, including calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP) and peptide histidine isoleucine (PHI). We isolated a high molecular weight peptide (M. W. 11,000) showing potent activity able to increase rat platelet cAMP in porcine thyroid gland. The peptide's N-terminal sequence was determined to be Ser-X-Asn-Thr-Ala-Thr- by gas phase sequencer analysis, a sequence identical to that of porcine CGRP. The peptide had CGRP immunoreactivity as well as platelet cAMP elevating activity. By gel filtration HPLC, synthetic human CGRP (M. W. 3790) was eluted in a position corresponding to M. W. 5,500. These results suggest that judging from its high molecular weight the above peptide is a dimeric form of CGRP.

Constitutive expression and production of tumor necrosis factor-beta in T-cell lines infected with HTLV-I and HTLV-II

A highly sensitive enzyme-linked immunoassay was developed to detect soluble levels of TNF-beta. Analysis of TNF-beta in culture supernatants from long-term T-cell lines infected with human T-cell lymphotropic virus (HTLV) types I and II demonstrated elevated levels of TNF-beta when compared with uninfected T-cell lines. Presence of interleukin-2 in the culture medium showed a synergistic effect upon TNF-beta production. Further, constitutive expression of TNF-beta mRNA was observed in most cell lines infected with HTLV-I or HTLV-II. These results demonstrate that infections with HTLV-I/II can alter production of TNF-beta, presumably via the transactivation of TNF-beta promoter by the tax protein of HTLV-I and HTLV-II.

Structure and developmental regulation of Golli-mbp, a 105-kilobase gene that encompasses the myelin basic protein gene and is expressed in cells in the oligodendrocyte lineage in the brain

We have identified a novel transcription unit of 105 kilobases (called the Golli-mbp gene) that encompasses the mouse myelin basic protein (MBP) gene. Three unique exons within this gene are alternatively spliced into MBP exons and introns to produce a family of MBP gene-related mRNAs that are under individual developmental regulation. These mRNAs are temporally expressed within cells of the oligodendrocyte lineage at progressive stages of differentiation. Thus, the MBP gene is a part of a more complex gene structure, the products of which may play a role in oligodendrocyte differentiation prior to myelination. One Golli-mbp mRNA that encodes a protein antigenically related to MBP is also expressed in the spleen and other non-neural tissues.

A target K+ channel for the LP-805-induced hyperpolarization in smooth muscle cells of the rabbit portal vein

The resting membrane potential of smooth muscle cells of the rabbit portal vein was -51.2 mV. LP-805 (8-tert-butyl-6,7-dihydropyrrolo[3,2-e] 5-methylpyrazolo [1,5-a] pyrimidine-3-carbonitrile) hyperpolarized the membrane to -62.3 mV (10 microM) and inhibited the burst spike discharges as measured using the microelectrode method. In dispersed smooth muscle cells, LP-805 (10 microM) generated an outward-current with a maximum amplitude of 68 pA at a holding potential of -40 mV in experiments using the voltage-clamp procedure. The reversal potential of the outward current evoked by LP-805 was -82 mV and this value was close to the equilibrium potential for K+ (-80 mV) in the present ionic conditions, suggesting that LP-805 activated the K+ channel. Generation of both the hyperpolarization and the outward current by LP-805 was inhibited by glibenclamide (> or = 1 microM). Using the cell-attached and cell-free patch-clamp (in the presence of GDP) procedures, the maxi-K+ channel current (150 pS) could be recorded in the absence of LP-805; application of LP-805 additionally opened a small conductance K+ channel current (15 pS) without change in the activity of the maxi-K+ channel. The maxi-K+ channel was sensitive to charybdotoxin (0.1 microM) and to intracellular Ca2+ ([Ca2+]i) concentration. The 15 pS channel was insensitive to [Ca2+]i and charybdotoxin, but sensitive to intracellular ATP concentration. Glibenclamide (> 1 microM) inhibited the 15 pS K+ channel activated by LP-805.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effects of granulocyte-colony stimulating factor on hematogram examinations]

Effects of granulocyte-colony stimulating factor (G-CSF) on hemograms were studied in the leukopenic phase after chemotherapy on patients with solid malignant tumors and lymphocytic malignancies. The samples were from patients with solid malignant tumors (solid tumor group) and from those with lymphocytic malignancies (lymphocytic malignancy group). In the control group, the increase rate and the decrease rate of the white blood cell count were 1.48 and 0.67, respectively. With the administration of G-CSF, they were 4.99 and 0.29 in the malignant tumor group, and 11.83 and 0.19 changes beyond the range of physiologic fluctuations with the administration of G-CSF. In term of increasing rate, immature myeloid cells were increased more remarkably than mature neutrophil by administration of G-CSF, indicating that the target cells of G-CSF are immature cells, and the increase of immature cells is responsible for the increase of the whole white blood cell count. Though immature myeloid cells with atypical morphology were rarely detected in the solid tumor group, they were observed more frequently in the lymphocytic malignancy group. In this study, we stress that the information about the history of G-CSF administration is indispensable for quality control of hemogram examinations.

Conformation of deltorphin-II in membrane environment studied by two-dimensional NMR spectroscopy and molecular dynamics calculations

Two-dimensional homonuclear Hartmann-Hahn spectroscopy and NOESY (nuclear Overhauser effect and exchange spectroscopy) 1H-NMR techniques have been used to obtain complete proton resonance assignments and to perform a conformational investigation of deltorphin-II (Tyr-D-Ala-Phe-Glu-Val-Val-Gly-NH2), a naturally occurring delta-selective opioid peptide, in the membrane-mimetic micelles of perdeuterated dodecylphosphocholine. This was done in order to examine conformational characteristics that would be closely related to the selectivity towards the delta-opioid receptor. With the use of the proton-proton distances derived from NOESY measurements, 50 possible three-dimensional structures were generated by means of distance-geometry calculations, and 25 of them were subjected to the molecular-dynamics simulations of 10 ps, which were energetically constrained for the NOE interproton distances. Most of the possible conformers simulated showed a common feature such that the conformation of deltorphin-II is characterized by the S-shaped back-bone structure in which the turn conformation of the Val-Val-Gly-NH2 sequence is located under the helically folded conformation of the N-terminal Tyr-D-Ala-Phe-Glu sequence. The possible relationship between this conformational characteristic and the delta-opioid-receptor selectivity has been discussed.

Generalized eruptive histiocytoma: report of a pediatric case

A one-year-old boy was seen with brownish, flat papules on his face, neck and upper arms. The lesions were symmetric, discrete, slightly raised, firm to the touch, and asymptomatic papular eruptions. Histological and immunohistochemical investigation revealed monomorphous infiltration of S-100 negative, lysozyme negative, and alpha 1-antitrypsin negative, but alpha 1-antichymotrypsin positive and vimentin positive histiocytic cells with small numbers of lymphocytic cells. The histiocytic cells did not show any foamy changes in the cytoplasm. No giant cells were found. The lesions increased in number during the first few years and then spontaneously regressed by the sixth year of age, leaving partial brownish pigmentation.

Tumor necrosis factor-alpha induces circular forms of human immunodeficiency virus type-1 DNA in the persistently infected low-level expressing cell line, ACH-2

The low human immunodeficiency virus type-1 (HIV-1) expressing T-cell line, ACH-2, was used to investigate accumulation of the circular, extrachromosomal form of HIV DNA (HD) after tumor necrosis factor-alpha (TNF-alpha) induction. We chose the 2 long terminal repeat (LTR) circular form to analyze unintegrated HD by polymerase chain reaction (PCR), using primer pairs which flank the 2 LTR HD. Approximately a 10-fold increase in 2 LTR HD was detected intracellularly in the TNF-alpha-induced ACH-2 cells using an end point-dilution assay. To examine the cellular compartment location of the 2 LTR HD accumulation, ACH-2 cells were fractionated into cytoplasmic and nuclear components and further subjected to PCR. A 4- to 5-fold increase in the 2 LTR HD signal was observed in the nuclear fraction. These results indicate that unintegrated HD increases in a chronically infected cell line after TNF-alpha induction. This phenomenon, which previously had been observed only with acute infections, may offer insight into basic pathogenic mechanisms.

Secondary early carcinoma in a reconstructed gastric tube after subtotal esophagectomy for early carcinoma of the esophagus

A 70-year-old man was found to have a moderately differentiated squamous cell carcinoma in the mid-esophagus on X-ray and endoscopy. These examinations revealed no lesion in the stomach at that time. Ten days after termination of preoperative hyperthermo-chemo-radiotherapy (HCR), a subtotal esophagectomy and gastric tube reconstruction via the retrosternal route were performed (pTNM stage I). Seven months later, another early cancer was detected in the reconstructed gastric tube. Via a median sternotomy, a wedge resection of the gastric tube was performed, and histopathological studies revealed a well-differentiated adenocarcinoma, which was limited to the submucosa (pTNM stage I). The patient has since done well with no signs of recurrence for the twenty-two months that have elapsed since the second operation was performed. Since the incidence of double cancer in the esophagus and stomach is high, and cases such as that described here will be detected more and more frequently in the future, not only a thorough investigation of a stomach intended for use in the reconstruction of the esophagus, but also strict postoperative checkups of the gastric tube when the esophagus has been reconstructed using the stomach must be considered of great importance.

Predictive value of intracellular ATP level for cell viability after heating in malignant cells

An adenosine triphosphate (ATP) assay is known to be a useful chemosensitivity test, which correctly reflects cell viability. We investigated the usefulness of ATP assay as a thermosensitivity test by comparing two world-wide accepted assays which included a succinate dehydrogenase (SD) assay and a colony assay. We exposed KSE-1 and KSE-2 cell lines to various degrees of hyperthermia at 42, 43 and 44 degrees C for 0.5, 1, 2, 3 and 4 h, respectively. The ATP activity for the KSE-1 and KSE-2 cell lines was 2.0 and 0.7% in change of cell viability after heating at 44 degrees C for 4 h, respectively. Colony formation rates in the KSE-1 and KSE-2 cell lines were 0.9 and 0%, respectively, whereas the SD activity of each cell line was 24.1 and 22.8%. As a whole, the ATP assay showed a closer correlation to the colony assay than the SD assay because the latter revealed a more than 20% pseudo-viability due to the response between the base and residual enzyme even after the cells had died. Thus, the ATP assay was judged to be more sensitive than the SD assay; it was also quicker than the colony assay in evaluating cell viability after heating. We propose that the ATP assay should be included as another useful thermosensitivity test for malignant cells.

Significant clinical response of activated carbon adsorbed-peplomycin against esophageal cancer: a pilot study

Activated carbon particle adsorbed-peplomycin (PEP-CH) was administered to three patients who had advanced esophageal cancer and its clinical usefulness was evaluated. The PEP-CH was injected endoscopically into the tumor or the adjacent normal esophageal tissue. Case 1 and case 3 were treated by topical injection of PEP-CH with or without surgery and case 2 was subjected to the PEP-CH treatment with radiation. The barium swallow and endoscopic examination exhibited a marked tumor reduction in all the patients at the end of the PEP-CH treatment. Although a marked clinical response was seen, case 1 died of postoperative complication. Two patients were capable of oral food intake after the treatment, which had been impossible before the treatment. There were no serious adverse side effects caused by the PEP-CH treatment in all the patients. PEP-CH should prove valuable as a new form of chemotherapy for the treatment of esophageal cancer patients.

The role of monoclonal antibody A7 as a drug modifier in cancer therapy

An anticancer antibiotic, neocarzinostatin (NCS), was covalently conjugated to the murine monoclonal antibody A7 (mAb A7), which recognizes the glycoprotein on the cell surface of human colon cancer. The biological and pharmacological properties of the conjugate (A7-NCS) were examined and compared with those of unconjugated NCS. A7-NCS exhibited a strong binding and cytotoxicity to the cell and an antigen-specific tumor accumulation. Significant tumoricidal effects in vivo were observed in the antigen-positive tumor-bearing mice treated with A7-NCS, whereas NCS mixed with mAb A7 and NCS alone were relatively ineffective. In the antigen-negative tumor, the tumoricidal effect of A7-NCS was lower than in the antigen-positive tumor. The NCS concentration in blood and tumor were significantly elevated by conjugation to mAb A7. The NCS localization in tumor was higher in the antigen-positive tumor than in the antigen-negative tumor. Death due to acute toxicity was observed at a dose of 20 units (U) NCS in mice treated with unconjugated NCS, whereas toxicity was seen with a much higher dose of NCS (100 U) if the drug was conjugated to the mAb. These findings show that mAb A7 confers more favorable pharmacological properties on an anticancer drug, making it potentially more useful for cancer chemotherapy.