Association of polymorphisms in complement component C3 gene with susceptibility to systemic lupus erythematosus.

OBJECTIVE: Identification of the genes responsible for systemic lupus erythematosus (SLE). METHODS: All the exons and putative promoter regions of 53 candidate genes (TNFRSF6/Fas, TNFSF6/FasL, Fli1, TNFSF10/TRAIL, TNFSF12/TWEAK, Bcl-2, PTEN, FADD, TRADD, CDKN1A, TNFRSF1A/TNFR1, TNFRSF4/OX40, TNFSF4/OX40L, TNFSF5/CD40L, TNFSF13B/BAFF, ICOS, CTLA4, CD28, FYN, G2A, CR2, PTPRC/CD45, CD22, CD19, Lyn, PDCD1, PTPN6, TGFB1, TGFB2, TGFB3, TGFBR1, TGFBR2, TGFBR3, CD3Z, DNASE1, APCS, MERTK, C3, C1QA, C1QB, C1QG, C2, MBL2, IGHM, IL-2, IL-4, IL-10, IFNG, TNFA, MAN2A1, TNFRSF11A/RANK, TNFRSF11B/OPG, TNFSF11/OPGL) were screened for single nucleotide polymorphisms (SNPs) and their association with SLE was assessed by case-control studies. A total of 509 cases and 964 controls of Japanese descent were enrolled. RESULTS: A total of 316 SNPs was identified. When analysed in the Japanese population, the allele frequencies of T at rs7951 and G at rs2230201 of the C3 gene were 0.110 and 0.626, respectively, in SLE patients; significantly higher than the frequencies of 0.081 and 0.584, respectively, in controls [odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.05-1.86, P = 0.016 and OR=1.19, 95% CI = 1.01-1.41, P = 0.038, respectively]. The mean serum C3 level of carriers of the rs7951 T allele was significantly lower than that of non-carriers of the T allele in 87 SLE patients whose medical records were available (P = 0.0018). CONCLUSION: rs7951 T allele of the C3 gene was significantly associated with SLE, and decreased serum level of C3 seems to be correlated with this allele.

X-ray crystal structure determination and molecular dynamics simulation of prophospholipase A2 inhibited by amide-type substrate analogues.

X-ray crystal structures of bovine pancreas prophospholipase A2 (proPLA2) inhibited by two amide-type inhibitors, [(R)-2-dodecanoyl-amino-1-hexanolphosphocholine (DAHPc) and (R)-2-dodecanoylamino-1-hexanolphosphoglycol (DAHPg)], were determined to R = 0.208 and 0.215 using reflections with up to 2.1 A resolution, respectively. Both complex crystals lacked defined electron densities for the prosequence of the N-terminal and for a loop region consisting of residues 65-70, retaining the disordered feature observed in free proPLA2 despite stabilization due to complex formation. The polar and nonpolar moieties of the amide-type inhibitors were located in the calcium-binding pocket and in the N-terminal alpha-helical hydrophobic region of the enzyme, respectively. As for the amide group of the inhibitor, which is lacking in the true substrate, a strong hydrogen bond was formed between the NH of the inhibitor and the unprotonated N(delta1) atom of His-48, resulting in the tight binding of the inhibitor to proPLA2, as well as to PLA2. The 20-30 times more potent inhibitory activity of DAHPg than DAHPc toward PLA2 could be explained by hydrogen bond formation between the glycol OH of DAHPg and the carbonyl O of Asp-49. The seven residues of the N-terminal prosequence of proPLA2, though disordered, block the access of a water molecule to Ala-1 of PLA2 or change the hydrogen-bonding property of Ala-1 alpha-amino group, resulting in breakage of the water-mediated hydrogen-bond network which is commonly formed in PLA2. The results of molecular dynamics (MD) calculation in an aqueous solution at 300 K indicate that this, rather than the close contact between the prosequence and the residues 65-70 loop region, is the main reason why the latter region becomes flexible in proPLA2, compared with in PLA2.

Ganciclovir is effective for prophylaxis and treatment of human herpesvirus-6 in allogeneic stem cell transplantation.

Human herpesvirus 6 (HHV-6) infection and disease are serious complications of allogeneic hematopoietic stem cell transplantation (allo-SCT). Ganciclovir (GCV) is effective against HHV-6 in vitro but the antiviral susceptibility of HHV-6 has not been well characterized in vivo. We retrospectively compared the HHV-6 reactivation rate in pediatric allo-SCT recipients with and without GCV prophylaxis. The HHV-6 reactivation rate at 3 weeks after allo-SCT in patients without prophylactic GCV administration was significantly higher than that in those receiving prophylactic GCV (11/28 vs 0/13, P < 0.01). Five of 36 patients without prophylactic GCV showed clinical manifestations including skin rash, interstitial pneumonitis, persistent thrombocytopenia, enterocolitis and thrombotic microangiopathy, respectively. HHV-6-associated symptoms were observed in one of the 13 patients receiving prophylactic GCV. This patient showed fever, diarrhea and graft rejection concomitantly with a sudden increase of HHV-6 DNA copy number. Patients who received GCV for treatment of HHV-6 infection showed an improvement in symptoms and/or decrease of HHV-6 copy number. Thus, GCV is effective for treating HHV-6 disease after allo-SCT in vivo.

Foscarnet therapy for ganciclovir-resistant cytomegalovirus retinitis after stem cell transplantation: effective monitoring of CMV infection by quantitative analysis of CMV mRNA.

We report three pediatric patients with ganciclovir-resistant cytomegalovirus (CMV) retinitis who were successfully treated with foscarnet. The patients were recipients of hematopoietic stem cell transplantation (SCT) from HLA-mismatched donors. Because these patients had developed or experienced progressive CMV retinitis during ganciclovir therapy, they received foscarnet therapy at 60 mg/kg every 8 h. Their retinitis resolved promptly after initiating foscarnet therapy, suggesting foscarnet's effectiveness in treating ganciclovir-resistant CMV infection. The amount of CMV mRNA was quantitatively measured using an NASBA technique, which amplified the beta2.7 transcripts specific for CMV replication. This technique was useful for monitoring disease activity in a more rapid and sensitive manner than the PCR assay for CMV DNA.

Dissociation of impairment between spatial memory, and motor function and emotional behavior in aged rats.

We investigated changes in learning and memory in aged rats, in relation to motor function and emotional behavior. Male Kbl Wistar aged rats (108-weeks-old) were divided into two groups, memory impaired and non-impaired, based on performance during six training trials in the Morris water maze task. Aged rats with a goal latency longer than the mean plus the 99% confidence limit of young rats, were regarded as memory impaired, whereas those with a goal latency within the range of the 99% confidence limit of the mean of young rats, were considered as memory non-impaired. Although the performance of the memory impaired aged rats in the standard test of the Morris water maze improved after six re-training trials to the level of the non-impaired aged rats and young rats, working memory impairment was evident. There were no differences in motor function and emotional behavior between the impaired and non-impaired aged rats. These results suggest that deficits of learning and memory in memory impaired aged rats can be dissociated from changes in motor function and emotional behavior.

Pigments from the cultured lichen mycobionts of Graphis scripta and G. Desquamescens.

Two new pigments, named grapheone and graphisquinone, were identified in the cultures of the spore-derived mycobionts of the lichens Graphis scripta and Graphis desquamescens, respectively.

5-Deoxy-7-methylbostrycoidin from cultured mycobionts from Haematomma sp.

An unusual alkaloid, the 2-aza-anthraquinone derivative, 5-deoxy-7-methyl bostrycoidin, was identified in the cultures of the spore-derived mycobionts of the lichen Haematomma sp., but not in the natural lichen thallus.

Regulation of androgen synthesis: the late steroidogenic pathway.

Studies of the regulation of androgen synthesis in steroidogenic cells have focused on both transcriptional and post-translational regulation of the proteins that catalyze these reactions: the P450c17 that catalyzes the production of DHEA or androstenedione in consecutive hydroxylase and lyase activities, and the 17 beta-hydroxysteroid dehydrogenase (17 beta-HSD) that catalyzes the conversion of androstenedione to testosterone. Our studies of the regulation of the CYP17 lyase activity at the molecular level have utilized species- and tissue-specific differences to identify target regulatory sequences. Adenovirus infection of rat CYP17 promoter/luciferase reporter gene constructs in primary cultures of rat adrenal and rat Leydig cells revealed a rat-specific domain between-1 and -108 bp that cause inhibition of both basal and cAMP-induced CYP17 transcription in the adrenal, but not the Leydig cell. In contrast, similar promoter constructs from other species exhibited substantial cAMP-induced transcriptional activity in the rat adrenal. Mutagenesis of the conserved region of the rat and human proteins reveals significant differences in the amino acid domains required for hydroxylase and lyase activities within and between the two species, consistent with their differential regulation of lyase activity. The 17 beta-hydroxysteroid dehydrogenase (17 beta-HSD) reaction requires a viable glucose transporter system for optimal activity, and a high-energy phosphate was discovered to be the requisite product of glucose metabolism in 17 beta-HSD activation. These studies have provided insight into potential mechanisms of control of androgen synthesis in the late steroidogenic pathway, at the transcriptional and post-translational levels.

Remission of progressive multifocal leukoencephalopathy following highly active antiretroviral therapy in a patient with HIV infection.

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease resulting from lytic infection of oligodendrocytes by the papovavirus JC (JCV). PML has also been recognized as an AIDS-defining illness. The incidence of PML has increased since 1987 and it occurs in up to 4% of patients with AIDS. To date, there is no treatment available for PML and it usually results in death within 3-6 months of diagnosis. However, there are some reports of remission of PML after antiretroviral therapy. We report a 12-year-old child with hemophilia B and developing AIDS with the onset of PML. With highly active antiretroviral therapy, PML subsided with an increase of CD4 count from 10 to 300/microl in spite of about 1.0 X 10(4) human immunodeficiency virus (HIV)-1-RNA copies. He has survived more than 1 year without specific therapy against JCV. Highly active antiretroviral therapy appears to have improved his prognosis in HIV-associated PML.

Malignant peripheral nerve sheath tumors of intrathoracic vagus nerve.

The authors report two cases of malignant peripheral nerve sheath tumors arising from the vagus nerve in the mediastinum in patients who had no stigmata of neurofibromatosis (von Recklinghausen's disease). Computed tomography showed homogeneous soft tissue masses, with minimal calcification seen in one patient. T2-weighted magnetic resonance images showed regions of low signal intensity caused by a dense cellular population.

Clinical significance of coronary artery calcification.

Coronary artery calcification (CAC) was easily demonstrated by plain CT-scan. The aim of this study was to clarify the clinical significance of CAC in cardiovascular diseases. The subjects were 90 patients with ischemic heart disease (30 myocardial infarction, 50 exertional angina pectoris and 10 variant form of angina pectoris; 46 males and 44 females, 68 +/- 10 y/o) and 50 patients without ischemic heart diseases (30 hypertension, 10 arrhythmia, 3 valvular disease, 2 cardiomyopathy, 2 congenital heart disease and 3 others; 25 males and 25 females 65 +/- 9 y/o). CAC and calcification of thoracic aorta were evaluated by plain CT-scan (1 second scan time and 5 mm slice). The relationship between CAC and other clinical features (age, sex, hypertension, diabetes mellitus, hyperlipidemia, smoking, resting ECG, exercise stress ECG, aortic calcification and optic fundi) were studied. CAC were seen more frequently in patients with ischemic heart disease (63%), old age (67%), aortic calcification (70%) and positive exercise testing (64%). On the other hand, CAC were rare in variant angina (30%). In younger patients (under 70 y/o), CAC were seen more frequently in diabetic patients. But, in older patients, CAC were frequently in those with hyperlipidemia. These results suggested that CAC was associated with not only systemic arteriosclerosis, but also ischemic heart disease, except vasospastic angina. The prognostic value of CAC would be studied later.

A case of right-sided aortic arch with isolation of the left subclavian artery: CT findings.

We report a case of right-sided aortic arch with isolation of the left subclavian artery diagnosed using computed tomography (CT). This was a rare type in which the left subclavian artery, originating from the pulmonary artery via the arterial duct, was isolated after closure of the ductus. Collateral circulation was considered to be obtained mainly from the left intercostal artery via the costocervical trunk through the supreme intercostal artery.

A case of isolated esophageal cyst in the posterior mediastinum.

We report a rare case of posterior mediastinal esophageal cyst associated with pulmonary anomaly that had no connection with the proper esophagus, on either CT or MRI, and suggest including this entity in the differential diagnosis of posterior mediastinal masses.

Involvement of reactive oxygen species in the induction of (S)-N-p-coumaroyloctopamine accumulation by beta-1,3-glucooligosaccharide elicitors in potato tuber tissues.

Treatment of potato tuber tissues with beta-1,3-glucooligosaccharide induces accumulation of (S)-N-p-coumaroyloctopamine (p-CO). We examined the role of reactive oxygen species (ROS) and nitric oxide (NO) in the signal transduction leading to p-CO accumulation. Induction was suppressed by an NADPH-oxidase inhibitor, diphenyleneiodonium chloride, and oxygen radical scavengers. H2O2 was generated in the tuber tissue within a few minutes of treatment with beta-1,3-glucooligosaccharide. On the other hand, treatment with NO specific scavenger, nitric oxide synthase inhibitor, and serine protease inhibitor did not inhibit p-CO induction. Our findings suggest that ROS generated by the action of NADPH-oxidase play an important role in this system, while NO and serine protease are unlikely to be involved in this process.

Beta-1,3-glucooligosaccharide induced activation of four enzymes responsible for N-p-coumaroyloctopamine biosynthesis in potato (Solanum tuberosum cv.) tuber tissue.

Potato tuber disks, when treated with laminarin, a beta-1,3-glucooligosaccharide from Laminaria digitata, accumulate a hydroxycinnamoyl amide compound, N-p-coumaroyloctopamine (p-CO). The biosynthesis of p-CO was investigated by feeding experiments, in order to show that the precursors of N-p-coumaroyl and octopamine moieties of p-CO are L-phenylalanine and L-tyrosine, respectively. The treatment of potato tuber tissue with laminarin resulted in elevated activities of four enzymes which are putatively involved in p-CO biosynthesis: phenylalanine ammonia lyase (PAL; EC 4.3.1.5), 4-hydroxycinnamic acid:CoA ligase (4CL; EC 6.2.1.12), hydroxycinnamoyl-CoA:tyramine N-(hydroxycinnamoyl)transferase (THT; EC 2.3.1.110) and tyrosine decarboxylase (TyrDC; EC 4.1.1.25). Among these, the response of TyrDC was specific to laminarin treatment, thus indicating that the regulation of TyrDC activity is critical for the accumulation of p-CO in potato tuber tissue.

Structure-activity relationship study of host-specific phytotoxins (AM-toxin analogs) using a new assay method with leaves from apple meristem culture.

AM-toxins are host-specific phytotoxins of the Alternaria alternata apple pathotype, which induce necrosis on apple leaves. In this study, we developed a new assay to measure the necrotic activity of AM-toxin analogs using cultured leaves from meristem cells. This method was not only more sensitive to AM-toxin I, but also more reliable than the previous one that used tree leaves due to the homogeneous nature of cultured leaves and to the method of application of toxins. Using this assay method we investigated a structure-activity relationship of AM-toxin analogs synthesized in this study. Most residues and the macrocyclic ring structure were strictly recognized by AM-toxin putative receptor, whereas the L-Ala binding subsite of the receptor allowed for side chain structures with various stereoelectronic properties. These findings are important for designing ligands for further experimental probing of the nature of the receptor.

Is diabetes mellitus a major risk factor in coronary artery bypass grafting? The influence of internal thoracic artery grafting on late survival in diabetic patients.

OBJECTIVE: The presence of diabetes could possibly have an adverse influence on the late results of coronary artery bypass grafting (CABG). A retrospective observational risk-unadjusted estimation study was conducted to clarify the magnitude of this unfavorable influence of diabetes based on our experience at Juntendo University. METHODS: Between January 1984 and December 1995, 1,618 primary CABG operations were performed and 99.0% of these patients were followed up for a mean period of 81.2 months with a maximal follow-up of 14 years. Among the 1,610 patients who were successfully followed up, 523 patients (32.5%) were diabetic and this cohort was compared with 1,087 nondiabetic patients regarding the patient profiles, perioperative outcome, and the long-term outcome. RESULTS: Diabetic patients included a higher proportion of females, a greater preoperative presence of renal insufficiency, a higher rate of three vessel disease, and reception of a greater number of grafts (mean: 2.5 versus 2.4) and an internal thoracic artery graft (68% versus 58%). Hospital mortality was not significantly different (2.1% vs 1.0%: ns). An actuarial analysis revealed a significantly unfavorable long-term survival in the diabetic group (59.6%) at 14 years, compared with the nondiabetic group (73.4%), however diabetic patients with an internal thoracic artery graft had a favorable long-term survival (82.0%) at 13 years, and this finding was almost identical to that of nondiabetic patients with an internal thoracic artery graft (88.5%). CONCLUSION: We conclude that the presence of diabetes appears to be a major risk factor in patients undergoing CABG. However, diabetic patients with an internal thoracic artery graft had a survival almost identical to that of nondiabetic patients with an internal thoracic artery graft.

[Incidence of pulmonary tuberculosis among workers of NTT in Tokyo area--annual transition by sex and age].

We investigated incidence of pulmonary tuberculosis for 31 years (from 1960 to 1990) by sex and age among workers of NTT (Nippon telegraph and telephone corporation) in Tokyo area. Annual transition of recent years was mainly analyzed and following results were obtained. (1) Incidence in male of the twenties, thirties and forties decreased smoothly from 1960 to around 1980, then came to standstill and increase tendency was suspected, that is to say, 1) incidence in male of the twenties was minimum in 1976 (21 per 100,000 persons). Annual reduction rate (minus means decrease, plus means increase) from 1960 to 1976 was -11.7% and that from 1977 to 1990 was -0.4%. 2) incidence in male of the thirties was minimum in 1983 (0 per 100,000 persons). Annual reduction rate from 1960 to 1982 was -8.8% and that from 1984 to 1990 was +6.8%. 3) incidence in male of the forties was minimum in 1981 (0 per 100,000 persons). Annual reduction rate from 1960 to 1980 was -11.5% and that from 1982 to 1990 was +1.3%. (2) Incidence in male of the fifties decreased gradually from the 1960's and no tendency of increase was observed. (3) Incidence in female of the twenties, thirties and forties decreased almost continuously from 1960 to 1990 and no tendency of increase was observed in each age group, but total incidence in female (from the teens to the sixties) seemed to be leveling off after 1979. From these results, stagnant or increase tendency of pulmonary tuberculosis in young and middle-aged male was noticed.

[Results of initial bacteriology of pulmonary tuberculosis among male NTT employees in the Tokyo area--annual transition and influence of fiberoptic bronchoscopy].

A study was made on the annual changes in the positive rate for acid-fast bacilli (AFB) at the initial bacteriological examination of newly detected pulmonary tuberculosis among male NTT (Nippon Telegraph and Telephone Corporation) employees in the Tokyo area during a period of 32 years from 1960 through 1991. The influence on the changes of recent introduction of fiberoptic bronchoscopy for obtaining the specimen was also analyzed, and the following results were obtained. 1. Results obtained by the conventional bacteriological method using expectorated sputum or aspirated gastric juice as the specimens. (1) The annual incidence of bacteriologically positive (smear and/or culture positive) cases constantly decreased and reached the lowest in 1981, then ceased to decline and remained at the level of 1981. (2) The annual ratio of AFB positive by smear and the ratio of smear and/or culture positive cases to the newly detected cases of pulmonary tuberculosis were constant during the entire observation period. (3) The ratio of AFB positive by smear to the newly detected cases annually increased but did not increase when the observation period was limited to within 1976 to 1991. 2. Results obtained by fiberoptic bronchoscopy in combination with conventional bacteriological methods. (1) Both the annual incidence of smear and/or culture positive cases and the ratio of these cases to the newly detected cases of pulmonary tuberculosis showed a tendency to increase in both the 80's and 90's.(ABSTRACT TRUNCATED AT 250 WORDS)

[Operative indication and risk factors for unruptured cerebral aneurysms].

Operative indication and risk factors for unruptured cerebral aneurysms were discussed. During the past 11 years, 38 aneurysms in 33 patients with a mean age of 54 years were operated on. All aneurysms were located in the anterior circulation; 16 were of carotid artery, 15 of the middle cerebral artery, 4 of the anterior communicating artery, and 3 of the distal anterior cerebral artery. Six cases (18.2%) developed neurological deficits postoperatively. The deficits were permanent in 3 cases (morbidity 9.1%). There was one operative death (mortality 3.0%). Operative risk factors were analyzed in 4 particular cases. Of these 4 cases, two cases had large aneurysms (14 and 16mm in diameter) located at carotid-ophthalmic and at the inferior wall of the carotid arteries, respectively. One developed unilateral blindness possibly due to operative manipulation, and the other showed hemiparesis with aphasia due to postoperative carotid stenosis caused by clipping. Of the rest 2 cases; one with multiple (carotid and middle cerebral) aneurysms developed hemiparesis because of postoperative stenosis of the atheromatous parent artery caused by clipping, and the other, with a large (17mm) aneurysm at the distal anterior cerebral artery, died of postoperative intracerebral hematoma. Both of these cases were associated with cerebral ischemic disease. All cases that developed postoperative neurological deficits had varying degrees of hypertension. Reviewing our series and other reports, it can be said that age is one of the most important factors that influence operative mortality. However, a lower risk of rupture develops as age increases. For those under 70 years of age, operation is considered safe in healthy individuals, especially among those without hypertension. However, in cases where there are large aneurysms, multiple lesions, less accessible locations and cerebral ischemic disease, operative risks should be kept in mind. Operative morbidity in these cases is relatively high compared to that found among others. Therefore, planning a meticulous surgical strategy and further careful operative manipulation are essentials, when surgical treatment is indicated.