Extensive intra-alveolar haemorrhage caused by disseminated strongyloidiasis

We describe here four cases of disseminated strongyloidiasis. In Okinawa, it has been reported that about 10% of the residents are infected with Strongyloides stercoralis, but disseminated cases are rare. Detailed histopathological examination revealed that the present four cases could clearly be separated into two groups, two acute cases and two subacute cases. The acute cases died rapidly due to extensive diffuse intra-alveolar haemorrhage in both lungs. However, there were no inflammatory infiltrates, abscesses or granulomas in the lungs. Worms were demonstrated in the alveolar spaces. No extensive bleeding was observed in any organs except the lungs. The acute cases could be diagnosed as severe diffuse intra-alveolar haemorrhage syndrome, but deposition of immune complex (parasite antigen and immunoglobulins) and complement C3c was not demonstrated in the alveolar wall and small vessels of the lung. The subacute cases exhibited no such extensive haemorrhage, but scattered microabscesses were found with sepsis. During the migration of the worms from the colon, enteric bacteria entered the circulation in the two subacute cases. The acute cases received steroid therapy before the dissemination of the worms, but the two subacute cases did not. Steroids might have influenced the Strongyloides stercoralis dissemination and/or the course of the disease.

Influences of immunosuppressive agents, FK506 and cyclosporin on systemic Candida albicans infection in mice

The effects of the immunosuppressive agents FK506 (tacrolimus) and cyclosporin (CyA) on Candida albicans infection in mice were compared with those of cyclophosphamide. FK506 and CyA did not exacerbate C. albicans infection in mice when the effects were determined on the basis of survival ratio and colony forming units (CFU) in the kidney, although cyclophosphamide (CY) impaired the host defence mechanisms of mice against C. albicans infection. The effects of FK506 and CyA on the body weight of mice, histopathological changes of lymphoid tissues and formation of granulomas in kidney were also studied in comparison with those of CY.

Progression from myelodysplastic syndrome with monosomy 7 to acute monoblastic leukemia with MLL gene rearrangement

We report a case of myelodysplastic syndrome (MDS) with the 11q23 translocation at its leukemic transformation. Southern blot analysis demonstrated that the MLL gene on chromosome 11 was rearranged during the progression from MDS to acute leukemia. The clinical observation in this case supports the notion that leukemic transformation involves multiple cytogenetic evolutionary progresses, and that MLL gene rearrangement corresponds to the final step of leukemogenesis.

Prophylactic effect of dietary glutamine supplementation on interleukin 8 and tumour necrosis factor alpha production in trinitrobenzene sulphonic acid induced colitis

BACKGROUND

It is well established that glutamine supplemented elemental diets result in less severe intestinal damage in experimental colitis. However, few studies have examined the mode of action of glutamine in reducing intestinal damage.

AIMS

To examine the effects of glutamine supplemented elemental diets on the potent inflammatory cytokines interleukin 8 (IL-8) and tumour necrosis factor alpha (TNF-alpha) in trinitrobenzene sulphonic acid (TNBS) induced colitis which presents with both acute and chronic features of ulcerative colitis.

METHODS

Sprague-Dawley rats were randomised into three dietary groups and fed 20% casein (controls), or 20% casein supplemented with either 2% glutamine (2% Gln) or 4% glutamine (4% Gln). After two weeks they received intracolonic TNBS to induce colitis.

RESULTS

Both Gln groups of rats gained more weight than the control group (p < 0.05) which had progressive weight loss. Colon weight, macroscopic, and microscopic damage scores for the Gln groups were lower than in the control group (p < 0.05). IL-8 and TNF-alpha concentrations in inflamed colonic tissues were lower in the Gln groups than in the control group (p < 0.05), and correlated well with disease severity. Bacterial translocation was lower both in incidence (p < 0.05) and in the number of colony forming units (p < 0.05) for the Gln groups, than in the control group. With respect to all indices studied, the 4% Gln group performed better than did the 2% Gln group.

CONCLUSION

Prophylactic glutamine supplementation modulates the inflammatory activities of IL-8 and TNF-alpha in TNBS induced colitis.

[Clonal analysis by fluorescence in situ hybridization in a patient with de nove acute myeloid leukemia with myelodysplasia]

A 12-year-old girl presenting leukocytosis, anemia and thrombocytopenia was diagnosed as de nove acute myeloid leukemia (AML, M2) with concurrent myelodysplastic features in myeloid and erythroid cells. Her karyotype was defined as 47, XX, +8[20]. Though she was treated successfully with multi-drug chemotherapy, she relapsed after 2 years of remission. A bone marrow transplantation from HLA matched her brother was performed to induce hematological remission which persisted for one year. She again relapsed with AML with myelodysplasia, and an abnormal complex karyotype was newly detected. She eventually died without further chemotherapy. We performed FISH on the patient's stained bone marrow smears using DNA probes for chromosome 8 and Y to analyze the clonality. The results showed that the most of blasts and bone marrow cells except lymphoid cells were of trisomy 8 at onset, while in the 1st remission, trisomy 8 clone was slightly detected only in monocytes. At 1st and 2nd relapse, trisomy 8 clone was detected again in most of myeloid cells. Thus, in this case, it was considered that underlying stem cell disorder with trisomy 8 during the entire disease course contributed to leukemogenesis.

Histopathological and electron microscopical studies on experimental Penicillium marneffei infection in mice

Experimental Penicillium marneffei infection in mice was investigated histopathologically and by electron microscopy. Viable conidia (5 x 10(6) cells) of P. marneffei were inoculated into each mouse of group A (BALB/c mice) and group B (BALB/c-nu/nu-SIc mice) through the tail vein. All the mice were sacrificed at intervals and the livers were examined. In group A, the conidia were phagocytosed by Kupffer cells soon after inoculation, and proliferated by fission in the cytoplasm. Marked proliferation of yeast cells was observed 7 and 14 days after inoculation. With proliferation of the fungus, the number of lysosomes in Kupffer cells increased, and numerous granulomas were formed in the liver. These granulomas consisted mainly of macrophages with yeast cells, together with a few polymorphonuclear leukocytes, lymphocytes and giant cells. From 28 days on yeast cells were gradually cleared from the granulomas, and 56 days after inoculation almost all the granulomas disappeared. In group B, at an early stage of infection, similar pathological changes to those seen in mice of group A were observed. However, as the infection progressed, the number of granulomas continued to increase and yeast cells continued to proliferate although lymphocytes did not infiltrate these granulomas. With proliferation of yeast cells the liver tissue was replaced with both yeast cells engulfed by macrophages and extracellular yeasts, and dissemination occurred.

Neoplastic nodular formation in mouse liver induced by repeated intraperitoneal injections of microcystin-LR

Neoplastic nodules were observed in mice liver treated with microcystin-LR (MCLR) by the intraperitoneal (i.p.) route over 28 weeks. After 100 i.p. injections of a sublethal dose (20 micrograms/kg) of MCLR, neoplastic nodules were observed without the use of an initiator. Multiple neoplastic nodules up to 5 mm in diameter were observed in the liver of mice in both groups, i.e. those injected 100 times i.p. and those injected 100 times with a 2 month withdrawal. The cysteine conjugate of MCLR was detected mainly in the affected livers. In contrast, when 80 micrograms/kg was orally administered 100 times, characteristic chronic injuries such as fibrous changes and nodule formation were not observed.

Theophylline metabolism in higher plants

Metabolism of [8-(14)C]theophylline was investigated in leaf segments from Camellia sinensis (tea), Camellia irrawadiensis, Ilex paraguariensis (maté) and Avena sativa, root segments of Vigna mungo seedlings and cell suspension cultures of Catharanthus roseus. There was extensive uptake and metabolism of [8-(14)C]theophylline by leaves of tea and Camellia irrawadiensis and, to a lesser extent, maté. These purine alkaloid-containing species converted [8-(14)C]theophylline into 3-methylxanthine, xanthine, the ureides allantoin and allantoic acid, and CO2. With the other test systems, which were from species that do not produce purine alkaloids, there were low levels of [8-(14)C]theophylline uptake which were accompanied by incorporation of relatively small amounts of label into 3-methylxanthine, xanthine and CO2. None of the higher plants converted [8-(14)C]theophylline to either 1-methyluric acid or 1,3-dimethyluric acid, which are the main catabolites of theophylline in mammals. The data indicate that the main route of theophylline degradation in higher plants involves a theophylline --> 3-methylxanthine --> xanthine --> uric acid --> allantoin --> allantoic acid --> --> CO2 + NH3 pathway. In tea and mate, large amounts of [8-(14)C]theophylline were also converted to theobromine and caffeine via a theophylline --> 3-methylxanthine --> theobromine --> caffeine salvage pathway. The diversity of theophylline metabolism in higher plants and mammals is discussed.

Enhancement of an inhibitory input to the feeding central pattern generator in Lymnaea stagnalis during conditioned taste-aversion learning

To study the neuronal mechanism of a conditioned taste-aversion (CTA) learning in the pond snail Lymnaea stagnalis, we examined the synaptic connection between the neuron 1 medial (N1M) cell and the cerebral giant cell (CGC), the former is an interneuron in central pattern generator for the feeding response and the latter is a regulatory neuron to the central pattern generator. Inhibitory postsynaptic potential (IPSP) which was evoked in the N1M cell by activation of the CGC was larger and lasted longer in the conditioned animal than that in the control animal. The electrical properties of the cell body of CGC and the responses of the CGC to the chemosensory inputs were not changed during the CTA learning. These results, together with the previous report indicating the existence of excitatory projection from the N1M cell to the feeding motoneuron, suggest that enhanced IPSP in the N1M cell may underlie the suppression of feeding responses in the Lymnaea CTA learning.

Effects of thrombopoietin (c-mpl ligand) on growth of blast cells from patients with transient abnormal myelopoiesis and acute myeloblastic leukemia

Thrombopoietin (TPO) is a ligand for c-mpl that promotes both proliferation and differentiation of megakaryocytes in vivo and in vitro. We investigated the expression of c-mpl transcripts and the effects of recombinant human TPO (rhTPO) on the proliferation and differentiation of human leukemic cell lines or fresh samples obtained from 32 patients with transient abnormal myelopoiesis (TAM) or acute myeloblastic leukemia (AML). Cells were cultured with TPO alone or combined with rh interleukin-3 (IL-3) or stem cell factor (SCF). Expression of c-mpl was verified in 6 of 13 cases tested. All but one of the cases that showed c-mpl expression responded to TPO. Blasts from all cases of TAM or French-American-British (FAB) subtype M7 showed growth responses to TPO with higher sensitivity than cells of other FAB subtypes and these responses were increased by addition of rhIL-3 or rhSCF in some cases. Responses of cells of other FAB subtypes varied. In addition, increased expression of platelet-specific surface antigens on MO7E cells after incubation with rhTPO was observed. These data suggest that TPO may be involved in the abnormal proliferation and differentiation of human leukemic cells, especially of M7 and TAM cells, considered to be of megakaryocytic lineage.

Decrease in Thy-1 expression on peripheral CD34 positive cells induced by G-CSF mobilization. The Tohoku Children Leukemia Study Group

In order to ascertain the cytological features of peripheral hematopoietic progenitor cells (PHPC) mobilized after administration of chemotherapeutic agents and G-CSF, lineage- and progenitor cell-specific surface markers on CD34 positive (+) cells were sequentially examined. Nineteen evaluable samples were obtained from a malignant lymphoma, an acute lymphoblastic leukemia and 5 neuroblastoma patients. CD38 and HLA-DR were respectively expressed on more than 95% and approximately 85% of CD34+ PHPC cells. CD19 was also expressed on the majority and CD117 on 10 to 20% of the CD34+ cells. The most striking finding was that the Thy-1(CDw90)+/CD34+ population was decreased at the peak of mobilization of CD34+ cells as compared to the early phase after G-CSF administration (approximately 20% vs. 60%). These results suggest that decrease in Thy-1 expression on CD34+ cells is related to mechanisms easing CD34+ cell mobilization to the peripheral blood.

A case of nonpenetrating traumatic aortic regurgitation detected by transesophageal echocardiography

A 67-year-old man, who had fell 5 meters, landing on his back, one month before, was referred because of heart failure due to aortic regurgitation (AR). Transesophageal echocardiogram (TEE) confirmed injuries in the aortic valve and the Valsalva sinus of the aorta before the surgery: the intimal flap in the Valsalva sinus of right coronary cusp (RCC), the prolapse of the RCC, and the dissection by longitudinal length of 3 cm in the Valsalva sinus of noncoronary cusp (NCC), ending as a blind pouch. Postoperative TEE confirmed the dissection was not repaired in the Valsalva sinus of the NCC. In this instance, TEE was extremely useful, compared with transthoracic echocardiography, computed tomography and magnetic resonance imaging, to assess the mechanism of AR following a nonpenetrating trauma, and to know to what degree the aortic valve and the Valsalva sinus of the aorta were destroyed.

Effects of repeated injections of palytoxin on lymphoid tissues in mice

Sublethal doses of palytoxin were i.p. injected repeatedly to mice, and the effects on lymphoid tissues were examined. The weight and morphology of the thymus were influenced during exposure but had generally recovered after 1 month of withdrawal. The ratio of lymphocytes to total leukocytes in blood was decreased during the injection term, and did not recover to a normal level even after 1 month of withdrawal. The component of B-cells in the lymphocytes was clarified as being responsible for the small number of lymphocytes in the recovery process.

Human small Maf proteins form heterodimers with CNC family transcription factors and recognize the NF-E2 motif

The transcription factor NF-E2, a heterodimeric protein complex composed of p45 and small Maf family proteins, is considered crucial for the regulation of erythroid gene expression and platelet formation. To facilitate the characterization of NF-E2 functions in human cells, we isolated cDNAs encoding two members of the small Maf family, MafK and MafG. The human mafK and mafG genes encode proteins of 156 and 162 amino acid residues, respectively, whose deduced amino acid sequences show approximately 95% identity to their respective chicken counterparts. Expression of mafK mRNA is high in heart, skeletal muscle and placenta, whereas mafG mRNA is abundant in skeletal muscle and is moderately expressed in heart and brain. Both are expressed in all hematopoietic cell lines, including those of erythroid and megakaryocytic lineages. In electrophoretic gel mobility shift assays binding to NF-E2 sites was found to depend on formation of homodimers or heterodimers with p45 and p45-related CNC family proteins. The results suggest that the small Maf family proteins function in human cells through interaction with various basic-leucine zipper-type transcription factors.

Hepatic necrosis in aged mice by oral administration of microcystin-LR

Aged mice (32 weeks) were orally administered microcystin-LR at 500 micrograms/kg, and injuries of the liver were estimated by microscopy 2 hr after treatment. Sixty-two per cent of aged mice proved to be sensitive to microcystin-LR, whereas such changes in the liver were not found in young mice (5 weeks). Uptake of the toxin into the liver was confirmed by high-performance liquid chromatography and frit-fast atom bombardment liquid chromatograph/mass spectrometry after clean-up with an immunoaffinity column. To verify the difference in sensitivity to microcystin-LR between aged and young mice, non-treated mice were examined, and among them aged mice were confirmed to have a rough surface of the stomach and small intestinal mucosa. These results suggested that the hepatotoxicity by oral administration of microcystin-LR is deeply related to aging, and particularly to conditions in the small intestine such as the permeability of capillaries in the villi.

Conserved structure, regulatory elements, and transcriptional regulation from the GATA-1 gene testis promoter

Transcription factor GATA-1 was first identified in erythroid cells, but was later shown to also be expressed in Sertoli cells of the mouse testis. GATA-1 transcription in testis initiates from a different first exon (exon IT) than the erythroid mRNA (transcribed from exon IE). To begin to address the question of how expression of GATA-1 might be differentially regulated in Sertoli and erythroid cells, we have cloned and determined the structure of the IT promoters of both the rat and mouse GATA-1 genes. The transcription regulatory mechanism(s) controlling the synthesis of exon IT-derived mRNA was investigated by transfection of wild-type and mutant reporter genes, with and without co-transfected GATA factor expression plasmids, into either fibroblasts or Sertoli cell lines. Two GATA binding sites in the IT promoter were found to be required for GATA factor-mediated activation in fibroblasts: GATA-IT-directed reporter gene expression was activated only after co-transfection with GATA-1, implying that transcriptional activation of GATA-1 in the testis might be at least partially mediated through these GATA regulatory elements. We also found that the endogenous GATA-1 gene was silent in primary culture and two different Sertoli cell lines, and that the repression of co-transfected GATA-1 reporter genes could not be relieved by forced expression of GATA-1 in Sertoli cells. Thus the GATA-IT promoter may be under the control of a regulatory network in Sertoli cells which involves both positive and negative regulation of transcription, and conserved GATA motifs found in the IT promoter may be required for transducing these effects.

Detection and identification of metabolites of microcystins formed in vivo in mouse and rat livers

The hepatic metabolism of microcystins (MCs), potent cyclic peptide hepatotoxins produced by cyanobacteria, was studied by i.p. injection in mice and rats. An immunoaffinity purification method using an anti-MC-LR monoclonal antibody showed a remarkable effect on the removal of contaminants in the hepatic cytosol and enabled us to analyze MCs and their metabolites by HPLC and Frit-FAB LC/MS. At 3, 6, and 24 h post-injection of MC-RR, a small percent of the applied dose was detected in all of the mouse livers together with several metabolites. Among them, GSH and Cys conjugates of MC-RR were identified at 3 and 24 h, respectively, by comparison with the chemically prepared standards, indicating that the thiols of GSH and Cys nucleophilically bound to the Mdha moiety of MCs. Another metabolite was presumed to be formed by both epoxidation followed by hydrolysis and sulfate conjugation in the Adda moiety and GSH conjugation in the Mdha moiety. In rat livers, MC-LR showed almost the same behavior as that of MC-RR in mouse livers. These results suggest that the conjugation of GSH with MCs may play a role in the metabolic pathway leading to detoxification of MCs.

Simultaneous intra- and extra-uterine pregnancy with ovarian hyperstimulation syndrome after induction of ovulation: a case report

We present a case of polycystic ovary syndrome (PCOS) that developed simultaneous intra- and extra-uterine pregnancy with ovarian hyperstimulation syndrome (OHSS) after induction of ovulation with pure FSH-HCG. At 9 weeks of pregnancy, the bilateral tubal pregnancy caused an imminent spontaneous abortion, and both Fallopian tubes were resected. After the laparotomy, the pregnancy progressed without problems until 31 weeks and 5 days of pregnancy, when signs of spontaneous abortion appeared, and healthy twin female babies were delivered by cesarean section. The incidence of heterotopic pregnancy is increasing in cases in which inducers of ovulation or ART, such as IVF-ET and GIFT, have been employed. One must be well aware that the danger of heterotopic pregnancy following induction of ovulation is imminent, particularly in cases with risk factors of multiple and/or extra-uterine pregnancy, such as PCOS, a history of tubal restoration, and sexually transmitted disease(s).

Expression of erythroid-specific genes in megakaryoblastic disorders

Currently available data indicate that erythroid and megakaryocytic differentiation pathways are closely related to each other, and there may exist progenitor cells common to those two lineages may exist. Acute megakaryoblastic leukemia (AML-M7) and transient myeloproliferative disorder in Down's syndrome (TMD) are characterized by rapid growth of abnormal blast cells which express megakaryocytic markers. These blast cells express lineage-specific transcription factors such as GATA-1 common to these lineages and frequently express erythroid-specific mRNAs such as gamma-globin and erythroid delta-aminolevulinate synthase (ALAS-E), indicating that most of the blasts in M7 and TMD cases have erythroid and megakaryocytic phenotypes. These results suggest that blasts in M7 and TMD may correspond to progenitors of both erythroid and megakaryocytic lineages.

Induction of intercellular adhesion molecule-1 in human nasal epithelial cells during respiratory syncytial virus infection

The effects of infection with respiratory syncytial virus (RSV) on expression of intercellular adhesion molecule (ICAM)-1 was determined in vitro in nasal epithelial cell cultures. Functional consequences of changes in ICAM-1 expression were assessed by measuring adhesion of a human leukaemic T-cell line to RSV-infected epithelial cells. Also, adhesion of phytohaemagglutinin-activated tonsillar lymphocytes (TL) to RSV-infected epithelial cells caused a significant increase in interleukin (IL)-4 or IL-5 production. Release of these cytokines was adhesion dependent as non-adherent TL produced significantly less IL-4 or IL-5. However, no significant difference was observed for IL-2 or interferon-gamma (IFN-gamma) production. These observations suggest that RSV-infected epithelial cells may induce T-helper type-2 (Th2)-like cytokines by mucosal lymphocytes during mucosal infection in vivo.

Intestinal injuries caused by experimental palytoxicosis in mice

Intestinal injuries in mice caused by i.p. administration of palytoxin at 1 microgram/kg were studied microscopically. Within 1 hr, bleeding started from small intestinal villi. At 6 hr, congestion in the villi and edema in the lamina propria in the crypt layer developed prominently. Edema and necrosis of lamina propria in the villus appeared after 16 hr. At 24 hr, villi lost their epithelial cells and then their length decreased to 1/4 to 1/8 of normal. Diarrhea was seen after 16 hr, accompanying severe peritonitis. Hypersecretion of mucus from the large intestine was considered to be physically stimulated by peritonitis, which then induced diarrhea.