Occlusion of the left coronary ostium due to fusion of the aortic cusp to the wall

We report on a patient with occlusion of the left coronary ostium and aortic regurgitation due to fusion of the left aortic cusp to the aortic wall. The left coronary flow was restored by excision of the adherent left aortic cusp and aortic valve replacement.

An approach for an immunoaffinity AIDS sensor using the conservative region of the HIV envelope protein (gp41) and its monoclonal antibody

A monoclonal antibody for the conservative region of gp41, which is one of the HIV envelope proteins, was produced. The antigen determining site of gp41 was examined using the epitope mapping technique, followed by an enzyme linked immunosorbent assay. Some peptides had comparable affinities for the monoclonal antibody, but the peptide EGIEE, having a slightly weaker immunoaffinity than gp41, was the most preferable for the construction of an immunoaffinity AIDS sensor. For the detection of gp41, EGIEE was labelled with catalase and used as a mimic antigen; it was bound to the antibody present on an immuno-membrane and, due to the replacement reaction of the mimic antigen by gp41, indirect quantitative measurement of gp41 was possible using an oxygen electrode. Anti-gp41 antibody was also detected using a mimic antibody, which was chemically modified with polyethylene glycol. An immunoaffinity AIDS sensor was constructed using the mimic molecules which were tailored to have a suitable immunoaffinity for HIV antigen and/or antibody.

Regulation of influenza virus RNA polymerase activity by cellular and viral factors

An in vitro RNA synthesis system mimicking replication of genomic influenza virus RNA was developed with nuclear extracts prepared from influenza virus-infected HeLa cells using exogenously added RNA templates. The RNA synthesizing activity was divided into two complementing fractions, i.e. the ribonucleoprotein (RNP) complexes and the fraction free of RNP, which could be replaced with RNP cores isolated from virions and nuclear extracts from uninfected cells, respectively. When nuclear extracts from uninfected cells were fractionated by phosphocellulose column chromatography, the stimulatory activity for RNA synthesis was further separated into two distinct fractions. One of them, tentatively designated RAF (RNA polymerase activating factor), stimulated RNA synthesis with either RNP cores or RNA polymerase and nucleocapsid protein purified from RNP cores as the enzyme source. In contrast, the other, designated PRF (polymerase regulating factor), functioned as an activator only when RNP cores were used as the enzyme source. Biochemical analyses revealed that PRF facilitates dissociation of RNA polymerase from RNP cores. Of interest is that virus-coded non-structural protein 1 (NS1), which has been thought to be involved in regulation of replication, counteracted PRF function. Roles of cellular factors and viral proteins, NS1 in particular, are discussed in terms of regulation of influenza virus RNA genome replication.

Efficient fuzzy control strategies for the application of pH-stat to fed-batch cultivation of genetically engineered Escherichia coli

In the cultivation of genetically engineered Escherichia coli it is very important to control the substrate concentration at an appropriate level in order to avoid the accumulation of acetate, thereby elevating the expression level of plasmid-encoded protein. In this paper, a pH-stat mode of fuzzy control was considered for the overexpression of beta-galactosidase in the fed-batch cultivation of recombinant E. coli. In the simple pH-stat fuzzy control, the response of pH change in the culture broth to the feeding rate of glucose was used to estimate the glucose consumption rate. In the modified pH-stat fuzzy control, the glucose consumption rate was accurately estimated by using pH change and the change in the carbon dioxide content of the exhaust gas. With this control strategy, the cell density could be increased to 72 g DCW dm-3, which was twofold higher than that attained in the cultivation with the simple pH-stat fuzzy control. The bulk beta-galactosidase concentration was increased to 4150 U cm-3, which was threefold higher than when the simple pH-stat control was used.

[Selective gene therapy of malignant gliomas using brain-specific promoters: its efficacy and basic investigations]

Retroviral vector is often used for gene therapy of malignant tumors. The main characteristic of this vector is that it integrates only into the genes of dividing and proliferating cells. Glioma cells proliferate actively, while surrounding normal brain cells rarely divide. Thus, we can expect the recombinant retrovirus modified to express cytotoxic genes to kill glioma cells selectively. However, this characteristic of specific toxicity to the dividing cells is also observed in many chemotherapeutic agents, and it is well known that they cause severe side effects, such as bone marrow suppression or diarrhea caused by simultaneous toxicity of the drugs to proliferating bone marrow cells or intestinal epithelial cells, respectively. We have cloned many genes which are specifically expressed in brain, and identified their promoter regions conferring tissue-specific expression. If we use the brain-specific promoters to regulate the expression of the toxic genes, these genes may not be expressed in the myeloid cells or intestinal epithelial cells, even if they were infected with the retrovirus. Therefore, we searched for brain-specific promoters which are also active in glioma cells to kill glioma cells specifically. Then, MBP promoter showed the strongest promoter activity in mouse glioma cells. These mouse glioma cells transduced with retrovirus containing the MBP promoter directing the herpes simplex virus type 1 thymidine kinase (HTK) gene were extremely sensitive to ganciclovir, even when transduced with the MBP promoter-HTK gene-containing retrovirus. And we could get complete remission in the mouse brain tumor models, which were transfected HTK genes in more than 25% glioma cells, with ganciclovir.(ABSTRACT TRUNCATED AT 250 WORDS)

Periosteal sunburst spiculation in osteosarcoma. A possible role for bone morphogenetic protein

Periosteal sunburst spiculation is a peculiar radiographic feature of osteosarcoma, and it represents a reactive ossification resulting from the action of normal osteoblasts rather than tumor cells. Because bone morphogenetic protein is known to be a potent inducer of ectopic bone formation, the authors hypothesized that bone morphogenetic protein may be involved in the pathogenesis of such reactive bone formation in osteosarcoma. Chinese hamster ovary cells transfected with the bone morphogenetic protein-4 gene were injected into the femurs of athymic nude mice to form experimental bone tumors producing bone morphogenetic protein. Two weeks after intramedullary injection, new bone formation was observed radiographically and histologically within the extraosseous portions of the tumors. This showed a close resemblance to sunburst spiculation in human osteosarcomas. In contrast, the control nontransformed Chinese hamster ovary tumors showed no extraosseous bone formation. Because the induced bone was composed of multiple parallel spicules similar to those found in human bone morphogenetic protein-producing osteosarcomas, these findings suggest that periosteal sunburst spiculation may be the result of bone morphogenetic protein production by osteosarcoma cells.

Cytologic evaluation of phyllodes tumors as compared to fibroadenomas of the breast

In an attempt to better understand the cytopathologic features of phyllodes tumors (PTs) and to differentiate PTs from fibroadenomas (FAs) of the breast, cytologic smears prepared from 17 and 19 histologically diagnosed cases of PT and FA, respectively, were reviewed. PT cases were histopathologically graded as benign, borderline and malignant. Cytologically, hypercellularity of stromal cells with recognizable cytoplasm was observed in 6 of 7 borderline and malignant PT cases, but none of the benign PT or FA cases revealed such hypercellular stroma. Between all PT and FA cases, no statistically significant differences could be obtained in the nuclear size of stromal cells, folding of epithelial cell sheets or number of foamy macrophages. The study revealed that the abundance of stromal cells with cytoplasm, not naked nuclei, was strongly suggestive of borderline and malignant PT, but the differentiation between benign PT and FA was difficult on the basis of the cytopathologic findings.

Postantibiotic effects and postantibiotic sub-MIC effects of benzylpenicillin on viridans streptococci isolated from patients with infective endocarditis

We investigated the postantibiotic effects (PAEs) and the postantibiotic sub-MIC effects of benzylpenicillin on three strains of viridans streptococci isolated from infective endocarditis patients. The PAEs of benzylpenicillin on penicillin tolerant Streptococcus sanguis TW-70 (0.4-3.9 h), penicillin tolerant S. sanguis TW-80 (0.3-6.3 h) and nontolerant Streptococcus oralis TW-186 (0.5-3.1 h) were dependent on exposure time. The PAEs were not concentration dependent for S. sanguis TW-70 and S. sanguis TW-80 above the MIC, and for S. oralis TW-186 above 16 x MIC. The antimicrobial effects of benzylpenicillin at sub-MIC concentrations were examined in bacteria pretreated with benzylpenicillin (8 x MIC) for 2 h and compared with untreated bacteria. At the sub-MICs tested, the regrowth of pretreated S. oralis TW-186 cells was more prolonged than that of untreated cells and bactericidal action was seen only in pretreated cells. These effects (so-called 'postantibiotic' sub-MIC effects') were not observed in penicillin tolerant S. sanguis TW-70. The presence of the postantibiotic sub-MIC effect may be an important factor in determining the dosing regimen for infective endocarditis.

Topographical evaluation of centration of excimer laser myopic photorefractive keratectomy

We evaluated the centration of excimer laser myopic photorefractive keratectomy by analyzing the corneal topography in 60 eyes of 37 patients. Computer-assisted analysis of corneal topography was performed preoperatively and one week postoperatively. The distance and the direction from the center of the entrance pupil to the center of the ablation was calculated using a personal computer. Downward displacement of the ablation relative to the center of the entrance pupil was observed in 51 eyes (85%). The mean distance of the center of the ablation from the center of the entrance pupil was 0.51 +/- 0.31 mm (range 0.06 mm to 1.64 mm). To achieve more precise centration, we recommend applying an eye-movement tracking system to photorefractive keratectomy.

Oval defect in detached posterior hyaloid membrane in idiopathic preretinal macular fibrosis

We examined the vitreous of 71 eyes with idiopathic preretinal macular fibrosis and observed complete posterior vitreous detachment in 48 eyes (68%), partial posterior vitreous detachment in 16 eyes (22%), and no posterior vitreous detachment in seven eyes (10%). Among the 48 eyes with posterior vitreous detachment, we observed that the detached posterior hyaloid membrane had an oval or round defect in 31 eyes (65%) and a break in the premacular area in 12 eyes (25%). The size and the contour of the premacular defects in the posterior hyaloid membrane corresponded to those characteristic of premacular fibrosis. A premacular oval defect in the detached posterior hyaloid membrane indicates that the vitreous cortex is a structural component of idiopathic premacular fibrosis. We postulate that the thin, premacular vitreous cortex, which forms the posterior wall of the premacular liquefied pocket, plays a key role in the development of idiopathic preretinal macular fibrosis in eyes with or without posterior vitreous detachment.

Effect of protein derivatives on pancreatic secretion and release of secretin and CCK in rats

We investigated the effect of intraduodenal administration of oligopeptide and a mixed amino acid solution, which contains the same amino acid composition as oligopeptide, on pancreatic exocrine secretion and the release of secretin and cholecystokinin (CCK). Anesthetized rats were prepared with pyloric ligation and cannulation of pancreatic duct and bile duct. Protein derivatives in three different doses (oligopeptide: 25, 100, and 400 mg/h; and mixed amino acid solution: 70, 140, and 280 mg/h, pH 7.0) were infused into the duodenum for 1 h. Pancreatic juice was collected, and plasma concentrations of secretin and CCK were measured by radioimmunoassay. In addition, the effect of intravenous injection of an antisecretin serum or a CCK antagonist, loxiglumide, on pancreatic secretion stimulated by oligopeptide or mixed amino acid solution was also studied. Oligopeptide produced a significant dose-related increase in pancreatic secretion including volume, HCO3-, amylase, and trypsin output, plasma secretin (r = 0.792, P < 0.001), and plasma CCK (r = 0.421, P < 0.01). Similarly, mixed amino acid solution produced a dose-related increase in pancreatic juice volume, HCO3-, amylase, and trypsin output. Compared with CCK, the percentage increase in plasma secretin was 7.3x and 2.8x higher in response to oligopeptide (400 mg/h) and mixed amino acid solution (280 mg/h), respectively. An antisecretin serum almost completely inhibited volume flow and HCO3- output stimulated by oligopeptide as well as mixed amino acid solution, but not amylase and trypsin output. In contrast, loxiglumide significantly suppressed amylase and trypsin output stimulated by protein derivatives, but did not affect volume flow or HCO3- output.(ABSTRACT TRUNCATED AT 250 WORDS)

[An experimental study on a chemosensitivity test with alginate microcapsule. Feasibility of in vivo succinic dehydrogenase inhibition test]

A new chemosensitivity test was evaluated by the MTT colorimetric asay with human tumor cell lines encapsulated in alginate microcapsules with semipermeable membranes. The proliferation of KATOIII in the microcapsules rapidly increased on the 4th day after the encapsulation. The change expressed on the proliferation curve of the encapsulated KATOIII was approximately 2 days behind the proliferation of the suspension culture. The encapsulated cell number reversed and further proliferation was recognized after the 12th day. After the incubation for 5 hours of encapsulated KATOIII with the medium supplemented with 0.5% MTT, a blue formazan crystal formation was observed radiating around the cells in the capsules. MTT assay depends on the cellular reduction of the absorbance spectra at 540 nm (OD540nm), for complete solubilization of the formazan by DMSO. The formazan formation was observed more significantly in serum medium culture than in serum free medium. In MIT assay when 0.1 mol succinic acid was added, OD540nm of encapsulated KATOIII increased by approximately 50% and its sensitivity also increased greatly. In comparison the results of MTT assay for encapsulated KATOIII and MKN28 with suspended cells under the same conditions (0.1, 1, 10 micrograms/ml of MMC and ADR, 0.5, 5, 50 micrograms/ml of 5FU, 10, 30, 50 micrograms/ml of CDDP), the calculated inhibition index (%) with encapsulated cells were similar to the percentages obtained in the former MTT assay. In this study with microcapsules, the formazan formation in the capsules and the absorbance were macroscopically inhibited when the drug concentration was increased. The encapsulated KATOIII, which was implanted intraperitoneally into rat with a 16-gauge needle, was recovered at a rate of 70.8% on the 8th day and at a rate of 54.5% on the 16th day. The recovered encapsulated KATOIII proliferated remarkably forming cell clots on the 8th day after implantation. Incubation with MTT promoted formazan formation and sufficient cell viability was recognized. The Tegafur concentration in the intraperitoneal microcapsules and the microcapsules containing KATOIII after the intravenous administration of Tegafur was similar to the intrahepatic level. The 5FU level in the microcapsules containing KATOIII was higher than that in the capsules alone. In an attempt to conduct an in vivo chemosensitivity test, encapsulated KATOIII and MKN28 were intraperitoneally implanted, 4 mg/kg of MMC, ADR and CDDP, and 75mg/kg of 5FU were intravenously administered on the 2nd and 4th days after the implantation. On the 6th day, MTT assay was performed on the recovered microcapsules containing cells and the inhibition index was calculated.(ABSTRACT TRUNCATED AT 400 WORDS)

The effect of an aldose reductase inhibitor (Epalrestat) on diabetic nephropathy in rats

In order to clarify the possible contribution of the abnormal polyol pathway to the development of diabetic nephropathy, the effect of aldose reductase inhibitor on renal function and morphology was examined in streptozotocin (STZ)-induced diabetic rats. Six months after STZ injection, glomerular filtration rate and renal plasma flow showed marked decline with significant increase in nuclear-free mesangial area (MA) and relative mesangial area (RMA; MA per glomerular area) in diabetic rats. Oral administration of an aldose reductase inhibitor, Epalrestat, prevented renal hypofunction and mesangial expansion in diabetic rats without influencing the levels of blood glucose. These results suggest that the abnormal polyol pathway in diabetic rats is closely related to the development of mesangial expansion, a morphologic representative of diabetic glomerulopathy, and renal hypofunction.

Synergistic activation by Ras and 14-3-3 protein of a mitogen-activated protein kinase kinase kinase named Ras-dependent extracellular signal-regulated kinase kinase stimulator

We have identified, in Xenopus oocyte cytosol, a protein kinase named REKS (Ras-dependent extracellular signal-regulated kinase (ERK)/mitogen-activated protein kinase kinase (MEK) stimulator), which phosphorylates and activates recombinant ERK2 through recombinant MEK in a recombinant GTP gamma S (guanosine 5'-(3-O-thio)triphosphate)-Ras-dependent manner. We show here that this REKS activity is synergistically enhanced by a combination of mammalian recombinant GTP gamma S-KiRas and 14-3-3 protein purified from rat brain. 14-3-3 protein is known to activate tyrosine and tryptophan hydroxylases, to modulate the protein kinase C activity, to stimulate secretion, and to show phospholipase A2 activity per se. 14-3-3 protein did not affect the MEK activity. 14-3-3 protein neither interacted with Ki-Ras nor affected the neurofibromin activity to stimulate the GTPase activity of Ki-Ras under the conditions where the recombinant N-terminal fragment of c-Raf-1 inhibited it. These results suggest that 14-3-3 protein has an additional function in the regulation of the Ras-MEK-ERK cascade pathway through the activation of REKS.

[A clinicobacteriologic study on sultamicillin fine granules in pediatric sinusitis]

We carried out clinical and bacteriological studies on sultamicillin (SBTPC) in pediatric sinusitis at 10 general practice settings. The results are summarized as follows. 1. The major isolated organisms from purulent nasal discharges were Streptococcus pneumoniae 27.5%, Haemophilus influenzae 32.4% and Moraxella catarrhalis 9.9%. Similar results were observed for the major isolates from nasopharynx. 2. 33% of the isolated S. pneumoniae were penicillin-insensitive S. pneumoniae (PISP) against which the MICs were equal to or higher than 0.1 microgram/ml. 3. PISP was isolated from 14% of all cases. 4. The clinical efficacy rate was 77.5% and was deemed satisfactory. 5. In the bacteriological study, persistence rate of PISP was 38.5% among the PISP from purulent nasal discharge and 60.0% among the PISP from nasopharynx which and these values were significantly higher than persistence rates of PSSP, H. influenzae and M. catarrhalis. 6. Adverse reactions were observed in 21.5% of all cases, involving diarrhea and loose stool.

New non-invasive rapid diagnosis of herpes simplex virus encephalitis by quantitative detection of intrathecal antigen with a chemiluminescence assay

A technique for detecting herpes simplex virus (HSV) antigen in CSF by measuring the antigen-antibody complex-activated complement-stimulated chemiluminescence in normal granulocytes was applied to 17 CSF samples from 10 patients with herpes simplex virus encephalitis (HSVE), and 26 samples from 22 patients with a non-HSVE brain illness. All CSF samples taken from the 5th to the 38th day (including seven from the 5th to the 10th day) of HSVE were positive, whereas those for all non-HSVE samples were negative. This assay required only five hours to yield a result.

[A case of benign epilepsy of children with centro-temporal EEG foci with multiple arachnoid cysts]

An 8-year-old boy with benign epilepsy of children with centro-temporal EEG foci (BECCT) with multiple arachnoid cysts was reported. He had febrile convulsions 3 times, for a few minutes each time, at the age of 7 months, and thereafter had generalized tonic-clonic convulsions of 2 minute duration twice in 2 days without fever. EEG showed spike & wave complexes predominantly in the right central area. CT revealed arachnoid cysts in the right temporal lobe and cerebellar hemisphere, and left frontal and central sulci. He has been treated with carbamazepine without neurosurgical operation for the arachnoid cysts, and no seizure has occurred besides a single episode at the age of 3 years. Only 3 cases of BECCT with arachnoid cysts have been reported in the literature. Two of these cases underwent neurosurgical operations for arachnoid cysts, but the operations led to improvement in neither the clinical course nor EEG findings. It is suggested that arachnoid cysts do not lead to poorer prognosis in a patient with BECCT.

[Microbiological and clinical studies of vancomycin resistant Leuconostoc spp. and Pediococcus spp. isolated from septicemia patients]

We described three septicemia cases in which blood cultures yielded gram-positive cocci identified as Leuconostoc spp. and Pediococcus spp. Patients were three male adults aged 63 to 71 years with severe underlying diseases, pancreatic cancer, esophageal cancer and diabetes mellitus with chronic renal failure. They had fever and chills at the onsets of septicemia with acute obstructive suppurative cholangitis, acute pneumonia, and infection complicated with invasion sites of esophageal cancer contagious to bronchus and subcutaneous tissue. Blood cultures yielded catalase and oxidase negative highly vancomycin-resistant (MIC: 1024 micrograms/ml <) gram-positive cocci showing alpha or gamma hemolysis on blood agar plates. Two cases were polymicrobial infections. In one case with esophageal cancer, clinical symptoms persisted after the start of antimicrobial chemotherapy and the patient died 10 days later associated with complications of esophageal cancer. Leuconostoc lactis, Leuconostoc mesenteroides subsp. dextranicum, and Pediococcus acidilactici wee identified by physiological reactions. These strains were also highly resistant to teicoplanin and fosfomycin, and tolerant to all rested beta-lactams such as benzylpenicillin. This is the first report in Japan to our knowledge on the identification of Leuconostoc spp. and Pediococcus spp. isolated from human infectious diseases.

Technetium-99m-HMPAO as a marker of chemical and irradiation lung injury: experimental and clinical investigations

We evaluated the ability of 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) to serve as a sensitive marker of lung injury.

METHODS

Two experimental rabbit models of minimal lung injury were designed using injections of a low dose (0.05 ml/kg) of oleic acid or 50 Gy of irradiation. In addition, we clinically investigated whether patients who received chemotherapy (n = 14) or radiotherapy (n = 13) for lung cancer showed high uptake of 99mTc-HMPAO in the lungs.

RESULTS

Despite the minimal endothelial lesions visualized by electron microscopy (edematous changes and blebbing), in both animal models, the lungs showed high uptake of 99mTc-HMPAO, which occurred rapidly within 1 min after injection. Clinically, the mean lung-to-liver ratio of 99mTc-HMPAO activity in the patients who received chemotherapy (0.649 +/- 0.185, p < 0.01) was significantly higher than that of the controls (n = 16; 0.387 +/- 0.108), and all 12 patients who received more than 30 Gy of irradiation showed abnormal uptake in the irradiated lungs, despite the lack of abnormal opacities on chest CT.

CONCLUSION

These findings suggest that 99mTc-HMPAO has the potential to be a sensitive marker of chemical and irradiation lung injury.