Analysis of vitamin D receptor binding affinities of enzymatically synthesized triterpenes including ambrein and unnatural onoceroids

Onoceroids are a rare family of triterpenes. One representative onoceroid is ambrein, which is the main component of ambergris used as a traditional medicine. We have previously identified the onoceroid synthase, BmeTC, in Bacillus megaterium and succeeded in creating ambrein synthase by introducing mutations into BmeTC. Owing to the structural similarity of ambrein to vitamin D, a molecule with diverse biological activities, we hypothesized that some of the activities of ambergris may be induced by the binding of ambrein to the vitamin D receptor (VDR). We demonstrated the VDR binding ability of ambrein. By comparing the structure-activity relationships of triterpenes with both the VDR affinity and osteoclastic differentiation-promoting activity, we observed that the activity of ambrein was not induced via the VDR. Therefore, some of the activities of ambergris, but not all, can be attributed to its VDR interaction. Additionally, six unnatural onoceroids were synthesized using the BmeTC reactions, and these compounds exhibited higher VDR affinity than that of ambrein. Enzymatic syntheses of onoceroid libraries will be valuable in creating a variety of bioactive compounds beyond ambergris.

Insight into the mechanism of geranyl-β-phellandrene formation catalyzed by Class IB terpene synthases

Terpene synthase (TS) from Bacillus alcalophilus (BalTS) is the only Class IB TS for which a 3D structure has been elucidated. Recently, geranyl-β-phellandrene, a novel cyclic diterpene, was identified as a product of BalTS in addition to the acyclic β-springene. In the present study, we have provided insight into the mechanism of geranyl-β-phellandrene formation. Deuterium labeling experiments revealed that the compound is produced via a 1,3-hydride shift. In addition, nonenzymatic reactions using divalent metal ions were performed. The enzyme is essential for the geranyl-β-phellandrene formation. Furthermore, BalTS variants targeting tyrosine residues enhanced the yield of geranyl-β-phellandrene and the proportion of the compound of the total products. It was suggested that the expansion of the active site space may allow the conformation of the intermediates necessary for cyclization. The present study describes the first Class IB TSs to successfully alter product profiles while retaining high enzyme activity.

Suppurative meningoencephalitis and perineuritis caused by Streptococcus gallolyticus in a Japanese Black calf

A 179-day-old calf, which was weak and stunted, showed neurological signs and was euthanized. Postmortem examination revealed extensive and severe cloudy area in the meninges, and pleural pneumonia. Gram-positive cocci were isolated from systemic organs. Biochemical and 16S rRNA gene sequence analyses identified the isolate as Streptococcus gallolyticus, and its subspecies was suggested to be gallolyticus (SGG). The isolate was classified as a novel sequence type (ST115) by the multilocus sequence typing scheme for SGG and showed susceptibility to penicillin, ampicillin, amoxicillin, florfenicol, sulfamethoxazole-trimethoprim, and chloramphenicol. Histopathologically, suppurative meningoencephalitis and perineuritis were detected. As SGG has been isolated solely from a cow with mastitis in Japan, this is the first SGG infection in a calf with suppurative meningoencephalitis and perineuritis in this country.

Insight into Isoprenoid Biosynthesis by Functional Analysis of Isoprenyl Diphosphate Synthases from Mycobacterium vanbaalenii and Mycobacterium tuberculosis

Comprehensive functional analyses of E-isoprenyl diphosphate synthases (E-IDSs) from nonpathogenic Mycobacterium vanbaalenii have been performed. Mv0992 and Mv1577 represent a nonaprenyl diphosphate (E-C₄₅ ) synthase and a geranylgeranyl diphosphate (E-C₂₀ ) synthase, respectively. Although Mv3536 was identified as an E-C₂₀ synthase using a single enzyme, co-incubation of Mv3536 and Z-IDSs (Mv4662 and Mv3822) strongly suggested it releases an intermediate geranyl diphosphate (E-C₁₀ ) during a continuous condensation reaction. Mv0992 and Mv3536 functions differed from those of the previously reported pathogenic Mycobacterium tuberculosis homologues Rv0562 and Rv2173, respectively. Re-analysis of Rv0562 and Rv2173 demonstrated that their functions were similar to those of Mv0992 and Mv3536 (Rv0562: E-C₄₅ synthase; Rv2173: E-C_10-15 synthase). The newly proposed functions of Rv0562 and Rv2173 would be in the biosynthesis of menaquinone and glycosyl carrier lipids essential for growth. Furthermore, a reduced allylic diphosphate could be used as the Z-IDS of the Mv3822 substrate, thereby introducing a potentially novel pathway of cyclic sesquarterpene biosynthesis.

Characterization of Class IB Terpene Synthase: The First Crystal Structure Bound with a Substrate Surrogate

Terpene synthases (TS) are classified into two broad types, Class I and II, based on the chemical strategy for initial carbocation formation and motif sequences of the catalytic site. We have recently identified a new class of enzymes, Class IB, showing the acceptability of long (C₂₀-C₃₅) prenyl-diphosphates as substrates and no amino acid sequence homology with known TS. Conversion of long prenyl-diphosphates such as heptaprenyl-diphosphate (C₃₅) is unusual and has never been reported for Class I and II enzymes. Therefore, the characterization of Class IB enzymes is crucial to understand the reaction mechanism of the extensive terpene synthesis. Here, we report the crystal structure bound with a substrate surrogate and biochemical analysis of a Class IB TS, using the enzyme from Bacillus alcalophilus (BalTS). The structure analysis revealed that the diphosphate part of the substrate is located around the two characteristic Asp-rich motifs, and the hydrophobic tail is accommodated in a unique hydrophobic long tunnel, where the C₃₅ prenyl-diphosphate, the longest substrate of BalTS, can be accepted. Biochemical analyses of BalTS showed that the enzymatic property, such as Mg²⁺ dependency, is similar to those of Class I enzymes. In addition, a new cyclic terpene was identified from BalTS reaction products. Mutational analysis revealed that five of the six Asp residues in the Asp-rich motifs and two His residues are essential for the formation of the cyclic skeleton. These results provided a clue to consider the application of the unusual large terpene synthesis by Class IB enzymes.

An Aromatic Farnesyltransferase Functions in Biosynthesis of the Anti-HIV Meroterpenoid Daurichromenic Acid

Rhododendron dauricum produces daurichromenic acid, an anti-HIV meroterpenoid, via oxidative cyclization of the farnesyl group of grifolic acid. The prenyltransferase (PT) that synthesizes grifolic acid is a farnesyltransferase in plant specialized metabolism. In this study, we demonstrated that the isoprenoid moiety of grifolic acid is derived from the 2-C-methyl-d-erythritol-4-phosphate pathway that takes place in plastids. We explored candidate sequences of plastid-localized PT homologs and identified a cDNA for this PT, RdPT1, which shares moderate sequence similarity with known aromatic PTs. RdPT1 is expressed exclusively in the glandular scales, where daurichromenic acid accumulates. In addition, the gene product was targeted to plastids in plant cells. The recombinant RdPT1 regiospecifically synthesized grifolic acid from orsellinic acid and farnesyl diphosphate, demonstrating that RdPT1 is the farnesyltransferase involved in daurichromenic acid biosynthesis. This enzyme strictly preferred orsellinic acid as a prenyl acceptor, whereas it had a relaxed specificity for prenyl donor structures, also accepting geranyl and geranylgeranyl diphosphates with modest efficiency to synthesize prenyl chain analogs of grifolic acid. Such a broad specificity is a unique catalytic feature of RdPT1 that is not shared among secondary metabolic aromatic PTs in plants. We discuss the unusual substrate preference of RdPT1 using a molecular modeling approach. The biochemical properties as well as the localization of RdPT1 suggest that this enzyme produces meroterpenoids in glandular scales cooperatively with previously identified daurichromenic acid synthase, probably for chemical defense on the surface of R. dauricum plants.

Crystal structure and functional analysis of large-terpene synthases belonging to a newly found subclass

The first crystal structure of a large-terpene synthase elucidated two novel Asp rich motifs and a new subclass of terpene synthases.

Thousands of terpenes have been identified to date. However, only two classes of enzymes are known to be involved in their biosynthesis, and each class has characteristic amino-acid motifs. We recently identified a novel large-terpene (C₂₅/C₃₀/C₃₅) synthase, which shares no motifs with known enzymes. To elucidate the molecular mechanism of this enzyme, we determined the crystal structure of a large-β-prene synthase from B. alcalophilus (BalTS). Surprisingly, the overall structure of BalTS is similar to that of the α-domain of class I terpene synthases although their primary structures are totally different from each other. Two novel aspartate-rich motifs, DYLDNLxD and DY(F,L,W)IDxxED, are identified, and mutations of any one of the aspartates eliminate its enzymatic activity. The present work leads us to propose a new subclass of terpene synthases, class IB, which is probably responsible for large-terpene biosynthesis.

Data on processing of Ti-25Nb-25Zr β-titanium alloys via powder metallurgy route: Methodology, microstructure and mechanical properties

The data presented in this article are related to the research article entitled “Cyclic Shear behavior of conventional and harmonic structure-designed Ti-25Nb-25Zr β-titanium alloy: Back-stress hardening and twinning inhibition” (Dirras et al., 2017) [1]. The datasheet describes the methods used to fabricate two β-titanium alloys having conventional microstructure and so-called harmonic structure (HS) design via a powder metallurgy route, namely the spark plasma sintering (SPS) route. The data show the as-processed unconsolidated powder microstructures as well as the post-SPS ones. The data illustrate the mechanical response under cyclic shear loading of consolidated alloy specimens. The data show how electron back scattering diffraction(EBSD) method is used to clearly identify induced deformation features in the case of the conventional alloy.

Bioinspired synthesis of pentacyclic onocerane triterpenoids

The first chemical synthesis of pentacyclic onocerane triterpenoids (+)-cupacinoxepin and (+)-onoceranoxide is described.

The first chemical synthesis of pentacyclic onocerane triterpenoids has been achieved. A putative biomimetic tricyclization cascade is employed to forge a fused decalin-/oxepane ring system. The synthetic route proceeds to (+)-cupacinoxepin in seven steps and to (+)-onoceranoxide in eight steps in the longest linear sequence, when starting from geranyl chloride and (+)-sclareolide. The bioinspired epoxypolyene cyclization is supported by computational and enzymatic studies.

Therapeutic effect of clarithromycin for respiratory-tract infections in children caused by Chlamydia pneumoniae. Research Group of Sapporo for Pediatric Chlamydial Infections

Children infected with Chlamydia pneumoniae sometimes experience lower respiratory tract infections such as pneumonia and bronchitis. Although numerous anti-microbial compounds have been reported to be active against the organism, most of them have not been in a clinical trial in infants and children with C. pneumoniae infection. Clarithromycin has been shown to express anti-chlamydial effects in vitro. In this study, we evaluated the clinical anti-C. pneumoniae properties of clarithromycin in children with mainly lower respiratory tract infection. We administered clarithromycin orally to 21 infants and children at a dose of 10-15 mg/kg/day divided into two or three doses for 4-21 days. Clinical symptoms, roentgenographic and laboratory abnormal findings improved. The overall clinical efficacy rate was 85.7% (18 of 21 cases). Administration of clarithromycin was considered to be a suitable treatment for improving lower respiratory infections in infants and children caused by C. pneumoniae.

Ultrasonographic assessment of Salmonella enterocolitis in children

BACKGROUND

Salmonella enterocolitis (SE) is one of the important causes of acute infectious diarrhoea. Imaging studies are rarely performed on these patients. Consequently, ultrasound (US) features of SE are controversial.

OBJECTIVE

To identify the clinical significance of US in the evaluation of SE.

MATERIAL AND METHODS

Abdominal US was performed in 15 patients with SE and 9 patients with Rotavirus enterocolitis (RE).

RESULTS

Ascites was present in 60 % and mural thickening of the colon in 40 % of patients with SE on abdominal US, whereas we could not identify these features in patients with RE. In patients with SE, colonic wall thickening; and ascites, the levels of C-reactive protein (CRP) were significantly higher as compared to patients with SE and no colonic wall thickening or ascites. Also, the stool occult blood test was positive more often in patients with colonic wall thickening and ascites on US than in patients without these findings. The colonic wall thickness significantly correlated with CRP and stool occult blood level.

CONCLUSIONS

US is able to identify pathological changes in bowel and intra-abdominal spaces. The US findings of ascites and colonic wall thickening may be useful for determining the severity of SE.

Acanthotic type of eccrine poroma on the arm: report of a case

A 72-year-old Japanese man with eccrine poroma on the arm is described. To the best of our knowledge, he is the fifth patient with this tumor on the arm reported from Japan. The histopathological type of the tumor of our patient was unique because it was acanthotic; those of the previous patients were all of the intradermal type.

Expression of cathepsin B-like enzyme activity in cell lysate from cultured human normal keratinocytes

In the present study, we have found that the cell lysate from cultured human normal keratinocytes from foreskin (HFKs) hydrolyzed alpha-N-benzoyl-DL-arginine beta-naphthylamide (BANA), and the BANA hydrolysis occurred most under conditions of 37 degrees C and pH 6.0. This activity was strongly inhibited by leupeptin, which is an inhibitor to cathepsin B. These results suggested that the cell lysate from cultured HFKs contained cathepsin B-like enzyme activity. This is the first report to demonstrate that cathepsin B-like enzyme activity was expressed in the cell lysate from human normal keratinocytes.

Ultrasonic assessment of the lingual thyroid gland in children

Demonstration of ectopic thyroid tissue is diagnostic of thyroid dysgenesis. Delineating the lingual thyroid is, therefore, one of the important issues in ultrasonic imaging. We delineated the lingual thyroid in eight patients with congenital hypothyroidism using two basic scanning positions: the midline sagittal and the posterior coronal views of the floor of the mouth. All the lingual thyroids were located close to the hyoid bone. This location correlated well with the observations on radioisotope scanning. We emphasise the importance of a knowledge of the sonographic anatomy of the floor of the mouth in obtaining satisfactory results in this examination.

Inhibitory effect of lead on tube formation by cultured human vascular endothelial cells

The effect of lead acetate (Pb) on the formation of capillary-like structures (tube formation) by cultured human umbilical vascular endothelial cells (HUVECs) was examined. HUVECs were seeded on a gelled basement membrane matrix (Matrigel). Treatment of HUVECs with 0.3-30.0 microM Pb for 24 hours inhibited the tube formation dose-dependently. The length of tube formation decreased time-dependently with 3.0-10.0 microM Pb. To elucidate the main target factor of Pb for this inhibition, the effects of Pb on the activity of protein kinase C (PKC) and Matrigel were examined. The addition of beta-phorbol 12-myristate 13-acetate (PMA, 50 nM), an activator of PKC, and isoquinolinesulfonamide derivative (H-7, 30 microM), an inhibitor of PKC, showed an increase and decrease in the tube formation, respectively. However, the results of simultaneous addition of Pb and either PMA or H-7 to HUVECs indicated that PMA and H-7 acted not synergistically but additively. When PKC activities in HUVECs were measured by a colorimetric assay after treatments with 3.0-10.0 microM Pb for 24 hours, there was no significant change in PKC activity in the cells. The Pb-inhibition of tube formation was suggested to be independent of PKC activity. Pretreatment of Matrigel with 3.0-10.0 microM Pb for different periods decreased the tube formation dose- and time-dependently. These findings suggest that Pb can inhibit the tube formation by HUVECs dose- and time-dependently and that the inhibitory effect of Pb could be dependent on the degeneration of Matrigel, not on PKC activity.

Retractile mesenteritis in a 12-year-old girl: CT findings

We report a pathologically proven case of retractile mesenteritis in a 12-year-old girl. Computed tomography (CT) demonstrated a large mass of fat density completely circumscribing the colon. Although the definitive diagnosis of retractile mesenteritis depends on histopathological findings, recognition of CT features is helpful in the diagnosis.

Methylmercury modulation of monocyte chemotactic protein-1 mRNA expression in human peripheral blood mononuclear cells

The effect of methylmercury (MeHg; CH3HgCl) on the gene expression of monocyte chemotactic protein-1 (MCP-1) by human peripheral blood mononuclear cells (PBMC) was examined. PBMC were exposed with or without thrombin (1 U/ml) or MeHg (0.3 or 3.0 microM) for 24 hours. The total RNA was reverse transcribed and then amplified by the method of reverse transcriptase-polymerase chain reaction (RT-PCR). Thrombin enhanced MCP-1 mRNA expression in PBMC. MeHg inhibited thrombin-stimulated MCP-1 mRNA expression in a dose dependent manner. These findings suggest that MeHg affects the atherosclerotic process by changing MCP-1 mRNA expression in PBMC.

Cadmium injures tube formation by cultured human vascular endothelial cells

The effect of cadmium chloride (Cd; CdCl2) on the tube formation by cultured human umbilical vascular endothelial cells (HUVEC) was examined. HUVEC were collected by enzymatic digestion with collagenase. Tube formation was studied by culturing the cells on a gelled basement membrane matrix (Matrigel). Treatment of HUVEC with 0.1 microM-1.0 mM Cd for 24 hours inhibited tube formation dose-dependently. The cadmium concentration inhibiting tube formation by 50% relative to untreated cells was about 150 microM. The length of tube formation decreased time-dependently with 150 microM Cd. The treatment of HUVEC by 50 nM of beta-phorbol 12-myristate 13-acetate (PMA), an activator of protein kinase C, increased tube formation. However, the inhibitory effect of Cd on tube formation was not affected by the addition of PMA. The pretreatment of the Matrigel by Cd inhibited tube formation similarly to the results of Cd treatment. These findings suggest that Cd inhibits the formation of a capillary network by HUVEC, and that the Cd-inhibitory effect on tube formation may have been dependent in this study on the degeneration of Matrigel by Cd.

The ten-day mark as a practical diagnostic approach for acute paranasal sinusitis in children

BACKGROUND

Sinusitis is one of the diseases most frequently overlooked by the primary practitioner.

METHODS

We suspected the diagnosis of sinusitis in children with respiratory symptoms that persisted for > 10 days: the 10-day mark. A radiographic projection of maxillary sinuses (Water's view) was indicated, and patients with abnormal radiographs were diagnosed as having sinusitis. After antimicrobial treatment for 2 weeks, we evaluated clinical outcome and follow-up radiographs.

RESULTS

The 10-day mark culled 146 suspected children from 2013 outpatients with respiratory complaints. Water's view radiographs revealed sinusitis in 135 patients (92.5% of the suspected children). They included 35 patients with allergy. After treatment only 4 patients in the allergy group (11%) improved completely. In contrast 61 nonallergic patients (61%) were completely improved.

CONCLUSIONS

The 10-day mark is a simple and practical diagnostic basis for acute paranasal sinusitis. The associated allergic respiratory diseases respond infrequently to antimicrobial treatment.

Copper enhances EDNO (endothelium-derived nitric oxide) activity by cultured human vascular endothelial cells

The effect of copper sulfate (Cu) on viable cell number, endothelium-derived nitric oxide (EDNO), and nitric oxide synthase (NOS) in cultured human umbilical vascular endothelial cells (HUVEC) was investigated. The viable cell number was not affected by the addition of Cu (1.0-500.0 microM). To assess the effect of EDNO by HUVEC, platelet aggregation experiments were performed, using cuvettes lined with HUVEC. Thrombin (0.05 units/ml)-induced platelet aggregation was markedly inhibited in the presence of HUVEC compared with aggregation in the absence of HUVEC. The HUVEC-dependent anti-platelet aggregatory effect was slightly reduced when HUVEC were pretreated with indomethacin (IND; 1.0 micro M), an inhibitor of the cyclo-oxygenase pathway. However, the thrombin-induced platelet aggregation in the presence of HUVEC pretreated with IND was smaller than that in the absence of HUVEC, which is dependent on EDNO. The anti-platelet aggregatory effect of HUVEC pretreated with IND was increased dose-dependently by 48-hour pretreatment of HUVEC with Cu (1.0-100.0 microM). To assess the effect of Cu on NOS, HUVEC were stained with NOS/NADPH diaphorase. However, there were no significant differences in the NOS-positive HUVEC cell count between cells without Cu and those with various concentrations of Cu. These findings suggest that Cu stimulates the activity of EDNO, which action may be dependent on Cu decreasing EDNO-oxidative damage.

Effect of lead on tube formation by cultured human vascular endothelial cells

The effect of lead acetate (Pb) on the growth of and tube formation by cultured human umbilical vascular endothelial cells (HUVEC) was examined. HUVEC were collected by enzymatic digestion with collagenase. The number of viable cells of HUVEC was negligibly affected by cultivation with Pb at concentrations of 1-100 microM, but was slightly reduced by cultivation at 500 microM. Tube formation was studied by culturing the cells on a gelled basement membrane matrix (Matrigel). Treatment of HUVEC with 0.1-50.0 microM Pb for 24 h inhibited tube formation dose-dependently. The length of tube formation decreased time-dependently with 1.0 microM Pb. These findings suggest that Pb inhibits the formation of a capillary network by HUVEC, and that Pb could be injurious to endothelial cell function.

T-cell receptor gene structures of HLA-A26-restricted cytotoxic T lymphocyte lines against human autologous pancreatic adenocarcinoma

We isolated two cytotoxic T lymphocyte (CTL) lines, which were independently obtained by mixed lymphocyte-tumor cell culture from tumor-infiltrating lymphocytes of a patient with pancreatic adenocarcinoma. Both lines behaved identically in all the functional aspects tested and appeared to be HLA-A26-restricted. We analyzed their T cell receptor (TCR) gene structures, including V-(D)-J junctional sequences, which are unique to each T-cell clonotype and contribute to TCR diversity. Each line consisted of a clonal T-cell expressing V alpha 18 and V beta 7. The alpha chain gene was composed of V alpha 18/J alpha F/C alpha and the beta-chain gene, of V beta 7.1/D beta/J beta 1.4/C beta 2. The sequences were all in-frame and therefore should yield functional transcripts. The junctional sequences were identical between the two lines. These data suggested that the two CTL clones having the same CDR3 had descended from a common precursor lymphocyte. The clonal expansion of CTL lines with the identical CDR3 implies that they are directed against the same tumor antigen, which seemed to be immunologically dominant in the specific interaction between the CTL and the autologous pancreatic adenocarcinoma.

Serotonergic measures in cyclosporine A treated rats

Whole blood and plasma serotonin (5-HT), its major metabolite--5-hydroxyindoleacetic acid (5-HIAA), renal cortical blood flow, serum creatinine and whole blood cyclosporine A (CyA) levels were investigated in rats administered with CyA at a dose of 5 mg/kg b.w. or 10 mg/kg b.w. for 14 consecutive days. Serum creatinine remained unaltered during CyA treatment and no apparent changes in excised kidneys were found. Dose-dependent increases in whole blood and plasma 5-HT as well as whole blood 5-HIAA levels were observed. Renal cortical blood flow declined significantly and correlated inversely with whole blood 5-HT and 5-HIAA as well as with plasma 5-HT. Whole blood 5-HT was positively related to whole blood CyA levels. Taking all these data into account and considering the fact that 5-HT is a potent vasoconstrictor, a possible role of this amine in the pathogenesis of renal ischemia during CyA administration is suggested.

Fibrinolysis and serotonin under cyclosporine A treatment in renal transplant recipients

Cyclosporine A (CyA), a potent immunosuppressive drug, has been used in renal transplant recipients with increasing frequency since 1982. Despite its efficacy, CyA therapy has been associated with an increased incidence of thromboembolic complications. This has been attributed to increased thromboxane production, reduced prostacyclin synthesis and increased platelet aggregability. The coagulation system is also altered in CyA-treated patients and some of these changes would favor thrombosis. Increased fibrinogen and FVII:C levels have also been associated with an enhanced risk of thrombosis. In contrast, CyA therapy was reported to increase the levels of antithrombin III and protein C, two proteins known to protect against venous thromboembolism. However, the possible effect of CyA on the fibrinolytic system has not been thoroughly investigated and rather confusing data have been reported concerning both enhancement and suppression of fibrinolysis. Serotonin (5-hydroxytryptamine, 5-HT) may play a role in hemostasis and platelet/vessel wall interactions. It may facilitate platelet thrombus formation by potentiating the aggregatory response to other agents such as ADP, collagen or epinephrine and by causing vasoconstriction. Taking all these data into consideration we have measured some fibrinolytic parameters, whole blood and plasma serotonin concentration in cyclosporine A- and non-cyclosporine A-treated kidney transplant recipients.

[Results of combination chemotherapy with etoposide, ifosfamide, peplomycin for advanced prostatic cancer]

Between August, 1986 and August, 1992, 16 combination chemotherapies with etoposide (100 mg/body, day 1-5), ifosfamide (50 mg/kg, day 1, 3, 5), peplomycin (5 mg/body, day 1-5) were performed on 13 patients with endocrine therapy-relapsed advanced prostatic cancer. Seven trials were performed on 5 patients who received DESP (diethylstilbestrol diphosphate) (500 mg/body, day 1-5) with the chemotherapy. In 9 trials performed on 9 patients who did not receive DESP, there was no response case. In 7 trials with DESP, one trial had a partial response (PR) (14%) and 4 remained objectively stable (stable) (57%). As to adverse effects, myelosuppression was observed in all trials but there was no lethal toxicity. The one-year survival rate of these patients treated with the chemotherapy alone and combined DESP were both about 20%. Therefore we should find a more effective treatment for endocrine relapsed prostatic cancer.

[An incidentally found asymptomatic pheochromocytoma: a case report--successful removal laparoscopic adrenalectomy]

A 31-year-old male was admitted to our hospital for further examination of a right adrenal mass, which was incidentally discovered by abdominal ultra-sonography in another hospital. The adrenaline and noradrenaline in the plasma and the adrenaline and VMA in the urine were slightly elevated, and catecholamines in the blood from the right adrenal vein were markedly increased. Glucose tolerance test showed a borderline case. Otherwise, there was no clinical sign. Asymptomatic pheochromocytoma originating from the right adrenal gland was suspected in the preoperative diagnosis. Laparoscopic right adrenalectomy was performed. Although the blood pressure was stable preoperatively, paroxysmal hypertension was observed during the tumor manipulation. Blood pressure was well controlled during the operation with ATP, nitroglycerin and phentolamine. Blood loss was less than 150ml, and there was no surgical complication. The resected tumor specimen was 32[28[33mm in size, weighed 14g, and histological examination showed typical pheochromocytoma. The post-operative course was unremarkable and glucose tolerance test was normalized after the operation. This is the first case of the successful removal of pheochromocytoma using the laparoscopic procedure.

[Experience of laparoscopic pelvic lymphadenectomy in 10 patients]

From November 1991 through January 1993, we performed laparoscopic lymphadenectomy on 10 patients. These patients were aged 54 to 77 years. All laparoscopic procedures were performed under general anesthesia. We dissected obturator lymph nodes on bilateral side. Total operation time ranged from 127 to 325 minutes. We could excise 3 to 9 lymph nodes on right side and 0 to 10 lymph nodes on left side. Blood loss was 180 ml in one patient, but minimal in the remaining 9 patients. Ureteral injury occurred during laparoscopic procedure in one patient. This injury could be managed with laparoscopic and cystoscopic procedure. Postoperatively complications were observed in 5 procedures, which consisted of subcutaneous emphysema in 2 procedures, fever (over 38 degrees C) in 2, shoulder and arm pain in 1, ileus in 1. The patient with ileus complained of abdominal fullness but he was able to ingest. All patients resumed their preoperative activity by postoperative day 3 to 5. We believe that this procedure was safe and useful for decision making in the management of our patients. We need further study on indications and techniques for this procedure.

Laparoscopic adrenalectomy: clinical experience with 12 cases

Laparoscopic adrenalectomy is a new procedure for the treatment of adrenal tumors. The clinical experience with this operation in 12 patients is reported. While adrenal tumors are relatively small and seem to be good candidates for laparoscopic surgery, this procedure is difficult because of the anatomical location. In our study laparoscopic adrenalectomy appeared to be successful, although massive bleeding occurred in 3 patients. These problems should be overcome as the technique is improved and new laparoscopic instruments are introduced.

Ileal duplication cyst associated with heterotopic pancreas: report of a case and literature review

A rare case of solitary ileal duplication cyst accompanied by heterotopic pancreas in the terminal ileum is presented. An 8 year old boy with an ovoid shaped, elastic soft and pendant-growing ileal duplication cyst associated with aberrant pancreatic tissue but not communicating with the lumen of the ileum, underwent an adhesiotomy for a small intestinal adhesion that caused bowel obstruction. The obstructive state of the intestine seemed to be caused by an inflammation of the duplication cyst which was 4.5 x 2.7 x 2.5 cm and oval in shape. Excision of the cyst and the heterotopic pancreas was curative. The histological findings were identical to heterotopic pancreas accompanied by ileal duplication without any clinical features of heterotopic pancreas. A review of the literature is presented along with the author's experience in a case of ileal duplication cyst associated with heterotopic pancreas located in the ileum.

Ultrasonic imaging of the tongue, mouth, and vocal cords in normal children: establishment of basic scanning positions

We examined the soft tissue anatomy of the tongue, mouth, and vocal cords in 25 healthy children by ultrasonography, and established basic scanning positions for these organs. In the tongue and the mouth--four scanning positions: the midline sagittal, the paramidline sagittal, the anterior coronal, and the posterior coronal--covered major anatomical components. We could delineate vocal cords in all subjects by transverse scanning on the thyroid cartilage. Although disorders associated with the tongue, floor of the mouth, and vocal cords are less frequent in children, one should recognize normal ultrasound findings to distinguish them from abnormalities.

Brefeldin A blocks the cytotoxicity of T cell receptor alpha/beta and gamma/delta cytotoxic T lymphocyte clones reacting against human autologous cancer cells

We studied the effector mechanism of T cell receptor (TCR) alpha/beta- and gamma/delta-type cytotoxic T lymphocyte (CTL) clones that react with human autologous tumor cells. Treatment of tumor cells with a fungal antibacterial reagent, brefeldin A (BFA), resulted in the inhibition of cytotoxicity of an autologous tumor (HST-2)-specific CD8+ TCR alpha/beta-type CTL, TcHST-2. Other anti-metabolites such as chloroquine, cycloheximide and colchicine did not affect the cytotoxicity. The cell-surface antigen expression, including MHC class I molecules, was not influenced by BFA treatment. Furthermore, BFA did not influence the cytotoxicity of lymphokine-activated killer cells and natural killer cells. Since BFA blocks the transport of peptides from endoplasmic reticulum to the Golgi apparatus, the above data suggest that BFA could affect washing out of the peptide fragments from the MHC class I groove. Consequently, target tumor cells were protected from killing by CTL. Moreover, we obtained a CD4-, 8-, TCR gamma/delta-type (V delta 1+) CTL clone, TcHOT, that reacts against an autologous ovarial carcinoma, HOT. BFA could also inhibit this cytotoxicity, and it is likely that different presenting molecules other than MHC class I proteins participate in the cytotoxicity of this TCR gamma/delta-type CTL. These studies suggest that both TCR alpha/beta- and gamma/delta-type CTL may require antigenic peptides that are most likely derived from the BFA-sensitive, intracellular endogenous target proteins.

[Clinical experience of simultaneous fiber-urethrocystoscopy and cystometry recording]

We performed fiber-urethroscopy and cystometry recording simultaneously in 15 male patients. Fifteen patients were consisted of 12 complaining of micturition difficulty (such as BPH, NB, BNS) and 3 normal control. Fiberscope, Olympus CYF-1 and BF3C10, and cystometry were connected the DISA system. Firstly, we insert fiberscope from the urethra to bladder careful, and then cystometry recording using carbon dioxide gas started under direct vision of fiberscope. We compared cystometrical parameters based on our original method to these on conventional one. There were slight statistical significances in the pressure at the first desire to void and the maximum desire to void. But these differences as well as the frequently and the size of uninhibited contraction were not induced by the caliber of the urethroscopy. In conclusion, cystometric recording and urethroscopic observation using fiberscope are simultaneously carried out safely without reducing their diagnostic accuracy.

Laparoscopic nephrectomy for atrophic kidney associated with ectopic ureter in a child

An atrophic right kidney located in the pelvic cavity associated with an ectopic ureter was completely removed from a 4-year-old girl by laparoscopic surgery. There were no serious complications during the operation or the postoperative period. The light shining from the tip of a fine fiberscope inserted into the ureter was used to delineate this structure during laparoscopic surgery.

In vitro proliferation and the cytotoxic specificity of a cryopreserved cytotoxic T cell clone reacting against human autologous tumor cells

Proliferation and functional maintenance of CTL after cell cryopreservation often proves to be quite difficult. We developed an improved method for proliferating cryopreserved CTL, and for gaining their specific cytotoxic function. T cells were cryopreserved at -180 degrees C in RPMI 1640 containing 50% FCS and 10% DMSO. The cryopreserved T cells were well recovered by culturing in a medium containing the supernatant of primary cultures with TIL and autologous tumor cells, in addition to a high concentration (350 U/ml) of rIL-2. Furthermore, these cells were proliferated more efficiently when MMC-treated autologous tumor cells were used in vitro as a feeder and an antigenic stimulant. However, such a high dose IL-2 cultivation resulted in the loss of cytotoxic reactivity of CTL clone. In contrast, the withdrawal of rIL-2 from in vitro cultivation for 24 h prior to the cytotoxic assays conferred the specificity of cytotoxicity on CTL. By these methods, one can obtain a large number of CTL, and pursue the physiologic detail of the specific cytotoxic mechanism of CTL against autologous human tumor cells.