Development of an ELISA assay for soluble CD35 (C3b/C4b receptor): high levels of soluble CD35 in LE-positive patients with hematological malignancies

Malignant cells usually lack CD35 (complement receptor type 1, C3b/C4b receptor), a differentiation surface antigen. We measured soluble forms of CD35 in the plasma of normal subjects and patients with various malignant diseases. A microassay for the determination of CD35 was established based on a sandwich enzyme immunoassay using 2 monoclonal antibodies that recognize different epitopes. Soluble CD35 was not detected in any plasma samples from normal subjects or from patients with a variety of solid cancers: i.e., levels were below 20 ng/ml. On the other hand, 3 of 70 patients with hematological malignancies showed high levels of plasma CD35. The molecular mass of the soluble form was about 200 kDa, which is similar in size to membrane forms of CD35. Although the clinical conditions differed in these patients, they had high transaminase titers and detectable autoantibody. Complement titers (CH50) and the levels of membrane complement regulatory proteins were within the normal range in these patients. Although the mechanism by which it is produced remains unknown, soluble CD35 is present in significant amounts in association with immunological disorders secondary to hematological malignancies.

Production of fibroblast proliferative cytokines from T lymphocytes stimulated by a B cell lymphoma line and their functional heterogeneity

Human mononuclear leukocytes (MNL) produced several factors with fibroblast proliferation activity (FPA) for HFL-1, a human lung fibroblast cell line, when MNL were cocultured with irradiated BALL-1, a B cell lymphoma line (BCLL), but not with other BCLL. The cellular source of BALL-1-induced FPA seemed to be CD4-positive T lymphocytes. On isoelectric electrophoresis, major activity of BALL-1-induced FPA was detected in the fractions around pH 4-5, and minor activity was present in the fractions around pH 6-7. Major BALL-1-induced FPA consisted of at least 4 different fibroblast proliferation factors (FPFs) according to their molecular weight; 320-600 kDa (P-I), 50-110 kDa (P-II), 22-38 kDa (P-III) and 4.6-11 kDa (P-IV). P-I had affinity to heparin though the rest had little or no affinity. FPA of P-I was suppressed by an antibody against acidic FGF, and FPA of P-III was suppressed by an antibody against IL-6. On the other hand, FPA of P-II and P-IV was suppressed by none of the antibodies against cytokines with FPA, such as FGF, IL-4, IL-6, IFN-gamma, TGF-beta and TNF-alpha. It was thus suggested that P-I was acidic FGF, that P-III was IL-6, and that P-II and P-IV were different cytokines from those described above. Furthermore, it was found that P-II and P-IV failed to exhibit proliferation activity for human umbilical vein endothelial cells (HUVEC).(ABSTRACT TRUNCATED AT 250 WORDS)

Direct, concentration-dependent inhibition by taurocholate of pancreatic exocrine secretion and CCK release in conscious rats

In conscious rats, bile inhibits pancreatic secretion. The role of luminal taurocholate (TC), a major component of rat bile, in the regulation of pancreatic secretion was studied in conscious rats with external bile and pancreatic fistulae. On the fourth postoperative day, after the basal collection of bile and pancreatic juice (PJ) returned to the duodenum, graded doses of TC (0, 0.4, 4, 40 mM) containing 10 mM CaCl2 were infused into the duodenum instead of bile and PJ for 2 hr (1 ml/hr), with or without 1 mg/ml of porcine trypsin. Luminal trypsin activities were not affected by any dose of TC. The increases in pancreatic secretion in response to diversion of bile and PJ were progressively inhibited with increasing doses of infused TC from 0 mM to 4 mM both with and without trypsin infusion. The effects with 4 and 40 mM TC were not significantly different. Changes in plasma cholecystokinin concentrations roughly correlated with changes in protein output in rats without trypsin infusion. We concluded that TC directly inhibited pancreatic secretion independent of the luminal trypsin activity and that its inhibitory action was concentration dependent.

Identification and characterization of membrane cofactor protein (CD46) in the human kidneys

Membrane cofactor protein (MCP, CD46) is an integral protein that serves as a cofactor for factor I in inactivating C3b/C4b deposited on the same cell membrane as C3bi/C4c+C4d. This C3b/C4b inactivation is closely associated with self-protection of host cells from autologous complement attack. We have studied the distribution and properties of MCP in the normal human kidney by immunohistochemical and immunoblotting methods using monoclonal antibodies against MCP. MCP was predominantly expressed on the juxtaglomerular apparatus. Glomerular capillary walls, mesangial areas, and tubulus were also MCP positive. Glomerulus MCP was composed of two major bands of 45-65 kDa, which were similar to those of lymphocyte MCP. The proportion of the high and low molecular weight components in glomerulus MCP, however, was considerably different from that of lymphocyte MCP among the individual samples tested. Glomerular epithelial cells and mesangial cells from an individual having equal amounts of high and low molecular weight components in the lymphocytes were cultured separately and the properties of their MCP investigated. MCP in the mesangial cells and glomerular epithelial cells showed profiles in which the upper band was predominant. The results may explain the unique distribution of the high and low molecular weight forms in the glomerulus. These forms of MCP together with factor I were all capable of inactivating C3b to C3bi. Message analysis suggested that glomerular epithelial cells and mesangial cells synthesized a single species of mRNA of 4.2 kb from which the polymorphic MCP species were generated. Flow cytometric analysis suggested that MCP was minimal in mesangial cells. These results, taken together with the previous reports on the distribution of other complement regulatory proteins, infer that the distribution profile of MCP is rather similar to that of DAF but differs from those of CD59 and CR1 in the normal human kidney; this may reflect the differences between their roles or functional properties in renal tissue.

[Quantitative flow-cytometric analysis of CD34-positive stem cells in peripheral blood stem cell harvests]

The percentage of CD34-positive cells (the CD34-positive rate) in peripheral blood stem cell harvests (PBSCH) was determined using two color flow cytometric methods, i.e., representation in a histogram (the histogram method) and the two-dimensional side scatter-fluorescence representation (the SSC-FL method). For all samples examined, the CD34-positive rate obtained using the histogram method was higher than that obtained using the SSC-FL method. This finding was probably due to the fact that some monocytes non-specifically reacted with anti-CD34 monoclonal antibody, and the histogram method could not distinguish these non-specifically stained cells from CD34-positive precursor cells. On the other hand, the SSC-FL method seemed to yield a more accurate measurement of the percentage of CD34-positive cells in PBSCH samples. Based on this finding, it is recommended that the histogram method, which is currently used at most commercial laboratories, be reviewed in favor of the SSC-FL method when the CD34-positive cell rate of PBSCH is to be determined.

[Reoperations for valvular heart disease through repeated median sternotomy incision]

One thousand and three hundred patients underwent open heart surgery for acquired valvular diseases in our hospital from 1952 through December 1993. There were 105 reoperative cases through repeated median sternotomy incision and 52 cases of prosthetic valve replacement by the same operator in the last 5 years. We studied technical procedures by these reoperative experience. There was only one case (1.9%) of hospital death in replacement cases. We believe that repeated open heart surgery for acquired valvular diseases should be done prior to deterioration of patient's clinical condition. We had to pay attention to facilitate mobilization of right atrium and aortic root in the aortic and mitral valvular reoperations. To decrease operative mortality of prosthetic valve replacement, each operative techniques were necessary by the reasons for reoperation.

[Radical radiation therapy of hepatocellular carcinoma]

Sixteen patients with residual or recurrent HCC following TAE were treated by radiation therapy (RTx). The total dose ranged from 58-64 Gy(TDF 99-113). RTx was performed between June 1988 and March 1991. A daily dose of 2 Gy, 5 days/week, or 3 Gy, 3 days/week, delivered by LINIAC 10 MV X-ray was selected. Tumors in the upper or lateral portion of the right lobe of the liver were selected in order to avoid radiation of the gastrointestinal organs. Liver function was evaluated by monitoring the clinical stage (General Rules for the Clinical and Pathological Study of Primary Liver Cancer, Liver Cancer Study Group of Japan) before and after RTx. Local control rates following RTx were 75% at 6 months, 45% at 1 year, 45% at 2 years and 36% at 3 years. Survival rates following initial therapy were 87.5% (1 year), 50% (2 years) and 34.3% (3 years). Among patients in clinical stages II and III, liver function tended to be aggravated following RTx, whereas patients in clinical stage I tended to remain in stage I. A Radiation dosage of 60 Gy is tolerable if patients in clinical stage I are selected and the gastrointestinal organs are excluded from the radiation field.

Distribution of glutamate- and GABA-immunoreactive neurons projecting to the vasomotor center of the intermediolateral nucleus of the lower thoracic cord of Wistar rats: a double-labeling study

The purpose of this study was to survey distribution of glutamatergic and GABAergic neurons in the brainstem with projections to the vasomotor center in the intermediolateral nucleus of the T11 segment of Wistar rats. This was done with retrograde transport of WGA-HRP and immunoreaction to glutamate and GABA. HRP/glutamate-labeled neurons were distributed in the rostral ventrolateral medulla (RVLM, 29%), A5 noradrenaline cell area (16%), paraventricular nucleus of the hypothalamus (14%) and caudal ventrolateral medulla (CVLM, 11%), while HRP/GABA-labeled neurons in the RVLM (65%) and CVLM (24%). This indicates that the glutamatergic and GABAergic neurons projecting to the spinal vasomotor center originate mainly from the RVLM and CVLM.

Comparison of the functional occlusal plane in adults with class III malocclusion showing open bite and non-open bite

A retrospective study of lateral cephalograms of 24 Japanese adults with Class III malocclusion was made in order to compare the angles of the horizontal plane between open bite and non-open bite cases. The following results were obtained: i) There was no significant difference in the angle of the NF-upper occlusal plane between the open bite and non-open bite groups. ii) There were significant differences between the two groups in the angle of the SN-upper and lower occlusal planes, the FH-upper and lower occlusal planes and MP-lower occlusal plane. There was also a significant difference between the groups in the distance from the Xi point to the upper occlusal plane. iii) In both the open bite and non-open bite groups there was a wide variation in occlusal plane angles, compared with normal cases.

Egg-jelly signal molecules for triggering the acrosome reaction in starfish spermatozoa

It was in the early 1950s that J.C. Dan discovered the acrosome reaction in sea urchins, starfishes and several other marine invertebrates at Misaki Marine Biological Station on the Pacific coast of Japan. We now know that in many animals including mammals the acrosome reaction is an essential, and probably the most central, change in spermatozoa for fertilization. Starfish spermatozoa undergo the acrosome reaction upon encountering the jelly coat consisting of glycoproteins, steroid saponins, oligopeptides and inorganic components. To induce the acrosome reaction, three egg jelly components act in concert on the spermatozoa: a highly sulfated glycoprotein named acrosome reaction-inducing substance (ARIS), a group of sulfated steroidal saponins named Co-ARIS, and a group of glutamine-rich tetratriacontapeptides named sperm activating peptide (SAP). The action of ARIS is quite species-specific due to the specificity of ARIS-receptors in a restricted domain of the sperm surface and depends very much on sulfated saccharide chains. Co-ARIS is not much species-specific and its action depends on the sulfate group and steroid side chain. SAPs have a ring of 25 residues and increase the intracellular pH of spermatozoa. None of them can induce the acrosome reaction by itself in normal sea water, but ARIS does induce it in high Ca2+ or high pH sea water. Although a combination of ARIS and either Co-ARIS or SAP induces the acrosome reaction in normal sea water, all three are required to mimic the full activity of dissolved jelly coat.

Monoclonal proliferation of double-negative (CD4-CD8-) T-cells bearing T-cell receptor-alpha beta followed by subsequent development of Hodgkin's disease

Expression of CD4 or CD8 on the cell surface is an important guide for discriminating the immunologic functions of T-cells. However, a minor T-cell subset lacking both CD4 and CD8 molecules but bearing the usual form of T-cell receptor (TCR)-alpha beta (CD4-CD8-TCR-alpha beta+ T-cells) has recently been found not only in mice but also in humans, and the clinical relevance of this newly defined subpopulation to human diseases is now of considerable interest. The authors present a patient in whom CD4-CD8-TCR-alpha beta+ T-cells showed monoclonal proliferation in the peripheral blood for more than 3 years, then disappeared spontaneously, followed by subsequent development of Hodgkin's disease. The pathologic roles of double-negative T-cell proliferation in this case are discussed from the viewpoint of premalignancy in lymphoproliferative diseases.

Stage-synchronization of the seminiferous tubules after vitamin A replacement in vitamin A deficient golden hamsters

The effect of vitamin A deficiency and vitamin A replacement on spermatogenesis in golden hamsters was studied using a light microscope. Male golden hamsters were fed a vitamin A deficient (VAD) diet from 3 weeks of age. Hamsters with a VAD diet reached maximum body weight at about 13 weeks. After 17 weeks, the body weight of the hamsters began to decrease. When their body weight decreased to 70 g, only Sertoli cells, spermatogonia, and a few spermatocytes were present within the seminiferous tubules. Administering retinol acetate (vitamin A) combined with a conventional diet to the VAD hamsters induced a reinitiation of spermatogenesis with stage-synchronization. At 9, 10, and 11 weeks after vitamin A replacement, the testes with active spermatogenesis possessed only a few successive stages of the seminiferous epithelial cycle.

Effect of physical properties of direct bonding adhesives on bonding to etched enamel

Five types of light-cured direct bonding adhesives with different volumes of microfiller were prepared for study of the relationships between bond strength to enamel, resinous tag length, and flexural strength, and between viscosity and resinous tag length. The resinous tag length was measured with the combination of 2,4,6-trichlorophenoxy methacrylate as a tracer and electron-probe microanalyzer. Correlating resinous tag length versus viscosity or bond strength after 1-day immersion, and flexural strength with bond strength after 1-day and 30-day immersion resulted in high correlation coefficients. However, the bond strength after thermocycling did not correlate with resinous tag length or flexural strength.

[A 75-year-old woman with multiple cranial nerve palsies and a paranasal mass]

We report a 75-year-old woman with multiple cranial nerve palsies. The patient was well until January, 1992 when she had an onset of deafness in her left ear; she developed left facial pain in September, 1992, and came to the ENT clinic of our Izunagaoka Juntendo Hospital. She had chronic sinusitis; she was referred to neurology clinic on September 25 because of decrease in the superficial sensation in the second division of the left trigeminal nerve. She developed blurring of her left vision, and was admitted to the neurology service of Juntendo Izunagaoka Hospital on December 7th, 1992. On admission, general physical examination was unremarkable. Neurologic examination revealed alert and mentally sound woman; higher cerebral functions were intact. In the cranial nerves, olfactory sensation was normal; the left vision was reduced to discriminate light and dark; the right vision was normal. Pupils were round and isocoric, but the light reflex was sluggish on the left side; the abduction of the left eye was impossible; other ocular muscles appeared intact. Sensation of the left face was almost completely lost; the corneal reflex was lost on the left side; no jaw deviation was noted. She had near complete left facial palsy of the peripheral type; the left ear was deaf. The movement of the left soft palate was slightly weak, but no deviation of the uvula was noted; she had no dysarthria or dysphagia.2/

Age-related changes in cytoskeletal components of the BDF1 mouse Sertoli cell

Age-related changes in mouse Sertoli cell cytoskeletal components (F-actin, vimentin and cytokeratin) were investigated by light and transmission electron microscopy and immunofluorescence using BDF1 mice from 3-33 months of age. In old mice (30 and 33 months of age), the testicular seminiferous epithelia were extremely thin, containing scarce round spermatids and spermatocytes with no elongated spermatids. In these epithelia, the Sertoli cells had lost their polarity and had become flattened. F-actin was detectable at the junction between adjoining Sertoli cells and around the spermatid head in young mice. In old mice, F-actin was distributed at the junction between adjacent Sertoli cells, around the spermatid head, and at the luminal side of the Sertoli cell cytoplasm. Vimentin was detected around the Sertoli cell nucleus and extended into the Sertoli cell trunk towards the tubular lumen in young mice. In old mice testes, however, vimentin was recognized around the Sertoli cell nucleus, but not in the Sertoli cell trunk. Additionally, sheet-like reactions of vimentin, running parallel to the basement membrane, were detected near the luminal surface. Although cytokeratin was not detected in the Sertoli cells of mice until 27 months of age, it was obvious in the extremely thin seminiferous epithelia of older mice. Cytokeratin was randomly distributed within the Sertoli cell cytoplasm. In these Sertoli cells, the expression of vimentin was concurrently detected. Detection of cytokeratin in the extremely thin seminiferous epithelia is one of the most characteristic phenomena of age-related testicular changes in Sertoli cells of older mice.

[Deterioration of liver function following endoscopic injection sclerotherapy of esophageal varices--significance of the new liver function test "intravariceal injection (I.I.) index"]

Changes of liver functions associated with endoscopic injection sclerotherapy (EIS) were investigated in 143 patients with remarkable esophageal varices. The index used for evaluating hepatic reserve was the ratio between the increase of total bilirubin and the increase of LDH after EIS [I.I. index = (delta T.Bil./delta LDH) x 100] in cases treated by intravariceal injection of 5% ethanolamine oleate. I.I. index value caused by hemolysis was stable and always below 0.2, while the elevation of I.I. index above 0.2 was regarded as the reflection of the deterioration of liver function. After the entire sessions of EIS, the changes of liver function tests before and after EIS were estimated in 104 cases using 3 factors as follows; (1) delta T.Bil.; increase of total bilirubin more than 0.5 mg/dl (2) delta PT; decrease of prothrombin time more than 5% (3) delta ICG R15; increase of ICG R15 more than 5%. I.I. index of group I (without any changes of 3 factors mentioned above; n = 66) was 0.22 +/- 0.16, approximately within normal range. However, in group II (with 1 factor; n = 29), group III (with 2 factors; n = 5), group IV (with all factors; n = 4), I.I. index was elevated according to the severity of their liver dysfunction. The cases whose I.I. index value increased gradually during the course of EIS, were apt to deteriorate the liver functions and therefore, should be carefully observed. Also, I.I. index seems to reflect the prognosis of the patients treated by EIS for some extent, since the survival period of the cases treated by EIS were correlative with the value of I.I. index (r = -0.542, p < 0.01), and I.I. index of 32 cases who survived for longer than 5 years after EIS was almost normal (0.22 +/- 0.15).

[Cerebellar ataxia with hypogonadotropic hypogonadism and mental disturbance]

Cerebellar ataxia with hypogonadotropic hypogonadism is a rare condition. Both hypothalamic LHRH and pituitary gonadotropin deficiency may appear with cerebellar ataxia. In this report, a 19-year-old man who presented with progressive cerebellar ataxia and mental disturbance was found to have low plasma gonadotropin levels. No rise in gonadotropin was demonstrated after repeated stimulation with LHRH. Our findings suggested that the cause of hypogonadism was pituitary gonadotropin deficiency, or both hypothalamic and pituitary dysfunction. The endocrinological data and clinical features of our patient and all other reported cases suggest that the age of onset of the illness is related to the type of endocrinological abnormality: young-onset patients may have endocrine disturbances involving both the hypothalamus and the pituitary gland, which may be affected secondary to the hypothalamic disturbance, whereas adult-onset patients may show only hypothalamic disturbance.

[Therapeutic policy for elderly hypertensives in Japan--a questionnaire survey of specialists]

In order to clarify the therapeutic policy for hypertension in the elderly, we mailed a questionnaire to 147 specialists in Japan and received 123 replies. The upper age limit for antihypertensive treatment was considered to be 80-85 years old by about 50% of the specialists, but the other 50% did not consider an upper age limit. The range of the systolic blood pressure (BP) for which drug treatment was indicated in those without cardiovascular complications was considered to be increased with age, being 160 mmHg and higher in those aged 60-69, 160-170 mmHg and higher in those aged 70-79, and 170-180 mmHg and higher in those aged 80-89, while the level of diastolic BP requiring treatment was considered to be 90-95 mmHg and higher in all age ranges. The goal of BP control was considered to be less than 150/90 mmHg in those aged 60-69, and less than 160/90 mmHg in those aged 70-79 by the majority of the specialists, and to be higher in those aged 80-90, i.e. less than 170-180/95-100 mmHg by more than 20% of the specialists. As the initial selection of antihypertensive regimen, calcium antagonists followed by angiotensin I-converting enzyme inhibitors (ACEI) were selected by the majority, while diuretics, beta-blockers and alpha 1 blockers were chosen by the minority.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of systemic cooling and rewarming on the evoked spinal cord potentials and local spinal cord blood flow in dogs

Changes in evoked spinal cord potential (ESCP) and in local spinal cord blood flow (local SCBF) were measured simultaneously in eight dogs in the course of systemic cooling and rewarming using a water mattress. PaCO2 was maintained at 35-40 mm Hg (temperature-uncorrected values) by adjusting ventilatory volume every 1 degree C change of esophageal temperature under N2O (60%)-O2-isoflurane (1.15%) anesthesia. Local SCBF and arterial blood pressure decreased and ESCP latencies increased linearly with the decrease in body temperature to 23-24 degrees C. The conductive ESCPs (non-synaptic components) showed temporary augmentation in amplitude before eventual decrease under cooling. These showed a tendency to return to the precooling baselines after the initiation of rewarming. These results demonstrate that conductive ESCPs could be available for intraoperative monitoring of spinal function under hypothermia down to 23-24 degrees C.

Use of a thermodilution renal vein catheter to measure renal blood flow in patients with essential hypertension

Our objective was to investigate the changes in renal hemodynamics, and the role of these changes in the pathogenesis of essential hypertension. We used a thermodilution renal vein catheter and measured left renal blood flow in 21 patients with essential hypertension. Arterial pressure was monitored concurrently. Cardiac output was measured in 11 patients to calculate total peripheral vascular resistance. Systolic, diastolic, and mean arterial pressure were 187 +/- 7 mmHg, 97 +/- 5 mmHg and 127 +/- 5 mmHg, respectively. Left renal blood flow was 8.01 +/- 0.38 ml/s. Left renal vascular resistance, calculated as mean arterial pressure divided by left renal blood flow, was 16.4 +/- 0.8 mmHg ml-1s, and was positively correlated with systolic, diastolic and mean arterial pressures (p < 0.05). However, no significant correlation was observed between arterial pressure and left renal blood flow. Plasma renin activity in left renal venous blood, measured in 15 patients, was not significantly correlated with renal hemodynamics. Cardiac output and total peripheral vascular resistance were 81.4 +/- 6.0 l/min and 1.68 +/- 0.18 mmHg ml-1s, respectively. Total peripheral vascular resistance was not significantly correlated with either left renal blood flow or renal vascular resistance. The data suggest that a rise in renal vascular resistance may parallel the rise in blood pressure, but not that of total peripheral vascular resistance.