[A case of Sjögren's syndrome presenting with hypokalemic myopathy due to renal tubular acidosis].

A 37-year-old woman was admitted to our university hospital because of severe flaccid quadriplegia. Her laboratory data, lip biopsy and muscle biopsy findings were compatible with hypokalemic myopathy due to renal tubular acidosis(RTA) type I associated with primary Sjögren's syndrome. Kidney biopsy revealed chronic tubulointerstitial nephritis(TIN), consisting of focal mononuclear cell infiltration with tubulitis, interstitial fibrosis and tubular atrophy. Immunohistochemical analysis of the renal biopsy specimens showed that the infiltrating mononuclear cells were predominantly CD8+T cells, and CD68+ cells(macrophages), whereas CD4+ T cells were fewer in number. Following potassium administration and alkali therapy, hypokalemia and metabolic acidosis were ameliorated and limb palsy gradually subsided. Finally, RTA improved with prednisolon and short term cyclophosphamide treatment without supplemental potassium and alkali therapy.

Transcription of emrKY is regulated by the EvgA-EvgS two-component system in Escherichia coli K-12.

Spontaneous mutations have been isolated in Escherichia coli that result in the constitutive expression of an emrKY promoter. These mutations were found to be single-nucleotide substitutions within the linker region of the sensor protein EvgS, which is part of a two-component regulatory system along with EvgA. In the linker mutants (evgSI and evgS4), emrKY expression became constitutive and MIC against sodium deoxycholate was 20 mg/ml, eight-fold higher than in the wild type. Furthermore, the start site of transcription from the promoter of emrKY was identified; EvgA was shown to bind at the -52 to -84 region by the footprinting experiment.

Histochemical and Ultrastructural Analyses of the Epithelial Cells of the Body Surface Skin from the Terrestrial Slug, Incilaria fruhstorferi.

Dorsal and ventral epithelium of the terrestrial slug, Incilaria fruhstorferi, is simple and consists of five cell types: microvillous, ciliated, round mucous, tubular mucous and channel. Microvillous cells were similar to human intestinal epithelial cells morphologically and functionally. At the base of microvilli, pinocytic vesicles which ultimately fused to form larger vacuoles, or multivesicular bodies were present. At the edge of tail or mouth, ciliated epithelial cells possessed the typical axonemes (9 plus 2 arrangement of microtubles). Mucous secretory cells were either tubular or round and their granules were membrane-bound and secreted by exocytosis. Granules of round mucous cells were proteinaceous but those of tubular cells were acidic mucopolysaccharides. Channel cells were elongate U-shaped and the central lumen was filled with a large amount of fluid (hemolymph). The function of channel cells is thought to remove hemolymph accumulated during hyperhydration. Our experiments of some markers-injection revealed that the fluid containing large molecules passed transcellularly from the hemolymph, across the basal or side region of the cell and into the central lumen. These results suggest that channel cell of the slug skin and vertebrate nephron showed some parallels in structure and function.

Comparisons between radioactive and non-radioactive gas lantern mantles.

Gas lantern mantles containing radioactive thorium have been used for more than 100 years. Although thorium was once believed to be indispensable for giving a bright light, non-radioactive mantles are now available. From the radioactivities of the daughter nuclides, we estimated the levels of radioactivity of 232Th and 228Th in 11 mantles. The mantles contained various levels of radioactivity from background levels to 1410 +/- 140 Bq. Our finding that radioactive and non-radioactive mantles are equally bright suggests that there is no advantage in using radioactive mantles. A remaining problem is that gas lantern mantles are sold without any information about radioactivity.

Monitoring of 3H surface contamination by noncontact radioluminography.

A phosphor screen imaging technique has been developed to detect 3H contamination on floor surfaces. A 3H imaging plate is elevated a maximum of 0.1 cm above the surface being monitored. This technique prevents the imaging plate from being cross-contaminated. Unlike the traditional smear test, this technique can be used to monitor fixed contamination.

Cloning and sequencing of three C-type lectins from body surface mucus of the land slug, Incilaria fruhstorferi.

Three C-type lectins of 15 kDa were isolated from the water-soluble fraction (WSF) of the body surface mucus of the land slug, Incilaria fruhstorferi. Based on their partial amino acid sequences, the nucleotide sequences of cDNAs encoding these lectins, named incilarin A, B and C, were determined. cDNAs of incilarin A, B and C consisted of 673, 663 and 715 bp, and deduced amino acids were 150, 149 and 156 residues, respectively. All three lectins had signal peptides of 17 amino acid residues at their N-termini. They showed 44-55% amino acid sequence identity with each other, and lower but significant homology with the other animal C-type lectins and antifreeze protein. Incilarin A and B seem to possess two intramolecular disulfide bonds in the carbohydrate-binding domain (CRD) conserved among the animal C-type lectins, however, one of these bonds is absent in incilarin C.

Syndrome of inappropriate secretion of antidiuretic hormone in elderly patients with rheumatoid arthritis associated with infections: report of two cases.

Two rheumatoid arthritis (RA) patients with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) during the course of infection are herein reported. One patient developed SIADH during the course of a localized cutaneous herpes zoster infection while the other developed SIADH in conjunction with Staphylococcus simulans septicemia. We consider that the development of SIADH was strongly associated with superimposed infections in the underlying RA. This is the first report discussing the association of SIADH and infections in RA patients in which SIADH is diagnosed by measurement of plasma ADH.

Incilaria mucus agglutinated human erythrocytes.

The body surface mucus from the land slug, Incilaria fruhstorferi, not only opsonized sheep red blood cells (SRBC) and agglutinated human types A and B erythrocytes (HRBC) but also caused hemolysis of B type HRBC 12 h after agglutination. The mucus-induced hemagglutination was specifically inhibited by a low concentration of N-acetyl D-galactosamine (GalNAc), and all of this activity was completely inactivated by heating at 56 degrees C for 30 min. SDS-polyacrylamide gel electrophoresis of water soluble fraction of the mucus showed that this fraction contained several proteins, the molecular mass of the main band being 35 KD.

Blood cell-producing site in the land slug, Incilaria fruhstorferi.

Blood cell-producing site in a yeast-particle-injected slug, Incilaria fruhstorferi, was studied by light and electron microscopy, in vivo and in vitro. Cells lining the vascular system and hemocoel wall were discontinuous, scattered, and morphologically resembled fibroblasts. One hour after injection of yeast-particles as foreign material, the lining cells projected into the lumen and 3 h later, the cells were gradually released from the wall. They were morphologically similar to macrophage-like cells that phagocytose foreign material. In tissue culture of the hemocoel wall from yeast-injected slugs, cells that migrated from the explants consisted mainly of fibroblast- and macrophage-like cells. These two kinds of cells were weakly positive to non-specific esterase reaction, whereas circulating hemolymph cells were strongly positive. After administration of bromodeoxy-uridine (BrdU), labeled cells were most commonly found in the ventral side of the body and around the hemal space of the center of the dorsal wall. These results agree with our hypothesis that fibroblasts in the connective tissue of the hemocoel wall of the land slug can transform into macrophages of hemolymph.

Methotrexate for steroid-resistant systemic lupus erythematosus.

We here report two patients with steroid-resistant systemic lupus erythematosus (SLE) who were successfully treated with methotrexate (MTX). In both cases, a steroid resistant high fever, associated with mild myositis and pancytopenia were the main common findings, and all these symptoms were alleviated within a few days either by 7.5 mg or 5 mg MTX per week. The number of CD4+ cells increased along with the clinical improvement, whereas the number of CD20+ cells and HLA-DR expressing cells also decreased. Taking into account the side effects of high dose corticosteroids and cyclophosphamides, treatment with a weekly low dose of MTX is known to contribute to an improvement in the long-term prognosis for patients with refractory SLE.

[The comparison of clinical features between early rheumatoid arthritis and established rheumatoid arthritis].

Clinical features between 69 early RA patients (within a year duration) and 79 established RA patients (more than 3 years duration) were compared retrospectively. There were no significant differences about frequencies of morning stiffness (68.2% vs 54.4%) and rheumatoid nodules (20.2% vs 15.2%) between early RA and established RA. There were also no significant differences between two groups about elevation of ESR (92.8% vs 97.4%), positivity of CRP (97.1% vs 94.9%) and rheumatoid factor (RF) (82.6% vs 93.7%), and Lansbury activity index (AI) (mean 68.8% vs 78.8%). After hospitalization and treatment, all clinical indices (ESR, CRP, RF, AI) improved significantly in both groups. There, however, were clinically more "marked improvement" (39.1% vs 16.4%) and "remission" (8.7% vs none) in early RA group. We conclude that by hospitalization and treatment, clinical improvement can be expected in both early and established RA, but to secure satisfactory improvement, early detection and intervention of RA would be recommended.

Hemolymph cells and the platelet-like structures of the land slug, Incilaria bilineata (Gastropoda: Pulmonata).

3 morphologically distinct hemolymph cell-types, Types I, II and III, were found by light and electron microscopy of hemolymph from the land slug, Incilaria bilineata. In addition, vast numbers of the platelet-like structures were present in the collected hemolymph. Type I cells were macrophage-like, Type II cells were lymphocyte-like and Type III cells were fibroblast-like. Among these hemolymph cells, only Type I cells could recognize foreign materials and phagocytose them. Type I cells, whether from circulating hemolymph or from the heart-kidney region (regarded as a hemopoietic organ), could be maintained for only 4 d in cultivation because the cells gradually divided within 3 or 4 d. Thus, the platelet-like structures appear to be derived from Type I cells, which readily fragmentize and function by clamping onto foreign materials.

Phagocytosis by hemolymph cells of the land slug, Incilaria fruhstorferi Collinge (Gastropoda: Pulmonata).

Phagocytosis by hemolymph cells of the land slug, Incilaria fruhstorferi Collinge, were studied with the scanning electron microscopy (SEM) and the transmission electron microscopy (TEM). The fate of foreign materials, i.e., sheep red blood cells (SRBC) and latex beads, introduced into the hemocoel of the slug were followed. Certain hemocytes named as Type I cell were involved in spontaneous cyto-adherence while both Type II and III cells were not observed to adhere to foreign materials. SRBC and latex beads (luminal diameter 0.79 micron) were phagocytosed and latex beads (luminal diameter 15.8 micron) were engulfed by Type I cells. In vitro phagocytosis experiments showed that SRBC formed the rosette structure surrounding a Type I cell and both SRBC and latex beads (luminal diameter 0.79 micron) were swallowed by Type I cells in vivo. The plate-like structures with long fine fibers attached the latex beads. The latex beads were often seen deep in the aggregates of plate-like structures.

The ultrastructure of hemolymph cells of the land slug, Incilaria fruhstorferi Collinge (Gastropoda: Pulmonata).

3 morphologically distinct hemolymph cell-types, Type I, II and III, were found in the hemolymph of the land slug, large Japanese native slug, Incilaria fruhstorferi Collinge. Type I cell, measuring approximately 35 microns in diameter, had extensive pseudopodia with supporting ribs and a kidney-shaped or lobulated nucleus. Sometimes it possessed long filopodia (approximately 50 microns) with branched fibers. It contained residual bodies, multivesicular bodies, Golgi apparatus, free ribosomes and glycogen-like deposits. Type II cell, approximately 5 microns in diameter, did not form large pseudopodia, had a higher nucleus to cytoplasm ratio. It contained scattered free ribosomes surrounding the round nucleus. Type III cell, approximately 75 X 15 microns, was a fibroblast-like cell. It contained microfibrils at the rim of perinuclear cytoplasm and possessed collagen-like fibers outside of the cytoplasmic membrane. Numerous plate-like structures, which had not been reported yet, were usually observed. They, measuring 1 to 5 microns in diameter, were oval, but when in contact with glass, they possessed long and fine fibers. They lacked nucleus.

Nerve fiber caliber analysis in the mouse facial trunk distal to the stylomastoid foramen with the electron microscope.

Nerve fiber counts and caliber analysis were performed with the electron microscope on 5 facial trunks distal to the stylomastoid foramen from 3 mice. On an average, about 89% of the total nerve fibers (3,205) were myelinated and about 11% unmyelinated. Majority (80.5%) of the myelin sheaths of the myelinated fibers in the nerves were 2.0-4.5 microns and majority (86.4%) of their axons were 1.0-3.0 micron in minor diameter. Their frequency distributions were similar in pattern to that of the large fiber zone of the motor root of the mouse facial nerve. Majority (86%) of the unmyelinated fibers in the facial trunk distal to the stylomastoid foramen were 0.1-0.5 micron in minor diameter. Its frequency distribution showed that the unmyelinated fibers of the facial trunk tend to be rather smaller than that of the other nerves examined in the previous studies. Ratios of the circumferential length of the myelinated fibers to that of the circles with the same areas ranged from 1.00 to 1.98, with 1.02-1.10 being most frequent (72%). Ratios of the axons of the myelinated fibers ranged from 1.00 to 2.54, with 1.04-1.14 being most frequent (51.8%). Ratios of the unmyelinated fibers ranged from 1.00-1.18 (84%), and those which over 1.20 were rare.

Ganglion cells in the facial nerve trunk of the mouse.

Numbers and distribution of the ganglion cells in the facial trunk distal to the ggl. geniculi of the mouse were examined with the light microscope. Counts of the ganglion cells in 22 nerves from 14 mice showed that all specimens contained some ganglion cells and numbers of the ganglion cells were various (1--80) and, on an average, there were 24 ganglion cells in each facial trunk. Ganglion cells existed most frequently in the dorsal corner and the dorso-lateral border of the small fiber zone of the facial trunk near the level of the origin of the n. stapedius. Also they were often found in the facial trunk near the origin of the chorda tympani and near the cross contact of the r. auricularis n. vagi with the facial trunk. These ganglion cells may be sensory neurons.