VISUALIZATION OF LOWER EXTREMITY LYMPHEDEMA IN THE SAME COHORT USING (^99m)Tc-HUMAN SERUM ALBUMIN AND (^99m)Tc-PHYTATE LYMPHOSCINTIGRAPHY WITH SPECT-CT

Lymphoscintigraphy with single-photon emission computed tomography (SPECT-CT) is useful in diagnosing lymphedema. However, there are multiple timings, techniques, and tracers utilized worldwide without any comparison. We examined and compared the image clarity with two different radiotracers, 99mTc-human serum albumin (HSA) and 99mTc-phytate (phytate), in the same patients. The study retrospectivity examined 46 limbs of 36 patients who underwent lymphoscintigraphy using HSA and phytate from January 2013 to September 2018. Tracer accumulation in the lymph nodes, linear pattern (LP), and dermal backflow (DBF) were qualitatively analyzed; contrast-to-noise ratios (CNR) of DBF and standardized uptake value ratio (SUVR) of LP were also quantitatively analyzed. Neither lymph node accumulation nor DBF identification showed significant difference. However, a significant difference was observed between the LP identification of the unaffected (p<0.001) and affected sides (p<0.001). On quantitative evaluation, CNR and SUVR of LP was significantly higher with HSA than with phytate (p<0.001). SUVR of LP was also significantly higher with HSA than with phytate in both unaffected (p=0.002) and affected (p=0.005) sides. Overall, images acquired with HSA were clearer than that with phytate, and the identification of LP was particularly better with HSA than with phytate. Thus, lymphoscintigraphy using HSA is preferred over phytate for both diagnosis and evaluation of disease severity and surgical site selection.

Visualization of lower extremity lymphedema in the same cohort using 99mTc-human serum albumin and 99mTc-phytate lymphoscintigraphy with SPECT-CT

Lymphoscintigraphy with single-photon emission computed tomography (SPECT-CT) is useful in diagnosing lymphedema. However, there are multiple timings, techniques, and tracers utilized worldwide without any comparison. We examined and compared the image clarity with two different radiotracers, 99mTc human serum albumin (HSA) and 99mTc phytate (phytate), in the same patients. The study retrospectivity examined 46 limbs of 36 patients who underwent lymphoscintigraphy using HSA and phytate from January 2013 to September 2018. Tracer accumulation in the lymph nodes, linear pattern (LP), and dermal backflow (DBF) were qualitatively analyzed; contrast-to-noise ratios (CNR) of DBF and standardized uptake value ratio (SUVR) of LP were also quantitatively analyzed. Neither lymph node accumulation nor DBF identification showed significant difference. However, a significant difference was observed between the LP identification of the unaffected (p<0.001) and affected sides (p<0.001). On quantitative evaluation, CNR and SUVR of LP was significantly higher with HSA than with phytate (p<0.001). SUVR of LP was also significantly higher with HSA than with phytate in both unaffected (p=0.002) and affected (p=0.005) sides. Overall, images acquired with HSA were clearer than that with phytate, and the identification of LP was particularly better with HSA than with phytate. Thus, lymphoscintigraphy using HSA is preferred over phytate for both diagnosis and evaluation of disease severity and surgical site selection.

Blockade of the KATP channel Kir6.2 by memantine represents a novel mechanism relevant to Alzheimer's disease therapy

Here, we report a novel target of the drug memantine, ATP-sensitive K⁺ (K_ATP) channels, potentially relevant to memory improvement. We confirmed that memantine antagonizes memory impairment in Alzheimer's model APP23 mice. Memantine increased CaMKII activity in the APP23 mouse hippocampus, and memantine-induced enhancement of hippocampal long-term potentiation (LTP) and CaMKII activity was totally abolished by treatment with pinacidil, a specific opener of K_ATP channels. Memantine also inhibited Kir6.1 and Kir6.2 K_ATP channels and elevated intracellular Ca²⁺ concentrations in neuro2A cells overexpressing Kir6.1 or Kir6.2. Kir6.2 was preferentially expressed at postsynaptic regions of hippocampal neurons, whereas Kir6.1 was predominant in dendrites and cell bodies of pyramidal neurons. Finally, we confirmed that Kir6.2 mutant mice exhibit severe memory deficits and impaired hippocampal LTP, impairments that cannot be rescued by memantine administration. Altogether, our studies show that memantine modulates Kir6.2 activity, and that the Kir6.2 channel is a novel target for therapeutics to improve memory impairment in Alzheimer disease patients.

Endocytosis following dopamine D2 receptor activation is critical for neuronal activity and dendritic spine formation via Rabex-5/PDGFRβ signaling in striatopallidal medium spiny neurons

Aberrant dopamine D₂ receptor (D₂R) activity is associated with neuropsychiatric disorders, making those receptors targets for antipsychotic drugs. Here, we report that novel signaling through the intracellularly localized D₂R long isoform (D_2LR) elicits extracellular signal-regulated kinase (ERK) activation and dendritic spine formation through Rabex-5/platelet-derived growth factor receptor-β (PDGFRβ)-mediated endocytosis in mouse striatum. We found that D_2LR directly binds to and activates Rabex-5, promoting early-endosome formation. Endosomes containing D_2LR and PDGFRβ are then transported to the Golgi apparatus, where those complexes trigger Gαi3-mediated ERK signaling. Loss of intracellular D_2LR-mediated ERK activation decreased neuronal activity and dendritic spine density in striatopallidal medium spiny neurons (MSNs). In addition, dendritic spine density in striatopallidal MSNs significantly increased following treatment of striatal slices from wild-type mice with quinpirole, a D₂R agonist, but those changes were lacking in D_2LR knockout mice. Moreover, intracellular D_2LR signaling mediated effects of a typical antipsychotic drug, haloperidol, in inducing catalepsy behavior. Taken together, intracellular D_2LR signaling through Rabex-5/PDGFRβ is critical for ERK activation, dendritic spine formation and neuronal activity in striatopallidal MSNs of mice.

Synthesis of Silica Nanotube Using Myelin Figure as Template and their Formation Mechanism

Silica nanotubes are synthesized through a sol-gel reaction of tetraethyl orthosilicate (TEOS) using myelin figures of Pluronic P123 as the structure-directing agent. The simultaneous progression of the formation of molecular assemblies that act as templates and the formation of silica frameworks though a sol-gel reaction of the silica precursor is a characteristic of this reaction system. The synthesized silica nanotubes were characterized using transmission electron microscopy (TEM), nitrogen adsorption/desorption measurements, and Fourier-transform infrared spectroscopy (FT-IR). The silica nanotubes were unilamellar with diameters of approximately 30 nm, membrane thicknesses of approximately 10 nm, and lengths exceeding a few hundred nanometers. The Brunauer-Emmett-Teller (BET) specific surface area was 589.46 m(2)/g. Silica nanotubes can also be obtained using other Pluronic surfactants that can form myelin figures. In this work, we also investigated the formation mechanism of the silica nanotubes. The typical diameter of a myelin figure is a few tens of micrometers. However, myelin figures with diameters of approximately 10 µm can form in systems with TEOS because bifurcation is induced by minute silica nuclei that form during the initial reaction between TEOS and water. Freeze fracture TEM (FF-TEM) observations revealed the existence of myelin figures with diameters of 20 to 30 nm, which are the same size and shape as the synthesized silica nanotubes. These results indicate that bifurcation of the myelin figures is induced by the silica nuclei that form via the initial reaction of TEOS, which result in the formation of bifurcated myelin figures with diameters of ~10 µm. Myelin figures with diameters of 20 to 30 nm form on the surface, and they become templates where the reaction of TEOS progresses to form silica nanotubes with diameters of approximately 30 nm.

Human elastic cartilage engineering from cartilage progenitor cells using rotating wall vessel bioreactor

Transplantation of bioengineered elastic cartilage is considered to be a promising approach for patients with craniofacial defects. We have previously shown that human ear perichondrium harbors a population of cartilage progenitor cells (CPCs). The aim of this study was to examine the use of a rotating wall vessel (RWV) bioreactor for CPCs to engineer 3-D elastic cartilage in vitro. Human CPCs isolated from ear perichondrium were expanded and differentiated into chondrocytes under 2-D culture conditions. Fully differentiated CPCs were seeded into recently developed pC-HAp/ChS (porous material consisted of collagen, hydroxyapatite, and chondroitinsulfate) scaffolds and 3-D cultivated utilizing a RWV bioreactor. 3-D engineered constructs appeared shiny with a yellowish, cartilage-like morphology. The shape of the molded scaffold was maintained after RWV cultivation. Hematoxylin and eosin staining showed engraftment of CPCs inside pC-HAp/ChS. Alcian blue and Elastica Van Gieson staining showed of proteoglycan and elastic fibers, which are unique extracellular matrices of elastic cartilage. Thus, human CPCs formed elastic cartilage-like tissue after 3-D cultivation in a RWV bioreactor. These techniques may assist future efforts to reconstruct complicate structures composed of elastic cartilage in vitro.

Classification of lymphoscintigraphy and relevance to surgical indication for lymphaticovenous anastomosis in upper limb lymphedema

Upper limb lymphedema that develops after breast cancer surgery causes physical discomfort and psychological distress, and it can require both conservative and surgical treatment. Lymphaticovenous anastomosis has been reported to be an effective treatment; however the disease severity criteria that define indications for this treatment remain unclear. Here, we examined lymphoscintigraphic findings in 78 patients with secondary upper limb lymphedema and classified them into 5 major types (Type I-V) and 3 subtypes (Subtype E, L, and 0). Results revealed that this classification is related to the clinical stage scale of the International Society of Lymphology. Based on intraoperative examination findings in 20 of the 78 patients, lymphatic pressure is likely to be further elevated in Type II-V cases which are characterized by the presence of dermal back flow. Therefore, lymphaticovenous anastomosis should be considered as a treatment option for lymphedema in Type II-V cases. Furthermore, there are only limited lymph vessel sites usable for lymphaticovenous anastomosis in more severe lymphedema types [Types IV and Type V (which is characterized by dermal backflow only in the hand)]. The findings in Type IV-V cases suggest that therapeutic strategies for severe upper limb lymphedema need further consideration.

The RING heterodimer BRCA1-BARD1 is a ubiquitin ligase inactivated by a breast cancer-derived mutation

BRCA1-BARD1 constitutes a heterodimeric RING finger complex associated through its N-terminal regions. Here we demonstrate that the BRCA1-BARD1 heterodimeric RING finger complex contains significant ubiquitin ligase activity that can be disrupted by a breast cancer-derived RING finger mutation in BRCA1. Whereas individually BRCA1 and BARD1 have very low ubiquitin ligase activities in vitro, BRCA1 combined with BARD1 exhibits dramatically higher activity. Bacterially purified RING finger domains comprising residues 1-304 of BRCA1 and residues 25-189 of BARD1 are capable of polymerizing ubiquitin. The steady-state level of transfected BRCA1 in vivo was increased by co-transfection of BARD1, and reciprocally that of transfected BARD1 was increased by BRCA1 in a dose-dependent manner. The breast cancer-derived BARD1-interaction-deficient mutant, BRCA1(C61G), does not exhibit ubiquitin ligase activity in vitro. These results suggest that the BRCA1-BARD1 complex contains a ubiquitin ligase activity that is important in prevention of breast and ovarian cancer development.

Radical hysterectomy: An anatomic evaluation of parametrial dissection

OBJECTIVES

This study was designed to demonstrate a reduction in the amount of blood loss for vesicouterine ligament dissection and to investigate the intrapelvic autonomic nerve pathway and its preservation by means of anatomic analysis.

METHODS

The anchoring mechanism of the pelvic viscera to the pelvic wall was divided into a supporting system facing laterally and a suspensory system facing dorsoventrally. An operative procedure was designed in which both systems were separated and dissected independently.

RESULTS

Between the two systems, an artificial space was developed, which required a new dissection method for the parametrium and revealed a new anatomic pathway for the ureter and autonomic nerve. The amount of blood loss (mean +/- SD) during dissection of the vesicouterine ligament was ultimately 260.1 +/- 114.8 ml. Postoperatively, the maximum capacity of the bladder was 393.9 +/- 40.4 ml, maximum detrusor pressure 6.3 +/- 4.1 cm H(2)O, mean compliance >10 ml/cm H(2)O, residual urine 23.8 +/- 9.4 ml, and maximum flow rate 25. +/- 8 2.2 ml/s, respectively.

CONCLUSION

A new classification for the parametrium and its dissection method have been established. Development of this new operative procedure has also contributed to a decrease in blood loss and preservation of bladder function.

Myofibroblastoma of the neck in a heifer

A 1.5-year-old Holstein heifer had a subcutaneous tumor mass (20 cm diameter) on the ventral portion of the neck, and the tumor was diagnosed as a locally invasive myofibroblastoma. It consisted of moderately cellular fibrous tissue, and the interlobular septum of the thymus was invaded by tumor cells. The neoplastic cells were positive for alpha smooth muscle actin and vimentin, but not for desmin. Electron microscopy disclosed the presence of moderately developed rough endoplasmic reticulum and microfilaments with focal densities.

[Decreasing seropositivity of cytomegalovirus of pregnant women in Japan]

We examined seroprevalence of cytomegalovirus (CMV) of pregnant women for 18 years since 1980 with complement-fixing antibody (CF) and specific IgG antibody. CF seropositive rate decreased gradually from 93.2% to 66.7%. CMV-IgG Seropositive rates were 87.4% in 1985, and 75.2% in 1996 to 1997. Age and parity of pregnant women associated with the immune status; 35.6% of recent young primipara were susceptible.

A new proposal for radical hysterectomy

OBJECTIVE

The authors revised the surgical procedure for radical hysterectomy utilizing detailed observation of the venous system, connective fascial sheets, and neural pathways within the uterine supports.

STUDY DESIGN

The anterior, middle, and posterior uterine supports were reclassified into two systems, supporting or fascial and drainage or areoral. Supporting system consisted of the superficial layer of the vesicouterine ligament, fascial part of the Mackenrodt ligament, sacrouterine ligament, and rectovaginal ligament, whereas drainage system consisted of the deep layer of the vesicouterine ligament, vascular part of the Mackenrodt ligament, and the so-called mesoureter. The operative procedure was planned according to the continuity of these ligaments and executed first by excising the fascia and then dissecting the denuded areoral tissue.

RESULTS

Among the 15 patients who underwent surgery for uterine cancer during a 2-year period the mean (SD) time required for the operation was 305.5 +/- 30.5 min and the mean (SD) total volume of blood loss 592.0 +/- 238.2 ml. A mean (SD) period of 14.3 +/- 3.8 postoperative days was required until the volume of the residual urine decreased to less than 50 mL.

CONCLUSION

The present operation has been structured more three-dimensionally and systematically than before. Further, safety of the operation was significantly improved including prevention of hemorrhage and preservation of bladder function.

[Simplified avidity assay of rubella IgG antibody in rubella virus infection]

Simplified avidity assay of rubella IgG antibody with urea was evaluated to distinguish primary rubella from reinfection. In this method urea washing was done once for 10 minutes. The avidity index (AI) was calculated as the optical density percentage for the urea-washed well when compared to that of the non-treated well. We examined 292 sera from 50 patients with primary infection collected 6 to 2,259 days after the rash appeared, 29 sera from 11 patients with rubella reinfection and 69 sera from 68 pregnant women without fetal infection and having a high hemagglutination inhibition (HI) antibody. In primary infection AI increased gradually from 0%, and reached a plateau of about 60% four months after the rash appeared, whereas the mean AIs of patients after reinfection and with high HI antibody were as high as 87.1% and 89.9%, respectively. These results indicate that the simplified avidity assay in rubella IgG antibody is also valuable in diagnosing recent primary rubella in pregnant women with a high HI antibody.

[Avidity of rubella IgG antibody in rubella virus infection]

The avidity assay of rubella IgG antibody with urea was evaluated to distinguish the early convalescent phase of primary rubella from the late one and reinfection. We examined 116 sera from 23 patients with primary infection collected 7 to 1,477 days after the rash appeared and 25 sera from 8 patients with rubella reinfection and 16 sera from 15 pregnant women without fetal infection having high hemagglutination inhibition (HI) antibody or weak positive rubella IgM antibody. The avidity index (AI) was calculated as the ratio of the optical density from the urea-washed well to that of the non-treated well, expressed as a percentage. In primary infection AI were lower than 30% within 30 days after the rash appeared, then gradually increased and reached a plateau of 60 to 80% three months later, whereas the AIs of patients after reinfection, with high HI antibody and weak positive IgM antibody were as high as 79.2 +/- 7.5%, 93.5 +/- 4.1% and 90.6 +/- 5.0%, respectively. These results indicate that the measurement of avidity in rubella IgG antibody is valuable in diagnosing recent primary rubella in pregnant women having a high HI antibody or IgM antibody.

Purification of a kininogenase (kininogenase-2) from the venom of Agkistrodon caliginosus (Kankoku-Mamushi)

From the partially purified capillary permeability-increasing enzyme obtained from A. caliginosus venom, another kininogenase (kininogenase-2) was purified by gel filtration on Sephadex G-100 and ion-exchange chromatography on CM-Sephadex C-50, DEAE-Sephadex A-50, S-Sepharose Fast Flow and Q-Sepharose Fast Flow. The purified enzyme was homogeneous by polyacrylamide gel electrophoresis at pH 8.3 and SDS-gel electrophoresis. The kininogenase-2 had arginine ester hydrolytic and capillary permeability-increasing activities, and did not show any caseinolytic or clotting activity in a similar manner to a previously purified kininogenase (kininogenase-1). The purified kininogenase-2 liberated bradykinin on incubation with purified bovine high mol. wt kininogen. The rate of bradykinin release from the kininogen by kininogenase-2 was slower than that by the kininogenase-1, although both enzymes rapidly cleaved the peptide bonds in the kininogen molecule.

Dissection of the cardinal ligament in radical hysterectomy for cervical cancer with emphasis on the lateral ligament

Surgical experience with carcinomas of the uterus and rectum has provided new insights into the surgical anatomy of a lamina, which separates the paravesical space from the pararectal space. It has been proved that each of the lamina consists of the cardinal and lateral ligaments and pelvic splanchnic nerves, descending in the following order. The cardinal and lateral ligaments, as a connective stalk, insert into the lateral walls of the uterus and rectum extending from the inner aspect of the pelvic wall. Clarification of this structural relationship led to the development of a new procedure for the dissection of the cardinal ligament in radical hysterectomy, while still preserving the lateral ligament. This facilitated systematic dissection of the cardinal and uterosacral ligaments with posterior manipulation, leading to a reduction in blood loss and to prevention of brisk bleeding from the venous plexuses.

Purification of a kininogenase from the venom of Agkistrodon caliginosus (Kankoku-Mamushi)

During the isolation of a capillary permeability-increasing enzyme from the venom of A. caliginosus, a kininogenase was also purified from the venom by gel filtration on Sephadex G-100, ion-exchange chromatographies on CM-Sephadex C-50 and DEAE-Sephadex A-50, and gel filtration on Sephadex G-75. By this procedure, 11 mg of the purified enzyme were obtained from 4 g of the venom. The purified enzyme was homogeneous by polyacrylamide disc gel electrophoresis at pH 8.3 and sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and did not show any caseinolytic or clotting activity. The purified enzyme released bradykinin from purified bovine high mol.wt kininogen. The capillary permeability was increased by injection of the purified enzyme into the depilated skin of the back of a rabbit. It is supposed that the capillary permeability-increasing activity exerted by the enzyme is due to the release of bradykinin.

Some properties of a kininogenase from the venom of Agkistrodon caliginosus (Kankoku-Mamushi)

A kininogenase (bradykinin-releasing enzyme) from the venom of A. caliginosus, is a single polypeptide-chain glycoprotein with a mol.wt of about 33,500, which contains 10.1% carbohydrate. The isoelectric point of the enzyme is 3.5 and the enzyme has 274 amino acid residues based on the mol.wt of 33,500. The enzyme hydrolyzed arginine esters more readily than lysine esters, but did not hydrolyze tyrosine ester. The activity of the enzyme on hydrolysis of arginine ester or on liberation of kinin from purified bovine high mol.wt kininogen was inhibited by diisopropylfluorophosphate, indicating that the serine hydroxyl group is involved in enzymatic activity. Moreover, the enzyme split N-alpha-carbobenzoxy-Gly-Pro-Arg-p-nitroanilide (PNA), H.D.Val-Leu-Arg-PNA, H.D.Pro-Phe-Arg-PNA, H.D.Phe-pipecolyl-Arg-PNA and Pro-Phe-Arg-4-methylcoumaryl-7-amide more readily than the other chromogenic or fluorogenic substrates. This result indicates that the substrate specificity of the enzyme is broader than that of mammalian serine proteinases.

[Antibody response to live rubella vaccination and its clinical meanings]

Serological antibody response for over a year to rubella live virus vaccination was examined by hemagglutination inhibition (HI) test and enzyme-linked immunosorbent assay (ELISA) of 22 seronegative and 25 seropositive sera of young women. In the seronegative group, some HI antibody response appeared first 2 weeks after the vaccination. A positive response of ELISA-IgM was first observed at 3 weeks, showing slowly declining values within the following year. Similarly, ELISA-IgG response occurred first and was positive 3 weeks later with gradual increases in both ELISA-values and positive ratios for 5 months. In the seropositive group, responses of both ELISA-IgM and -IgG were found within a few levels of ELISA-values from 2 weeks after the vaccination. Higher ELISA-IgM values observed after the natural infections than those following in the vaccination should be cited. These possibly show different amounts of viral antigens introduced in vivo. Reinfection of high HI antibody cases may be distinguished by small changes in the ELISA-value's pattern. When the above data are taken together, single measurement of ELISA-IgM does not seem to always be definitive and characteristic changes in positive patterns may be much more important in clinically diagnosing recent rubella virus infection.

[Studies on the management of pregnant women having high hemagglutination inhibition (HI) antibody titer of rubella virus in the first trimester examination of rubella virus antibody in the pregnant women having high HI titer by different methods and prognosis of their infants after birth]

Several serological studies of rubella virus (RV) infection were carried out on sera of 45 pregnant women having RV hemagglutination inhibition (HI) antibody titer more than 1:512 in the first trimester, including a follow-up study of these women's pregnancies. In order to detect RV-specific IgM antibody, various procedures were employed as follows: Complement fixation test (CF), HI test after treatment of the sera with Protein-A (ProA-HI), enzyme linked immunosorbent assay (ELISA) by indirect or sandwich procedures and several tests using fractionated sera by sucrose density gradient ultracentrifugation (SDG). Positive ratios found with the CF test and ProA-HI were 26.7% and 20.0%, respectively. In indirect ELISA, 4 cases were positive for RV-specific IgM, but all sera were negative in sandwich ELISA and SDG tests. Both RV isolation from urine of some infants and detection of high RV-specific IgM antibody in cord sera failed to be positive. Of 44 pregnancies, 4 cases resulted in spontaneous abortion and all others in normal delivery. These forty normal infants had no sign of congenital rubella syndrome, but one case among them showed polysyndactyly . The results obtained here seemed to indicate that sandwich ELISA is the most valuable and convenient method among the tested procedures for clinically determined diagnosis of recent RV infection in pregnant women having a high HI antibody titer.

Primary trabecular carcinoid of the ovary

A case of primary trabecular carcinoid of the ovary apparently occurring from the foregut element of a mature cystic teratoma was reported. The tumor was found incidentally and resected surgically from a 56-year-old female. The cystic teratoma found in the tumor was composed of only respiratory epithelium except a colliculus which showed a picture of tonsil-like tissue. No thyroid tissue was found. The trabeculae of the tumor cells were longer and wavier near the cystic teratoma, while they were straight and short at the periphery. The tumor cells had argyrophil granules but negative in argentaffin granules. The electronmicroscopy revealed many round neurosecretory granules measuring from 170 to 290 nm in diameter. The histogenesis was also discussed.

Histopathological evaluation of disseminated intravascular coagulation in Haemophilus somnus infection in cattle

The frequency and distribution of fibrin thrombi (microthrombi) in the main organs of spontaneously infected cattle were investigated to evaluate disseminated intravascular coagulation (DIC) in Haemophilus somnus infection. This infection is well known as infectious thrombo-embolic meningo-encephalitis (ITEME) and is characterized histopathologically by formation of thrombi, necrosis of blood vessels and neutrophil infiltration. The precise pathogenic mechanism of this disease has not yet been fully elucidated. The liver, spleen, kidney, lung, heart and brain of 11 cattle showing thromboembolic meningo-encephalitis were examined histopathologically and special attention was paid to fibrin thrombi. PTAH staining showed a high frequency of fibrin thrombi in the small vessels and capillaries in more than 3 organs and all the cases were regarded as falling within the histopathological criterion of DIC. The results of the present study indicate that the pathogenesis of the infection is closely related to the DIC.

[Clinical evaluation of sulbactam/cefoperazone in the field of obstetrics and gynecology]

One or 2 grams of sulbactam/cefoperazone (SBT/CPZ) in 250 ml of 5% glucose solution was administered twice daily by drip infusion to 10 patients with female genital organ infections. The clinical effectiveness was seen in 8 patients but not in 2 patients associated with emergence of replaced organism or non-eradicated causative organism. Antibacterial activity of SBT/CPZ vs. CPZ in the 20 clinical isolates revealed that SBT/CPZ was 1 or 3 tubes superior to CPZ alone in the beta-lactamase producing organisms, but, 1 or 2 tubes inferior to CPZ in the beta-lactamase non-producing organisms. In 1 case increases in GOT and GPT, and in another increases in GOT and GPT, and a decrease in platelets were observed even though their degrees were mild.

Dexamethasone enhances human cytomegalovirus replication in human epithelial cell cultures

An epithelial human hepatoma cell line (PLC/PRF/5) and a primary epithelial human baby kidney (HBK) cell culture showed restricted growth of human cytomegalovirus (HCMV). Treatment of these two epithelial cell cultures with dexamethasone greatly enhanced their ability to support HCMV replication. Growth kinetic experiments and infectious center assay revealed that in both the hormone-treated cultures infectious progeny virus appeared earlier by 1 or 2 days and 5- or 10-fold more cells are able to produce infectious virus. There was an approximate 50- or 100-fold increase in virus yield compared to that in the untreated control cultures. Enhanced HCMV replication in the hormone-treated cultures was not due to differences in the cell growth or the virus adsorption and was supported by evidence of increased synthesis of HCMV-specific immediate early antigens and DNA.

[Therapeutic effect of T-1982 (cefbuperazone) on the gynecologic infectious diseases]

T-1982 (cefbuperazone), a new cephamycin antibiotic with broad spectrum against Gram-positive, negative aerobic and anaerobic organisms, was clinically and bacteriologically evaluated on the gynecologic infectious diseases. Fourteen cases hospitalized at Kanazawa Medical University Hospital and the affiliated hospitals from October 1981 to July 1982 were treated with T-1982. By clinical symptoms, signs and bacteriological examinations the patients were diagnosed as pelveoperitonitis (1), intrauterine infection (3), adnexitis (3), infectious diseases of external genitalia (4), infectious abortion (1), vulvar hematoma (1), and rectovaginal fistula (1). T-1982 was administered intravenously or by drip infusion at a dose of 0.5-2.0 g twice a day after dissolved in a saline solution or a 5% glucose solution. Based on the improvement of clinical findings and antibacterial effect of T-1982, results were evaluated as excellent, good, poor and unknown. Clinical effects more than good were shown in 9 of 11 cases which could be followed up exactly on the therapeutic of T-1982. Two cases showing poor response were pelveoperitonitis and pyometra under carcinoma colli uteri stage IIIb, respectively. In 8 of 11 cases, antibacterial effect of T-1982 could be evaluated. Thirteen strains of aerobic and anaerobic bacteria were disappeared by T-1982 therapy, while no effect was seen on 5 strains. On the side effect of T-1982, exanthema was observed in 1 case but disappeared soon after the cessation of administration.

Evidence for early membrane antigens in cytomegalovirus-infected cells

Human cytomegalovirus (HCMV) induces membrane antigens (MA) which are detectable by immunofluorescent techniques as early as 24 h after infection. These antigens appear on the surface of infected cells in non-permissive human epithelioid and animal cells in addition to permissive human cells. The synthesis of the MA occurs in the presence of a DNA synthesis inhibitor, whereas RNA and protein synthesis inhibitors prevent its formation completely. These results demonstrate that the MA is a newly synthesized protein coded by an early function of the viral genome.

[Establishment of persistent cytomegalovirus infection in primary cultured trophoblastic cells (author's transl)]

The primary cultured cells (Ch) derived from chorionic villi were infected with human cytomegalovirus (CMV). The main results obtained are as follows. 1) The primary cultured trophoblastic cell (Ch) infected with CMV have been maintained in the state of CMV persistent infection for over 6 months. These cells (Ch/CMV) were the CMV-carrier cells in a balance between the cytolysis by CMV-specific cytopathic effect (CPE) and the growth of uninfected cells, showing the CMV persistent infection at the cell population levels. 2) The Ch/CMV cells have persistently released infectious CMV with titers ranging from 1.6 X 10(2) to 1.2 X 10(4) PFU/ml into the culture fluid. CMV-specific antigens were detectable by immunofluorescent antibody staining of the virus releasing cells. 3) These Ch/CMV cells still maintained an ability to secret estrone and estradiol. When these abilities lowered in the successive cultures, the cells encountered the cytolysis by CMV release. 4) Infectious titer of CMV released from Ch/CMV cells reduced by the addition of estrogen in the culture media. In this case, however CMV-specific CPE occurred with a similar pattern as the control one lacked an addition of estrogen. 5) It was suggested that estrogen synthesis in the cells may play an important role in an establishment or a maintenance of CMV persistent infection.

Neural changes in recurrent genital infection of infectious bovine rhinotracheitis virus in calves treated with dexamethasone

Recurrent genital infection with infectious bovine rhinotracheitis (IBR) virus was induced in calves by dexamethasone (DM) treatment 3 months after primary infection. The virus was first recovered from vaginal secretions on the 3rd day after the initiation of DM treatment; however, the virus was not recovered at all from nasal secretions or from the cerebrospinal fluid of the DM-treated calves. The significant neural changes in all recurrent infected calves were nonsuppurative poliomyelitis in the lumbosacral spinal cords and their ganglia, and they were more severe in the sacrospinal cords than in other parts of the spinal cord. The virus antigen was detected in the sacrospinal ganglia and peripheral nerve fibres in the submucosa of the vagina by the fluorescent antibody technique on the 4th and 6th days after the start of DM treatment. These observations indicated that nonsuppurative poliomyelitis may be a characteristic lesion in recurrent genital infection of IBR virus. The sacrospinal cords and ganglia are considered as latent sites of IBR virus.

Separation of cell-dependent antibody (CDA) and inhibitory antibody by protein-A affinity chromatography and the effect of fractions on antibody-dependent cellular cytotoxicity (ADCC)

The nature of cell-dependent antibody (CDA) and the mechanism of inhibition of antibody-dependent cellular cytotoxicity (ADCC) were studied in the ADCC assay system in which culture cells of methylcholanthrene-induced rat fibrosarcoma (KMT-50) were used as target cells, xenogeneic antiserum (rabbit anti-KMT-50) as the CDA, and human peripheral blood leucocytes (PBL) as effector cells, respectively. By using protein-A Sepharose CL-4B affinity column chromatography of rabbit anti-KMT-50 serum, CDA was shown to bind protein A. Complement dependent-cytotoxicity (CDC), however, was demonstrated in both the adsorbed fraction (eluate) and the non-adsorbed fraction (effluent) to protein A from the same affinity column chromatography. These data confirmed that CDA was IgG with an intact Fc portion. Inhibition of ADCC occurred by pretreatment of effector cells with rabbit anti-effector (human PBL) serum even with extremely small amounts of antiserum. Such inhibition was demonstrated with the eluate but not with the effluent from protein-A Sepharose CL-4B affinity column chromatography of rabbit anti-effector serum. F(ab')2 fragments of the same eluate (IgG) did not inhibit the ADCC activity. These data showed that the inhibition of ADCC was induced by the blocking of Fc receptors of effector cells with the Fc portions of IgG in anti-effector serum. The data obtained indicate the usefulness of protein A in separation and analysis of CDA and in investigation of the inhibitory mechanisms of ADCC.