Processing of a fusion protein by endoprotease in COS-1 cells for secretion of mature peptide by using a chimeric expression vector

The subtilisin-related proprotein convertase furin is expressed in various mammalian tissues. Expecting that COS-1 cells have a furin-like endoprotease, we constructed a fusion expression vector for production of a recombinant foreign protein having no signal peptide or a protein in truncated form into secreted mature protein. A cDNA fragment encoding N-terminal procalcitonin (pro-CT) of human calcitonin precursor was inserted into the mammalian expression vector pME18S. We used PCR techniques to generate four kinds of cDNAs encoding the C terminus of the pro-CT with Arg residues at P4 (Arg-Xaa-Lys-Arg), P6 (Arg-Xaa-Xaa-Xaa-Lys-Arg), or both (Arg-Xaa-Arg-Xaa-Lys-Arg), in addition to the Lys-Arg motif at the cleavage site, in order to determine the conditions for efficient processing in nonendocrine cells, such as COS-1 cells. The cDNA coding for the Fc fragment of human immunoglobulin G1 was fused in-frame to the cDNA encoding pro-CT at its C terminus. Upon transfection of the chimeric plasmids into COS-1 cells, almost all of the fusion protein with the Arg residues at both P4 and P6 were processed into secreted Fc product, even without cotransfection of furin. These results indicate that COS-1 cells have a furin-like endoprotease and suggest that pro-CT, with the Arg residues at both P4 and P6, can be used as a carrier peptide for expression of a foreign protein having no signal peptide or a protein in truncated form in COS-1 cells.

[Cross-allergenicity between rice and buckwheat antigens and immediate hypersensitive reactions induced by buckwheat ingestion]

Immediate hypersensitive reactions (IHR) induced by buckwheat ingestion are considered to be IgE-mediated. However we found 28 subjects without IHR to buckwheat ingestion out of 46 subjects who had positive RAST values for both buckwheat and rice antigens. The IHR-positive group showed significantly higher RAST values for buckwheat antigens (p < 0.01) but lower RAST values for rice antigens (p < 0.01) than did the IHR-negative group. RAST values for buckwheat and rice were significantly correlated with each other (p < 0.01) in the IHR-negative group, but not in the IHR-positive group. An effective dose-dependent inhibition was obtained in a RAST inhibition assay between homologous combinations of inhibitor and disc antigens such as rice and rice or buckwheat and buckwheat. The IHR-positive group showed no significant RAST inhibition between heterogeneous combinations of rice and buckwheat antigens. In contrast, the IHR-negative group showed a significant decrease in IgE binding even in the RAST inhibition assay between heterogenous combinations. These results led to the conclusion that there is cross-reactivity with IgE antibodies between buckwheat and rice and that IgE antibodies from IHR-negative subjects might recognize the epitopes on buckwheat antigens which cross react with rice antigens, whereas IgE antibodies from IHR-positive subjects might bind to buckwheat-specific epitopes.

Cardiovascular response and red cell membrane sodium transport in hypertensive cardiac hypertrophy

To investigate the involvement of the sympathetic nervous system and cell membrane sodium transport in hypertensive cardiac hypertrophy, we divided 51 middle-aged male patients with essential hypertension into cardiac hypertrophy and noncardiac hypertrophy groups. We then compared the plasma noradrenaline concentration after exercise, the cardiovascular response to exercise and sympathomimetic agents, and cell membrane sodium transport in the two groups. There were differences between the cardiac hypertrophy and noncardiac hypertrophy groups with regard to the pressor response to exercise and noradrenaline (i.e. the response to sympathetic alpha-receptor stimulation) as well as the intracellular sodium concentration and cell membrane sodium transport. We concluded that there were abnormalities of the pressor response to alpha-receptor stimulation and of intracellular sodium concentration and cell membrane sodium transport in patients with hypertension and cardiac hypertrophy. These abnormalities might play some role in the pathogenesis of hypertensive cardiac hypertrophy.

[Accumulation of a disopyramide metabolite in renal failure]

Twenty-nine cases of hypoglycemia induced by disopyramide (DP) have been reported in the literature to date. Twenty of the reported cases showed hypo-renal function and a high concentration was rare. DP is metabolized to mono-N-dealkyldisopyramide (MND) in the liver and accumulation of MND is to be expected in renal failure. Both DP and MND bind mainly to alpha-1-acid glycoprotein (AAG) in the plasma. In 10 hemodialysis (HD) patients with normal liver function receiving DP therapy in the steady state. DP, MND and AAG were measured pre- and post-HD. Ten patients with normal renal and liver function were selected as the controls. The DP concentration was 2.08 +/- 0.39 micrograms/ml (mean +/- SD) in the control group, and the pre- and post-HD levels were 2.40 +/- 1.08 micrograms/ml and 1.73 +/- 0.87 micrograms/ml, respectively, in the HD group. The MND concentration was 0.42 +/- 0.23 micrograms/ml in the controls, 1.53 +/- 0.52 micrograms/ml in pre-HD and 1.08 +/- 0.32 micrograms/ml in post-HD. Although DP and MND are both classified as substances of small molecular weight, the average decrease in plasma concentration from pre- to post-HD was under 30% with both agents. The MND/DP ratio in the HD group was higher than in the controls, but there was no significant difference between pre- and post-HD. The AAG level was 75 +/- 5mg/dl in the controls and 109 +/- 11mg/dl before HD in the HD group (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Immunohistochemical localization of plasminogen activator inhibitor-1 in human coronary atherosclerotic lesions involved in acute myocardial infarction

Immunohistochemical localization of plasminogen activator inhibitor-1 (PAI-1) was studied using the streptavidin-biotin method in human atherosclerotic coronary arteries. The patients (one male and two females), whose ages ranged from 61 to 78 years, died of anteroseptal acute myocardial infarction without having received any thrombolytic therapy. PAI-1 immunoreactivities (IRs) were mainly detected in the endothelial cells, smooth muscle cells, and collagen fibers of the coronary arterial intima and not in thrombi. Remarkable immunohistochemical staining was seen in intimal collagen fibers. In one patient, intimal PAI-1 IRs partly bordered a thrombus and surrounded a large atheroma rich in cholesterol crystals. Our results suggest that PAI-1 is present in both cellular and extracellular components of human coronary atherosclerotic lesions.

Quantitative structure-activity relationship (QSAR) study of elastase substrates and inhibitors

One hundred Suc-X-Y-Ala-pNA peptides: (Suc: succinyl, pNA: p-nitroanilide, X, Y: Gly, Ala, Val, Leu, Ile, Phe, Pro, alpha-aminobutyric acid, norvaline, norleucine) were synthesized and their reaction constants with porcine pancreatic elastase (Km, kcat and kcat/Km) were determined. These reaction constants were quantitatively analyzed using the Free-Wilson/Fujita-Ban method. The contribution of amino acid side chains to the reaction constants Km, kcat and kcat/Km, expressed logarithmically, was found to be additive. On the other hand, 19 elastase inhibitors of the general formula CF3CO-X-Y-Ala-pNA (X,Y: ten amino acids) were synthesized, and their inhibition constants were compared with the Michaelis constant for the corresponding substrates and analyzed using free-energy-related substituent constants. In the analysis of amino acid side chains in the Y position, the Ki value of the inhibitor was generally correlated to the Km value of the substrate, which corresponded to the inhibitor, thus confirming the validity of the equation. log(1/Ki) = 1.271 log(1/Km) + 4.831 This study may serve as a prototypical approach to unraveling structure-activity relationships of peptide substrates and inhibitors of medicinal or agricultural importance.

Expression of intercellular adhesion molecule-1 on cardiac myocytes for myocarditis before and during immunosuppressive therapy

Right ventricular endomyocardial biopsies were performed in 15 patients with unexplained cardiac dysfunction, and the expression of intercellular adhesion molecule-1 (ICAM-1) on the myocardium was examined using the streptavidin-biotin complex method. Three of 15 patients (20%) had histologic evidence of myocarditis, and 2 of 15 patients (13%) had borderline myocarditis. The patients with biopsy-proven myocarditis received immunosuppressive therapy (prednisolone 60 mg/day). Two of the 3 patients demonstrated a substantial increase (> 10%) in percent fractional shortening and left ventricular ejection fraction during therapy. Subsequent biopsies revealed ongoing myocarditis in 1 patient, and resolved myocarditis in the other. The remaining patient had persistent cardiac dysfunction, but the subsequent biopsy revealed resolving myocarditis. ICAM-1 immunoreactivity was observed on cardiac myocytes, vascular endothelial cells, and interstitial cells of the patients with myocarditis. However, in patients without myocarditis, ICAM-1 immunoreactivity was observed only on vascular endothelial cells and interstitial cells. ICAM-1 immunoreactivity was still observed on cardiac myocytes in the patients with ongoing or resolving myocarditis during immunosuppressive therapy, but was not detected in the patient with resolved myocarditis. This study demonstrates that ICAM-1 is expressed on cardiac myocytes of patients with myocarditis and persistent cardiac dysfunction despite immunosuppressive therapy. The persistent expression of ICAM-1 may cause chronic inflammation of the myocardium.

A common T-cell epitope between human thyroglobulin and human thyroid peroxidase is related to murine experimental autoimmune thyroiditis

We have investigated functional common T-cell epitopes between human thyroglobulin (hTg) and human thyroid peroxidase (hTPO) in mice. Four hTg peptides, Tg-P1, Tg-P2, Tg-P3 and Tg-P4, in which 5 amino acid residues are identical to those of hTPO, and 1 hTPO peptide, TPO-P4 relevant to Tg-P4, were prepared. Among these peptides, only Tg-P4 (residues 2730-2743) and TPO-P4 (residues 118-131) were highly antigenic and both peptides shared the common T-cell epitope. In addition, when the spleen cells from mice immunized with mouse Tg (mTg) were restimulated in vitro by Tg-P4 or TPO-P4 as well as by mTg, these cells transferred thyroiditis to naive recipient mice. These findings indicate that this common T-cell epitope between hTg and hTPO is immunogenic and related to the development of murine experimental autoimmune thyroiditis.

[Peripheral polyneuropathy due to sarcoidosis in a patient with intrathoracic, ocular and skin lesions]

Sarcoidosis is a multisystem disorder of unknown etiology presenting most frequently with bilateral hilar lymphadenopathy (BHL), pulmonary infiltration, and ocular and skin lesions. Neurological manifestations are found in about 5% of patients with systemic sarcoidosis. We report the case of a 58-year-old woman with neurosarcoidosis manifesting as isolated, peripheral polyneuropathy. This is a rare neurological manifestation. Two years before admission, she was found to have an abnormal chest radiograph showing BHL, and pulmonary sarcoidosis was diagnosed by lung biopsy. Six months later, she noted facial erythematous lesions, and lupus pernio was confirmed by skin biopsy. Fifteen months before admission, she developed visual disturbance of the right eye caused by sarcoid-uveitis. Two months before admission, she complained of paresthesia and weakness of limbs. She was admitted for nerve-biopsy. Sural nerve biopsy revealed sarcoid granulomas in the epineurial space, periangitis and axonal degeneration. Neurologically, the diagnosis of mononeuritis multiplex without cranial nerve palsy was made. Treatment with 30 mg prednisolone daily was initiated, and neurological and extraneurological improvement was noticeable within two weeks of treatment. The dose was carefully lowered over several months.

Distant metastasis of hepatocellular carcinoma after successful treatment of the primary lesion

Recent advances in both diagnosis and treatment of hepatocellular carcinoma (HCC) have improved the prognosis and changed the clinical significance of the subsequently increasing distant metastases. Of 163 patients with HCC, 76 (47%) were treated successfully. The cumulative recurrence rate in these patients was 65% after 3 years, and 82% after 5 years. Six patients with HCC in whom distant metastases were detected after successful treatment of the primary lesion, are reported. Two patients underwent curative surgical resection, and four cases were treated medically, resulting in a 31.9 to 94.3% reduction in tumor size in the CT scan image. Distant metastases without intrahepatic recurrence were diagnosed 10 to 46 months after the treatment of the primary lesions. The sites of the metastases included bone 3; lung 2; and adrenal gland 1. Distant metastases found after successful treatment of the primary lesions are of great clinical significance for the treatment of HCC.

Effect of nicardipine on the blood flow velocity in the vessel near a cerebral aneurysm of the internal carotid artery during cerebral aneurysm surgery: its therapeutic use for intra-operative hypertension

Seven patients scheduled for clipping of an aneurysm of the internal carotid artery after subarachnoid haemorrhage, were studied in order to evaluate the efficacy of a bolus injection of nicardipine (2 mg) in the treatment of intra-operative hypertension on the blood flow velocity of vessel near the aneurysm under isoflurane anaesthesia. The blood flow velocity of the vessel near the aneurysm was measured using a 20 MHz ultrasound Doppler flowmeter. Nicardipine bolus significantly decreased the mean arterial blood pressure by about 30% (P < 0.01). The blood flow velocity of the internal carotid artery increased after the nicardipine bolus (from 43.3 +/- 9.9 to 51.7 +/- 15.0 cm s-1) (P < 0.05) but returned to the pre-injection level within 30 min (43.9 +/- 10.4 cm s-1). Nicardipine proved effective for control of intra-operative hypertension during aneurysm clipping.

Accumulation of a disopyramide metabolite in renal failure

Ten hemodialysis (HD) patients with normal liver function received disopyramide (DP) therapy in the steady state. DP, mono-N-dealkyldisopyramide (MND) and alpha-1-acid glycoprotein (AAG) were measured before and after HD. Ten patients with normal renal and liver function were selected as controls. The DP concentration was 2.08 +/- 0.39 micrograms/ml (mean +/- SD) in the control group, and the pre and post HD levels were 2.40 +/- 1.08 micrograms/ml and 1.73 +/- 0.87 micrograms/ml, respectively, in the HD group. The MND concentration was 0.42 +/- 0.23 microgram/ml in controls, 1.53 +/- 0.52 micrograms/ml in pre HD and 1.08 +/- 0.32 microgram/ml in post-HD. Although DP and MND are both classified as small molecular weight substances, the average decrease in plasma concentration from pre to post HD was under 30% with both agents. The MND/DP ratio in the HD group was higher than in controls, but there was no significant difference between pre and post HD. The AAG level was 75 +/- 5 mg/dl in controls and 109 +/- 11 mg/dL before HD in the HD group (p < 0.001). In conclusion, an MND accumulation was observed in HD patients receiving DP therapy. Because the anticholinergic effect of MND is 24 times that of DP, MND is thought to contribute in some way to the hypoglycemia induced by DP in renal failure.

Trans-activation and stable integration of the maize transposable element Ds cotransfected with the Ac transposase gene in transgenic rice plants

To develop an efficient gene tagging system in rice, a plasmid was constructed carrying a non-autonomous maize Ds element in the untranslated leader sequence of a hygromycin B resistance gene fused with the 35S promoter of cauliflower mosaic virus. This plasmid was cotransfected by electroporation into rice protoplasts together with a plasmid containing the maize Ac transposase gene transcribed from the 35S promoter. Five lines of evidence obtained from the analyses of hygromycin B-resistant calli, regenerated plants and their progeny showed that the introduced Ds was trans-activated by the Ac transposase gene in rice. (1) Cotransfection of the two plasmids is necessary for generation of hygromycin B resistant transformants. (2) Ds excision sites are detected by Southern blot hybridization. (3) Characteristic sequence alterations are found at Ds excision sites. (4) Newly integrated Ds is detected in the rice genome. (5) Generation of 8 bp target duplications is observed at the Ds integration sites on the rice chromosomes. Our results also show that Ds can be trans-activated by the transiently expressed Ac transposase at early stages of protoplast culture and integrated stably into the rice genome, while the cotransfected Ac transposase gene is not integrated. Segregation data from such a transgenic rice plant carrying no Ac transposase gene showed that four Ds copies were stably integrated into three different chromosomes, one of which also contained the functional hph gene restored by Ds excision. The results indicate that a dispersed distribution of Ds throughout genomes not bearing the active Ac transposase gene can be achieved by simultaneous transfection with Ds and the Ac transposase gene.

Observation of biological materials by X-ray photoelectron-conversion contact microscopy

Dried biological specimens, such as fossil diatoms, collagen, nerve tissue and spicule of Trepang, were observed by X-ray photoelectron-conversion contact microscopy. A spatial resolution of 0.2 microns was attained. The fossil diatom image shows a clear difference below and above the carbon K-absorption edge (4.46 nm).

Structure and expression of novel protein-tyrosine kinases, Emb and Emt, in hematopoietic cells

Two novel tyrosine kinase cDNAs were obtained from murine mast cells. These kinases, Emb and Emt, constitute a novel tyrosine kinase subfamily which may also include Tec, a kinase preferentially expressed in liver, and Dsrc28, a fruit fly kinase. Both lack hydrophobic stretches characteristic of the transmembrane domains found in growth factor receptor tyrosine kinases and carboxyl-terminal, negative regulatory tyrosine residue found in Src family kinases. In addition to the Src homology region 2 (SH2) and SH3 domains characteristic of the Src family kinases and other signaling molecules, Emb and Emt share a similar amino-terminal domain comprised mainly of two repeat segments. The emb 2.7-kb transcript was expressed in mast cells, myeloid cells and B lymphocytes while the emt 4.6-kb mRNA in mast cells, myeloid cells and T lymphocytes. The evidence for in vitro tyrosine kinase activity of Emb and Emt proteins is also provided.

Lack of peptide-release activity responding to codon UGA in Mycoplasma capricolum

In Mycoplasma capricolum, a relative of Gram-positive eubacteria with a high genomic AT-content (75%), codon UGA is assigned to tryptophan instead of termination signal. Thus, in this bacterium the release factor 2 (RF-2), that recognizes UAA and UGA termination codons in eubacteria such as Escherichia coli and Bacillus subtilis, would be either specific to UAA or deleted. To test this, we have constructed a cell-free translation system using synthetic mRNA including codon UAA [mRNA(UAA)], UAG [mRNA(UAG)] and UGA [mRNA(UGA)] in-frame. In the absence of tryptophan, the translation of mRNA(UGA) ceased at UGA sites without appreciable release of the synthesized peptides from the ribosomes, whereas with mRNA(UAA) or mRNA(UAG) the bulk of the peptides was released. Upon addition of the E.coli S-100 fraction or B.subtilis S-100 fraction to the translation system, the synthesized peptides with mRNA(UGA) were almost completely released from the ribosomes, presumably because of the presence of RF-2 active to UGA in the added S-100 fraction. These data suggest that RF-2 is deleted or its activity to UGA is strongly weakened in M.capricolum.

Anesthetic interaction between midazolam and halothane in humans

The present study was undertaken in humans to determine the anesthetic efficacy of midazolam in terms of its ability to reduce halothane minimum alveolar anesthetic concentration (MAC). Fifty women scheduled for simple or radical hysterectomy were allocated randomly to one of four groups; group A was given no midazolam as a control; groups B, C, and D were given midazolam intravenously by a bolus of 0.1, 0.2, and 0.4 mg/kg followed by infusion of 1, 2, and 4 micrograms.kg-1 x min-1, respectively. Halothane MAC was 0.78%, 0.47%, 0.38%, and 0.23% at mean serum midazolam concentrations of 0, 134, 250, and 539 ng/mL in groups A, B, C, and D, respectively. The interaction between halothane and midazolam in the anesthetic efficacy conformed to an exponential fit. The results indicate that midazolam produces marked reduction of halothane MAC in humans at serum concentrations lower than that required to cause sleep. Lastly, midazolam's potentiation of halothane has a saturated nature.

Time-related differential effects of epidural morphine on the neuraxis

To clarify the site and potency of the analgesic and anesthetic action of epidurally administered morphine, we investigated the effects of epidurally and intravenously administered morphine (100 micrograms/kg) on change in the pressure pain threshold (PPT) and the minimum alveolar concentration (MAC) of halothane. Epidural morphine (EM) increased PPT significantly (P < 0.01) at the points around the surgical incision by 40% and 60% from baseline compared with intravenous morphine (IM) with which PPT remained at baseline 1 and 2 h after administration, respectively. Duration of analgesia was much longer in EM than in IM (18 h vs 1.7 h). EM increased PPT from preoperative value at the forehead and the points around the surgical incision by 9.9% and -24.9% at 1 h, by 10.9% and 3.8% at 4 h, and by -19.5% and -50.4% at 12 h after administration at mean values, respectively. Halothane MAC in EM and IM were 0.54% and 0.57%, respectively, 40 min after administration. Halothane MAC in EM at 4 h and 12 h after administration were 0.45% and 0.70%, respectively. The results suggest that EM provides long-lasting analgesia by its time-related differential effects on the neuraxis.

A case of appendiceal mucocele showing massive mucous production with concomitant colonic cancer

A 58-year-old male patient presented with abnormal discharge of 200 ml transparent fecal mucus. Irregular protuberance of the ascending colon into the adjacent ileocecal region was observed by colonofiberscopy, and a cystic lesion in the ileocecal region was suggested by computerized axial tomography. Pale yellowish semitransparent jellied substances were observed exudating from the site of ileocecal resection. The diagnosis established was moderately differentiated colonic adenocarcinoma and a mucocele of the appendix. The mucus discharge disappeared after resection. Biochemical analysis of the mucus suggested the mucocele as a source of the discharged mucus. We report an extremely rare case of mucocele of the appendix that may be related to the cause of mucous stool.

[Quantitation of regional myocardial blood flow using continuous inhalation of C15O2 and positron emission tomography]

A C15O2 continuous inhalation and a steady-state theory using positron emission tomography (PET) have been used to quantitate regional cerebral blood flow. We extended this method for quantitative regional myocardial blood flow (RMBF) measurement. Forty-three patients, involving 4 normal volunteers, 16 patients with coronary heart disease (CHD), 20 patients with hypertrophic cardiomyopathy (HCM), and 3 patients with dilated cardiomyopathy (DCM), were studied. 6 min-scan was recorded in the steady-state condition during C15O2 continuous inhalation. A C15O inhalation scan was required to obtain the blood pool image. The subtracted image showed myocardial perfusion image. These images demonstrated homogeneous accumulation in normal volunteers. Reduced accumulation were detected in patients with myocardial infarction. Hypertrophied myocardium was demonstrated in patients with HCM. Diffuse heterogeneous accumulation was demonstrated in patients with DCM. Fourteen patients with HCM, whose left ventricular myocardial thicknesses were more than 20 mm, were selected for the RMBF measurement to minimize errors due to the partial volume effect. The arterial blood activity was measured by assigning a region of interest to the left atrial cavity on PET images. RMBF was calculated using the steady-state theory. Calculated flow values ranged from 21.2 to 152.6 ml/min/100 g. The good correlation was obtained between RMBF using 13NH3 first pass method and RMBF using gas inhalation method in six patients. These results indicate that C15O2 PET has the potential capability for the noninvasive quantitation of RMBF.

Endothelin-2-converting enzyme from human renal adenocarcinoma cells is a phosphoramidon-sensitive, membrane-bound metalloprotease

From the membrane fraction of cultured human renal adenocarcinoma (ACHN) cells, two endothelin-2-converting enzymes (ECE-2A and ECE-2B) were solubilized with detergent Lubrol PX and separated by hydrophobic butyl fast-performance liquid chromatography. The pH range of the converting activity of ECE-2B for big endothelin-1 (big ET-1), big ET-2, or big ET-3, was very narrow, and the optimal pH for each substrate was significantly different; the pH optimum for big ET-1 was 6.8 and that for big ET-2 or big ET-3 was 6.4. The ET-converting activity was abolished by phosphoramidon, 1,10-phenanthroline and EDTA but was not inhibited by thiorphan, E-64, leupeptin, PCMS, p-APMSF, or pepstatin A. The conversion efficiency for big ET-2 or big ET-3 by ECE-2B was approximately one-eighth of that for big ET-1. The molecular weight of ECE-2B was estimated to be 400 kDa by gel filtration. Because these characteristics of ECE-2B are very similar to those of ET-1-converting enzyme (ECE-1) in endothelial cells, these results raise the possibility that ECE-2B is identical to ECE-1 and that a single ECE physiologically converts all big ETs to the corresponding ETs in ET-producing cells.

[A case of primary cardiac amyloidosis with amyloid A protein]

A case of cardiac amyloidosis in a 46-year-old male is reported. He was admitted for dyspnea. Physical examination revealed third and forth heart sound and hepatomegaly. Radiographic heart-thoracic ratio was 53%. Electrocardiogram showed first degree A-V block, rS pattern in V1-V4 leads, and ambulatory electrocardiogram showed ventricular tachycardia. Echocardiogram revealed hypertrophy and highly refractile echoes of the left ventricular wall. Endomyocardial biopsy was performed and it demonstrated amyloid fibrils, which were characterized immunohistochemically as Amyloid A (AA) protein, which is generally a constituent in secondary amyloidosis. Urine protein electrophoresis showed lambda type Bence-Jones protein, but bone marrow biopsy was normal. There was no evidence of malignancy, chronic inflammatory disease, or collagen disease. This case was diagnosed as primary amyloidosis with AA protein. It is rare that, in spite of its being a case of primary amyloidosis, its constituent protein is AA protein.

Effect of phosphoramidon on big endothelin-2 conversion into endothelin-2 in human renal adenocarcinoma (ACHN) cells. Analysis of endothelin-2 biosynthetic pathway

The biosynthetic pathway of endothelin (ET)-2 was analyzed in cultured ACHN cells. In the supernatant, we detected three ET-2-related peptides, ET-2, big ET-2(1-38) and big ET-2(22-38). Phosphoramidon decreased the amount of ET-2 and increased that of big ET-2(1-38) dose-dependently. The amount of big ET-2(1-37) did not significantly change. These results suggest that big ET-2 is composed of 38 and not 37 amino acid residues, and that a putative ET-2-converting enzyme (ECE-2) should be classified as a phosphoramidon-sensitive neutral metalloprotease, bearing a resemblance to the putative ET-1-converting enzyme (ECE-1) in endothelial cells.

Identification of an upstream regulatory region essential for cell type-specific transcription of the pro-alpha 2(V) collagen gene (COL5A2)

The transcriptional features of the human alpha 2(V) collagen gene (COL5A2) were examined by transfection experiments coupled to various DNA binding assays. This approach identified an upstream region essential for the cell type-specific expression of the COL5A2 promoter. Within this region are two nuclear factor-binding sites, FP-A and FP-B, responsible for the formation of distinct DNA-protein complexes. Mutations introduced across each of the two binding sites eliminated the formation of the cognate complex and decreased promoter activity by about 3-fold (FP-A) and 40-fold (FP-B) in transfection experiments. Competition experiments using recognition sequences for known transcription factors exhibiting some similarity to the FP-A- and FP-B-binding sites failed to inhibit COL5A2/protein interactions. Thus, COL5A2 expression appears to be under the positive control of a short regulatory sequence likely to harbor two novel nuclear factor-binding sites.

Clearance of HBsAg in seven patients with chronic hepatitis B

The natural history of chronic hepatitis B patients who spontaneously cleared serum HBsAg was investigated. A total of 351 patients with chronic hepatitis B were observed in our hospital for at least 3 yr. Seven of these patients became HBsAg negative during the follow-up period. HBsAg disappeared within 6 mo (range = 11 to 169 days, mean = 70 days) after acute elevation of ALT. ALT levels as high as 500 IU were found in three patients, whereas such elevation was not demonstrated in the other four patients. After the disappearance of HBsAg, ALT levels returned to normal in all patients. With one exception, all patients seroconverted to antibody to HBsAg; however, hepatitis B virus DNA remained detectable in serum using the polymerase chain reaction in five patients. The titer of percent inhibition of antibody to HBcAg gradually decreased to less than 70% when a 1:200 dilution of the serum of six patients was used. Four of the patients had active liver disease develop: two had chronic active hepatitis and two had cirrhosis. Three of these four patients subsequently had hepatocellular carcinoma develop. These findings suggest that patients may suffer complications of chronic hepatitis even after normalization of transaminase activities and after the clearance of HBsAg. Thus hepatitis B virus should be considered as a possible factor associated with hepatocellular carcinoma even in the absence of HBsAg, particularly if serum hepatitis B virus DNA persists.

Evaluation of morphological changes of the atherosclerotic aorta by enhanced computed tomography

Enhanced and non-enhanced computed tomography (CT) were performed in 405 subjects (222 men; 183 women; mean age 57 years). Intimal atherosclerotic changes of the aorta were quantified by enhanced CT, revealing the atheromatous intima to be projecting and thick-walled, while non-enhanced CT demonstrated aortic calcification. We measured the degree of aortic intimal changes at various segments of the aorta. In 224 cases, CT was performed from the aortic root to the bifurcation of the abdominal aorta. Intimal changes were found predominantly at the aortic arch, the middle descending thoracic and the infrarenal abdominal aorta. As for the intimal changes, aortic calcification and aortic pulse wave velocity were significant atherosclerotic characteristics. The aortic diameter did not show a significant association with intimal change. Among the various atherosclerotic risk factors, intimal change was significantly associated with age, systolic blood pressure, serum total cholesterol and diabetes mellitus, whereas gender, diastolic blood pressure, relative weight and cigarette use were not significantly related. For coronary artery disease and arteriosclerosis obliterans, aortic intimal changes constituted a significant atherosclerotic feature. In cerebrovascular disease, however, aortic intimal change did not play a significant role.

[Usefulness of 18F-fluorodeoxyglucose positron emission tomography for evaluating myocardial viability in old myocardial infarction]

The purpose of this study is to compare the characteristics of images obtained by positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) in the fasted state (> 6 hours) and in the glucose-loaded state (oral 50 g glucose load). In the both condition FDG-PET were performed in 18 cases with old myocardial infarction. PET images in the fasted state were divided into 2 groups (Group A; 12 cases and Group B; 6 cases). FDG uptake of normal region was visually absent (grade 0) in group A, whereas it was visually apparent (grade 1-3) in group B. Serum free fatty acid in group B was significantly lower than that in group A. In the 7 cases, the relation between myocardial FDG uptake of the infarcted regions and reversibility after coronary intervention was studied. Both in the fasted and in the glucose-loaded state, postoperative improvement was observed in the segments, in which myocardial uptake of FDG were visually apparent (glucose-loaded state, 11/13 segments; fasted state, 6/8 segments). Therefore FDG-PET images appeared to be useful for evaluating myocardial viability.

[Effect of DQ-2556, a new cephalosporin derivative, on fecal microflora]

A new cephalosporin derivative antibacterial agent, DQ-2556, was administered intravenously to 4 healthy adult male volunteers at 2 grams per dosage 2 times a day for 5 days, and degrees of effects of drug concentrations on the fecal microflora were investigated. 1. The total viable count remained unchanged during the study period due to the minimal change in the number of members of the family Bacteroidaceae, which were the most dominant organisms. In one of the volunteers, however, the total count was remarkably reduced immediately after the end of administration of the drug. 2. Among the obligate anaerobes, most of the organisms decreased except members of the family Bacteroidaceae. A marked increase of lecithinase-positive clostridia was noted in 2 volunteers. 3. The number of aerobes, including facultative anaerobes, members of the family Enterobacteriaceae were suppressed but bacilli and yeasts showed slight increases. In many cases, increases in enterococci were also observed. 4. DQ-2556 was not detected in the feces from any of the volunteers during the study period. 5. Neither Clostridium difficile nor its toxin D-1 was detected in any of the volunteers. 6. Diarrhoea or other side-effects were not noted in any of the volunteers.

Effect of nipradilol on cardiovascular hemodynamics during exercise in angina pectoris with old myocardial infarction

Nipradilol (3,4-dihydro-(2-hydroxy-3-isopropylamino)-propoxy-3-nitroxy-2H-1- benzopyran, K-351, CAS 81486-22-8) is a new type of beta-blocker with vasodilating action. The effect of nipradilol on hemodynamics at rest and during exercise with a multi-stage bicycle ergometer in supine position was studied in 8 male patients suffering from angina pectoris with old myocardial infarction. Nipradilol was orally given at the daily dose of 12 mg (b.i.d.) for one week, and various hemodynamic parameters were measured at rest and during exercise before and after the treatment with nipradilol. At rest, the blood pressure was almost unchanged, heart rate was significantly reduced, cardiac output tended to decrease, and the pulmonary blood pressure and left ventricular ejection fraction (EF) were almost unchanged. At peak exercise, the blood pressure tended to decline, heart rate was significantly reduced, cardiac output tended to decrease and the pulmonary blood pressure and EF increased significantly. Consequently, the antianginal effect of nipradilol is considered to be attributable to the reduction in myocardial oxygen consumption caused by a decrease in double product. It is thus suggested that nipradilol exerts its antianginal effect without adversely affecting the cardiac performance.

Chimeric HU-IHF proteins that alter DNA-binding ability

Chimeric proteins between Escherichia coli histone-like HU and IHF were constructed by genetic engineering, in which part of the arm region was replaced by the corresponding region of IHF alpha (designated as HupANhimA) or IHF beta (HupANhimD); alternatively, an alpha-helix 2-beta 1 region was replaced by the corresponding region of IHF alpha (HupAXhimA) or IHF beta (HupAXhimD) (symbols N and X indicate NotI and XhoI junctions). These proteins were synthesized in a hupA-hupB double-deletion mutant. HupANhimA exhibited marked reduction in nonspecific DNA binding in vitro, and a drastic loss of HU activity in replicative transposition of Mu phage in vivo. HupANhimD also showed a significant reduction in the ability for DNA binding, though this protein supported Mu phage development. In contrast, the other two chimeric HU proteins showed only slight changes in nonspecific DNA-binding ability: they retained activities for transposition of Mu phage in vivo. These observations confirm that the flexible arm of HU-2, a domain proposed for DNA binding [Tanaka et al., Nature 310 (1984) 376-381; Goshima et al., Gene 96 (1990) 141-145], plays an important role in the physiological function of this protein. The results indicate that a unique conformation of the arm structure of HU protein, particularly the N-terminal half of a two-strand antiparallel beta-ribbon of the structure, is important for the DNA-binding ability of this protein.

Unoperated thoracic aortic aneurysms: survival rates of the patients and determinants of prognosis

The purpose of this study was to evaluate the long-term prognosis of unoperated thoracic aortic aneurysms, and to detect the risk factors which determine the prognosis of unoperated patients. The subjects were 52 unoperated patients with 58 thoracic aortic aneurysms (22 of the ascending aorta, 36 of the descending aorta or the aortic arch) and 38 with abdominal aortic aneurysms. The survival rates of the patients with ascending aortic aneurysms at 3 years and 5 years and those of the patients with descending aortic aneurysms at 5 years were significantly higher than those of the patients with abdominal aortic aneurysms. The risk factors for rupture of thoracic aortic aneurysms were the large size of aneurysms and non-management by the cardiologist and the risk factors for death unrelated to the aneurysms were patient age, male gender and non-management by the cardiologist.

Reverse redistribution on Tl-201 SPECT images after reperfusion therapy for acute myocardial infarction: possible mechanism and prognostic implications

So-called reverse redistribution on stress Tl-201 imaging has been reported previously, but its significance and clinical implications are not well understood. In patients who received reperfusion therapy for acute myocardial infarction, we frequently observed reverse redistribution on stress Tl-201 images. To investigate the significance of reverse redistribution, 61 patients who underwent reperfusion within 4 h of the onset of chest pain underwent submaximal exercise Tl-201 imaging 3 weeks later. We performed simultaneous coronary arteriography and left ventriculography. We divided these 61 patients into three groups based on the pattern of Tl-201 images. Reverse redistribution was found in 19 patients (Group A), 12 patients had redistribution (Group B), and 30 patients had nonreversible defects (Group C). All patients in Group A had less residual stenosis than those in the other groups, and showed significant improvement of left ventricular function. Furthermore, 12 patients (Group A) demonstrated reverse redistribution or a normal pattern in a follow-up study performed 12 months later. However, in the delayed images the defect was smaller than that shown in the previous study. None of the patients had any symptoms and all returned to their previous occupations. In conclusion, reverse redistribution was common in patients undergoing reperfusion therapy for acute myocardial infarction, especially those with little residual stenosis. Reverse redistribution appears to indicate improved regional wall function in such patients.

[Pulmonary kinetics of 13N-ammonia in smoking subjects--a quantitative study using dynamic PET]

To evaluate the effect of smoking on nonrespiratory function in the lung, a dynamic PET with 13NH3 in the lung was performed in 18 normal volunteers without lung disease nor congestion (9 non-smokers, 4 exsmokers, 5 smokers). After intravenous bolus injection of 13NH3, twenty serial 5.5-second scans followed by six 30-second scans were performed. Regions of interests were assigned on the ventral, lateral and dorsal part of the right lung and time-activity curves were generated through 26 images. The activity curve demonstrated a biexponential clearance from the lung with fast and slow component. The retention fraction (RF), fractional size of the slow component, was calculated, and the half-times (t 1/2) of both components were also evaluated. A significant increase of RF and prolongation of t 1/2 of slow component were observed in smokers compared to non-smokers and exsmokers. However, no significant difference of RF nor t 1/2 of both components was observed between non-smokers and exsmokers. These results suggest that long term smoking may modify the pulmonary kinetics of 13NH3, but the change is reversible after cessation of smoking for one year or longer.

Expansion rate of thoracic aortic aneurysms and influencing factors

The risk of rupture of an aortic aneurysm increases with size and rapid expansion rate. We studied the expansion rate of thoracic aortic aneurysms and the factors influencing expansion rate, and compared the results with those of abdominal aortic aneurysms. Forty thoracic aortic aneurysms and 25 abdominal aortic aneurysms were serially examined with enhanced and nonenhanced computed tomography. The mean expansion rate of thoracic aortic aneurysms was 1.3 +/- 1.2 mm/yr and was significantly lower than 3.9 +/- 3.2 mm/yr of abdominal aortic aneurysms. The factors increasing expansion rate of thoracic aortic aneurysms were initial size of aneurysms, diastolic blood pressure, and presence of renal failure by univariate analysis. Multivariate analysis concerning the entire aortic aneurysms also revealed that the large size of the aneurysm and the presence of the aortic aneurysm in the abdomen increased expansion rate of aneurysms.

High-energy phosphate metabolism of the myocardium in normal subjects and patients with various cardiomyopathies--the study using ECG gated MR spectroscopy with a localization technique

Nuclear magnetic resonance spectroscopy (MRS) is a new technique for the evaluation of myocardial metabolism. Recently, localized MRS has been clinically available to measure by a non-invasive method the relative concentrations of the high-energy phosphate metabolites in the myocardium. We performed ECG gated P-31 MRS using ISIS (image-selected in vivo spectroscopy) in 15 normal volunteers, 12 patients with hypertrophic cardiomyopathy, 12 with left ventricular hypertrophy, 6 with dilated cardiomyopathy and 11 with specific heart muscle disease. Myocardial peak height ratios of PCr/gamma-ATP, Pi/gamma-ATP and PCr/Pi were measured. Myocardial P-31 MRS demonstrated a significant decrease in the ratio PCr/ATP in patients with hypertrophic cardiomyopathy and specific heart muscle disease as compared with normal subjects, indicating myocardial metabolic disturbance in these patients. The ratio of PCr/ATP in patients with dilated cardiomyopathy did not differ significantly from that of normal subjects. However, exercise MRS revealed a marked decrease of PCr peak in an asymptomatic patient with dilated cardiomyopathy, which may indicate a latent metabolic disturbance in the myocardium of dilated cardiomyopathy.

Prolongation of canine epidural anesthesia by liposome encapsulation of lidocaine

The purpose of our study was to produce a long-acting lidocaine by using a liposome that would entrap the drug. Egg yolk phosphatidylcholine and cholesterol were used as liposome materials. After epidural administration, the pharmacodynamics and pharmacokinetics of liposomal and free lidocaine were studied in 20 dogs. Two percent liposomal or free lidocaine (3.0 mL) was injected into the lumbar epidural space. Nerve blocking effects were estimated by measuring somatosensory evoked potentials. Recovery time from the epidural block in the liposomal lidocaine group (170 +/- 49.5 min) was approximately three times longer than that in the free lidocaine group (61 +/- 18.1 min). The areas under the drug concentration-time curves (AUC0-infinity) and time to maximal concentration (Tmax) in the liposomal lidocaine group were significantly larger than those in the free lidocaine group. These results suggest that the prolongation of epidural blockade by liposomal lidocaine is caused by a slow release of the drug from liposomes. The present study suggests that liposomal lidocaine can be used as a long-acting local anesthetic.

Segmental analgesic effect and reduction of halothane MAC from epidural fentanyl in humans

To clarify the site of action of epidural fentanyl, we compared the effects of epidural and intravenous fentanyl on the change in pressure pain threshold (PPT) and the minimum alveolar concentration (MAC) of halothane. Seventy patients who underwent gastrectomy in the PPT study group and 84 female patients who underwent hysterectomy in the MAC study group were assigned randomly to seven groups in each study. The seven groups each received a bolus injection of 1, 2, or 4 micrograms/kg of fentanyl, either intravenously or epidurally, and of saline solution epidurally. Compared with intravenous fentanyl, epidural fentanyl significantly increased (P less than 0.01) PPT around surgical incisions by approximately 50%, 100%, and 150% of preadministration levels 1 h after administration of 1, 2, and 4 micrograms/kg, respectively, and significantly reduced (P less than 0.05) halothane MAC at the same doses. These data suggest that the more potent analgesic and anesthetic effects of epidural fentanyl, compared with intravenous fentanyl, are due mainly to the segmental analgesia produced by its spinal analgesic action.