Inhibitory effect of M50054, a novel inhibitor of apoptosis, on anti-Fas-antibody-induced hepatitis and chemotherapy-induced alopecia

M50054, 2,2'-methylenebis (1,3-cyclohexanedione), was identified as a novel inhibitor of apoptosis (programmed cell death) using an in vitro cell death assay system induced in human Fas-expressing WC8 cells by soluble human Fas ligand. Furthermore, M50054 inhibited the apoptotic cell death of U937, a human monocytic leukemic cell line, induced by anticancer agents such as etoposide; it was also confirmed that M50054 inhibited apoptotic features such as DNA fragmentation and phosphatidylserine exposure in these cells. These anti-apoptotic effects were attributable to inhibition of caspase-3 activation. Additionally, M50054 significantly inhibited anti-Fas-antibody-induced elevation of plasma alanine aminotransferase and aspartate aminotransferase. Alopecia (hair loss) symptoms were also significantly improved with topical treatment with M50054. In conclusion, M50054 inhibits apoptosis induced by a variety of stimuli via inhibition of caspase-3 activation, and may thus be effective for hepatitis and chemotherapy-induced alopecia.

Biochemical evidence for localization of AMPA-type glutamate receptor subunits in the dendritic raft

A low density Triton-insoluble fraction with characteristic lipid composition was prepared from synaptic plasma membrane from the rat forebrain. The fraction was named dendritic raft based on its absence of the presynaptic marker synaptophysin, the presence of postsynaptic Glutamate receptor (GluR) subunits, and its resemblance to raft, caveolae-like structure. We found a differential distribution of NMDA-type and AMPA-type GluR subunits in the dendritic raft and postsynaptic density (PSD) fractions; the latter type GluR subunits were localized to the dendritic raft as well as PSD fraction, whereas the former type was mostly localized to the PSD fraction. We also found the differential distribution of the components of ras/mitogen-activated protein kinase (MAPK) pathway to the dendritic raft and PSD fractions. Dendritic raft and PSD may possibly interact at the postsynaptic sites for efficient signal processing that is required for expression of synaptic plasticity.

Primary retroperitoneal ganglioneuroblastoma in an adult

A case of retroperitoneal ganglioneuroblastoma in a 60-year-old man is reported. This retroperitoneal tumor was surgically removed and pathologic diagnosis was ganglioneuroblastoma. Ganglioneuroblastoma usually occurs in children and is extremely rare in adults. The characteristics are described of an unusual tumor based on the published reports.

Assessment of coronary artery bypass surgery by exercise thallium imaging

The purpose of this study was to assess the coronary artery bypass grafting (CABG) in exercise thallium-201 scintigraphy. The study was performed on 18 consecutive patients undergoing elective surgery. We compared the results of the scintigraphic examinations, 1 week before and 1 month postoperatively. Of the 47 bypass grafts, 20 (42. 6%) grafts contributed to the improvement of the ischemic areas and 38% of the bypass grafts did not change the scintigraphic patterns after surgery. Some bypass grafts had been performed on the stenotic arteries that dominated the areas which preoperatively showed normal exercise scintigraphic patterns yet were considered to worsen in the near future. Such grafts main contribution may be to protect and to increase the overall myocardial washout ratio for prevention of an enlargement of ischemic areas.

Arginine-55 in the beta-arm is essential for the activity of DNA-binding protein HU from Bacillus stearothermophilus

DNA-binding protein HU (BstHU) from Bacillus stearothermophilus is a homodimeric protein which binds to DNA in a sequence-nonspecific manner. In order to identify the Arg residues essential for DNA binding, four Arg residues (Arg-53, Arg-55, Arg-58, and Arg-61) within the beta-arm structure were replaced either by Gln, Lys, or Glu residues, and the resulting mutants were characterized with respect to their DNA-binding activity by a filter-binding analysis and surface plasmon resonance analysis. The results indicate that three Arg residues (Arg-55, Arg-58, and Arg-61) play a crucial role in DNA binding as positively charged recognition groups in the order of Arg-55 > Arg-58 > Arg-61 and that these are required to decrease the dissociation rate constant for BstHU-DNA interaction. In contrast, the Arg-53 residue was found to make no contribution to the binding activity of BstHU.

A 22-year course of the Kay-Shiley disc valve with muscle guard at the mitral position

Almost 33 years have elapsed since the introduction of the Kay-Shiley disc valve in Japan. Following the development of pyrolite carbon, the Kay-Shiley valve is no longer in clinical use. We report the case of a female patient who had had an isolated mitral valve replacement with the Kay-Shiley disc valve with single muscle guard 22 years previously. After numerous thromboembolic episodes with the Kay-Shiley disc valve, a successful reoperation was done with the CarboMedics valve. The explanted valve revealed that the grooved occluder disc had a loosely adherent clot. The thromboembolism is a notorious complication associated with this valve. We recommend re-replacement of the Kay-Shiley valve whenever possible.

Pulse intravenous cyclophosphamide treatment for steroid-resistant interstitial pneumonitis associated with polymyositis

Interstitial pneumonitis (IP) is a serious complication in polymyositis/dermatomyositis (PM/DM), leading to significant morbidity or mortality. Here, we report the successful treatment by pulse intravenous administration of cyclophosphamide in the early course of lung involvement in PM, and with subsequent low-dosage oral administration of azathioprine in a patient with steroid-resistant IP associated with PM/DM. Although the precise pharmacological mechanism induced by cyclophosphamide in this disease remains unclear, such a cytotoxic drug raises the possibility of control of steroid-resistant PM/DM-associated IP when used in the early course of IP.

[Necessity and usefulness of detection by PCR of mecA and aac(6')/aph(2") genes for identification of arbekacin-resistant MRSA]

Arbekacin (ABK)-resistant bacteria (43 strains) isolated as MRSA by regular clinical procedures in Japanese clinics in 1998 were characterized in terms of taxonomic properties, aminoglycoside resistance, and mecA and aac(6')/aph(2") genes linking with ABK-resistant MRSA. Taxonomically the 43 strains fell into Staphylococcus aureus (33 strains) and Enterococcus (10 strains). As to ABK resistance, the 13 strains of MRSA clinically reported as high ABK resistance (128 micrograms/ml or higher) did not show clear high ABK resistance except for 2 strains when their ABK resistance was tested using 0.5% NaCl containing nutrient agar. We designed and established the primers and conditions for PCR to detect the above two resistance genes. PCR analysis of DNAs from the 43 strains clearly indicated that only 33 strains identified taxonomically as S. aureus possessed mecA indicating MRSA and 23 out of them possessed aac(6')/aph(2"). The other 10 strains of MRSA lacking aac(6')/aph(2") were ABK-sensitive. Thus, there were a good correlation between ABK resistance and aac(6')/aph(2") existence. Based on these, it was conclusive that the appropriate ABK resistance test as well as the detection of mecA and aac(6')/aph(2") genes by PCR are necessary and useful to avoid false ABK-resistant MRSA strains.

Management of recurrent pilocytic astrocytoma with leptomeningeal dissemination in childhood

Two cases of recurrent pilocytic astrocytoma with leptomeningeal dissemination (LMD) are described. A 6-year-old boy presented with a cerebellar tumor, which was subtotally removed. Tumor recurrence with LMD occurred 4 years later. Reoperation for tumor removal followed by craniospinal irradiation stabilized the LMD over 5 years. A 4-year-old girl presented with a chiasmatic-hypothalamic tumor. Partial removal of the tumor was followed by radiation therapy. Tumor regrowth with LMD occurred 4 years later and was managed by reoperation, chemotherapy and radiotherapy. Tumor recurrence with LMD can be stabilized by multimodal treatment without tumor progression.

Characterization of beta-1,2-mannosyltransferase in Candida guilliermondii and its utilization in the synthesis of novel oligosaccharides

A particulate insoluble enzyme fraction containing mannosyltransferases from Candida guilliermondii IFO 10279 strain cells was obtained as the residue after extracting a 105,000 x g pellet of cell homogenate with 1% Triton X-100. Incubation of this fraction with a mannopentaose, Manalpha1-->3(Manalpha1-->6)Manalpha1-->2Manalpha1+ ++-->2Man, in the presence of GDP-mannose and Mn2+ ion at pH 6.0 gave a third type of beta-1,2 linkage-containing mannohexaose, Manbeta1-->2Manalpha1-->3(Manalpha1-->6)Manalpha1++ +-->2Manalpha1-->2Man , the structure of which was identified by means of a sequential NMR assignment. The results of a substrate specificity study indicated that the beta-1,2-mannosyltransferase requires a mannobiosyl unit, Manalpha1--> 3Manalpha1-->, at the nonreducing terminal site. We synthesized novel oligosaccharides using substrates possessing a nonreducing terminal alpha-1,3-linked mannose unit prepared from various yeast mannans. Further incubation of the enzymatically synthesized oligosaccharide with the enzyme fraction gave the following structure, Manbeta1-->2Manbeta1-->2Manalpha1-->3(Manalpha1- ->6)Manalpha1--> 2Manalpha1-->2Man, which has been found to correspond to antigenic factor 9. Incubation of Candida albicans serotype B mannan with the enzyme fraction gave significantly transformed mannan, which contains the third type of beta-1,2-linked mannose units.

[Variations in mesenchymal cell activity between rheumatic and non-rheumatic valve disease]

Deoxyribonucleic acid (DNA) synthesis of mesenchymal cells in the diseased valve tissue of patients with rheumatic and non-rheumatic valve diseases were compared. Surgically resected mitral valves from eight rheumatic and eight non-rheumatic patients in their 40s were examined immunohistochemically to estimate the activity of the various mesenchymal cells by cell cycle analysis, using monoclonal antibodies to cyclin E, A, B1, p53, and b cl-2 after routine tissue fixation, paraffin embedding and sectioning. Cyclin B1-positive fibrocytes and fibroblasts of the spongiosa and fibrosa were observed in all non-rheumatic cases, whereas some lymphocytes in the perivascular area were cyclin B1-, p53- and b cl-2-positive in rheumatic cases. The distinct qualitative difference in the mesenchymal cells of valve tissue between rheumatic and non-rheumatic etiologies suggests a different mode of valve pathology.

[Concealed infective endocarditis]

The occurrence of concealed infection or "natural remission" in infective endocarditis was investigated microscopically in 35 consecutive patients (36 valves) with infective endocarditis (between April 1987 and May 1995). Four patients were considered as having concealed or silent infective endocarditis. Preoperative diagnosis of these patients was mitral valve prolapse, rheumatic aortic valve stenosis with insufficiency, aortic valve prolapse and hypertrophic cardiomyopathy, respectively. These patients did not present with any clinical signs of infective endocarditis such as cardiac murmur and ventricular dysfunction. Histological examination of the excised valves revealed valvular perforation, small round cell infiltration, neovascularization, remnants of vascular smooth muscle cells, and organizing vegetations. These findings are consistent with the histological findings of infective endocarditis. Latent infective endocarditis may be present without inflammatory manifestation.

Characterization of alpha-1,6-mannosyltransferase responsible for the synthesis of branched side chains in Candida albicans mannan

A particulate insoluble fraction from Candida albicans NIH B-792 (serotype B) strain cells was obtained as the residue after extracting a 105000 x g pellet of cell homogenate with 1% Triton X-100. Incubation of this fraction with a mannopentaose, Man alpha 1-->3Man alpha 1-->2Man alpha 1-->Man alpha 1-->2Man, in the presence of GDP-mannose and Mn2+ at pH 6.0 gave a branched mannohexaose, [sequence: see text] 6 the structure of which was identified by means of sequential off assignment. However, the enzyme fraction obtained from Candida parapsilosis gave Man alpha 1-->2Man alpha 1-->3Man alpha 1-->2Man alpha 1-->2 Man alpha 1-->2Man under the same conditions. These results demonstrate the finding that the structural difference in the mannans of these two species is due to the presence of alpha-1.6-linked branching mannose units in the C. albicans mannan [Shibata, N., Ikuta, K., Imai, T., Satoh, Y., Satoh, R., Suzuki, A., Kojima, C., Kobayashi, H., Hisamichi, K. & Suzuki, S. (1995) J. Biol. Chem. 270, 1113-1122]. The substrate-specificity study of the enzyme indicated that the structural requirement of the alpha-1,6-mannosyltransferase is Man alpha 1-->3Man alpha 1-->. The alpha-1,6-mannosyltransferase also transferred the alpha-1,6-linked branching mannose unit to the mannan of Saccharomyces cerevisiae. The transformation of the mannan was detected by the appearance of antigenic factor 4 using an enzyme-linked immunosorbent assay and two-dimensional homonuclear Hartmann-Hahn spectroscopy.

Induction of Ley antigen by 5-aza-2'-deoxycytidine in association with differentiation and apoptosis in human pancreatic cancer cells

We investigated the effect of 5-aza-2'-deoxycytidine (ADC) (a specific inhibitor of DNA methylation) on differentiation, Lewisy (Ley) antigen expression, and DNA fragmentation (a biochemical marker of apoptosis) in human pancreatic cancer MIA PaCa-2 cells. ADC markedly inhibited the growth of MIA PaCa-2 cells. Flow cytometric analysis showed that ADC suppressed the cell population in the G1 phase, but enhanced it in the G2/M phase. On the other hand, several markers of cell differentiation including morphological and biochemical alterations were distinctly induced in cells treated with ADC. Morphologically, the cells were enlarged and thinner than the untreated control cells, and intracellular alkaline phosphatase (ALP) activity was markedly increased. Additionally, biochemical markers of apoptosis including DNA fragmentation and Ley antigen expression were induced in association with the appearance of morphological and biochemical markers of differentiation (ALP). These results suggest that the hypomethylation of DNA is involved in the molecular mechanism of growth inhibition, induction of apoptosis, and differentiation in human pancreatic cancer MIA PaCa-2 cells.

[Surgical pathology of infective endocarditis]

Underlying pathologic disorders of infected valves were analyzed in 36 consecutive patients with infective endocarditis (from April 1987 to May 1995) of 18 aortic, 11 mitral and 8 prosthetic valves. Among 29 cases of native valve endocarditis, 27 had known organic changes [aortic valve prolapse 8, bicuspid aortic valve 4, annuloaortic ectasia 1, mitral valve prolapse 9 (including 2 cases associated with hypertrophic cardiomyopathy), looping chordae 1, rheumatic heart disease 4]. However, the remaining two cases had unknown etiology. Histological examination of these two aortic valves revealed proliferation of small vessels and remnants of vascular smooth muscle cells, suggesting postinflammatory valve prolapse. Five cases with definite pathology had no clinical signs of infection. The preponderance of surgically resected valves with infective endocarditis in Japan is non-rheumatic in origin.

Induction by 5-aza-2'-deoxycytidine, an inhibitor of DNA methylation, of Le(y) antigen, apoptosis and differentiation in human lung cancer cells

We recently developed a monoclonal antibody directed to carbohydrate antigen Le(y), BM-1/JIMRO, and found that expression of Le(y) antigen defined by BM-1/JIMRO was associated with the process of apoptosis, but not with cell proliferation or necrosis. In the present experiments, we examined with BM-1/JIMRO the effects of various differentiation inducers on the growth and expression of Le(y) antigen in human lung cancer A549 cells. We found that a specific inhibitor of methylation of DNA, 5-aza-2' deoxycytidine (ADC), could markedly induce expression of Le(y) antigen in association with induction of apoptosis and differentiation in the A549 cells. These results suggest that hypomethylation of DNA is involved in the molecular mechanisms of induction of Le(y) antigen, apoptosis and differentiation in the cells.

[A case of quadricuspid aortic valve associated with mitral insufficiency]

We report a case of a 70-year-old woman who had congenital quadricuspid aortic valve. She had undergone Manouguian's operation because of the narrow annulus associated with aortic steno-insufficiency and mitral insufficiency. The aortic valve was found to have 4 equal-sized cusps. The noncoronary cusp was divided into two equal parts. This congenital quadricuspid valve was extremely rare anomaly and we have nerve seen the case which had been corrected surgically by Manouguian's procedure. The aortic valve was replaced by a 23 mm St. Jude Medical prosthesis and the mitral valve was replaced by a 29 mm CarboMedics prosthesis. The postoperative course was uneventful and she is doing well six months after operation.

[Autologous fibrin glue from concentrated platelet rich plasma: intraoperative plasma sequestration using autotransfusion device]

Making autologous fibrin glue from intraoperatively collected concentrated platelet rich plasma (C-PRP) was attempted in 5 patients who underwent elective coronary artery bypass. The autologous blood was withdrawn from the patient before cardiopulmonary bypass and sequestrated for C-PRP, concentrated red cells (CRC) and platelet poor plasma (PPP) using an Electromedics Elmd-500 autotransfusion device. CRC and PPP were returned intravenously to the patient as needed intraoperatively or postoperatively. Aprotinin was dissolved in C-PRP to yield a concentration of 1000U/ml to the aim of suppressing the plasmin activity. In another syringe, thrombin was dissolved in 2% calcium chloride solution to 1000U/ml. The C-PRP/aprotinin was mixed in ratios of 20:1, 10:1, 5:1, 3:1 to the thrombin/C a++ solution and observed the time for clotting. The 10:1 and 5:1 mixture usually clotted within 3-5 seconds, whereas it was necessary 5 or more seconds in other ratios. Therefore we used in the ratio of 5:1 for all patients. The fibrin glue from this technique is little different from the fibrin glue on the market in its viscosity, and has some major advantages 1. large amount of glue is available 2. simple and inexpensive 3. eliminate the risk of side effect such as virus transmission.

[Successful treatment by Konno's operation for congenital aortic stenosis associated with hypoplastic valve ring]

A 47-year-old woman with congenital aortic stenosis associated with hypoplastic aortic valve ring underwent aortic valve replacement by Konno method. We have to be careful preventing residual VSD because the left ventricular muscle was weak in the aged with congenital aortic stenosis. In early postoperative period, we also have to do a careful treatment in case by Konno's operation, particularly in the patient of advanced age. However, she made a satisfactory recovery with adequate size of aortic valve replacement.

[Extraction of infected pacemaker electrode using catheter and snare]

A 85-year-old man had undergone implantation of a transvenous pacemaker system in 1982. Nine years later the generator was explanted and he was underwent implantation of a new generator and electrode. After one year of the second operation, infection of the old electrode had been noted and it was not cured in spite of partial explantation of the infected electrode and appropriate antibiotic therapy. We decided to remove the infected electrode and succeeded in extraction using catheter and snare. The patient's recovery was uneventful. We suggest catheter and snare is useful for explantation of chronic transvenous pacemaker electrodes.

[Report of a case of the anomalous origin of the right coronary artery from the pulmonary artery with atrial fibrillation and bradycardia]

A 62-year-old man who was referred to implantation of pacemaker on account of severe bradycardia revealed anomalous origin of the right coronary artery from the pulmonary artery on aortography. The aortic root cineangiogram demonstrated single left coronary artery arising from the aorta with retrograde filling of the right coronary artery (RCA) which drained into the main pulmonary artery. Chest X-ray revealed marked cardiomegaly and treadmill exercise test shows positive at stage 2 of the Bruce protocol. Operation was performed under cardiopulmonary bypass. Although we tried to transplant the RCA to the aorta, the arterial wall was very fragile and could't bear arterial pressure. Therefore the RCA was ligated at its origin and disconnected from the pulmonary artery. Post operative course was uncomplicated and the patient was discharged without any symptoms.

[A case of gastric cancer with multiple liver metastases effectively treated with PMUE (CDDP, MMC, UFT, etoposide) hepatic arterial chemotherapy]

A 62-year-old male patient with progressive gastric cancer and multiple liver metastases (H3, P0, ss gamma, n4) underwent total gastrectomy (R1). After 2 years and 2 months, he was re-hospitalized with epigastric tumor caused by re-manifestation of liver metastasis as well as inappetence. Since a large focus of liver metastasis and intraportal tumor embolism was identified, a continuous intraarterial infusion tube utilizing Infuse-A-Port was inserted in the hepatic artery. After conducting 2 cycles of PMUE intra-arterial chemotherapy, the tumor size was reduced by 84% (PR); and CEA, which had been high upon rehospitalization, recovered to the normal level. After discharge, the patient has been receiving 5-FU arterial infusion as an outpatient and undergoing UFT oral chemotherapy. The efficacy has continued and he has been well for 3 years since operation. Often operations for gastric cancer accompanied with multiple liver metastasis meet with little success, and almost no case of prolonged survival has been reported. In this case, the effectiveness of PMUE arterial infusion chemotherapy was clear, the patient has been well for 3 years since operation, and is an interesting example with seemingly good prospects for long-survival.

Homeostasis as regulated by activated macrophage. III. Protective effect of LPSw (lipopolysaccharide (LPS) of wheat flour) on gastric ulcer in mice as compared with those of other LPS from various sources

Protective effect of lipopolysaccharide (LPS) from various sources on gastric ulcer has been examined in mice using parenteral as well as oral route. Ulcer is induced by indomethacin, stress or alcohol. LPS was prepared from 6 species of bacteria (Escherichia coli, Pantoea agglomerans, Serratia ficaria, Enterobacter cloacae, Bordetella pertussis, Alcaligenes faecalis) and from wheat flour. When administered intravenously, LPS of Pantoea agglomerans was the most effective among other LPS examined. Lipopolysaccharide of wheat flour (LPSw) showed a significantly protective effect by the oral route, especially when given ad libitum in drinking water to mice.

[Prophylactic intravesical BCG for bladder tumor after surgery of upper tract urothelial carcinoma]

We report the result of prophylactic intravesical instillation of BCG after surgery of upper tract urothelial carcinoma. The BCG Tokyo 172 strain was given preoperatively and/or postoperatively, as a rule, in a dose of 80 mg in 30 ml saline instilled into the bladder. Only one (14.3%) of the 7 patients with intravesical BCG developed bladder tumor at 14 month after surgery, while (45.4%) of 11 patients who did not receive intravesical BCG suffered from bladder tumor within 2 years after surgery. Prophylactic intravesical instillation of BCG reduced significantly (p less than 0.005) the recurrence of bladder tumor after the surgery of renal pelvis and ureteral tumor.

[Human respiratory tract infection by Pasteurella multocida subsp. multocida presumably derived from the cat]

Pasteurella multocida is a Gram-negative short rod-shaped bacteria that has been recognized as a pathogen of hemorrhagic septicemia and fowl cholera in the veterinary medicine. Infections by this microorganism as seen in the foreign literature vary widely from local infections due to bites and scratches by animals to general infections such as infections of the respiratory tract, sepsis, and meningitis. In Japan, reported cases of P. multocida infections are predominantly local infections, followed by respiratory infection. Recently, death of diabetic patients due to septicemia by this pathogen has also been reported. In this study, we experienced a case of respiratory tract infection in which the pathogen P. multocida subsp. multocida was suggested to have been transmitted from a pet cat by the agreement of the serotype of the bacterial isolates between the patient and the cat. This case was evaluated from the zoonotic viewpoint. The patient was a 68-year-old male who had been followed up since 1982 with a diagnosis of bronchiectasis. After his referral to our hospital, P. multocida subsp. multocida was isolated from his bloody sputum and, then, from the cat kept by the patient. The tow isolates were identical in terms of the biochemical properties, drug susceptibility profile, and serotype (-:1), and the derivation of P. multocida subsp. multocida infection from cat was established for the first time in this report. The incidence of P. multocida infections is increasing in Japan, and particular attention is considered to be needed about these conditions as zoonoses as indicated in "Preventive Measures against Zoonoses Derived from Pet Animals (Dog, Cat)", an official communication from the Ministry of Health and Welfare to related institutions in 1989. Also, to check whether the patient keeps any pet at the clinical inquiry is a practice of bacteriological importance in all fields of medicine.

[Long-term results of percutaneous transluminal angioplasty in patients with renovascular hypertension--a follow-up study on renal function and renal size]

Twenty patients with renovascular hypertension were followed for at least 1 year (mean 3.3 years) after successful percutaneous transluminal angioplasty (PTA). Renal arteries were patent in 13 (65%) patients and were re-stenosed in 7 (35%). In 12 patients with unilaterally stenosed renal artery which were patent at the end of the follow up period, 6 patients were normotensive, the other 6 patients had less degree of hypertension. Determinations of renal vein renin were only of limited prognostic value. Renal blood flow pattern by doppler echography improved after PTA in the 12 patients. Radioisotope renogram showed tendency of improved Tmax ratio (stenotic kidney/nonstenotic kidney) from 1.5 +/- 0.8 to 1.0 +/- 0.2 (mean +/- SD, p less than 0.1). Serum creatinine levels decreased significantly from 1.2 +/- 0.5 mg/dl to 1.0 +/- 0.2 mg/dl (p less than 0.05) and creatinine clearance increased from 72.1 +/- 18.5 ml/min to 99.6 +/- 31.7 ml/min (p less than 0.02). The size of the stenosed kidneys increased from 11.2 +/- 0.7 cm to 12.0 +/- 0.8 cm (p less than 0.01), while the size of the contralateral kidneys did not change. These results indicate that PTA has favorable long-term effects on blood pressure and renal function with restoration of renal size in cases with patent renal arteries after this procedure.

Left ventricular structural characteristics in unilateral renovascular hypertension and primary aldosteronism

To assess the importance of the renin-angiotensin system and plasma volume as determinants of hypertensive left ventricular hypertrophy and its anatomy, patients with unilateral renovascular hypertension and primary aldosteronism were studied by echocardiography. Blood pressure, age and sex were matched as closely as possible. The 19 patients with unilateral renovascular hypertension and the 19 patients with primary aldosteronism were similar in age, sex and blood pressure (168 +/- 19/97 +/- 11 and 163 +/- 17/99 +/- 10 mm Hg, respectively), but plasma volume was increased in the patients with primary aldosteronism. Interventricular septal thickness, left ventricular posterior wall thickness, left ventricular mass index and relative wall thickness did not differ between the 2 groups of patients. There was a significant correlation between the level of systolic blood pressure and either left ventricular mass index (r = 0.34, p less than 0.05) or relative wall thickness (r = 0.58, p less than 0.001) in both groups of patients. Left ventricular end-diastolic dimension index was increased in the patients with primary aldosteronism compared with those with unilateral renovascular hypertension (3.2 +/- 0.4 vs 2.9 +/- 0.3 cm/m2, p less than 0.02). When confined to the patients with systolic pressure greater than or equal to 150 mm Hg, relative wall thickness was significantly increased in the patients with unilateral renovascular hypertension. Patients with primary aldosteronism and unilateral renovascular hypertension of similar blood pressure levels, age and sex have almost identical degrees of left ventricular hypertrophy and anatomy. In contrast, the patients with primary oldosteronism had increased left ventricular dimension index.(ABSTRACT TRUNCATED AT 250 WORDS)

Measurement of left atrial systolic time intervals in hypertensive patients using Doppler echocardiography: relation to fourth heart sound and left ventricular wall thickness

The concept of left atrial systolic time intervals and Doppler echocardiography were used in a quantitative assessment of left atrial function in relation to the presence or absence of a fourth heart sound and to left ventricular hypertrophy in 47 patients with hypertension. Left atrial systolic time interval indexes included atrial pre-ejection period (the time between the onset of an electrocardiographic P wave and the onset of left ventricular inflow during atrial systole [A wave]), corrected atrial pre-ejection period (the atrial pre-ejection period divided by the duration of the P wave), and atrial ejection time (the time between the onset and cessation of the A wave). Twenty-one patients with a fourth heart sound on the phonocardiogram had a shorter atrial pre-ejection period (81 +/- 10 versus 89 +/- 14 ms p less than 0.05) and a corrected atrial pre-ejection period (66 +/- 17 versus 83 +/- 18 ms, p less than 0.01), as well as a longer atrial ejection time (147 +/- 15 versus 126 +/- 13 ms, p less than 0.001) than did 26 patients without a fourth heart sound. The ratio of atrial pre-ejection period to atrial ejection time and that of corrected atrial pre-ejection period to atrial ejection time was smaller in patients with than in patients without a fourth heart sound (0.56 +/- 0.08 versus 0.71 +/- 0.11, p less than 0.001; 0.46 +/- 0.16 ms-1 versus 0.67 +/- 0.17 ms-1, p less than 0.001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Hypertensive complications and home blood pressure: comparison with blood pressure measured in the doctor's office

We have compared hypertensive target organ damage with home blood pressure readings (HBPs) and with office blood pressure readings (OBPs) in 100 patients with mild to moderate essential hypertension. The correlation between blood pressure levels and hypertensive target organ damage in HBPs and OBPs were similar (r = .42, p less than 0.001 for systolic HBPs; r = .33, p less than 0.001 for diastolic HBPs; r = .42, p less than 0.001 for systolic OBPs; r = .34, p less than 0.001 for diastolic OBPs). In most instances, HBPs were lower than corresponding OBPs. Among individual patients whose OBPs were identical, HBPs in some instances differed strikingly. Optic fundi abnormalities were significantly more severe in patients whose systolic HBPs were 150 mmHg or greater, than in those whose systolic HBPs were less than 150 mmHg (p less than 0.05). Hypertensive complications did not differ among office hypertensive patients who were normotensive or borderline hypertensive at home, from the differences of OBPs. We concluded that overall hypertensive complications were equally related to HBPs and OBPs, but patients with discrepancies between HBPs and OBPs had fewer hypertensive complications. Thus, both OBPs and HBPs should be considered in deciding therapy.

Heterogeneity of bovine corneal proteokeratan sulfate

Proteokeratan sulfate was extracted and purified from bovine corneal stroma and then characterized by chemical and biochemical analyses. It was fractionated into several fractions by affinity chromatography on a concanavalin A-Sepharose column or by hydrophobic chromatography on a phenyl-Sepharose column. These fractions differed widely from one another in carbohydrate content, though no significant differences of their amino acid compositions were observed. One fraction (ca. 25%, on a dry weight basis) tightly bound to a concanavalin A-Sepharose column, compared with another fraction (ca. 65%) weakly bound to the same column, was poor in galactose and N-acetylglucosamine, but contained mannose in a high proportion. Fractions (ca. 30%) tightly bound to a phenyl-Sepharose column, in contrast to the one (ca. 66%) weakly bound, had low carbohydrate contents, like the fraction tightly bound to a concanavalin A-Sepharose column. Additionally, the fractions tightly bound to these affinity columns exhibited strong inhibitory actions on erythrocyte-concanavalin A agglutination. To obtain further details of the carbohydrate moiety of the proteokeratan sulfate, an attempt was made to separate and characterize peptidokeratan sulfate and Asn-linked oligosaccharide derived from some proteokeratan sulfate fractions. The present work revealed that the proteokeratan sulfate contains keratan sulfate and high mannose-type oligosaccharide in an approximate chain number ratio of 3.5:1.0, the keratan sulfate content varies widely and the oligosaccharide content increases with decrease of the keratan sulfate content, and the protein core is homogeneous at least with respect to the amino acid composition.

Improved purification of Aspergillus oryzae 1,2-alpha-mannosidase by using mannan gel affinity chromatography

In order to facilitate the purification of 1,2-alpha-mannosidase from an enzyme product of Aspergillus oryzae, we have devised a rapid and simple procedure. A partially purified enzyme preparation obtained from the A. oryzae enzyme product, by means of ammonium sulfate fractionation followed by CM-Sephadex C-50 chromatography, was subjected to affinity chromatography with baker's yeast mannan gel as an adsorbent. 1,2-alpha-Mannosidase was retarded and well separated from the major protein peak on the affinity column. After a second affinity chromatography under the same conditions, 1,2-alpha-mannosidase was finally purified 7,500-fold with a 22.9% yield. The enzyme preparation thus obtained was quite suitable for the structural analysis of glycoconjugates.

Purification and characterization of endo-beta-N-acetylglucosaminidase of Aspergillus oryzae

An endo-beta-N-acetylglucosaminidase which hydrolyzes the N,N'-diacetylchitobiosyl linkage in asparagine-linked oligosaccharides was purified from the enzyme product of Aspergillus oryzae. Its substrate specificity was similar to that of endo-beta-N-acetylglucosaminidase H from Streptomyces griseus with respect to the relative activities toward the glycopeptides obtained from ovalbumin and bovine IgG. The present endoglycosidase exhibited a broad optimum pH range and was relatively stable. Metal ions, chelating agents and D-mannose did not have a significant effect on the enzyme activity.

[Clinical efficacy of cefotaxime in the field of internal medicine]

Fifty-eight patients were treated with cefotaxime (CTX, Claforan) intravenously. Almost all patients (54 patients) had underlying diseases that were 16 cases of diabetes mellitus, 10 cases of respiratory diseases, 8 cases of cerebral vascular disturbance, 6 cases of renal diseases and blood diseases, 5 cases of carcinoma and hypertension, 4 cases of cholelithiasis, 3 cases of heart diseases and 7 cases of other diseases. The clinical efficacy of CTX in 34 cases of RTI, 11 cases of UTI, 8 cases of BTI and 5 cases of other infection was excellent in 11 cases, good in 27 cases, fair in 12 cases, poor in 4 cases and unclear in 4 cases. The over all clinical effectiveness was 70.4%. No adverse reaction was observed except for 2 cases (general fatigue in 1 case and eruption and itching in another). These results obtained should support the usefulness of CTX.