Isolation and characterization of new restriction endonucleases from Vibrio parahaemolyticus: VpaK32I enzyme with the class-IIS heptanucleotide specificity, GCTCTTCN1/N4

Six restriction endonucleases (ENases), classified into four different specificities, were found in a screen among 68 reference strains of Vibrio parahaemolyticus of human origin. Five of these ENases are isoschizomers of well-known ENases, while the remaining one, designated VpaK32I, is a novel and highly efficient class-IIS ENase with the hepatanucleotide recognition site, 5'-GCTCTTC(1/4)-3'.

Experimental study on Reye's syndrome: inhibitory effect of interferon alfa on acetylsalicylate-induced injury to rat liver mitochondria

Viral infection and acetylsalicylate (ASA)-induced mitochondrial aberration have been reported to play important roles in the pathogenesis of Reye's syndrome. We report that increasing amounts of ASA (0 to 250 mumol/L) resulted in increases in state 4 respiration and decreases in state 3 respiration in rat liver mitochondria in vitro when using alpha-ketoglutarate and/or beta-hydroxybutyrate as respiratory substrates, but not when using succinate as substrate. Interferon alfa (IFN-alpha) (1.5 to 5 x 10(4)IU/mL, approximately 1/100 the therapeutic dosage for humans) and interleukin-1 (IL-1) (1.5 to 2 x 10(4)IU/mL, nearly equivalent to the therapeutic dosage) decreased the severity of the above effects via interaction with mitochondrial membranes. Interferon gamma (IFN-gamma) and interleukin-2 (IL-2) had no such protective effect. Electron microscopic observation indicated that IFN-alpha prevented the induction of mitochondrial swelling by ASA. These results suggest that IFN-alpha may prove to be effective for the treatment of Reye's syndrome.

Purification of restriction endonuclease EcoO128I produced by an enteropathogenic Escherichia coli O128Ly3

Restriction endonuclease EcoO128I, an isoschizomer of BstEII, was purified from a rough mutant of Escherichia coli O128Ly3. EcoO128I should be more convenient for recombinant DNA applications than BstEII, because of its improved cleavage activity at 37 degrees C.

[Coronary artery disease in diabetic patients]

Although it is well known that diabetics have high mortality rates due to ischemic heart disease (IHD), controversies still exist about the severity of coronary artery disease in diabetics compared to nondiabetics. We compared coronary arteriographies of 50 diabetics with IHD to those of 50 nondiabetics with IHD. In regard to coronary risk factors, incidence of obesity was significantly higher in diabetics. Incidence of hypertension, hypercholesteremia, hyperuricemia was higher, although not significant, in diabetics. Incidence of smoking was significantly higher in nondiabetics. The diabetic group showed a significantly higher incidence of patients with more than two or three diseased vessels, and a significantly higher number of diseased coronaries with more than 50% stenosis per patient compared to nondiabetics (5.6 +/- 3.7 vs 3.7 +/- 3.2). The distribution of diseased coronaries with more than 75% stenosis showed no difference between diabetics and nondiabetics. The incidence of coronary spasm was significantly lower in diabetics (12% vs 28%). The high incidence of multiple vessel disease in diabetics was thought to be due to other complicated coronary risk factors, especially hypertension and hypercholesteremia.

Factors contributing to deficiencies in cell-mediated immunity in esophageal cancer patients

Based on the previous data which indicated a preoperative decrease in cell-mediated immunity (CMI) is associated with the occurrence of infectious complications following surgery on patients with esophageal cancer, we examined possible factors contributing to a decrease in CMI levels. A multiple linear regression analysis was made on data from 76 patients with esophageal cancer and 53 with gastric cancer as the control. In patients with esophageal cancer, both protein-calorie malnutrition (PCM) and age factor contributed to a decrease in CMI, although the contribution of the latter was weak while the stage of the cancer and the grade of dysphagia showed no such contribution. The PCM and stage of the cancer were contributing factors in patients with gastric cancer. Thus, these results indicate that PCM and old age, and not the presence of malignant tumors, play a significant role in deficiency in CMI in patients with esophageal cancer.

Increases in immunoglobulin and complement in patients with esophageal or gastric cancer

Based on data providing evidence that the enhancement of serum IgG and IgA is associated with the occurrence of infectious complications following surgery in patients with esophageal cancer, we examined the possible factors contributing to alterations in the serum IgG, IgA, IgM, C3, C4, and CH50 levels. A multiple linear regression analysis was made on data obtained from 71 patients with esophageal cancer and 57 with gastric cancer. In the patients with esophageal cancer, age and protein-calorie malnutrition (PCM) were related to the elevation of IgG levels while the stage of cancer was linked to that of IgA. The sex and IgM levels were also seen to be related. Age and the stage of cancer were associated with reductions in C3, C4, and CH50 levels, although in the patients with gastric cancer, the stage of cancer and elevations of these complement levels were related. Thus, age, PCM, and tumor malignancy are all factors related to the enhancement of IgG or IgA in patients with esophageal cancer.

Adenoma of the nipple

We report herein a case of a 42 year old woman with adenoma of the nipple of her left breast. The diseased nipple was enlarged, reddened and a hard elastic mass was palpable within its substance. There was an area of eczematoid erosion on the surface. Incisional biopsy revealed a picture of adenoma and therefore the nipple was excised. Five years postoperatively, there has been no recurrence of the disease. To our knowledge, only thirteen cases of adenoma of the nipple have been reported in the Japanese literature. Some clinical features and treatments are discussed in a review following the case report. Although rare, adenoma of the nipple should be borne in mind to avoid a misdiagnosis of malignancy and unnecessarily extensive surgery.

Primary anorectal malignant melanoma

A case of primary anorectal malignant melanoma seen in a 46 year old woman is presented herein. Her most marked symptoms were bloody stools and anal pain. Endoscopic examination indicated a tumor with ulceration but without pigmentation in the anorectal region. Histologic examination of the biopsied specimens showed spindle-shaped cells with atypia proliferating in a bandlike arrangement, as in leiomyosarcoma. An abdominoperineal resection was done and detailed histological examination of the tumor confirmed the nature of the tumor to be malignant melanoma. The postoperative immunochemotherapy consisted of Dimetyl-Triazeno-Imidasole-Carboxamide (DTIC), Amino-Methyl-Pyrimidinyl-Methyl-Chlorethyl-Nitrosourea-Hydrochlori de (ACNU), Vincristine (VCR) and OK-432. The patient has been well without recurrence for fifteen months following her operation through the continuous administration of these agents.

The preservative-exchange method using a sextuple-bag system for a 10-week storage period of red blood cells

Prolonged storage of red blood cells in a liquid state was achieved by replacing the preservative using a sextuple-bag system. The bag system consists of one primary bag containing citrate-phosphate-dextrose (CPD) solution, three satellite bags containing saline-adenine-glucose-phosphate-maltose (SAGP-maltose) solution, and two empty satellite bags to remove plasma and buffy coat. Preservative can be exchanged three times in this closed system. The system is able to supply nutrients, such as glucose, and to remove harmful metabolites, such as lactic acid, by exchanging the preservative during storage. As a result, red cells stored by this method showed much higher levels of total adenylate and morphological score after the second preservative exchange, when compared with red cells stored by the conventional method (P < 0.01). Judging from these two in-vitro parameters, red cells may tolerate storage for at least 10 weeks in a liquid state. This method might be useful for 'predeposit autologous transfusion', as it is more convenient and more cost effective than the freeze-preservation method.

Clinical significance of ras p21 overexpression for patients with an advanced colorectal cancer

The expression of ras oncogene product p21 was examined in 45 paraffin-embedded sections of primary advanced colorectal cancers, using the anti-v-H-ras p21 monoclonal antibody Y13-259. Fourteen of these specimens (31 percent) were stained positively. The incidence of lymphatic vessel invasion of cancer cells and lymph node metastasis correlated statistically with the overexpression of ras p21. The depth of invasion and incidence of liver metastasis in the p21-positive group were more prominent than in the p21-negative group. Statistically significant differences were evident in operative curability and clinical stage at initial surgery and in the long-term survival rate between these groups (P less than 0.05). We propose that ras p21 overexpression may serve as a marker to predict the prognosis of colorectal cancer.

Acute phase proteins and infectious complications after surgery for esophageal cancer

Severe septic complications are the major cause of operative mortality in patients with esophageal cancer. We examined the levels of acute phase proteins together with infection-related complications after surgery in a large number of patients with esophageal cancer and compared them with a group of patients with gastric cancer and healthy controls. Elevations in alpha 1-antitrypsin, alpha 1-acidglycoprotein, haptoglobin and ceruloplasmin were evident in patients with esophageal cancer, being more predominant when compared to the findings in patients with gastric cancer. Although the mean levels of alpha 2-macroglobulin were not significantly elevated in either patients with esophageal cancer or those with gastric cancer, the average level immediately prior to surgery was higher in esophageal cancer patients with postoperative septic complications than in those without any such problems. Preoperative radiation therapy and total parenteral nutrition did not significantly alter the levels of acute phase proteins. It would thus appear that the elevation in alpha 2-macroglobulin is associated with the occurrence of infectious complications following surgery in patients with esophageal cancer.

Complications of infection and immunologic status after surgery for patients with esophageal cancer

Correlations between defective cell-mediated immunity (CMI) and infections following surgery for esophageal cancer were evaluated. Peripheral lymphocytes, T cells, B cells, PHA transformation, and PPD skin test were measured in 81 patients with esophageal cancer, 58 with gastric cancer, and 50 healthy controls. The depression of CMI was predominant to a similar extent in patients with esophageal cancer and in those with gastric cancer. The average level of PHA transformation immediately before surgery was significantly lower in the esophageal cancer patients with fatal septic complications than in those without such problems. Although preoperative radiation therapy markedly depressed the levels of the four parameters, this association was also noted in 28 patients not given radiation. It thus appears that PHA transformation may be valuable in the prediction of fatal septic complications after major surgery in patients with esophageal cancer.

Factors influencing the acute phase protein levels in patients with esophageal cancer

Based on the findings that the enhancement of serum alpha 2-macroglobulin (A2M) is associated with the occurrence of infectious complications following surgery in patients with esophageal cancer, we examined possible factors which could contribute to the alterations of serum acute phase protein levels in patients with this disease. A multiple linear regression analysis was made for 71 patients with esophageal cancer and 58 with gastric cancer. In patients with esophageal cancer, protein calorie malnutrition (PCM) and age factors more strongly contributed to the alteration of 6 acute phase protein levels than did the malignant tumor when compared to those with gastric acner. PCM was negatively associated with A2M levels while it was positively associated with alpha 1-acidglycoprotein (A1AG) and haptoglobin (Hp) levels. Age did not contribute to the A2M levels but did have a negative effect on the Hp, ceruloplasmin (Cp) and fibronectin (Fn) levels. On the other hand, the malignant tumor was positively related only to the A1AG levels. Since none of these factors contributed to the elevation of A2M levels, it is suggested that the presence of chronic infection might be a factor contributing to the A2M increase which was associated with the occurrence of postoperative infectious complications in patients with this disease.

Successful 0 degree C liquid preservation of red blood cells

In an effort to determine the lowest acceptable temperature for liquid preservation of red blood cells, the latter were stored at 5, 0, -2 and -5 degrees C. When polyvinylchloride (PVC) bags plasticized with di(2-ethylhexyl)phthalate (DEHP) were used as containers, hemolysis of red cells stored for 42 days at 0 degree C was lower than at the other three temperatures. Adenosine triphosphate (ATP) levels, morphology scores, and deformability indices were also best maintained at 0 degree C, and erythrocyte osmotic fragility did not increase at that temperature. On the other hand, when blood was stored in glass bottles at 0 degree C, hemolysis and erythrocyte osmotic fragility increased. The addition of DEHP to red cells stored in glass bottles at 0 degree C decreased hemolysis and erythrocyte osmotic fragility to levels equal to those in PVC bags. Thus, storage of red cells can be done at temperatures as low as 0 degree C, if PVC bags are used as the container. Previous negative assessments of storage temperatures below 4 degrees C, may be due to the use of glass bottles as containers for blood preservation.

Factors related to malnutrition in patients with esophageal cancer

Based on data indicating that decreases in body weight (BW), arm muscle circumference (AMC), and rapid-turnover proteins (RTPs) correlate with fatal septic complications after surgery for esophageal cancer, we examined possible factors contributing to protein-calorie malnutrition (PCM) in patients with this disease. Eight parameters of nutritional status were assessed. Associations between sex, age, stage of cancer, and degree of dysphagia and PCM were analyzed via multiple linear regression for 75 patients with esophageal cancer and 58 with gastric cancer. These four factors independently contributed to PCM in patients with esophageal cancer, whereas malignant tumor and age contributed to PCM in those with gastric cancer. The degree of dysphagia was related to decreases in serum albumin and RTP and weakly related to decreases in BW and AMC. Stage of cancer, age, and sex were associated with reductions in albumin and/or RTP. Thus, we conclude that simple starvation, malignant tumor, age, and sex contribute to PCM and probably to the occurrence of fatal septic complications postoperatively.

Preoperative assessment of cervical lymph node involvement in esophageal cancer

Lymphoscintigraphy (LS) and computed tomography (CT) were used preoperatively to assess nodal involvement in 23 patients with esophageal cancer. LS predicted nodal involvement with a high sensitivity and low specificity since false positives were frequent while in contrast, CT predicted it with high specificity and low sensitivity. The combination of LS and CT improved sensitivity by up to 87 per cent but not specificity. The positive image of nodes in LS was associated with malignant cell involvement and/or reactive changes in the nodes, especially sinus histiocytosis and germinal center hyperplasia. When cervical nodes were involved, bilateral images of lymph flows were often lost and by using the images of lymph flow as well as those of the nodes, the combination predicted cervical nodal involvement with a sensitivity of 83 per cent and a specificity of 86 per cent. Thus, the combination of LS and CT is beneficial for preoperatively estimating cervical nodal involvement in esophageal cancer.

Enhanced immunoglobulin levels correlate with infectious complications after surgery in esophageal cancer

Severe septic complications account for the high mortality of patients with esophageal cancer. We examined the levels of immunoglobulins and complements together with infection-related complications in a large number of patients. Enhancements of IgG, IgA, C3, C4, and CH50 were evident in patients with esophageal cancer and were more predominant compared to findings in cases of gastric cancer. Average levels of IgG and IgA immediately before surgery were significantly higher in esophageal cancer patients with postoperative septic complications than in those without such problems. Preoperative radiation therapy and total parenteral nutrition did not significantly alter the levels of immunoglobulins and complements. It would thus appear that the enhancement of IgG and IgA is associated with the occurrence of infectious complications following surgery for patients with esophageal cancer.

[A case of nonresectable gastric cancer completely responding to combined chemotherapy according to the mode of progression]

The case was a 82-year-old man with advanced gastric Borrmann 3 cancer on the posterior wall of the cardia. Laparotomy revealed peritoneal dissemination (P3) and liver metastasis (H1). Because of his advanced age and on the basis of local findings, gastrectomy was not performed. In order to treat peritoneal dissemination with two-route chemotherapy, two tubes were placed beneath the cul-de-sac of Douglas and the left subphrenic cavity and at the same time, for the purpose of intra-arterial chemotherapy, one more tube was inserted into the proper hepatic artery. At day 12 and day 25 after the operation, 5-FU (500 mg)-Lipiodol (10 ml) emulsion was infused through the tube inserted into the proper hepatic artery. Within 24 hours following the infusion, hyperthermotherapy was carried out at 42 degrees C for 40 minutes. In addition, two-route chemotherapy with CDDP (100 mg)-STS was given at day 14 and day 28 after the operation. Furthermore, one course of FAM [5-FU (1,500 mg), ADM (30 mg) and MMC (10 mg)] therapy was initiated five weeks after the operation. Although no further chemotherapy was performed thereafter, both gastric endoscopy and CT scanning disclosed complete disappearance of the tumor one year after the operation. This result suggests that combined chemotherapy according to the part of progression is effective for advanced gastric cancer.

[Two stages three fields lymph node dissection in esophageal cancer]

In order to indicate the three fields lymph node dissection method to wider ranges of patients with esophageal cancer, the two stages technique was applied to those with moderate disturbance of general physical conditions. Fifty eight patients with esophageal cancer admitted to our clinic from January 1986 to December 1988 and 38, in whom those with cervical esophageal cancer were excluded, employed esophagectomy. Of them, 26 patients (68%) received the three fields dissection method, 13 being due to the one stage technique and the remaining 12 being due to the one stage technique and the remaining 13 being due to the two stages technique. The three fields dissection method was indicated to patients who were younger than 75 years of age, were expected to receive curative resections or had no, mild and moderate disturbances of the physical conditions. The one stage technique was applied to patients with no and mild disturbances of the physical conditions while the two stages technique was to those with moderate disturbance. The general physical conditions were evaluated with the past history, underlying diseases, functions of the main organs and the ability of host defense. In the first operation of the two stage technique, subtotal esophagectomy and dissection of the regional lymph nodes including the paratracheal ones were performed. After approximately one month, esophageal reconstruction with the gastric tube and dissection of the regional nodes of the abdomen and neck were done in the second operation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Unresectable stage 4-cancer of the esophagus well responded to combined chemoradiotherapy--a case report]

We experienced a long-term survived case with unresectable Stage 4 esophageal carcinoma well responded to chemoradiotherapy of combination of cisplatin (C), vindesine (V) and peplomycin (P) with radiotherapy (R). The patient was a male, aged 53, and diagnosed to have carcinoma, 8 cm in length, located at the IuCe region of the esophagus and right subclavicular lymph node metastasis on admission. He received radiotherapy at total dose of 60 Gy for the primary and metastatic lesions, and also 2 cycle CVP chemotherapy concomitantly. The mass of the primary lesion endoscopically changed to a flat area with small erosion while the right subclavicular metastatic node disappeared and was not found on CT after the end of the treatment. Objective response of this case was determined to the partial response since carcinoma cells were still found at the flat lesion. After discharge, 9 cycles of CVP therapy were further given in 3-year periods. At present, the patient is alive well although a part of the primary esophageal lesion is proved to have malignancy on biopsy.

Widespread occurrence of specific restriction endonucleases in Salmonella infantis, Salmonella thompson, and Salmonella blockley isolated from humans in Japan

Specific restriction endonucleases were detected in three serotypes of Salmonella spp. isolated from humans in Japan from 1970 to 1987: an isoschizomer of AvaII endonuclease at a frequency of 0.91 in Salmonella infantis, an isoschizomer of KpnI at a frequency of 0.34 in Salmonella thompson, and an isoschizomer of StyI at a frequency of 0.30 in Salmonella blockley. Of interest is that restriction endonuclease-producing S. thompson was detected at high frequencies in the 1970s but at low frequencies in the 1980s.

Correlations between preoperative malnutrition and septic complications of esophageal cancer surgery

Eight measures were used to assess the nutritional status of 80 patients with esophageal cancer, 58 with gastric cancer, and 50 healthy controls. Postoperative complications were divided into three categories: septic, anastomotic leakage, and nonseptic. Protein-calorie malnutrition (PCM) of esophageal cancer patients was characterized by a greater depletion of arm muscle circumference (AMC) and body weight (BW) compared with findings in the gastric cancer patients. Average AMC, BW, triceps skinfold (TSF), and levels of retinol-binding protein (RBP) on admission were lower in patients who suffered fatal septic complications than in those who did not. The reduction of AMC, BW, and RBP was observed even after preoperative total parenteral nutrition (TPN). It is concluded that patients with a nutritional depletion as assessed by these measures on admission should be treated with preoperative TPN, and, if nutritional correction of these measures is poor, other perioperative therapy to prevent fatal septic complications should be given.

[Suppression of lipid peroxidation by sho-saiko-to and its components in rat liver subcellular membranes]

In order to elucidate anti-inflammatory action of Sho-saiko-to, its components were analyzed and purified by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC), and their effects on lipid peroxidation were compared with those of Sho-saiko-to in guinea pig neutrophils, rat liver mitochondria and microsomes. The results obtained were as follows: 1) Sho-saiko-to gave no effect on arachidonate- and PMA (phorbol 13-myristate 12-acetate)-induced NADPH-O2- generation in neutrophils though it gave a weak LPS-like effect on the cells. No inhibition of reduced nicotinamido adenine dinucleotide phosphate (NADPH) oxidation was shown in liver microsomes. However, it markedly inhibited iron-induced lipid peroxidation in microsomes and mitochondria. 2) The active components to suppress lipid peroxidation could be concentrated in a lipid-soluble fraction from the Sho-saiko-to solution. The ED50 values to give 50% inhibition of the mitochondrial lipid peroxidation were 160 ng/mg prot, and 50 micrograms/mg prot, for the lipid-soluble fraction and Sho-saiko-to, respectively. 3) The components in the lipid-soluble fraction were further separated by TLC and HPLC, and their inhibitory effects on the lipid peroxidation were examined. The active components were baicalein, ginsenoside Rf and baicalin, of which ED50 values were 0.2, 0.2 and 1 nmol/mg prot, respectively. Glycyrrhizin and its derivatives, ginsenoside (except ginsenoside Rf), and saikosaponins gave no effect in the concentration examined. 4) From these results anti-inflammatory action of Sho-saiko-to was discussed.

Restriction endonuclease PshAI from Plesiomonas shigelloides with the novel recognition site 5'-GACNN/NNGTC

A new restriction endonuclease (ENase), PshAI, has been isolated from Plesiomonas shigelloides 319-73, an organism that causes food poisoning in humans. The enzyme was stable and produced a yield of 410 units/g of cells. In the presence of 10 mM MgCl2, PshAI recognizes and cleaves the nucleotide sequence 5'-GACNN/NNGTC, producing blunt ends. PshAI will be useful for structural analysis and molecular cloning of DNA, because no ENases recognizing sequence GACNNNNGTC have been previously described.