Serum thrombopoietin and plasma glycocalicin concentrations as useful diagnostic markers in thrombocytopenic disorders

Using enzyme-linked immunosorbent assays, we measured the concentrations of serum thrombopoietin (TPO) and plasma glycocalicin, a proteolytic fragment of platelet glycoprotien Ib alpha, in 13 patients with myelodysplastic syndrome (MDS), aplastic anaemia (AA) or idiopathic thrombocytopenic purpura (ITP). In the patients with AA or MDS, the TPO concentrations were remarkably increased, and their glycocalicin concentrations were decreased compared with the normal control individuals. In the patients with ITP, however, the TPO and glycocalicin levels were not changed as much as in the AA/MDS patients in spite of the same degree of thrombocytopenia. During immunosuppressive treatment of ITP patients, there was an inverse relationship between the level of TPO and the platelet count. Thus, measurements of TPO and glycocalicin levels are useful for the diagnosis of thrombocytopenia, and our results from ITP patients did not support the model which suggested the simple feedback regulation of TPO in thrombocytopenia.

Cyclic change of cytokines in a patient with cyclic thrombocytopenia

The serial change of various cytokines in the serum from a patient with cyclic thrombocytopenia is described. Interleukin 7, stem cell factor, and transforming growth factor beta 1 synchronized with the platelet count, and there was a significant positive correlation between the three cytokines and the platelet count. Levels of macrophage colony-stimulating factor, thrombopoietin, platelet-associated IgG and erythropoietin changed reciprocally with the platelet count, and there was a significant negative correlation between the platelet count and these cytokines except erythropoietin. No cyclic change was observed in IL-3, IL-6, IL-11, granulocyte-macrophage colony-stimulating factor, or leukaemia inhibitory factor. These observations suggest that this disease involves two cyclic changes: megakaryocytopoiesis and platelet destruction, in both of which the cytokines play an important role.

A sensitive sandwich ELISA for measuring thrombopoietin in human serum: serum thrombopoietin levels in healthy volunteers and in patients with haemopoietic disorders

A sensitive sandwich enzyme-linked immunosorbent assay (ELISA) has been established to estimate serum thrombopoietin (TPO) concentrations in healthy volunteers and patients with haemopoietic disorders. The ELISA uses a mouse monoclonal antibody (Ab) as the capture Ab and a biotinylated rabbit polyclonal Ab as the detector. The ELISA was reproducible, highly sensitive and specific for human TPO. The coefficients of intra-and inter assay variation were from 3.0% to 4.9% and from 5.9% to 6.1%, respectively. The quantitative limit of the ELISA was 0.09 fmol/ml in serum. The quantitative limit was lower than the normal level. The dose-response curves of serum samples from healthy volunteers and patients with haemopoietic disorders were parallel to the standard curves. The ELISA did not cross-react with a variety of blood components and cytokines to produce false-positive results. The serum TPO concentrations from 29 normal males and 21 females were 0.79 +/- 0.35 and 0.70 +/- 0.26 fmol/ml, respectively. Serum TPO levels in patients with aplastic anaemia (AA), acute lymphocytic leukemia (ALL) and essential thrombocythaemia (ET) were measured using the ELISA. The serum TPO levels in the patients with ET (n = 6, 2.80 +/- 1.55 fmol/ml) were higher than the normal level. The patients with AA (n = 7, 18.53 +/- 12.37 fmol/ml) and ALL (n = 5, 10.36 +/- 5.57 fmol/ml) had significantly higher serum TPO levels than normal individuals. These results indicate that the ELISA specific to TPO should prove useful in measuring the TPO concentration in serum samples.

Circulating thrombopoietin level in chronic immune thrombocytopenic purpura

The circulating thrombopoietin (TPO) level in 43 patients with chronic immune thrombocytopenic purpura (ITP) was examined by an ELISA system. The TPO level (mean +/- SD) in ITP patients was mildly elevated (1.86 +/- 1.17 fmol/ml) compared to that in normal subjects (0.76 +/- 0.21), and was within the normal range in 30% of ITP patients. In contrast, the TPO level in patients with aplastic anaemia was very high, 12.35 +/- 6.42 fmol/ml. There was no correlation between TPO level and platelet count in ITP patients. Splenectomy was performed in two ITP patients, after which platelet counts increased to normal levels and TPO levels showed a transient increase. These data suggest that reactive TPO production against thrombocytopenia in ITP is small when compared to that in aplastic anaemia. Relative endogenous TPO deficiency may play some role in the pathophysiology of thrombocytopenia in ITP patients.

Isolation, partial characterization, and mode of action of Acidocin J1132, a two-component bacteriocin produced by Lactobacillus acidophilus JCM 1132

Lactobacillus acidophilus JCM 1132 produces a heat-stable, two-component bacteriocin designated acidocin J1132 that has a narrow inhibitory spectrum. Maximum production of acidocin J1132 in MRS broth was detected at pH 5.0. Acidocin J1132 was purified by ammonium sulfate precipitation and sequential cation exchange and reversed-phase chromatographies. Acidocin J1132 activity was associated with two components, termed alpha and beta. On the basis of N-terminal amino acid sequencing and the molecular masses of the alpha and beta components, it is interpreted that the compounds differ by an additional glycine residue in the beta component. Both alpha and beta had inhibitory activity, and an increase in activity by the complementary action of the two components was observed. Acidocin J1132 is bactericidal and dissipates the membrane potential and the pH gradient in sensitive cells, which affect such proton motive force-dependent processes as amino acid transport. Acidocin J1132 also caused efflux of preaccumulated amino acid taken up via a unidirectional ATP-driven transport system. Secondary structure prediction revealed the presence of an amphiphilic alpha-helix region that could form hydrophilic pores. These results suggest that acidocin J1132 is a pore-forming bacteriocin that creates cell membrane channels through the "barrel-stave" mechanism.

Coexpression of thrombopoietin and c-mpl genes in human acute myeloblastic leukemia cells

Thrombopoietin (TPO) is a recently identified hematopoietic growth factor that is essential for the growth and development of megakaryocytes. We have previously shown that TPO induces proliferation of acute myeloblastic leukemia (AML) cells in vitro. In this study, we have examined the expression of TPO and its receptor c-mpl in a series of AML cases and human leukemia cell lines. The mRNA transcripts of TPO were detectable in 18 of 50 AML cases and in some myeloid leukemia cell lines (HEL, M07E and CMK) by means of reverse transcriptase polymerase chain reaction (RT-PCR). In addition, TPO transcripts were coexpressed with c-mpl transcripts in 10 of 50 AML cases and in HEL, M07E and CMK cells. With regard to the French-American-British (FAB) classification, coexpression OF TPO and c-mpl was observed with high frequency in AML cases of M7-type. Despite the TPO expression in a substantial fraction of leukemia cells, biological activity of TPO was not found in the conditioned medium that was obtained from cultivation of TPO mRNA-positive leukemia cells. These results suggest that TPO may not commonly participate in the abnormal growth of AML cells as an extracellular autocrine growth factor.

[Diagnostic value of high N-isopropyl-p-[123I] iodoamphetamine (IMP) uptake in brain tumors]

The diagnostic value of high N-isopropyl-p-[123I] iodoamphetamine (123I-IMP) uptake in histologically proven intracranial tumors was evaluated in 54 patients with both early (15-35 min after injection) and delayed (4 hours) SPECT before treatment. Higher uptake in the tumor compared with normal cerebral cortex was observed in early scans in all of the five patients with primary intracranial malignant lymphoma, in two of 16 meningiomas, two of seven astrocytomas, one of three pituitary adenomas, and one central neurocytoma. Among these 11 cases all the malignant lymphomas showed persistent high uptake in delayed scans, whereas other tumors showed decreased uptake in delayed scans. This persistent high 123I-IMP uptake was characteristic of primary intracranial malignant lymphomas and was useful in the diagnosis of intracranial malignant lymphoma.

Cloning and nucleotide sequence of the gene for acidocin 8912, a bacteriocin from Lactobacillus acidophilus TK8912

Acidocin 8912 is a bacteriocin produced by Lactobacillus acidophilus TK8912. The acidocin 8912 structural gene, acdT, was cloned and determined. It was located on the 14-kb plasmid pL103 and encoded a 46 amino acid precursor including a 20 amino acid N-terminal extension. The precursor sequence of the acdT gene shows a conservation of the general structural characteristics of the bacteriocin precursors from some lactic acid bacteria.

Hurler syndrome with severe complication in post-bone marrow transplantation course: life threatening interstitial pneumonitis and hypertension

Bone marrow transplantation (BMT) was performed in a 3 year old patient with Hurler syndrome. The post-BMT course was complicated by interstitial pneumonitis and severe hypertension, which were life threatening. The patient responded well to therapy and recovered. BMT in this patient resulted in significant clinical improvement in the signs and symptoms of Hurler syndrome. Biochemical improvement, including elevated alpha-L-iduronidase activity in white blood cells and decreased urinary glycosaminoglycan excretion was significant. However, skeletal and neurological impairment were not improved. We conclude that BMT for Hurler syndrome should be performed at an earlier stage, before severe neuronal damage has occurred. Moreover, BMT is a high risk procedure and there will always be a possibility that life threatening complications will occur, as in our case.

Identification of the replication region of Lactobacillus acidophilus plasmid pLA103

The structure of the region necessary for replication of the plasmid pLA103 from Lactobacillus acidophilus TK8912 has been characterized. Sequence analysis revealed that the replication region contained an open reading frame (OrfA) encoding a 282-amino acid peptide preceded by a 22-bp tandem repeat sequence region. The predicted OrfA protein showed homology to the replication protein of a plasmid from Pediococcus halophilus. The plasmid containing the repeat sequence region preceding OrfA was able to replicate in the Lactobacillus host when provided with OrfA in trans, suggesting that the repeat sequence region contains the origin sequence essential for the pLA103 replication.

NMR spectroscopic characterization of adinazolam mesylate: pH-dependent structure change in aqueous solution and active methylene

The present study is to investigate structural changes of adinazolam mesylate in aqueous solution under various pH conditions by NMR spectroscopy. By plotting of the signal integration and chemical shifts of the side chain, pKa values for imine hydrolysis and the side chain amine were determined. Conformational analysis of the side chain was performed with deuterium-induced isotope effects on chemical shifts, nuclear Overhauser effects, relaxation times, and energy calculations. Hydrogen/deuterium exchange due to an active methylene at the 4-position under basic conditions was revealed.

Expression of laminin in vestibular ganglia and nerves in herpes simplex virus infectious chick embryo

The expression of laminin in the vestibular ganglia and nerves in herpes simplex virus I (HSV-I) infectious chick embryos was examined by immuno-histochemistry. In 9-day-old normal chick embryos, the surface of the vestibular ganglion cells and the vestibular nerves were labelled with laminin, while, in HSV-I infectious chick embryos, the staining of laminin in the vestibular ganglia and nerves was very weak. These results suggest that HSV-I injures vestibular ganglia and nerves, and that laminin is a good marker of the degeneration and innervation of developing vestibular nerves.

Neurotological evaluation of Harada's disease

We have had 30 patients with Harada's disease at our clinic from 1980 to 1993 and their neurotological findings were retrospectively reviewed. There were 12 males and 18 females, whose ages ranged from 15-years to 67-years. Preceding symptoms such as headache or common cold were observed in 50% of the patients. Pleocytosis of the cerebrospinal fluid was found in 89% of the patients. Subjective cochlear and/or vestibular symptoms were noted in 60% of the patients. In 43 of the 50 ears, sensorineural hearing loss (< 40 dB) was observed. In 77% of the patients, vestibular function tests gave abnormal results. On the basis of our findings, it was suggested that Harada's disease with vertiginous and cochlear symptoms could be classified as follows: cochlear type, peripheral vestibular type, cochleovestibular type, central type, and 'unclassified', based on the neurotological results.

Effect of hypergravity on vestibular compensation in guinea pigs

The effect of hypergravity on vestibular compensation was studied in guinea pigs. Pharmacological labyrinthectomy was performed by injecting chloroform into the middle ear cavity under ether anesthesia. The guinea pigs were exposed to hypergravity on a centrifuge. The animals were divided into four groups: a group stimulated with 2G after labyrinthectomy of the right ear, a group stimulated with 2G after labyrinthectomy of the left ear to evaluate the influence of the centrifugal rotation, a group stimulated with acceleration and deceleration alone, and a control group which was maintained under similar conditions, but without centrifugation. Head deviation and nystagmus were recorded and analysed to assess the process of compensation at 1, 3, 5, 7 and 9 h after labyrinthectomy. The 2G-stimulated group showed faster compensation in head deviation than the control group. In this study, the hypergravity stimulation seemed to facilitate the compensation in head deviation.

Early onset of cecal perforation in neonatal, recto-sigmoid type Hirschsprung's disease

Hirschsprung's disease has been considered to cause intestinal perforation in rare cases. Even if a perforation occurs, the majority of cases are associated with the long-segment or total colonic type. Our case developed the perforation in the neonatal period in spite of being of the recto-sigmoidal type, and it affected the cecum. We do not have a good explanation for this condition. However, the pathological examination of the specimens of the perforated cecum revealed some necrosis (ulceration, subcutaneous hemorrhage, congestion and severe edema) which was considered to be caused by ischemia, secondary to a localized vascular accident in the wall of the distended intestine.

Choristoma of the nasopharynx

A choristoma is a tumor-like mass consisting of tissues that are foreign to the site at which they are located. A hamartoma, on the other hand, is a tumor-like mass consisting of tissues that are native to the site of origin. We report a choristoma in the nasopharynx that consisted of normal skin tissue.

[Equilibrium of small animals in "drop shaft" experimentation--preliminary study on the frog with vestibular neurectomy]

We have newly designed instruments for equilibrium experimentation, using a drop shaft, and studied the behavior and EMG Patterns of frogs with or without unilateral vestibular neurectomy, as a preliminary study at JAMIC (Japan Microgravity Center). The results are reported herein and the efficacy of the drop shaft in equilibrium experimentation is also documented. 1) In unilateral vestibular neurectomized frogs, posture--head tilt, leg flexion on the affected side, and leg extension on the opposite side--is maintained and persists under microgravity. Rolling to the affected side was also observed. 2) The latencies of the EMG responses from M. tibialis anticus and M. longissimus dorsi were prolonged on the affected side. 3) The frog is suitable for use in equilibrium experiments utilizing a drop shaft. 4) The JAMIC drop shaft can be used to obtain constant and stable microgravity, 10(-4) G for 10 sec, which is similar to that in space. Drop shafts are suitable for equilibrium experimentation.

[Relapse of acute leukemia after allogeneic bone marrow transplantation]

The relapses of 45 acute leukemia patients who underwent allogeneic bone marrow transplantation between April 1976 and February 1992 were analyzed clinically. The relapse rates of acute nonlymphocytic leukemia (ANLL) and acute lymphocytic leukemia (ALL) were 4/26 (15%) and 9/19 (47%), respectively. Although multivariate analysis could not be done, a high frequency of leukemia relapse was significantly associated with ALL, a younger age, history of extramedullary leukemia and blood-type identity. Chromosomal abnormalities at diagnosis, interval from diagnosis to bone marrow transplantation (BMT) and graft-versus-host disease (GVHD) prophylaxis were likely to be predictive of relapse. On the other hand, neither stage of leukemia at BMT, acute GVHD, sex, nor WBC count at diagnosis was a predictive factor. Eight of 10 relapsed patients achieved complete remission posttransplant, but the duration of remission was only 138 days on average. Four second BMT procedures for relapsed leukemia were carried out but were associated with many complications. However, one is alive well over 6 years after the second transplantation. There is a high treatment-related mortality following second BMT, but there is some possibility of long survival in some patients.

[Effect of retroauricular galvanic stimulation on muscle atrophy in the unweighted rat hindlimb]

Hindlimb unweighting in the rat may serve as an experimental model simulating muscle atrophy under weightlessness. As a preventive measure, retroauricular galvanic stimulation was delivered to the unweighted rat hindlimb and the weights of the bilateral soleus and gastrocnemius muscles were compared. Wistar rats, with unweighted hindlimbs, were divided into two groups; the control group which received no galvanic stimulation and a galvanically stimulated group which received galvanic stimulation (bipolar biauricular, 1 mA in intensity, 500 msec in duration, 1 Hz in frequency) for one hour twice a day for 7 days using an electronic stimulator made by NIHON-KODEN (MODEL SEN-1101). The weights of the soleus and gastrocnemius muscles on both sides were measured in each group using a balance (METTLER AT201). The results were as follows: 1. Muscle weights in the galvanically stimulated group were greater than those in the control group. 2. A statistically significant difference between right and left soleus muscle weights was obtained in the galvanically stimulated group (P < 0.01). 3. We found no significant difference between the two sides in the weights of gastrocnemius muscles. It is presumed that retroauricular galvanic stimulation exerts some influence, not only on vestibular organs, but also on hindlimb muscles through the lateral vestibulo-spinal tract and, in addition, through the spinal motor neuron. Therefore, we speculate that galvanic stimulation might prevent atrophy of the unweighted hindlimb muscle.

A case of cerebellar infarction occurred with the 8th cranial nerve symptoms

A rare case, 32-year-old man, of cerebellar infarction with the occurrence of the 8th cranial nerve symptoms was reported. On the neuro-otological examination, hearing test and caloric test showed a severe hearing loss and no response on the right side, respectively, and the spontaneous horizontal nystagmus fixed to the left direction was observed. Magnetic resonance (MR) imaging showed the infarctions in the areas of anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) on the right side. On the 14th illness day, the 8th cranial nerve symptoms disappeared, and on the 12th illness day, right hearing level and caloric response were significantly improved. We suggested that such an early recovery of the subjective symptoms and neuro-otological findings may be attributable to the recanalized circulation disturbance or the development of collateral circulation.

Human cystathionine beta-synthase cDNA: sequence, alternative splicing and expression in cultured cells

Cystathionine beta-synthase (CBS) deficiency is the major cause of homocystinuria in humans. The most frequent symptoms of homocystinuria include: dislocated optic lenses, vascular disorders, skeletal abnormalities and mental retardation. Patients with this deficiency have elevated levels of homocyst(e)ine, methionine and low cysteine in their body fluids. These abnormal levels often partially or fully normalize upon treatment with pharmacological doses of vitamin B6. To investigate the molecular and biochemical basis for these conditions, it was necessary to determine the nucleotide and polypeptide sequence of CBS. We report here the human CBS cDNA sequence of 2,554 nucleotides encoding the CBS subunit of 551 amino acids. An intron of 214 bp appears to be retained in the 3'-untranslated region of most of the fibroblast and liver mRNA. We also report a frequent Mspl polymorphism in the 3'-untranslated sequence and two synonymous mutations in the coding region: 699C/T (Y233Y) and 1080C/T (A360A). The amino acid sequence similarity of human and rat CBS is greater than 90%; the enzyme also exhibits 52% similarity to O-acetylserine(thiol)-lyase from bacteria and plants. Lastly, we demonstrate that expression of the human enzyme in CHO cells yields enzymatically active protein of the expected size with a half-life of approximately 14 hrs.

Detection of minimal residual disease in Philadelphia chromosome positive acute lymphoblastic leukemia: rationale for bone marrow transplantation from the polymerase chain reaction point of view

Bone marrow transplantation (BMT) is performed as curative therapy for acute lymphoblastic leukemia (ALL). In most patients, BMT is performed at the time of remission which implies that the number of leukemic cells is less than 5% of all hematopoietic cells, namely, 0 to 10(10) leukemia cells in the body. Thus, some patients may well undergo BMT despite the fact that no leukemic cells are left in the body. In this respect, more accurate diagnosis of complete remission status would be to the patients' benefit. To detect minimal residual disease (MRD) not found by light-microscopy, further strategies are required after achieving hematological remission. Cytogenetic methods, Southern blot analysis and conventional immunological techniques can all provide accurate diagnosis, however, the sensitivity of these techniques for the detection of MRD is just as low as that of the light microscopy. Recently, polymerase chain reaction (PCR) has become available for the detection of low levels of chimeric bcr-abl transcripts in Philadelphia chromosome positive (Ph1) ALL patients. With this assay, investigators have reported MRD in patients after chemotherapy or BMT. Most patients who achieve hematological remission after conventional chemotherapy still have bcr-abl transcript detectable by PCR, confirming the general concept that this particular leukemia needs BMT in order to cure the disease. Some patients who had MRD prior to BMT continued disease free survival > 1 year after BMT with a negative PCR result and in these patients, MRD seems to have been eradicated by the BMT procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

[Ontogeny of the pronephros and mesonephros in the South African clawed frog, Xenopus laevis Daudin, with special reference to the appearance and movement of the renin-immunopositive cells]

Development of the pronephros and mesonephros of Xenopus laevis was morphologically studied in the larvae immediately after hatch (stage 35/36) to the end of metamorphosis (stage 66) together with the appearance of renin-immunopositive cells. The pronephros consisted of 3 pairs of pronephric tubules at stage 35/36 and became functional at stage 37/38 with the opening of the pronephric ducts to the cloaca. It increased thereafter in volume, but became degenerative at stage 56, lost a part of the pronephric ducts at stage 60, and completely disappeared at stage 64. The mesonephros displayed its anlage at stage 42, and gained the immature renal corpuscles at stage 48. At stage 49, it was equipped with the matured nephrons. The mesonephric tubules differentiated into the neck, proximal, intermediate and distal parts. The collecting tubules and ducts were also observed at this stage. At stage 56, a part of the mesonephric tubules degenerated and were displaced by newly formed tubules. Reorganization of the mesonephros was not completed at the end of metamorphosis. Renin-immunopositive cells did not appear in the pronephros, but were observed at the diverging part of the renal artery from the dorsal aorta, and in the walls of arteries and afferent arterioles within the mesonephros in a low frequency of appearance.