Target degradation specificity of phytoplasma effector phyllogen is regulated by the recruitment of host proteasome shuttle protein

Phytoplasmas infect a wide variety of plants and can cause distinctive symptoms including the conversion of floral organs into leaf-like organs, known as phyllody. Phyllody is induced by an effector protein family called phyllogens, which interact with floral MADS-box transcription factors (MTFs) responsible for determining the identity of floral organs. The MTF/phyllogen complex then interacts with the proteasomal shuttle protein RADIATION SENSITIVE23 (RAD23), which facilitates delivery of the MTF/phyllogen complex to the host proteasome for MTF degradation. Previous studies have indicated that the MTF degradation specificity of phyllogens is determined by their ability to bind to MTFs. However, in the present study, we discovered a novel mechanism determining the degradation specificity through detailed functional analyses of a phyllogen homologue of rice yellow dwarf phytoplasma (PHYLRYD ). PHYLRYD degraded a narrower range of floral MTFs than other phyllody-inducing phyllogens, resulting in compromised phyllody phenotypes in plants. Interestingly, PHYLRYD was able to bind to some floral MTFs that PHYLRYD was unable to efficiently degrade. However, the complex of PHYLRYD and the non-degradable MTF could not interact with RAD23. These results indicate that the MTF degradation specificity of PHYLRYD is correlated with the ability to form the MTF/PHYLRYD /RAD23 ternary complex, rather than the ability to bind to MTF. This study elucidated that phyllogen target specificity is regulated by both the MTF-binding ability and RAD23 recruitment ability of the MTF/phyllogen complex.

Interaction of EXA1 and eIF4E Family Members Facilitates Potexvirus Infection in Arabidopsis thaliana

Plant viruses depend on a number of host factors for successful infection. Deficiency of critical host factors confers recessively inherited viral resistance in plants. For example, loss of Essential for poteXvirus Accumulation 1 (EXA1) in Arabidopsis thaliana confers resistance to potexviruses. However, the molecular mechanism of how EXA1 assists potexvirus infection remains largely unknown. Previous studies reported that the salicylic acid (SA) pathway is upregulated in exa1 mutants, and EXA1 modulates hypersensitive response-related cell death during EDS1-dependent effector-triggered immunity. Here, we show that exa1-mediated viral resistance is mostly independent of SA and EDS1 pathways. We demonstrate that Arabidopsis EXA1 interacts with three members of the eukaryotic translation initiation factor 4E (eIF4E) family, eIF4E1, eIFiso4E, and novel cap-binding protein (nCBP), through the eIF4E-binding motif (4EBM). Expression of EXA1 in exa1 mutants restored infection by the potexvirus Plantago asiatica mosaic virus (PlAMV), but EXA1 with mutations in 4EBM only partially restored infection. In virus inoculation experiments using Arabidopsis knockout mutants, EXA1 promoted PlAMV infection in concert with nCBP, but the functions of eIFiso4E and nCBP in promoting PlAMV infection were redundant. By contrast, the promotion of PlAMV infection by eIF4E1 was, at least partially, EXA1 independent. Taken together, our results imply that the interaction of EXA1-eIF4E family members is essential for efficient PlAMV multiplication, although specific roles of three eIF4E family members in PlAMV infection differ. IMPORTANCE The genus Potexvirus comprises a group of plant RNA viruses, including viruses that cause serious damage to agricultural crops. We previously showed that loss of Essential for poteXvirus Accumulation 1 (EXA1) in Arabidopsis thaliana confers resistance to potexviruses. EXA1 may thus play a critical role in the success of potexvirus infection; hence, elucidation of its mechanism of action is crucial for understanding the infection process of potexviruses and for effective viral control. Previous studies reported that loss of EXA1 enhances plant immune responses, but our results indicate that this is not the primary mechanism of exa1-mediated viral resistance. Here, we show that Arabidopsis EXA1 assists infection by the potexvirus Plantago asiatica mosaic virus (PlAMV) by interacting with the eukaryotic translation initiation factor 4E family. Our results imply that EXA1 contributes to PlAMV multiplication by regulating translation.

Random mutagenesis-based screening of the interface of phyllogen, a bacterial phyllody-inducing effector, for interaction with plant MADS-box proteins

To understand protein function deeply, it is important to identify how it interacts physically with its target. Phyllogen is a phyllody-inducing effector that interacts with the K domain of plant MADS-box transcription factors (MTFs), which is followed by proteasome-mediated degradation of the MTF. Although several amino acid residues of phyllogen have been identified as being responsible for the interaction, the exact interface of the interaction has not been elucidated. In this study, we comprehensively explored interface residues based on random mutagenesis using error-prone PCR. Two novel residues, at which mutations enhanced the affinity of phyllogen to MTF, were identified. These residues, and all other known interaction-involved residues, are clustered together at the surface of the protein structure of phyllogen, indicating that they constitute the interface of the interaction. Moreover, in silico structural prediction of the protein complex using ColabFold suggested that phyllogen interacts with the K domain of MTF via the putative interface. Our study facilitates an understanding of the interaction mechanisms between phyllogen and MTF.

A phytoplasma effector acts as a ubiquitin-like mediator between floral MADS-box proteins and proteasome shuttle proteins

Plant pathogenic bacteria have developed effectors to manipulate host cell functions to facilitate infection. A certain number of effectors use the conserved ubiquitin-proteasome system in eukaryotic to proteolyze targets. The proteasome utilization mechanism is mainly mediated by ubiquitin interaction with target proteins destined for degradation. Phyllogens are a family of protein effectors produced by pathogenic phytoplasmas that transform flowers into leaves in diverse plants. Here, we present a noncanonical mechanism for phyllogen action that involves the proteasome and is ubiquitin-independent. Phyllogens induce proteasomal degradation of floral MADS-box transcription factors (MTFs) in the presence of RADIATION-SENSITIVE23 (RAD23) shuttle proteins, which recruit ubiquitinated proteins to the proteasome. Intracellular localization analysis revealed that phyllogen induced colocalization of MTF with RAD23. The MTF/phyllogen/RAD23 ternary protein complex was detected not only in planta but also in vitro in the absence of ubiquitin, showing that phyllogen directly mediates interaction between MTF and RAD23. A Lys-less nonubiquitinated phyllogen mutant induced degradation of MTF or a Lys-less mutant of MTF. Furthermore, the method of sequential formation of the MTF/phyllogen/RAD23 protein complex was elucidated, first by MTF/phyllogen interaction and then RAD23 recruitment. Phyllogen recognized both the evolutionarily conserved tetramerization region of MTF and the ubiquitin-associated domain of RAD23. Our findings indicate that phyllogen functionally mimics ubiquitin as a mediator between MTF and RAD23.

Simultaneous production of sphingolipids and ethanol byKluyveromyces thermotolerans

Kluyveromyces thermotolerans strain NBRC 1674 was selected for the simultaneous production of sphingolipids and ethanol from beet molasses. The strain gradually synthesized ethanol with fermentation periods and attained a level slightly higher than that of the strain of Saccharomyces cerevisiae usually used for ethanol production. The sphingolipids accumulated in the cells were composed of almost equal amounts of free ceramides and glucosylceramides. The sphingoid bases and fatty acids of the two sphingolipids differed from each other and changed under aerobic and anaerobic growth conditions. Oxygen limitation may cause accumulation of sphinganine by inhibiting sphingolipid desaturases and enhance its proportion in both the sphingolipids.

Rare case of biphasic tumor of the breast with prominent CD34-positive spindle cells

We report an unusual case of biphasic tumor of the breast with prominent CD34-positive spindle cells. A 53-year-old woman presented with a mass in her right breast. Following an incisional biopsy, a partial mastectomy was done. Histologically, the tumor was a biphasic variant of a malignant spindle cell tumor of the breast. The lack of a leaf-like structure, together with the apparent myoid features of the spindle-shaped tumor cells, made it difficult to distinguish from malignant phyllodes tumor and from myoepithelial carcinoma. Immunohistochemistry revealed the spindle-shaped tumor cells to be myofibroblastic, but not myoepithelial in nature, ultimately categorizing this tumor as a malignant phyllodes tumor with prominent myofibroblastic differentiation.

Interaction between DNA-cationic liposome complexes and erythrocytes is an important factor in systemic gene transfer via the intravenous route in mice: the role of the neutral helper lipid

Recent studies have indicated that there are many barriers to successful systemic gene delivery via cationic lipid vectors using the intravenous route. The purpose of this study was to investigate the effect of binding and interaction between erythrocytes, a major constituent of blood cells, and the complexes, in relation to the role of the helper lipid, on the in vivo gene delivery to the lung following intravenous injection. We used three types of cationic lipid vectors, DNA-DOTMA/Chol liposome complexes, DNA-DOTMA liposome complexes, and DNA-DOTMA/DOPE liposome complexes. Although the three types of vectors bind to murine blood cells in vivo and in vitro, DOTMA/Chol and DOTMA complexes with a higher in vivo transfection activity do not induce fusion between erythrocytes, whereas DOTMA/DOPE complexes, a less efficient vector in vivo, induce fusion between the erythrocytes after a short incubation period. Pre-incubation of DOTMA/DOPE complexes with erythrocytes significantly reduced the transfection efficiency while DOTMA/Chol- and DOTMA complexes were more resistant to such treatment. The differences in the physicochemical and structural properties of these complexes could explain the differences in interaction with erythrocytes and subsequent gene expression. Lipids in DOTMA/Chol and DOTMA complexes have a stable lamellar structure. However, lipids in DOTMA/DOPE complexes have a highly curved structure with high fluidity. These results indicate that the interaction with erythrocytes depends on the properties of the cationic lipid vectors and this is an important factor for intravenous gene delivery using cationic lipid vectors.

Assessment of health-related quality of life in renal transplant and hemodialysis patients using the SF-36 health survey

OBJECTIVES

To determine whether the health-related quality of life (HQOL) for renal transplant patients improved using SF-36 survey scores and to examine which clinical measures after renal transplantation are connected to aspects of their HQOL.

METHODS

A total of 117 renal transplant patients and 114 hemodialysis patients, including 49 awaiting transplantation and 65 not awaiting transplantation, were included in this study. The scale scores of the SF-36 survey concerning HQOL were compared between the two groups of patients. The relationships of the clinical episode and complications with the scale scores were examined.

RESULTS

The renal transplant patients had significantly higher scores in the physical functioning, bodily pain, general health, and social functioning scales than did the hemodialysis patients. The role-physical functioning, bodily pain, and social functioning scales of the transplant patients were significantly higher than those of the hemodialysis patients not awaiting transplantation. In contrast, the scores, except for that of general health, of the transplant patients were not significantly different from those of the hemodialysis patients awaiting transplantation. Multiple regression analysis demonstrated that the scale scores of physical functioning, general health, and vitality were significantly dependent on the serum level of creatinine in the renal transplant patients (P <0.05). The scores of physical functioning and general health of the patients with a creatinine level >2 mg/dL were significantly lower than those of the patients with 1 mg/dL < creatinine level </=1.5 mg/dL or a creatinine level </=1 mg/dL (P <0.05). An episode of hospitalization was not related to the scale scores, but an instance of rejection had an effect on the scores of social functioning and role-emotional functioning.

CONCLUSIONS

The SF-36 health survey is a short but comprehensive scale for evaluating a patient's HQOL. The renal transplant patients' HQOL improved compared with that of the hemodialysis patients. The most important factor affecting HQOL was the serum creatinine level at the time of testing with the SF-36 survey.

[A comparative study on the clinical utility of cefozopran and cefpirome against complicated urinary tract infections]

Aiming at evaluating the utility of cefozopran (CZOP) against complicated urinary tract infections with the velocity of eradication of causal bacteria in early treatment and clinical efficacy by new criteria of UTIs, a comparative study was conducted using cefpirome (CPR) as the control drug. CZOP and CPR were administered by intravenous drip infusion at a dose of 1 g twice daily. The duration of treatment was for 5 days. The study method involved randomized assignment of the subjects to either group CZOP or group CPR. The results were as follows: 1. Of a total of 80 cases treated, 65 (CZOP group--32 cases, CPR group--33 cases) were evaluated for efficacy. 2. The overall clinical efficacy evaluation according to the criteria proposed by Japanese UTI Committee rated the CZOP group as 90.6% (29/32), and the CPR group as 90.9% (30/33), with no significant difference between the 2 groups. Clinical efficacy evaluated by attending physicians rated the CZOP group as 93.8% (30/32) and the CPR group as 90.9% (30/33). There was no significant difference between the 2 groups. 3. The efficacy rates to pyuria on day 2 were 26.7% and 0% for the CZOP group and the CPR group, respectively, indicating a higher efficacy rate for the former (p < 0.05). Those on after treatment were 59.4% and 54.5% for the CZOP group and the CPR group, respectively, with no significant difference between the 2 groups. 4. Regarding the bacteriological effect, the eradication rates of both groups were over 90% on day 1 and after treatment. There was no significant difference between the 2 groups. 5. Side effects occurred in 1 case (2.6%) out of 39 in the CZOP group and in 1 case (2.4%) out of 41 in the CPR group. Laboratory test value fluctuation was noted in 8 (20.5%) of 39 cases in the CZOP group and 11 (26.8%) of 41 cases in the CPR group. There was no significant difference between the 2 groups. The results indicate that CZOP achieves an early efficacy to pyuria, and is as useful as CPR against complicated urinary tract infections.

Effect of DNA/liposome mixing ratio on the physicochemical characteristics, cellular uptake and intracellular trafficking of plasmid DNA/cationic liposome complexes and subsequent gene expression

In order to identify the important factors involved in cationic liposome-mediated gene transfer, in vitro transfection efficiencies by plasmid DNA complexed with DOTMA/DOPE liposomes at different DNA/liposome mixing ratios were evaluated using four types of cultured cells with respect to their physicochemical properties. Significant changes were observed in the particle size and zeta potential of the complexes as well as in their structures, assessed by atomic force microscopy, which depended on the mixing ratio. In transfection experiments, except for RAW 264.7 cells (mouse macrophages), efficient gene expression was obtained in MBT-2 cells (mouse bladder tumor), NLH3T3 cells (mouse fibroblasts) and HUVEC (human umbilical vein endothelial cells) at an optimal ratio of 1:5, 1:7.5 or 1:5, respectively. On the other hand, cellular uptake of the [32P]DNA/liposome complexes increased in all cell types with an increase in the mixing ratio, which was not reflected by the transfection efficiency. The cellular damage determined by MTT assay was minimal even at the highest DNA/liposome ratio (1:10), indicating that the lower gene expression level at the higher ratio was not due to cytotoxicity induced by the complex. An ethidium bromide intercalation assay showed that the release of plasmid DNA from the complex, following the addition of negatively charged liposomes, was restricted as the mixing ratio increased. Furthermore, confocal microscopic studies using HUVEC showed that the 1:5 complexes exhibited a dispersed distribution in the cytoplasm whereas a punctuate intracellular distribution was observed for the 1:10 complexes. This suggests that there was a significant difference in intracellular trafficking, probably release from the endosomes or lysosomes, of the plasmid DNA/cationic liposome complexes between these mixing ratios. Taken together, these findings suggest that the DNA/liposome mixing ratio significantly affects the intracellular trafficking of plasmid DNA complexed with the cationic liposomes, which is an important determinant of the optimal mixing ratio in cationic liposome-mediated transfection.

Klinefelter's syndrome in the male infertility clinic

The clinical features of patients with Klinefelter's syndrome attending a male infertility clinic have been investigated in order to consider their assisted reproduction treatment options. Over 12 years, a total of 148 patients with sterility due to azoospermia had Klinefelter's syndrome. Eight patients were shown by fluorescence in-situ hybridization (FISH) on metaphase spreads to be mosaic (46,XY/47,XXY), and 140 patients showed only 47,XXY. Small testes were observed in 95% of patients and gynaecomastia was seen in 12.4%. Half of the patients showed hypergonadotrophic hypogonadism, while others showed normogonadism (usually hypergonadotrophic). Spermatozoa were observed in semen from one patient with mosaicism and one without. Three-colour FISH revealed hyperploidy in 2.7% and 2.3% of these spermatozoa respectively. Multiple-site testicular biopsies in five recent patients were performed and yielded a specimen with round and elongated spermatids in one patient with 47,XXY karyotype. This sample was cryopreserved for future intracytoplasmic sperm injection. At follow-up, 46% of couples had chosen artificial insemination with donor sperm, and none had chosen adoption. Two patients developed testicular tumours, one a mature teratoma and the other a Leydig cell tumour. Two patients required androgen replacement therapy.

Relationship of acrosin activity to sperm function tests

Acrosin activity of spermatozoa from infertile patients and fertile volunteers was measured. Acrosin activity of spermatozoa from asthenozoospermic patients and patients with unexplained infertility was lower than that from fertile volunteers. We utilize the zona-free hamster egg-sperm penetration test to select candidates for conventional in vitro fertilization among unexplained infertile patients. The zona-free hamster egg sperm penetration test, however, requires several hours and special equipment which are not used in the clinical setting. It is preferable that other sperm function tests or a combination of them can replace this test. Thus three distinct tests of sperm function, namely, acrosin activity, Penetrak test, hypo-osmotic swelling test, were compared with the hamster test, using spermatozoa from patients with unexplained infertility. A combination of the Penetrak test and measurement of acrosin activity could predict the results of the zona-free hamster egg sperm penetration test with 88.2% accuracy. Thus, the hamster test should be done when either Penetrak test or measurement of acrosin activity showed abnormal values.

Tamsulosin and chlormadinone for the treatment of benign prostatic hyperplasia. The Kobe University YM617 Study Group

The recent introduction of selective alpha-adrenoceptor blockers adds a further therapeutic option for the treatment of benign prostatic hyperplasia (BPH). Tamsulosin, a selective alpha 1-blocker, has proved effective in relieving irritative and obstructive symptoms caused by BPH. To investigate whether the combination of tamsulosin with the anti-androgenic drug chlormadinone is of further therapeutic benefit, 80 patients randomly received tamsulosin 0.2 mg daily, chlormadinone 50 mg daily or a combination of tamsulosin 0.2 mg and chlormadinone 50 mg daily for 16 weeks. Greater improvement in subjective symptoms of BPH was obtained with either tamsulosin alone or in combination with chlormadinone than with chlormadinone alone. However, the greatest improvement in objective uroflowmetric data was obtained with chlormadinone in combination with tamsulosin. Thus, the combination of tamsulosin with chlormadinone appears to be more beneficial than either of these agents used as monotherapy. Further investigation is required to fully evaluate the therapeutic effects of this combination. After the trial period one-third of the chlormadinone and tamsulosin/chlormadinone-treated patients needed no further treatment due to the satisfactory relief of symptoms. At 12 months follow-up, however, one-fourth of the patients had undergone transurethral resection of the prostate (TUR-P) regardless of medication. This suggests a limitation of the medical treatment of BPH.

Crystallization and preliminary X-ray analysis of 3-isopropylmalate dehydrogenase from the moderate facultative thermophile Bacillus coagulans

Three crystalline forms of 3-isopropylmalate dehydrogenase from the moderate facultative thermophile Bacillus coagulans were obtained by hanging-drop vapor-diffusion methods. One of them, which had crystallized under slightly milder conditions than the others, was suitable for X-ray analysis. Its asymmetric unit contains one dimeric molecule and the solvent content is higher than in other protein crystals. The crystal structure was solved in a preliminary manner by the molecular-replacement technique.

Crystal structure of a pyrimidine dimer-specific excision repair enzyme from bacteriophage T4: refinement at 1.45 A and X-ray analysis of the three active site mutants

Crystallographic study of bacteriophage T4 endonuclease V, which is involved in the initial step of the pyrimidine dimer-specific excision repair pathway, has been carried out with respect to the wild-type and three different mutant enzymes. This enzyme catalyzes the cleavage of the N-glycosyl bond at the 5'-side of the pyrimidine dimer, and subsequently incises the phosphodiester bond at the apyrimidinic site through a beta-elimination reaction. The structure of the wild-type enzyme refined at 1.45 A resolution reveals the detailed molecular architecture. The enzyme is composed of a single compact domain classified as an all-alpha structure. The molecule is stabilized mainly by three hydrophobic cores, two of which include many aromatic side-chain interactions. The structure has a unique folding motif, where the amino-terminal segment penetrates between two major alpha-helices and prevents their direct contact, and it is incompatible with the close-packing category of helices for protein folding. The concave surface, covered with many positive charges, implies an interface for DNA binding. The glycosylase catalytic center, which comprises Glu23 and the surrounding basic residues Arg3, Arg22 and Arg26, lie in this basic surface. The crystal structures of the three active-site mutants, in which Glu23 was replaced by Gln(E23Q) and Asp (E23D), respectively, and Arg3 by Gln (R3Q), have been determined at atomic resolution. The backbone structures of the E23Q and R3Q mutants were almost identical with that of the wild-type, while the E23D mutation induces a small, but significant, change in the backbone structure, such as an increase of the central kink of the H1 helix at Pro25. In the catalytic center of the glycosylase, however, these three mutations do not generate notable movements of protein atoms, except for significant shifts of some bound water molecules. Thus, the structural differences between the wild-type and each mutant are confined to the remarkably small region around their replaced chemical groups. Combined with the biochemical studies and the difference circular dichroism measurements, these results allow us to conclude that the negatively charged carboxyl group of Glu23 is essential for the cleavage of the N-glycosyl bond, and that the positively charged guanidino group of Arg3 is crucial to bind the substrate, a DNA duplex containing a pyrimidine dimer. The amino terminal alpha-amino group is located at a position approximately 4.4 A away from the carboxyl group of Glu23. These structural features are generally consistent with the reaction scheme proposed by Dodson and co-workers.

Structural composition of hammerhead ribozymes

Eleven kinds of hammerhead ribozymes were designed and synthesized to investigate the structural composition of the complexes and to find suitable crystallization conditions, the substrate chains having been modified to prevent hydrolysis. Electrophoresis patterns indicated that the two strands except for the substrate chain form a binary complex and that they form a ternary complex when mixed with the substrate chain. Both complexes were crystallized. The crystal of the binary complex belongs to a Laue symmetry of 32 (space group of P321, P3(1)21, or P3(2)21) with cell dimensions of a = b = 53.4 and c = 59.4 A. The volume per one nucleotide allows the asymmetric unit to contain one binary complex. Our results suggest that the catalytic part forms a rigid ribozyme structure which induces a scissile reaction when the substrate is bound, in a similar manner to an enzyme protein.

Müllerian duct cyst with 46, XYq-

We report a case of a müllerian duct cyst associated with a 46, XYq- chromosome anomaly. Müllerian duct cyst is a consequence of the abnormal regression of paramesonephric derivative. In the past many different manifestations have been associated with the 46, XYq-, anomaly. We discuss the possibility that a müllerian duct cyst may be one clinical manifestation of 46, XYq-.

The significance of gonadotropin-releasing hormone test for predicting fertility after varicocelectomy

To predict the surgical outcome in 30 infertile men with varicocele, endocrinologic evaluation by the GnRH test was performed before and 6 months after the high ligation of the left internal spermatic vein. Semen analysis was performed and the levels of basal T and PRL were examined preoperatively and 6 months postoperatively. In the pregnancy group, the preoperative excessive response of LH to the GnRH test decreased significantly after surgery. Significant reduction in the LH response is considered to be a valuable parameter for predicting fertility.

Müllerian duct cyst with 46, XYq-

We report a case of a müllerian duct cyst associated with a 46, XYq- chromosome anomaly. Müllerian duct cyst is a consequence of the abnormal regression of paramesonephric derivative. In the past many different manifestations have been associated with the 46, XYq-, anomaly. We discuss the possibility that a müllerian duct cyst may be one clinical manifestation of 46, XYq-.

[Ultrastructure of immotile spermatozoa obtained from infertile male patients]

We sometimes experienced infertile patients whose sperms had no motility but were not stained by Eosin Y. In this paper we report five cases of so-called "immotile spermatozoa". The ultrastructure of sperm tails was examined by transmission electrone microscope (TEM). These cases were selected from the out-patient population who attended infertility clinic of our department. The semen analyses showed that all the cases had sperm motility below 1% and more than 90% of the spermatozoa were proven alive. Family history revealed that one case had an infertile sibling. None of them had situs inversus, bronchiectasis and chronic sinusitis which are classic trias of Kartagener's syndrome. They had no symptoms of upper respiratory tract infection which was caused by the abnormality in the flagella of the respiratory tract. The TEM pictures of sperm tails showed partial deletion of inner dynein arms in two cases, lack of central microtubular doublets (so-called 9 + 0) in two cases and disarrangement of microtubular doublets in one case. For the treatment of these cases there is no effective means but AID. However, the rapid progress of IVF-ET techniques and a report that the spermatozoa from Kartagener's syndrome had showed penetration into eggs encouraged us to think the micromanipulation of spermatozoa with IVF-ET as a hopeful option of the treatment in the near future.

Fracture through united vascularized bone grafts

The secondary fracture rate in 53 patients undergoing vascularized bone transfer for long-bone reconstruction, with a follow-up period of at least 2 years, is evaluated in this report. Twelve fractures occurred in 10 patients. Characteristics of the fractures were: (1) most occurred at the tibia recipient site; (2) most occurred through the transferred vascularized bone segment, rather than at its junctions; and (3) all fractures occurred within 1 year following bone union. When the fracture occurred in adults, union was relatively easily obtained by application of simple external fixation; on the other hand, union was difficult to obtain in patients with congenital pseudarthrosis of the tibia.

Common expression of parathyroid hormone-related protein and no correlation of calcium level in renal cell carcinomas

BACKGROUND

Parathyroid hormone-related protein (PTHrP) is the predominant cause of humoral hypercalcemia of malignancy (HHM).

METHODS

Using a PTHrP-specific monoclonal antibody (MoAb), 4B3, the authors investigated the immunohistochemical localization of PTHrP in formalin-fixed and paraffin-embedded sections of normal human kidney tissues and tissues from 42 human renal cell carcinomas obtained at operation or autopsy.

RESULTS

In normal renal tissues, the distal tubules and collecting ducts showed positive immunostaining. PTHrP was detected in 40 of 42 renal cell carcinoma tissues (95%). Histopathologically, the granular cell subtypes of renal cell carcinomas tended to be more strongly positive than the clear cell subtypes. There was no significant correlation between the level of immunostaining and each patient's serum calcium level.

CONCLUSION

PTHrP was commonly observed in renal cell carcinomas, and no significant correlation was seen between the intensity of PTHrP staining and the serum calcium level.

Idiopathic retroperitoneal fibrosis: a case of unilateral lesion

Here we report a case of idiopathic retroperitoneal fibrosis, a unilateral case, which resulted in remission by ureterolysis with intraperitonealization. A 24-year-old female was hospitalized because of hydronephrosis. Many examinations were performed with the suspicion of malignant disease, but no apparent cause was detected. We suspected idiopathic retroperitoneal fibrosis and performed surgical exploration. The pathological diagnosis was retroperitoneal fibrosis. Ureterolysis with intraperitonealization of the ureter was performed. Six months later, marked improvement of the right hydronephrosis was observed without steroid therapy.

Crystal structures of ribonuclease F1 of Fusarium moniliforme in its free form and in complex with 2'GMP

RNase F1, a guanine-specific ribonuclease from Fusarium moniliforme, was crystallized in two different forms, in the absence of an inhibitor and in the presence of 2'GMP. The crystal structure of the RNase F1 free form was solved by the molecular replacement method, using the co-ordinates of the RNase T1 complex with 2'GMP, and was refined to a final R-factor of 18.7%, using the data extended to 1.3 A resolution. For the crystal structure of the RNase F1 complex with 2'GMP, the solution of the molecular replacement method was obtained on the basis of the co-ordinates of the RNase F1 free form, and was refined to a final R-factor of 16.8%, using the data up to 2 A resolution. The two crystal structures of the RNase F1 free form and the complex with 2'GMP are very similar to each other as reflected by a small root-mean-square displacement (r.m.s.d.) value of 0.43 A for all C alpha atoms. The main differences between the two structures are associated with binding of 2'GMP in the substrate recognition site in the loop between Tyr42 and Glu46. A structural comparison between RNase F1 and RNase T1 shows a substantial similarity between all the C alpha atoms, as evidenced by a r.m.s.d. value of 1.4 A. The loop from residues 32 to 38 was strikingly different between these two enzymes, in both its conformation and its hydrogen bonding schemes. The side-chain of a catalytically active residue, His92, is shifted away from the catalytic site in RNase F1 by 1.3 A and 0.85 A with respect to the corresponding positions in the RNase T1 free form and in the RNase T1 complex with 2'GMP, respectively. In the RNase F1 complex, the guanine base of 2'GMP has a syn conformation about the glycosyl bond, and the furanose ring assumes a 3'-exo pucker, which is different from that found in the complex with RNase T1. In the catalytic site of the RNase F1 complex with 2'GMP, one water molecule was observed, which bridges the phosphate oxygen atoms of 2'GMP and the side-chains of the catalytically important residues, His92 and Arg77, through hydrogen bonds. A water molecule occupying the same position was found in the RNase F1 free form. The significance of this water molecule in the hydrolytic reaction is discussed.

[Subpopulation of leucocytes in the semen from fertile and infertile men--immunohistochemical and flow-cytometric analysis]

It is hard to differentiate leucocytes from immature germ cells among many round cells in ejaculated semen. Recently monoclonal antibodies (MoAbs) which recognize surface antigen of various subtypes of leucocytes are available. In this study we applied a panel of MoAbs for leucocyte subpopulations (granulocytes, T-lymphocytes, B-lymphocytes, Monocytes/Macrophages and pan-leucocytes). Semen smears from 64 mild oligozoospermic patients and 5 fertile volunteers were stained by immunohistological technique (avidin-biotin-immunoperoxidase method). We found highly varying total leucocyte numbers ranging from 1200 to 2.2 x 10(8) per ejaculate. When comparing semen from infertile patients with those from fertile donors, statistically significant higher medians of total leucocytes, total granulocytes and monocytes/macrophages were seen in infertile group. We compared a total number of leucocytes obtained from conventional Papanicolaou staining with that from immunohistochemical staining. Both were almost identical but the former gave a little bit higher value, because of the difficulty in differentiating leucocytes from immature germ cell by Papanicolaou staining. Moreover we performed an experiment to evaluate the applicability of flow-cytometry (FCM) to count leucocytes in semen. Cells in the semen smears were stained with MoAbs recognizing the surface antigen shared by every leucocyte, and percentage of the leucocytes which were thus stained with MoAbs was compared with that determined by FCM. Results from FCM constantly gave lower value than these from immunostaining. This is probably because FCM could not differentiate leucocytes from contaminated non cell substances (e.g. cell debris). From the present study it is not adequate to use FCM for the detection of leucocytes in semen as applied in haematology. Further techniques to remove non-cellular substances should be established for its application in semen analysis.

Preliminary crystallographic studies on hammerhead ribozymes

Crystallization of hammerhead ribozymes was tried by the hanging drop vapor diffusion method. The crystals grown up to 0.5 x 0.05 x 0.05 mm3 in size gave diffraction patterns with about 5 A resolution using synchrotron radiation. The crystal was determined to be trigonal with space group P3(1) or P3(2) and cell parameters a = b = 49.6 A and c = 53.3 A.

[A case of chronic scrotal hematocele and review of the literature]

A 38-year-old man visited our hospital because of swelling of left scrotal content. He had no history of trauma of scrotum, fever, pain or dysuria. Physical examination revealed a tumor larger than a fist in the left scrotum. Ultrasonography revealed an echogenic mass with echolucent area in the scrotum. Surgical extirpation of the left scrotal tumor was performed under the diagnosis of left testicular tumor. The mass was encapsulated by a white fibrous membrane and was 700 g in weight. The tumor contained 200 ml of dark brown pus-like material. Histological examination revealed deposition of cholesterine crista and infiltration of lymphocyte in tunica vaginalis with extremely atrophic testis, destructive spermatogenesis and atrophic epididymis. Twenty one cases of chronic scrotal hematocele have been reported in the Japanese literature. The age of the patients reported was 38 to 77 years old with a mean age of 65 years. Orchiectomy was done under the diagnosis of testicular tumor in 20 of the 21 cases. Our case was thought to be of an idiopathic chronic scrotal hematocele. The disease should be considered even in the absence of a particular cause such as injury and inflammation of scrotal content.

[Microsurgical autotransplantation of abdominal testis]

A 32-year-old man who had bilateral non-palpable testis underwent microsurgical orchidopexy of the right abdominal testis. Inferior epigastric vessels were used for the recipient vessels. Ischemic time during the operation was 40 minutes. Postoperative doppler readings revealed excellent blood flow to the testis, and HCG-stimulating test revealed good response. Now, 2 years after surgery, no sign of atrophy is found.

Androgenic regulation of enzymes involved in DNA synthesis in epididymis of young rats

In the epididymis of young rats, activities of DNA polymerases alpha, beta and gamma and DNA topoisomerase I decreased after castration. DNA polymerase alpha and gamma increased with androgen administration and activity reached 81.3% and 78.0%, respectively, of the activity in the sham-operated group on day 21. Activity of DNA polymerase beta remained at the activity of day 7 during androgen administration and was almost the same as that in the sham-operated group on day 21. DNA topoisomerase I activity showed a slight increase with androgen administration and reached 50.3% of that in the sham-operated group. The activities of these enzymes were not fully restored to those in the sham-operated group. These results indicate that in young rats activities of epididymal DNA polymerase alpha and gamma and DNA topoisomerase I are partially, and that of DNA polymerase beta wholly, dependent on androgens and may provide a means of investigating the regulation of epididymal cell proliferation.

Crystallization and preliminary X-ray studies of a Bacillus subtilis and Thermus thermophilus HB8 chimeric 3-isopropylmalate dehydrogenase and thermostable mutants of it

A new type of chimeric 3-isopropylmalate dehydrogenase (2T2M6T) was produced by expressing the fused gene of Bacillus subtilis and Thermus thermophilus. The enzyme shows heat stability intermediate between those of the parents. The crystal of the enzyme belongs to the space group of P3(2)21, with cell dimensions of a = b = 78.9 A and c = 158.9 A. Two thermostable mutants of the chimeric enzyme were prepared by site-directed mutagenesis and then crystallized.

[Clinical study on surgical treatment of renal cell carcinoma with pulmonary metastases]

This study reviewed the surgical therapy for lung metastatic foci of renal cell carcinoma. During the 14 years from 1977 to 1991, lung metastatic foci were removed in 10 patients with renal cell carcinoma at our hospital. Six of them died of cancer and four are alive. The prognosis tended to be better the longer the interval from nephrectomy to lung metastasis. Neither the number of metastatic foci nor the surgical technique produced any difference in the prognosis. The prognosis tended to be better for patients with clear cell tumors than for those with granular cell tumors. For the treatment of lung metastasis of renal cell carcinoma, since we have no better therapy than surgical removal at the present, it is our duty to attempt to improve the prognosis of patients by the resection of metastatic foci whenever possible. However, the use of adjuvant therapy such as interferon should be considered, and the indications for operation and the timing of surgery reviewed.

[A case of infected caliceal diverticulum]

A 60-year-old woman was admitted to our clinic with the chief complaint of high fever. Antibiotic therapy had produced no improvement in another hospital and she was referred to our hospital for further examination and treatment. Intravenous pyelography showed left non visualized kidney and a stone shadow in left ureter. Computed tomography showed a cystic lesion, 9 x 9 x 8 cm, in the upper pole of the left kidney. We punctured and drained 400 cc of turbid yellowish fluid by a transcutaneous route. The nephrostogram clearly showed a communication with infundibulum. A diagnosis of infected caliceal diverticulum was made. Further examination demonstrated no function of left kidney and we performed nephrectomy. She has reported no symptoms for 6 months after the operation.

X-ray structure of T4 endonuclease V: an excision repair enzyme specific for a pyrimidine dimer

The x-ray structure of T4 endonuclease V, an enzyme responsible for the first step of a pyrimidine-dimer-specific excision-repair pathway, was determined at a 1.6-angstrom resolution. The enzyme consists of a single compact domain classified into an all-alpha structure. This single domain has two distinct catalytic activities; it functions as a pyrimidine dimer glycosylase and as an apurinic-apyrimidinic endonuclease. The amino-terminal segment penetrates between two major helices and prevents their direct contact. The refined structure suggests the residues involved in the substrate binding and the catalysis of the glycosylation reaction.

Clinical and pathological evaluations of methotrexate, vinblastine, adriamycin and cisplatin chemotherapy for advanced urothelial cancers

We have treated advanced transitional-cell carcinoma of the urothelial tract with methotrexate, vinblastine, Adriamycin, and cisplatin (M-VAC) chemotherapy since July of 1985. We analyzed the effect of that chemotherapy in 26 patients with advanced urothelial cancer who were treated in our hospital and followed up. They were divided into two groups. Group 1 consisted of 15 patients with distant metastases. In all, 11 of them received M-VAC as adjuvant chemotherapy for metastatic lesions after surgical removal of the primary lesion, and the remaining 4 patients were not operable since they had very advanced-stage tumors; they received only M-VAC chemotherapy. Group 2 contained 11 patients who received M-VAC neo-adjuvant chemotherapy. In group 1, the overall response rate was 57.1% and the mean duration of response was 12.6 months. In the 11 patients who had received M-VAC as adjuvant therapy after surgical removal of the primary tumor, the mean duration of response was 14.1 months. After M-VAC chemotherapy, six patients underwent surgical resection of metastatic lesions and restaging was done pathologically in these cases. The clinical response coincided with the pathological response in all six cases. In group 2, 5 of 11 patients experienced histological downstaging of the resected bladder. M-VAC chemotherapy combined with surgical resection of residual tumors has proved to be an effective option against advanced urothelial cancer.

[Usefulness of dipstick test for determining leukocytes and bacteria in urine]

The value of a simple dipstick test (BMtestLN, Boehringer Mannheim-Shionogi) for determination of leukocytes and bacteria in urine was examined. This test consisted of detection of esterase, an enzyme present in leukocytes and the nitrate reduced by bacteria. A total of 666 clinical urine specimens were tested with both tests. The evaluation of leukocytes in urine was compared with microscopic examination, and the identification and measurement of strains was performed using a semiquantitative plate culture method as a reference. The leukocyte esterase test had a sensitivity of 85.3%, a specificity of 67.3%, positive predictive value of 54.7% and negative predictive value of 90.8%. The range of the sensitivity value of nitrate test was 25.7% for the detection of bacteriuria (bacteria greater than or equal to 10(4) CFU/ml). This test had a specificity of 99.6%, positive predictive value of 94.8% and negative value of 82.9%. We concluded that this dipstick test is not useful for determination of the slight change of pyuria, but sensitive for the determination of acute and untreated urinary tract infections.

[Present status on bladder replacement--colon bladder replacement]

Bladder replacement using a detubularized right colonic segment was successfully performed on 22 male patients with bladder cancer after radical cystectomy. There were 10 early postoperative complications and one of them required reoperation. Urodynamic studies, performed on 16 patients, showed a low pressure reservoir at a large capacity without any involuntary spikes in every case. Of the 16 patients, 4 were nocturnally enuretic and 1 was partially continent. The other 11 patients (68.8%) were totally continent and voiding well, except one who was on intermittent self-catheterization. The incidence of urinary reservoir infections in patients treated with colon bladder replacement was investigated in 18 patients. The incidence rate of bacteriuria was 5.6% and the positive rate of pyuria was 27.8%. The detection rate of bacteriuria and pyuria was significantly low in patients after colon bladder replacement. These findings indicate that colon bladder replacement can be an ideal option for selected patients with bladder cancer.

[A case of acquired cystic disease of bilateral kidneys with renal cell carcinoma following long-term hemodialysis]

We report a case of bilateral renal cell carcinoma which developed during about 14 years of hemodialysis. The patient of male was a 39-year-old with a chief complaint of macrohematuria 14 years prior to dialysis therapy. Computed tomography revealed multiple cystic changes of bilateral kidneys and a high density area in the right kidney. He was admitted to our department in April 1988. He was suspected of renal cell carcinoma of the right kidney and underwent transperitoneal radical nephrectomy on the right kidney. The left kidney was also resected simultaneously in part because it failed to function and in part because the long-term hemodialyzed patients are considered to have a complication of renal cell carcinoma at a high frequency. Pathological diagnosis was bilateral acquired cystic disease of the kidney (ACDK) with renal cell carcinoma. The kidney develops multiple cystic changes following long-term hemodialysis, which forms a high risk for development of renal cell carcinoma. This is a case of bilateral renal cell carcinoma which occurred after long-term hemodialysis, was reported with discussion and reference to the literature.

[Diagnosis of male infertility]

The diagnostic methods for male infertility in our clinic are reviewed, and the following are emphasized. In azoospermia, examinations for obstructive azoospermia such as testicular biopsy should be made focussing on patients with 10 ml or higher testicular volume and with 20 mIU/ml or lower serum FSH level. In hypospermic patients, examination of post-ejaculated urine and ultrasonotomography examination of prostate are necessary for the diagnosis of incomplete retrograde ejaculation and obstruction or stenosis of the ejaculatory ducts.

[VAB-6 chemotherapy of advanced testicular cancers--its efficacy and limitation]

Fifteen patients with advanced testicular germ cell tumor were treated by VAB-6 chemotherapy after radical orchiectomy. CR was achieved in two (13.3%) and PR in nine (60.0%). The one, three and five year survival rates were 92.2, 64.2 and 51.4%, respectively. Nine patients (60.0%) remain with no evidence of disease (NED) after combined therapy (chemotherapy and surgery) with a median follow up of 4.3 months. We performed resection of the residual tumors and examined histologically. Out of 11 cases, four (36.3%) were with necrosis/fibrosis, two (18.2%) teratoma and five (45.5%) cancer. All of the six cases with non-cancerous tissues remain in NED. However, only two of the five cases with cancerous tissues remain in NED. We studied the NED rate based on four prognostic factors, (1) bulky abdominal diseases, (2) advanced lung diseases, (3) other metasteses, and (4) choriocarcinoma. In our analysis, advanced lung diseases and choriocarcinoma were poor prognostic factors. We should treat these poor prognostic cases initially with VP-16, ifosfamide, high doses cisplatin etc, which were used as salvaged drugs.