Simple spectrophotometric analysis of passive and active ear cutaneous anaphylaxis in the mouse

Homologous passive cutaneous anaphylaxis (PCA) and active cutaneous anaphylaxis (ACA) to ovalbumin and DNP-hapten were studied in the ears of female BALB/c mice by means of assessing Evans blue dye leakage. For the quantitative evaluation of PCA and ACA, a hand-held spectrophotometer and the conventional colorimetric method were used to detect the amount of extravasated dye. The value of deltaE*ab (a numerical expression of color) obtained with the hand-held spectrophotometer and the amount of extravasated dye showed a good correlation. In the mouse ear, the sensitivity of PCA reaction was comparable to that of PCA in the rat, and deltaE*ab in the PCA and ACA reactions correlated well with the dilutions of sera and of the antigen, respectively. Thus, using a hand-held spectrophotometer is a simple, quantitative and sensitive method for ascertaining the extent of immediate-type hypersensitivity in the mouse.

Infundibulocystic basal cell carcinoma

We report on a 72-year-old male patient with a solitary, dome-shaped tumor on the preauricular region. Histologically, it showed an intradermal basaloid cell tumor composed of many anastomosing epithelial cords. There were multiple infundibular cystic structures containing corneocytes lined by follicular infundibular epithelium and bud-like structures simulating the follicular germs throughout the neoplasm. Follicular bulbs and papillae were absent within the tumor. The stroma was scant and not highly fibroplastic. The tumor was diagnosed as infundibulocystic basal cell carcinoma, a recently described, uncommon variant of basal cell carcinoma.

Long-term allograft acceptance in a patient with posttransplant lymphoproliferative disorder: correlation with intragraft viral interleukin-10

BACKGROUND

Viral (v) interleukin (IL)-10 is expressed by Epstein-Barr virus (EBV) and has pro- and anti-inflammatory actions similar to human IL-10. EBV is also a known factor in the development of posttransplant lymphoproliferative disorder (PTLPD) in allograft recipients. We observed a patient with widespread PTLPD 9 months after renal transplantation, who subsequently maintained renal function despite minimal immunosuppression, and we investigated a possible link between these factors.

METHODS

The patient's chart was reviewed for relevant history. EBV DNA in blood and tissues was assessed by polymerase chain reaction. Human and vIL-10 and gamma-interferon mRNA were evaluated with reverse transcription-polymerase chain reaction using nested primers.

RESULTS

After the diagnosis of PTLPD, the patient was maintained on prednisone (8 mg/day) as the only immunosuppression with preserved renal function for 17 months until death as a result of pulmonary failure. She had continuously high blood levels of EBV DNA, although only mild persistent intrarenal atypical lymphocytic infiltrates. Human IL-10 mRNA was never present; in contrast, intragraft vIL-10 mRNA was identified and associated with resolution of an intervening episode of severe acute transplant rejection.

CONCLUSIONS

We suggest that the preserved renal function resulted from the anti-inflammatory actions of vIL-10 inhibiting acute rejection in the renal allograft.

Ureteritis and cholecystitis: two unusual manifestations of cytomegalovirus disease in renal transplant recipients

BACKGROUND

Common clinical manifestations of cytomegalovirus (CMV) infection include flu-like symptoms with fever, diarrhea, leukopenia, and elevated liver enzymes. Diagnosis is made by detection of the virus by buffy-coat blood culture or by polymerase chain reaction (PCR) analysis.

METHODS

Here we describe two renal transplant recipients who presented with unusual manifestations of CMV disease (cholecystitis and ureteritis). In both patients, no symptoms or signs of systemic CMV infection were present, and they were thought to have other common causes for cholecystitis and ureteral obstruction.

RESULTS

Retrospective analysis of peripheral blood by PCR analysis was positive for CMV DNA. Histologic examination of the resected gall bladder and stenotic ureteric segment showed CMV inclusions, confirmed subsequently by in situ hybridization. Thus, we report that CMV infection may present with acute cholecystitis or ureteral obstruction without its classical clinical symptoms.

CONCLUSIONS

Because CMV infection is common in transplant patients, the atypical manifestations of CMV should be considered in the differential diagnosis of posttransplant complications. Detection of CMV DNA in the peripheral blood by PCR analysis may help identify these patients.

[Correlations between cell proliferating activity and apoptosis in the colorectal cancer and apoptosis in the mucosa adjacent to colorectal cancer]

To investigate the growth and progression of colorectal cancer, cell production versus cell loss in colorectal cancer was examined using the proliferating cell nuclear antigen (PCNA) positivity rate and apoptotic index (AI). Cell loss was then examined using AI in the mucosa adjacent to colorectal cancer. The higher the PCNA positivity rate, the higher the apoptotic index in colorectal cancer. These results suggested that changes in cell production and cell loss may be closely correlated and play a role in the growth and progression of colorectal cancer. In patients with advanced colorectal cancer, the mucous composition of the adjacent mucosa was classified as sialomucin-predominant. Apoptosis at the proliferating zone in the mucosa adjacent to colorectal cancer (one or two glandular ducts) was also examined using the TUNEL method. This suggests that the mucosa adjacent to cancer is involved in apoptosis.

Folliculosebaceous cystic hamartoma with a neural component: an immunohistochemical study

We present a case of follicular cystic hamartoma, a distinctive cutaneous malformation characterized by marked overgrowth of folliculosebaceous units accompanied by appreciable mesenchymal alterations, including fibroplasia, increased vascular components, and numerous adipocytes. A conspicuous feature of our case is an aggregation of thick trespassing nerve bundles in the deep portion of the neoplasm. An immunohistochemical study revealed the nerve bundles were immunoreactive for the general neuronal marker protein gene product 9.5. The nerves, however, stained negatively with antibodies against neuropeptides such as calcitonin gene-related peptide, substance P, vasoactive intestinal polypeptide, and neuropeptide Y, all of which are known to be contained in normal cutaneous nerves. The presence of these aberrant nerve bundles devoid of the normal expression of neuropeptides supports the concept that folliculosebaceous cystic hamartoma is a true, tumor-like malformation characterized by abnormal overgrowth of normal components of the skin.

Cytomegalovirus infection induces anti-endothelial cell antibodies in cardiac and renal allograft recipients

Cytomegalovirus (CMV) infection represents a significant morbidity factor for transplant recipients. CMV infection has an association with the development of allograft rejection (AR) through graft endothelial cell (EC) damage, but the mechanisms are not yet clear. There are few reports addressing the role of humoral immunity in vascular EC injury mediated by CMV infection whereas many reports are available regarding the mechanism(s) of CMV-associated allograft EC injury mediated by cellular immunity. Here we examine the incidence of CMV infection in 40 cardiac and 25 renal allograft recipients using polymerase chain reaction (PCR) techniques. We also monitored sera for the development of anti-EC antibodies (AECA) using an ELISA with human umbilical vein ECs as targets, and IL-2 levels using an ELISA. AECA levels (immunoglobulin-G and immunoglobulin-M) were significantly elevated in allograft recipients who demonstrated CMV-PCR positivity when compared with the CMV-PCR negative group (IgG: 23.1 +/- 16.4 vs 4.7 +/- 4.5, p < 0.0001; IgM: 47.0 +/- 53.6 vs 7.0 +/- 11.2, p < 0.0001). Serum AECA (IgG and IgM) levels increased one to four weeks after CMV DNA was detected and elevated AECA levels persisted for at least one to two months, and sometimes for several months. Elevated AECA levels correlated well with serum IL-2 levels. These results suggest that CMV infection is associated with an increased humoral immune response to EC antigens, which may be a risk factor for vascular rejection, chronic rejection and decreased allograft survival.

Correlation of cytomegalovirus DNA levels with response to antiviral therapy in cardiac and renal allograft recipients

BACKGROUND

Cytomegalovirus (CMV) infection represents a significant morbidity factor for transplant recipients. A rapid, sensitive, specific, and reliable test is desirable for early detection of CMV infection and for monitoring the efficacy of antiviral therapy.

METHODS

We examined the incidence of CMV infection in 95 cardiac and 25 renal allograft recipients followed for up to 3 years using qualitative and quantitative polymerase chain reaction (PCR) techniques. Results were subsequently correlated with clinical findings. Of the 236 samples analyzed by the CMV PCR, 84 and 20 were also analyzed by blood buffy coat culture and anti-CMV antibody IgM assays, respectively.

RESULTS

The sensitivity of the CMV PCR was found to be superior to that of the other assays, although the specificity of the blood buffy coat culture is as good as that of the CMV PCR, which is higher than that of the anti-CMV antibody IgM assay. CMV infection was detected by the CMV PCR in 17 of 95 cardiac and 9 of 25 renal transplant recipients. Clinical symptoms were observed when > or =500 copies of CMV DNA/1 microg of total DNA were detected by a quantitative CMV PCR assay using an external control CMV plasmid; however, some patients had symptoms when 50-100 copies were present. The levels of CMV DNA detected varied (50-1000 copies) in patients who developed asymptomatic CMV infection. The CMV DNA levels decreased to 50-100 copies 1-2 weeks after antiviral therapy was initiated and correlated well with disappearance of clinical symptoms. CMV DNA levels decreased to < or =5 copies at 4-7 weeks after treatment. This contrasts with patients who were unresponsive to anti-CMV therapy, in whom high levels of CMV DNA (> or =500 copies) persisted for at least 5 weeks and significant levels of CMV DNA (50-100 copies) were detected for several months afterward, despite multiple courses of anti-CMV therapy. Clinical symptoms also did not disappear during this period of observation.

CONCLUSIONS

(1) The CMV PCR represents a rapid, sensitive, specific, reliable test for detection of CMV infection, especially for detection of virus replication in an incipient phase. (2) The quantitative CMV PCR is useful for monitoring the efficacy of antiviral therapy to distinguish patients who respond to therapy from those who do not. (3) CMV DNA levels > or =500 copies/1 microg of total DNA analyzed by the quantitative CMV PCR can be used to differentiate CMV infection from other infections and rejection.

Tyrosine phosphorylation sites at amino acids 239 and 240 of Shc are involved in epidermal growth factor-induced mitogenic signaling that is distinct from Ras/mitogen-activated protein kinase activation

Epidermal growth factor (EGF) induces tyrosine phosphorylation of the Shc adapter protein, which plays an important role in EGF-stimulated mitogenesis. Shc stimulates Ras/mitogen-activated protein kinase (MAPK) through forming a complex with Grb2 at the phosphorylated tyrosine (Y) residue 317. In this study, we identified novel phosphorylation sites of Shc, at Y239 and Y240. To define the Shc pathway further, we used NIH 3T3 cells expressing the previously characterized mutant EGF receptor (EGF-R) which lacks all known autophosphorylation sites but retains EGF-stimulated mitogenesis with selective phosphorylation of Shc. We constructed wild-type (WT) or mutant Shc cDNAs in which Y317 or/and Y239 and Y240 are replaced with phenylalanine (F) and introduced them into NIH 3T3 cells expressing WT or mutant EGF-R. In the WT EGF-R-expressing cells, the Y239/240/317F Shc, but not Y317F or Y239/240F Shc, decreased EGF-stimulated cell growth. In the mutant EGF-R-expressing cells, Y317F Shc or Y239/240F Shc decreased EGF-stimulated cell growth significantly, though Y317F was a little more potent than Y239/240F. Although cells expressing the Y317F Shc hardly activated MAPK in response to EGF, cells expressing the Y239/240F Shc fully activated MAPK. In contrast, Y239/240F Shc, but not Y317F Shc, reduced the EGF-induced c-myc message. These results suggest that Shc activates two distinct signaling pathways, Y317 to Ras/MAPK and Y239 and Y240 to another pathway including Myc, and that both are involved in EGF-induced mitogenic signaling.

Selective expression of the interleukin-2 gene discriminates between the auto- and allo-mixed lymphocyte reaction

The in vitro mixed lymphocyte reaction (MLR) is a useful model to study alloresponsiveness to histocompatibility antigens. Secretion of different cytokine proteins in the supernatant of allo-MLR cultures has been reported in a few studies with no reference to results in auto-MLR. Since most cytokines are autocrine factors, their levels in the supernatant may not reflect the actual intracellular production. Therefore, we studied cytokine gene expression in auto- and allo-MLR by Northern dot blotting and reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. mRNA for IL-beta and IL-8 was detected in both auto- and allo-MLR by Northern dot blotting. mRNA for IL-2, gamma-IFN, TNF-alpha, IL-4, IL-10 and IL-2 receptor (IL-2R) was not found by Northern dot blotting and could only be detected by RT-PCR. Expression of mRNA for IL-4, IL-10, TNF-alpha, gamma-IFN and IL-2R by RT-PCR analysis was seen in both auto- and allo-MLR. There was slightly increased expression of gamma-IFN, IL-2R and TNF-alpha in allo-MLR in comparison to auto-MLR. However, IL-2 was exclusively expressed in allo-MLR and was detected as early as 5 h of initiation of culture. These results indicate that mRNA expression for a number of cytokines can be seen in both auto- and allo-MLR using RT-PCR analysis. However, the consistent expression of IL-2 in the allo-MLR indicates that it is an important cytokine which discriminates an allo- from an autoresponse. These findings suggest that detection of IL-2 gene expression by RT-PCR may be useful for immune monitoring of allograft rejection.

Ultrastructural evidence for the participation of Langerhans cells in cutaneous photoaging processes: a quantitative comparative study

Langerhans cells were studied comparatively by electron microscopy in order to explore their possible participation in cutaneous photoaging processes in chronically photodamaged preauricular skin and in paired sun-protected postauricular sites of 25 Caucasian women aged 56-76 years. The characteristic ultrastructural features of Langerhans cells in photodamaged skin compared to those in sun-protected skin were as follows: (1) a significant decrease in the density of Langerhans cells and Birbeck granules, and an increase in the number of indeterminate cells, (2) an inversely proportional relationship between intraepidermal density of Langerhans cells and the severity of epidermal photodamage, (3) frequent apposition of Langerhans cells to vacuolar structures of photodamaged keratinocytes, (4) predominant distribution of Langerhans cells in the lower epidermis, (5) degenerative changes suggesting direct cellular damage, without evidence of apoptosis, (6) a strong correlation of the number of degenerated Langerhans cells with the degree of epidermal photodamage, (7) loss of dendritic processes, (8) direct contact of Langerhans cells with melanocytes suggesting interaction between these two types of cells, (9) juxtaposition of Langerhans cells and lymphocytes in the epidermis. These results suggest marked qualitative and quantitative ultrastructural differences in Langerhans cells between photodamaged and intrinsically aged skin and the positive involvement of Langerhans cells in the processes of cutaneous photoaging.

[Specific determination of deltamethrin and tralomethrin by preparative HPLC and GC-ECD]

Tralomethrin quickly changes to deltamethrin in gas chromatograph by debromination. Therefore deltamethrin and tralomethrin are not able to be distinguished by gas chromatographic determination. A method for specific determination of deltamethrin and tralomethrin was established. The method consists of fractionation by high performance liquid chromatography and determination by gas chromatography. Recoveries of deltamethrin and tralomethrin spiked to three agricultural products were from 42 to 78% and from 18 to 76%, respectively with relative standard deviations ranging from 0.3 to 15%. From the analysis of samples spiked with tralomethrin, it was found that a part of tralomethrin quickly changed to deltamethrin in homogenate of agricultural products. The addition of phosphoric acid to the homogenate did not prevent the change of tralomethrin.

Changes of expressions of phosphotyrosine phosphatases in rat hepatocellular carcinoma induced by 3'-methyl-4-dimethylamino-azobenzene

Using rats with hepatocellular carcinoma induced by 3'-methyl-4-dimethylamino-azobenzene (3'-MeDAB), we evaluated the expression of a protein tyrosine phosphatase (PTPase) in the tumor region, non-tumorous region and control rat liver. The expression of SHPTP2 increased 4.1 fold (p < 0.05) in mRNA, 2.1 fold (p < 0.01) in cytosol fraction, and 5.1 fold (p < 0.05) in membrane fraction, respectively, at a protein level in the tumor region compared with control liver. The expression of other phosphatases, LAR, LRP, and PTPase1B, did not change significantly. SHPTP2 phosphatase activity in the tumor region from rats also increased compared with control, suggesting that an increase of this activity may parallel the expression of SHPTP2. This increase of expression of SHPTP2 may contribute to the progression of hepatocellular carcinoma in this rat model.

Innervation of melanocytes in human skin

Communication between the nervous system and epidermal melanocytes has been suspected on the basis of their common embryologic origin and apparent parallel involvement in several disease processes, but never proven. In this study, confocal microscopic analysis of human skin sections stained with antibodies specific for melanocytes and nerve fibers showed intraepidermal nerve endings in contact with melanocytes. This intimate contact was confirmed by electron microscopy, which further demonstrated thickening of apposing plasma membranes between melanocytes and nerve fibers, similar to synaptic contacts seen in nervous tissue. Since many intraepidermal nerve fibers are afferent nerves that act in a "neurosecretory" fashion through their terminals, cultured human melanocytes were stimulated with calcitonin gene-related peptide (CGRP), substance P, or vasoactive intestinal peptide, neuropeptides known to be present in cutaneous nerves, to examine their possible functions in the epidermal melanin unit. CGRP increased DNA synthesis rate of melanocytes in a concentration- and time-dependent manner. Cell yields after 5 d were increased 25% compared with controls maintained in an otherwise optimized medium. Furthermore, stimulation by CGRP induced rapid and dose-dependent accumulation of intracellular cAMP, suggesting that the mitogenic effect is mediated by the cAMP pathway. These studies confirm and expand a single earlier report in an animal model of physical contact between melanocytes and cutaneous nerves and for the first time strongly suggest that the nervous system may exert a tonic effect on melanocytes in normal or diseased human skin.

Epidermal innervation correlates with severity of photodamage. A quantitative ultrastructural study

Intraepidermal nerve fibers were studied by electron microscopy in chronically photodamaged preauricular skin and in paired sun-protected postauricular sites of 20 Caucasian women aged 56-70 years. As previously reported, basal keratinocytes in the sun-exposed skin showed various degrees of degenerative changes including intracellular vacuolar structures and widened intercellular spaces. Neurites were frequently closely apposed to basal keratinocytes in preauricular sun-exposed skin, but were observed less than 10% as often in sun-protected postauricular skin. When degree of epidermal photodamage was quantified by means of the number of degenerated keratinocytes per 100 keratinocytes in the basal layer, the number of intraepidermal nerve fibers was significantly correlated by linear regression analysis to the severity of epidermal photodamage (r = 0.913) independent of anatomical sites. These results demonstrate for the first time a correlation between degree of epidermal innervation and chronic photodamage and suggest the possibility of neural involvement in the pathophysiology and/or repair of photodamaged skin.

Expression of 135-kDa insecticidal protein gene from Bacillus thuringiensis in the yeast Saccharomyces cerevisiae

Bacillus thuringiensis subsp. aizawai produces 130-kDa and 135-kDa (CryIA(a)) insecticidal proteins. When Saccharomyces cerevisiae was transformed by the vector carrying a cryIA(a) gene, the gene expression could not be observed. When the 5'-upstream region from the initiation codon was removed using a synthetic oligonucleotide, the CryIA(a) protein was successfully synthesized in yeast. The yeast extract containing CryIA(a) protein had insecticidal activity against Plutella xylostella larvae.

Quantitative evaluation of passive cutaneous anaphylaxis (PCA) using a hand-held spectrophotometer

A hand-held spectrophotometer was used for the quantitative evaluation of PCA caused by anti-TNP-IgE and TNP-BSA. A good relationship existed between the dilution of sera and the value of delta E*ab (a numerical expression of color) obtained by a hand-held spectrophotometer. In addition, the value of delta E*ab and the amount of Evans blue measured by the conventional colorimetric method correlated well. Because the method using a hand-held spectrophotometer provides a simple and objective analysis, it appears that the method is suitable as a substitute for the conventional method, which is time-consuming and requires killing animals cruelly.

[Efficacy of sulbactam/cefoperazone in respiratory tract infections in elderly patients with underlying respiratory diseases]

We examined the clinical effect of sulbactam/cefoperazone (SBT/CPZ) on respiratory tract infections in elderly patients (from 65 to 91, average 70.8) with underlying respiratory diseases. Thirty (30) patients (25 men and 5 women) were registered and SBT/CPZ (2 g/day) divided into two doses, was administered intravenously through drip infusion. The efficacy rate was 63% (excellent in 1 patient and good in 18 patients). No significant difference in efficacy was found among patient's age groups (group 1: 65-69, group 2: 70-74, group 3: 75-79, group 4: > 80). Bacterial eradication rate was 50% (6 out of 12 strains). An adverse reaction occurred in one patient, who experienced uticaria. Laboratory abnormalities, which were increasing with their ages, were observed in 12 patients during the study. These results suggest that SBT/CPZ was effective, but we found it is important to use caution in the treatment of elderly patients on respiratory tract infections with underlying respiratory diseases.

Nitric oxide but not carbon monoxide is involved in spatial learning of mice

The aim of the present study was to elucidate the role of carbon monoxide (CO) in learning and to compare it with that of nitric oxide (NO). Effects of an inhibitor of heme oxygenase which produces CO, Zn-protoporphyrin IX, on passive avoidance learning and spatial learning in mice were examined using step through, step down and water maze tests. Zn-protoporphyrin IX (10, 20 nmol, i.c.v.) affected neither type of learning. In contrast, N-omega-nitro-L-arginine (40 nmol, i.c.v.), an inhibitor of NO synthase, impaired spatial learning, but not passive avoidance learning. These results suggest that NO but not CO is involved in spatial learning.

Histopathological study of stromal smooth muscle cells in fibroadenoma of the breast

Smooth muscle cells are extremely rare stromal components of fibroadenoma. Eighty-five cases of fibroadenoma were reviewed in order to investigate the frequency of smooth muscle cells and to discuss its origin. Of the 85 cases, four (4.7%) cases showed smooth muscle cells in the stroma. Distribution in terms of age and tumor size did not show any difference from other cases. Three cases were classified as an intracanalicular subtype, and one was a mastopathic subtype. The cells possessed most of the ultrastructural characteristics of smooth muscle cells, but poor indentation of nuclear contours suggested the last remnant of fibroblasts. It was therefore easy to recognize the cells derived from fibroblasts. In two of four cases, smooth muscle cells were observed in the stroma, which had marked hyalinization and calcification. Therefore, it was supposed that smooth muscle cells could appear in the stroma of long-standing tumors.

[Measurement of the plasma transforming growth factor-beta 1 (TGF-beta 1) level in patients of gastric carcinoma--compared with the serum IAP level and the lymphocyte subsets (CD3, CD4, CD8)]

We evaluated the clinical significance of the plasma TGF-beta 1 by enzyme-linked immunosorbent assay (ELISA) in 40 patients with gastric carcinoma before operation who were hospitalized at our department between August 1992 and March 1993. Moreover, we examined the correlation of the immunosuppressive acidic protein (IAP) in the serum with the plasma TGF-beta 1 level. The lymphocyte subsets were analyzed with monoclonal antibodies (CD3, CD4, CD8) and compared with the plasma TGF-beta 1 level. Results 1) The plasma TGF-beta 1 was significantly high in patients with advanced stage of gastric carcinoma (with respect to the depth invasion) and poorly differentiated adenocarcinoma (histological type) (p < 0.01). When the carcinoma was macroscopically found to be advanced, TGF-beta 1 was higher in the invasive type than in the noninvasive type (p < 0.05). 2) We found a significant correlation between the plasma TGF-beta 1 and IAP in the serum (n = 25, r = 0.677, p < 0.01). 3) The lymphocyte fraction of CD3, CD4 was decreased in patients with a high level of TGF-beta 1, and was related with the plasma TGF-beta 1 level. Thus, TGF-beta 1 was presumed to be deeply associated with in the growth and progression of gastric carcinoma and related to systemic immunosuppressive reaction.

Free eosinophil granules in urticaria: a correlation with the duration of wheals

To determine the factors associated with the duration of wheals in urticaria, we carried out a quantitative study of mast cells and eosinophils in both peripheral bloods and skin lesions. The percentage of cytoplasmic vacuolation, indicating a result of eosinophil degranulation of all types of specific granules of circulating eosinophils was significantly increased in the long-duration group compared with the short-duration group. Many extracellular free eosinophil granules were observed in the vicinity of disrupted eosinophils in the long-duration wheals. On the other hand, the short-duration wheals had few free eosinophil granules. The number of free eosinophil granules and the percentage of free eosinophil granules to eosinophils were significantly different between the long-and the short-duration wheals, whereas there was no significant difference between the early stage and the late stage of the long-duration wheals. The numbers of all inflammatory cells, eosinophils, and activated mast cells were increased in the late stage of the long-duration wheals. These findings suggest that free eosinophil granules liberated from infiltrating eosinophils by some stimulus may provoke the persistent activation of mast cells, and the mast-cell-derived mediators may induce the persistent state of inflammation in the long-duration wheals.

[Annual daily intakes of Hg, PCB and arsenic from fish and shellfish and comparative survey of their residue levels in fish by body weight]

We have been surveying toxic substances in food and foodstuffs and carrying out a total diet study on the intakes of various substances since 1979 in cooperation with local public institutes in Japan. In this paper, we report the daily intakes of mercury, PCB and arsenic from foods, and the relation between the concentrations of these substance in fish and the fish body weight. The intakes of mercury and arsenic were 6.9-11.0 micrograms/ man/day and 120-230 micrograms/man/day, respectively. The intakes of these substances remained on a stable level from 1979 to 1994. On the other hand, the intake of PCB decreased from 3.1 micrograms/man/day in 1979 to 0.9 microgram/man/day in 1994. Most of the intakes of mercury, PCB and arsenic were derived from the diet group "fish and shellfish". The level of mercury in fish increased with increasing fish body weight. For PCB and arsenic, there was no correlation between these concentrations in fish and the fish body weight, except that mackerel and croaker show a higher concentration of PCB when they are small. Arsenic shows almost a constant level in each fish regardless of their body weight.

Immunologic monitoring of OKT3 induction therapy in cardiac allograft recipients

OKT3 induction therapy was monitored in 31 cardiac allograft recipients during the 1st year posttransplant. Serum level of OKT3, anti-OKT3 antibodies, and interleukin-2 (IL-2) were monitored during the first 2 months posttransplant. These values were retrospectively correlated with allograft rejection episodes which occurred during the 1st year posttransplant and allograft survival rates over a 3-year observation period. We found that OKT3 induction therapy (10-14 days) was not associated with the development of anti-OKT3 antibodies manifest by dropping OKT3 levels during OKT3 therapy, and is not associated with the development of vascular rejection in our patient population. Patients with high titer ant-OKT3 antibodies, erratic serum OKT3 levels, and/or high serum IL-2 levels (> or = 5 ng/ml) during the first 2 months posttransplant showed a higher incidence of allograft rejection (predominantly cellular rejection) during the 1st year posttransplant and showed lower allograft survival rates. We also showed that a concomitant elevation of serum IL-2 levels was found in patients who developed anti-OKT3 antibodies. CD3+ T-cell levels were not predictive of inefficacy of OKT3 therapy. We conclude that immunologic monitoring of serum OKT3, anti-OKT3 antibody, and possibly serum IL-2 levels is critical for identification of patients who develop early, OKT3-resistant rejection episodes and for the identification of patients who may be more susceptible to allograft rejection and decreased allograft survival long after completion of OKT3 therapy.

[Imaging diagnosis of Creutzfeldt-Jakob disease]

Creutzfeldt-Jakob disease (CJD) is one of the "prion" diseases. MRI has been reported to detect some findings in this disease, particularly high intensity in the basal ganglia on T2WI. We reviewed six cases of CJD, and found additional characteristic findings. Cerebral atrophy was detected in two of six cases, and in one of these two, it progressed markedly during 8 months. No abnormal density or abnormal signal intensity was detected on CT or T1WI of MRI. Cerebral angiography was done in one patient, and no abnormality was detected. High signal intensity on T2WI in the basal ganglia was detected in five of six cases (83%). T2WI showed high signal intensity in the cerebral cortex in four of six cases (67%), and in three cases the temporal cortex was involved. The high signal intensity in the temporal cortex appeared prior to the appearance of abnormal intensity in the basal ganglia in two cases. We conclude that the high signal intensity in the temporal cortex on T2WI is an important sign and can lead to early diagnosis of CJD. We consider that these MR findings may represent a "prion" disease, not only CJD.

[Familial breast cancer]

Japanese breast cancer families were collected and classified into the following 7 types according to the onset age and the distribution of other cancers in the family lines; early-onset type, late-onset type, familial breast-ovarian cancer type, familial breast-prostate cancer type, familial breast-thyroid cancer type, familial male and female breast cancer type and multiple primary cancer type. We have detected no p53 germ line mutations in the patients from these families. Linkage with BRCA1 was not detected in any single families. These data indicate that neither BRCA1 or p53 is a major susceptible gene in Japanese familial breast cancer. However, in the two site-specific breast cancer families, the same nonsense mutation of the BRCA1 gene was detected.

[Detection of chromosomal aberration using fluorescence in situ hybridization on breast cancer]

The relationship between interphase cytogenetics and prognostic factors, especially the grade of nuclear atypism, nuclear DNA content, histological lymph node metastasis and clinical data was examined in 48 primary breast cancer specimens (touch preparation). Using fluorescence in situ hybridization (FISH) with a chromosome-specific DNA probe, the copy number of pericentrometric sequences on chromosome 17 was examined within the interphase nuclei in touch preparations from the tumor. The copy number of chromosome 17 was correlated with the increase in the grade of nuclear atypism, tumor size, histological lymph node metastasis and nuclear DNA content. In the diploid type of nuclear DNA content, the copy number of chromosome 17 was correlated with the increase in the grade of nuclear atypism and histological lymph node metastasis. In conclusion, the numerical chromosomal aberrations detected by FISH were found in the DNA diploid cases by FCM. The detection of numerical chromosomal aberrations by FISH provide important information about the prognostic factors.

Differential soluble interleukin-2R levels in bilateral bronchoalveolar lavage after single lung transplantation

Preliminary reports suggest that measurement of the soluble 55 kd subunit of the interleukin-2 receptor may facilitate the diagnosis of allograft rejection in solid organ transplants. Levels of soluble interleukin-2 receptor in serum or plasma have previously lacked sufficient sensitivity and specificity for the diagnosis of acute allograft rejection. Because single lung transplantation is preferentially performed for nonseptic end-stage pulmonary and cardiopulmonary maladies, we questioned whether the pattern of soluble interleukin-2 receptor recovery in bronchoalveolar lavage fluid obtained from both the native and transplanted lungs may enhance correct diagnosis. Fifty-three consecutive fiberoptic bronchoscopic procedures were performed with bilateral bronchoalveolar lavage fluid. Transbronchoscopic biopsies were histologically classified by the International Society for Heart Transplantation Working Formulation for Standardized Nomenclature. "Soluble interleukin-2 receptor index" was calculated as the quotient of soluble interleukin-2 receptor (in units per milliliter) by enzyme-linked immunosorbent assay, divided by protein (in milligrams per milliliter) to correct for differences in bronchoalveolar lavage fluid techniques and cellularity. Soluble interleukin-2 receptor indexes were significantly increased in the allograft bronchoalveolar lavage fluid during histologic grade A (acute rejection) versus normal transbronchoscopic biopsy specimens (3395 +/- 1298 U/mg versus 76 +/- 21 U/mg) associated with an increased transplanted/native lung ratio (69.9 +/- 46 versus 2 +/- 1 [mean +/- standard error of the mean]) (one-way analysis of variance, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of alpha-linolenic acid on the metabolism of omega-3 and omega-6 polyunsaturated fatty acids and histamine release in RBL-2H3 cells

We examined the effect of alpha-linolenic acid (18:3 (n-3)) pretreatment on the metabolism of omega-3 and omega-6 polyunsaturated fatty acids and histamine content and release of RBL-2H3 cells. RBL-2H3 cells grew without reduction in number when incubated with subculture media for 3 d and then placed again in serum-free medium with bovine serum albumin (BSA) and epidermal growth factor (EGF). Cholesterol pullulan (10 micrograms/ml) emulsified alpha-linolenic acid (20 micrograms/ml) was recommended as an additional form serum free medium. We determined the fatty acid composition in all neutral lipids, free fatty acids and all phospholipids in alpha-linolenic acid-treated cells. In all cases the concentration of alpha-linolenic acid and docosahexenoic acid (DHA, 22:6 (n-3)) was increased, while linolenic acid (18:2 (n-6)) was slightly and arachidonic acid (20:4 (n-6)) was markedly decreased. Content of histamine in alpha-linolenic acid-treated cells was remarkably lower than that of untreated cells. Accordingly, net histamine release stimulated by antigen or A23187 was also markedly decreased in the alpha-linolenic acid-treated cells, as was the percent histamine release stimulated by antigen. Results from our in vitro experiment suggest that the anti-allergic effect of alpha-linolenic acid may be caused either by the decrease in histamine content or by inhibition of the release of chemical mediator resulting from changes in the fatty acid composition.

Treatment of autoimmune diseases and systemic vasculitis with pooled human intravenous immune globulin

Treatment of autoimmune and vasculitic disorders with intravenous immune globulin (IVIG) has shown great promise. IVIG appears to provide large amounts of immunoregulatory substances that have the capacity to regulate the immune system in various ways. The ability of IVIG to regulate deleterious autoimmune responses and disease is largely directly related to its ability to stimulate the production of anti-idiotypic autoantibodies after infusion. In this respect, IVIG represents a novel immunoregulatory agent with the ability to control autoimmune and vasculitic disorders without subsequent predisposition to infectious complications. Future work and controlled clinical trials will be necessary to prove the efficacy of this therapy for specific autoimmune and vasculitic disorders.

Magnetic resonance imaging and quantitative analysis of contents of epidermoid and dermoid cysts

The intracapsular cholesterol, protein, and calcium contents of epidermoid and dermoid cysts from seven patients were compared with the signal intensities on T1-weighted spin-echo magnetic resonance (MR) images. All specimens had a paste-like consistency when resected. Epidermoid and dermoid cysts demonstrated a wide range of cholesterol and calcium contents, and epidermoid cysts were not always rich in cholesterol. Five patients had cysts with lower signal intensity than white matter, which contained more than 18.3 mg/g wet weight of protein. One of these patients had the highest cholesterol content of all seven patients (22.25 mg/g wet weight) and another had the highest calcium content (0.75 mg/g wet weight). Two patients had cysts with higher signal intensity than white matter, with protein contents of lower than 4.3 mg/g wet weight. High protein content (> 18.3 mg/g wet weight) may decrease signal intensity on T1-weighted MR images, while low protein content (< 4.3 mg/g wet weight) may increase signal intensity in epidermoid and dermoid cysts with high viscosity (paste-like consistency) contents.

Pathogenesis in pili torti: morphological study

To clarify the mechanism of pili torti formation, hair materials obtained from a patient with the typical classical type of pili torti were examined. Light microscopy, scanning electron microscopy (SEM), transmission electron microscopy, (TEM) and 3-D analysis revealed that: (1) The hair shaft was partly flattened. The hairs twisted clockwise or counter-clockwise on their own axis and some hairs were knotted. (2) Short hairs showed disruptions at the flattened or unflattened regions, at the knot, or at the root of branched hairs caused by longitudinal ruptures. (3) Light microscopically, cell vacuolation and irregularity in thickness of the outer root sheath (ORS) at the suprabulbar level were seen. At the middle to upper levels of the follicles, some eosinophilic pyknotic ORS cells were observed scattered around. (4) At the upper levels, the ORS and inner root sheath (IRS) partly revealed irregularity of thickness and formed an irregular-shaped hair canal. (5) By DACM staining, cytoplasmic SH fluorescence showed an irregular arrangement of the ORS cells. Some abnormal SH- or SS-positive cells were observed scattered throughout the ORS. (6) Ultrastructurally, the irregularities in thickness and cell shape of the IRS and ORS became visible at the level, where the Henle's layer keratinized. In the hair cortex, there was no abnormality of nuclei and the keratin fibers were normally produced, although fibers were partially wavy. (7) By 3-D analysis, hair twist was already seen at the middle level of the hair follicles.(ABSTRACT TRUNCATED AT 250 WORDS)

Modulation of immunoglobulin production and cytokine mRNA expression in peripheral blood mononuclear cells by intravenous immunoglobulin

Intravenous immunoglobulin (IVIG) has the potential to regulate Ig production, but the mechanism(s) responsible for this effect is unknown. In experiments reported here, we examined the ability of IVIG to regulate Ig production in human peripheral blood mononuclear cells (PBMCs) stimulated with pokeweed mitogen (PWM). IVIG (2-10 mg/ml) showed a potent (80-85%) inhibition of PWM-stimulated IgG, IgM, and IgA production. To determine more precisely how IVIG mediated the inhibition of Ig production, we studied Ig promoting cytokine gene expression after PWM stimulation with or without IVIG (2 and 10 mg/ml) using dot-blot techniques. RNA was isolated from PBMCs at predetermined time points and probed with cDNAs specific for human cytokines (IL-1 beta, IL-2, IL-2R, IL-4, IL-5, IL-6, gamma-IFN, and TNF-alpha). IL-6 mRNA accumulation was maximal at 4.5 hr post-PWM stimulation and was inhibited 64-75% when IVIG (10 mg/ml) was present. gamma-IFN mRNA levels peaked at 72 hr poststimulation and were also 68-75% inhibited by IVIG. IL-2 mRNA levels peaked at 4.5 hr and were 23-46% inhibited by IVIG. The inhibitory effect of IVIG on production of these cytokines (IL-6 and gamma-IFN) was also observed at the protein level in sonicated PBMCs after incubation with PWM and IVIG. The mRNA levels for other cytokines were not or only minimally inhibited by IVIG. Addition of IL-6, gamma-IFN, or IL-2 partially restored Ig production in IVIG-treated PWM-stimulated cultures, suggesting that inhibition of other cytokines or another mechanism(s) independent of cytokine inhibition might also be involved, although inhibition of IL-6, gamma-IFN, and IL-2 may be one of the critical factors in the suppression of Ig production by IVIG.

Determination of tomatine in foods by liquid chromatography after derivatization

A liquid chromatographic method for measuring tomatine levels in tomatoes and tomato products was developed. Tomatine was extracted with 1% acetic acid and purified on a C18 cartridge. Tomatine in the eluate was acetylated with acetic anhydride and isolated on a C18 cartridge. The solvent in the eluate was evaporated and the residue was dissolved in acetonitrile. An aliquot was injected into an Inertsil ODS-2 HPLC column and the acetylated tomatine was measured at 205 nm using a UV detector. The limit of determination was 1 microgram g-1. Tomatine was detected in the green portions of tomatoes and in tomato ketchups and juices at levels below 7 micrograms g-1.

Suppression of intestinal smooth muscle contraction by 4-ethylguaiacol, a constituent of wood creosote

Wood creosote, a mixture of phenolic compounds, suppresses in vitro contractions of rat intestine. To identify a compound in wood creosote able to inhibit intestinal motility, we screened its constituent phenolic compounds and found 4-ethylguaiacol (4-EG) as an active compound. It suppressed the spontaneous phasic (IC50 = 513 +/- 48 mumol/l) as well as spasmogenic-agent-induced tonic longitudinal contractions of isolated rat ileum in a reversible and concentration-dependent manner. KCl-depolarization-induced tonic contraction, which was susceptible to a calcium channel blocking agent, was also suppressed by 4-EG with an IC50 of 433 +/- 41 mumol/l. Furthermore, calcium-ionophore-induced contraction, which was affected by an influx of extracellular calcium ion that bypassed calcium channels, was suppressed by 4-EG with an IC50 of 97 +/- 18 mumol/l. These results support the concept that the effect of wood creosote to suppress intestinal motility is attributable, partially or entirely, to its component 4-EG and that this effect of 4-EG on the intestinal muscle is produced at some stage(s) of the muscle contraction process after influx of extracellular calcium into the cytosol of smooth muscle.

Tracheobronchial AL amyloidosis: histologic, immunohistochemical, ultrastructural, and immunoelectron microscopic observations

We have studied three cases of localized amyloidosis in the lower respiratory tract. Amyloid was nodularly or diffusely deposited in the lamina propria of the tracheobronchial mucosa. Its nature was confirmed by Congo red staining with green birefringence on polarized microscopy. "Tracheobronchopathia osteoplastica" also was demonstrated. Plasma cells and lymphocytes were scant in the amyloid mass. Few fibroblasts and even fewer macrophages were seen. The number of plasma cells was not increased in the bone marrow in any of our cases. Amyloid fibrils were demonstrated by electron microscopic examination. The amyloid P component was detected by immunohistochemical methods. The precursor protein of amyloidosis was shown to be amyloid L protein by the postembedding protein-A gold technique with anti-light chain antisera. The role of the plasma cells in amyloid formation, however, could not be ascertained. Based on these observations, amyloid fibril formation in tracheobronchial amyloidosis appears to be related to light chains secreted by local plasma cells, combined with amyloid P, calcium, and other factors.

Serum cytokine levels in heart allograft recipients: correlation with findings on endomyocardial biopsy

The ability to detect rejection of human cardiac allografts depends on endomyocardial biopsy diagnosis. Because cytokines are known to mediate allograft rejection events, we chose to examine serum levels of specific cytokines and receptors (interleukin-2 [IL-2], IL-2 receptor [IL-2R], and tumor necrosis factor alpha [TNF-alpha]) and to correlate those levels with findings on endomyocardial biopsy. Sequential sera samples from 23 cardiac allograft recipients were examined for the cytokine levels mentioned, and data correlated with findings on endomyocardial biopsy. Briefly, no statistically correlation of serum cytokine or receptor levels with the stage of allograft rejection was found. When sequential serum cytokine levels were determined in patients experiencing humoral and cellular allograft rejection events, the levels of TNF-alpha appeared to correlate well with endomyocardial biopsy findings. IL-2 and IL-2R levels in two patients who never experienced rejection were elevated on occasion, but TNF-alpha levels were always negative. In summary, measurement of serum cytokine (IL-2, IL-2R) levels in cardiac allograft recipients does not appear to correlate with findings on endomyocardial biopsy; however, elevated levels of TNF-alpha appear to predict more severe humoral allograft rejection episodes and may be helpful in this regard.

Suppression of intestinal smooth muscle contraction by phenolic compounds

Wood creosote, a mixture of guaiacol, creosol, and other related phenolic compounds, suppresses the spontaneous longitudinal phasic contractions of an isolated rat ileal segment. Thirty-two phenolic compounds were screened for this activity to identify the active substances in wood creosote. Of the 32 compounds tested, 2,3,6-trimethylphenol, 2,4,6-trimethylphenol, and 4-ethylguaiacol were most effective and their respective IC50 values were 0.035, 0.037, and 0.043 mM. Guaiacol and creosol, the chief constituents of wood creosote, were moderately effective and their respective IC50 values were 0.18 and 0.13 mM. Other phenolic compounds in wood creosote also suppressed the ileal contraction although their IC50 values differed markedly from each other. These results suggest that practically all of its constituent phenolic compounds contribute to wood creosote's capacity to suppress ileal contraction.

Serum interleukin-2 levels in lung transplant recipients: correlation with findings on transbronchial biopsy

Serum interleukin-2 (IL-2) levels were examined in the serum of 17 lung transplant recipients who underwent transbronchial biopsies to diagnose reasons for allograft dysfunction. Over 60 transbronchial biopsies were performed in these 17 patients in a 22-month observation period. Mean serum IL-2 levels were significantly elevated in patients experiencing allograft rejection (p less than 0.01), cytomegalovirus pneumonia (p less than 0.0006), and bacterial/fungal pneumonia (p less than 0.01), when compared with those with normal or nondiagnostic findings on transbronchial biopsies. Serum IL-2 levels were not extraordinarily elevated as seen in other types of allograft rejection and did not differentiate between infection and rejection. In addition, overlapping values were seen in the patient groups tested. Despite these limitations, elevated serum IL-2 levels in lung allograft recipients may provide supplemental information helpful in deciding when to perform transbronchial biopsies.

Length of the human umbilical cord in multiple pregnancy

The factors controlling the length of the human umbilical cord are uncertain. In the generally accepted 'tension theory', the length of the umbilical cord is proposed to increase the tensile force on it in the uterus. The greatest tensile force is supposed to be fetal movement. If this is so, the length of the umbilical cord should be shorter in multiple pregnancy than in single pregnancy. To examine this possibility we measured the umbilical cord lengths in 3314 singleton births, 82 twins births (164 infants), and 11 triplet or quadruplet births (35 infants). The cord lengths in multiple pregnancies (twins 51.3 cm, triplets and quadruplets 50.1 cm) tended to be shorter than that in singleton pregnancies (57.2 cm). However, no significant difference was found in the ratio of the umbilical cord length to the infant body weight in these groups. Therefore, we conclude that an important factor in determining the cord length is the size of the infant.

Characterization of contaminants in EMS-associated L-tryptophan samples by high-performance liquid chromatography

To identify chemical contaminant(s) associated with eosinophilia-myalgia syndrome (EMS), case and control lots of tryptophan were analyzed by HPLC with both UV and FL detection. Numerous contaminant peaks appeared on the chromatograms and some of them were identified as 5-hydroxytryptophan, indol aldehyde, indol, etc; from the retention time of authentic compounds. Among these, three peaks were significantly associated with case lots. One corresponds to di-tryptophan aminal of aldehyde (peak E). Others are unknown contaminants, UV-5 (FL-7) and UV-28 (FL-36). The structural elucidation and toxicological implication of UV-5 (FL-7) are currently in progress.

Characterization of AL amyloid protein identified by immunoelectron microscopy: a simple method using the protein A-gold technique

The classification of amyloidosis depends on the chemical nature of the specific amyloid protein involved. Because AL amyloid protein consists mainly of variable regions of light chain (LC), immunohistochemical staining with conventional anti-LC antisera cannot identify its protein. We were able to classify three cases of AL amyloidosis, including one case of AL-kappa LC and two cases of AL-lambda LC, using post-embedding protein A-gold immunoelectron microscopy on autopsy-derived tissues. We describe here our procedure in which a protein A-gold staining apparatus was used. The main advantage of this method is that many sections can be stained and washed simultaneously under the same conditions. These results suggest that the post-embedding protein A-gold technique using conventional kappa or lambda LC may be useful in diagnosing AL amyloidosis.