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Objective Emphysematous cystitis (EC) has a high mortality rate compared with urinary tract infection without emphysema. However, its prognostic factors have yet to be determined. The presence of venous gas is suspected to be a rare, adverse prognostic factor of EC. However, all four previously reported cases improved. We hypothesized that venous gas is not an adverse prognostic factor of EC and aimed to assess the effect of venous gas on the EC prognosis. Methods Medical records were reviewed retrospectively. Patients The patients diagnosed with EC at Yodogawa Christian Hospital between April 2004 and September 2014 were included. Results Venous gas was present in 15 of 23 patients with EC. There was no significant difference in the background or clinical presentation between patients with or without venous gas. All patients with venous gas survived without invasive measures, whereas 50% of patients without venous gas died. Conclusion There was no marked difference in the mortality rate due to EC between the patients with and without venous gas. Venous gas may be a more common and less worrying finding in EC than assumed. It does not reflect the severity of infection, and air embolisms have not been reported so far. Venous gas may not affect the prognosis. This may be due to the differences in the mechanism of venous gas production. Gas in EC may develop due to glucose fermentation and intravesical pressurization, in contrast to the necrotizing infection seen in other emphysematous infections. This is the first study to assess the effect of venous gas on EC prognosis.

In the 2004-2005 season, there was a large epidemic of the influenza B virus Yamagata group in Kobe, Japan. In hemagglutination inhibition tests, most of the clinical isolates from Kobe showed antigenicities similar to those of previous isolates (the vaccine-type virus). Only a few antigenic variants were isolated around the peak of the epidemic; however, Kobe residents developed antibodies against the variants during the season. The antigenic variants showed a one-point mutation of a nucleotide in the HA1 gene (C440A or G421A), which resulted in the substitution of one amino acid in the 150 loop of the HA molecule (T147N or G141R). The 150 loop is one of four epitopes of the hemagglutinin molecule of the influenza B virus. We established a system to detect one-point differences in the nucleotides of the 150 loop by means of high-resolution melting curve analysis with LCGreen. With this system, the isolates were determined to be the vaccine-type virus, antigenic variants, or a mixture of both. Some isolates were shown to be mixtures although they had been recognized as the vaccine-type virus with the hemagglutination inhibition tests. Thus, the antigenic variants appeared in the early period of the epidemic and were cocirculating with the vaccine-type virus during the epidemic.

Automated, high-throughput detection methods for single-nucleotide polymorphisms have been applied to the routine genotyping of genetic polymorphisms influencing drug metabolism. Melting curve analysis with LCGreen was introduced recently as one such technique which can be performed rapidly and easily. This technique was used to detect antigenic variants of the influenza B virus. The antigenic variants and vaccine-type strains of the influenza B virus are isolated from clinical specimens of one epidemic season, and they usually differ in one nucleotide in the HA1 gene, corresponding to one amino-acid substitution. By means of melting curve analysis with LCGreen, an antigenic variant clone and a vaccine-type clone were clearly distinguished. In addition, the proportions of the antigenic variants in the mixture-type isolates were estimated. The clinical isolates were detected as the vaccine-type strains, antigenic variants, or a mixture of both. It became clear that humans were infected with a mixture of the vaccine-type strains and the antigenic variants for a certain period after which the viral antigenicities vary. This technique will contribute to the analysis of antigenic shifts in influenza B virus.

Background: The coregulators of androgen receptors (AR) influence the transcriptional activity of AR. In order to better understand the mechanism of carcinogenesis in the prostate, we investigated the relationship between AR and AR coregulators in the early stage of prostate cancer. Methods: mRNA was purified from 15 samples of prostate cancer and normal tissue and transcribed into cDNA. We screened eight AR coregulators for different gene expressions in prostate cancer, comparing these with normal tissue by a real-time polymerase chain reaction Syber green method, then quantified each component of the AR transcriptional complex by a real-time PCR hybri-probe method. The extent of gene expression similarity was compared by simple Pearson correlation coefficient analysis between prostate cancer and normal tissue. We applied a z-test to calculate significant differences between r-values. Results: We found that the gene expression level of FHL2 decreased in prostate cancer compared with that of normal tissue and the gene expressions of PSA, AR and SMRT were not significant. The correlation coefficient analysis revealed that strong associations were found in the pairs of AR versus SMRT, AR versus FHL2 and SMRT versus FHL2 in prostate cancer, whereas similarity was found only in the pair of AR versus FHL2 in normal tissue. No association was observed between prostate-specific antigen and other genes. Conclusion: These results demonstrate that the AR-AR coregulator relationship is different between prostate cancer and normal tissue, leading to the hypothesis that the AR transcriptional complex is regulated differently between prostate cancer and normal tissue.

Alpha-tocopherol (a form of vitamin E) is a fat-soluble vitamin that can prevent lipid peroxidation of cell membranes. This antioxidant activity of alpha-tocopherol can help to prevent cardiovascular disease, atherosclerosis and cancer. We investigated the alpha-tocopherol level and the expression of alpha-tocopherol transfer protein (alpha-TTP) in the leukocytes of children with leukemia. The plasma and erythrocyte alpha-tocopherol levels did not differ between children with leukemia and the control group. However, lymphocytes from children with leukemia had significantly lower alpha-tocopherol levels than lymphocytes from the controls (58.4 +/- 39.0 ng/mg protein versus 188.9 +/- 133.6, respectively; p < 0.05), despite the higher plasma alpha-tocopherol/cholesterol ratio in the leukemia group (5.83 +/- 1.64 micromol/mmol versus 4.34 +/- 0.96, respectively; p < 0.05). No significant differences in the plasma and leukocyte levels of isoprostanes (the oxidative metabolites of arachidonic acid) were seen between the leukemia patients and controls. The plasma level of acrolein, a marker of oxidative stress, was also similar in the two groups. Investigation of alpha-TTP expression by leukocytes using real-time PCR showed no difference between the two groups. These findings suggest that there may be comparable levels of lipid peroxidation in children with untreated leukemia and controls, despite the reduced alpha-tocopherol level in leukemic leukocytes.

To study the neutralizing epitopes of influenza B virus Victoria group strains, two monoclonal antibodies (MAbs) were used to select antigenic variants of the virus. MAbs 10B8 and 8E6 were found to react with B/Victoria group strains in three tests, peroxidase–antiperoxidase staining, haemagglutination inhibition and neutralization tests; no reactivity with B/Yamagata group strains was observed. Analysis of the deduced amino acid sequences of 10B8-induced variants identified a single amino acid deletion at residue 165 or 170, as well as a single amino acid substitution at residues 164 (Asp→Tyr), 165 (Asn→Ser or Thr) or 203 (Lys→Thr or Asn). A single amino acid substitution at residue 241 (Pro→Ser) was observed in 8E6-induced variants. Three-dimensional analysis showed that the epitopes for both MAbs were situated in close proximity to each other. Since B/Yamagata group strains are characterized by amino acid deletions at residues 164–166, the epitope for MAb 10B8 is strictly specific for B/Victoria group strains.

Selective IgM deficiency (SIgMD) is a rare primary immunodeficiency disease, which is found in some patients with autoimmune diseases. The pathogenesis of SIgMD and the relationship of these diseases have remained unclear. The absence of secreted IgM was recently reported to accelerate the development of autoimmune diseases in lupus-prone lymphoproliferative (Ipr) mice. The reduction of secreted IgM production may relate with the progression of autoimmune diseases in human. We present a case of SIgMD associated with systemic lupus erythematosus (SLE), and examined the function and the IgM heavy chain gene of patient's lymphocytes. The number and the surface IgM expression of the patient's B cells were normal. In vitro stimulation of peripheral mononuclear cells by recombinant IL-2 and a B cell activator, Staphylococcus aureus Cowan strain I, could not overcome the reduction of IgM production, although the secreted form of IgM mRNA was detected. Sequence analysis of the IgM heavy chain gene and the IgM mRNA revealed no mutation or deletion. These findings suggested that SIgMD in this case was involved in the abnormality during B cell maturation. Further analysis is required to reveal the pathogenesis of SIgMD associated with SLE.

During the 1998-1999 influenza season, two distinct influenza B virus Yamagata group strains were isolated from the patients of a private clinic. Each responded differently to monoclonal antibodies (Mabs) 5H4 and 8B3 on staining, and hemagglutination inhibition and neutralizing tests. When the analysis of nucleotide sequences was undertaken, the identity of deduced amino acid sequences of the HA1 region was 94%, which suggested that they derived from different strains. They were termed 5H4-responding strains and 5H4-nonresponding strains, respectively. The analysis of laboratory-induced antigenic variants suggested that the amino acid at position 149 is important to the reactivity to 5H4. This residue was "Arg" in 5H4-responding strains and "Lys" in nonresponding strains. During the 1998-1999 season, a total of 100 influenza B virus strains were isolated and 5H4-responding strains were the major type (94 strains). In the 1999-2000 influenza season, only two influenza B virus strains were isolated. Neither responded to 5H4. However, analysis of the deduced amino acid sequences of the HA1 region suggested that one of the two strains was derived from the 5H4-responding strains of the previous season. The amino acid residue at position 149 was "Lys" in place of "Arg." These observations suggested that 5H4-nonresponding strains will increase in coming seasons.

My4+/LeuM3- molecule is recognized by My4, but not by LeuM3, both well known mAbs to CD14. In a previous study we showed that the My4+/LeuM3- molecule on a human monoblastic cell line, U937, is not CD14, but another cell surface antigen. The roles and functions of the My4+/LeuM3- molecule remained unknown. We now report that specific stimulation of Fc gammaR with aggregated IgG or anti-Fc gammaRII antibody down-modulated the My4+/LeuM3- molecules, as well as CD19, in a case of CD56-positive B cell lymphoma. Stimulation of Fc gammaR with anti-mu antibody, which induced concomitant stimulation of sIg, did not induce down-modulation of either molecule. Stimulation of CR2 (CD21), a protein which is functionally or physically associated with CD19, with anti-CR2 (CD21) mAbs also had no effect. The modulation occurred specifically on CD56-positive B-lymphoma cells, since My4+/LeuM3(-)-positive, CD56-negative B-lymphoma cells did not respond to the stimulation. These results suggest that CD19 and My4+/LeuM3- molecules are functionally or physically associated with Fc gammaR II on CD56 positive B-lymphoma cells defined as being at a terminal B cell differentiation stage.

We report a novel mutation in FcgammaRIIIA (the transmembrane-form CD16) on natural killer (NK) cells in a patient with polyneuropathy. She had no history of recurrent infections. Her NK cells expressed no detectable CD16; however, her NK cytotoxic activity was normal, suggesting that CD16 expression and cytotoxic activity are independent of one another. Molecular analysis revealed a deletion of a single adenine base in exon 4 of CD16 at nucleotide 550. This deletion generates a STOP codon in an extra-cellular domain of the FcgammaRIIIA gene, thereby truncating the CD16 molecule. The patient's NK cells were not recognized by the anti-CD16 monoclonal antibodies 3G8 and Leu11c. Whether the development of her polyneuropathy is associated with this novel mutation is unclear.

Expansion of the polyglutamine tracts in the androgen receptor (AR) has been recognized as a cause of X-linked spinal and bulbar muscular atrophy (SBMA). In the present study, NG108–15 cells were stably transfected with expression vectors coding for either the wild type (WT) AR gene (CAG repeat number=22) or a mutated (MT) AR gene (CAG repeat number=52). Cells proliferation and cell cycle parameters were evaluated for NG108–15-WT and NG108–15-MT cells in the presence or absence of androgen. NG108–15-WT cells demonstrated an androgen-dependent increase in cell number, while NG108–15-MT cells did not. Our results demonstrate that expansion of polyglutamine tracts in the AR may affect the proliferation and differentiation of nerve cells.

Polyglutamine tracts encoded by trinucleotide CAG repeats have been found in some transcription factors. Expansion of the polyglutamine tracts in the androgen receptor (AR) has been recognized as a cause of X-linked spinal and bulbar muscular atrophy (SBMA). To study the role of AR as a transcription factor in SBMA, we constructed AR genes encoding expanded polyglutamine tracts (repeat numbers = 52, 92, 132, and 212), and analyzed AR-induced transcriptional activation in NG108-15 cells. We found that AR-induced transcriptional activation gradually decreased with increasing glutamine repeat numbers, and polyglutamine expansion caused a specific reduction in transcription activity in motor neurons. However, the degree of reduction was slight in comparison with the normal AR gene and that of SBMA. Thus, subtle disorders of transcriptional control may occur in SBMA.

Storage of serum at 4°C elevated the titre of rheumatoid factor (RF) as measured by nephelometry with IgG-coated latex in 12 of 38 specimens positive for hepatitis C virus. Increased RF following cold storage was not detected in HCV-negative sera. Most of the sera showing the cold-dependent elevation of RF had decreased complement hemolytic activity (CH50) after the cold storage. The RF titre elevated by cold storage decreased to the level of fresh serum by the addition of guinea pig serum as a complement supplement in a dose-dependent fashion. Thus, in the serum of some HCV-infected patients, the affinity of RF appears to be weak, and the binding between the RF and IgG coated on latex may be inhibited by the complement components of fresh serum.

SUMMARY Complement activation at a low temperature in vitro and cryoglobulinaemia are associated with hepatitis C virus (HCV) infection. The frequency of HCV antibody positivity determined in serum specimens that showed the cold-dependent activation of complement was 100%, whereas it was 48% among sera with cryoglobulin. On the other hand, the frequency of cold activation among HCV-infected sera was 41%, and that of cryoglobulin 48%. Cold activation was not found in any HCV− sera studied, whereas cryoglobulin was found at a frequency of 14% in HCV− sera. Cold activation was also absent among hepatitis B virus (HBV) S antigen or antibody-positive sera, except a few that were both HBV+ and HCV+. Rheumatoid factor was also frequently detected in sera with cold activation or cryoglobulin. Cold activation and cryoglobulin may be generated by common mechanisms in which a low avidity, low temperature-preferring antibody may function. In sera with cold activation, fine particles of immune complexes, which do not form precipitates, may activate the complement system. HCV is a unique virus that coexists with antibody in the serum, therefore the avidity of the antibody for the virus antigen may be low, and occasionally react only at a low temperature. This may be why the in vitro phenomenon related to immune complexes occurs specifically in HCV-infected sera.

We describe here 3 patients with central nervous system infection caused by herpes simplex virus type 2 (HSV-2); one patient with brainstem encephalitis and two with recurrent transverse thoracic myelitis. All three patients showed increased IgG antibodies to HSV in the cerebrospinal fluid (CSF). HSV-2 DNA was demonstrated in the CSF by polymerase chain reaction (PCR) amplification. Upon treatment with acyclovir, one patient with myelitis partially recovered and the others completely recovered. It is important to recognize the wide spectrum of clinical manifestations of HSV-2 infection in the central nervous system (CNS).

The phenomenon of in vitro activation of the classical complement pathway at low temperatures (4–21°C) is known as cold activation, and has been suggested to be associated with non-A, non-B hepatitis. We re-examined the association by using newly developed markers of hepatitis C virus (HCV) infection. Twenty-one cases randomly selected from those fulfilling the screening criteria of complement cold activation all showed evidence of HCV infection. More than half of 55 HCV antibody-positive cases selected randomly from our laboratory samples showed a tendency towards cold activation, whereas none of the HCV antibody-negative sera showed cold activation. All the HCV antibody-positive cases were negative in cold activation when CH50 was assayed with plasma. These results, taken together, indicate that cold activation of the complement system is strongly associated with HCV infection.

Caveolin-1, an essential structural component of caveolae, functions as a negative regulator for signal transduction and has been suggested to be a candidate tumor suppressor. Lack of caveolin-1 expression has been implicated in the pathogenesis of oncogenic cell transformation and tumorigenesis in many cancers. On the other hand, over-expression has also been associated with tumor progression and metastasis in prostate cancers. Hence, alteration of caveolin-1 expression has been proposed as a clinical marker for diagnosis and prognosis in various cancers. For precise analyses of the caveolin expression in human T cell leukemia cell lines, we measured the mRNA levels of caveolin isoforms, caveolin-1alpha, -1beta, -2, and -3 with real-time RT-PCR using external standards for each isoform. In the panel of human T cell leukemia cell lines tested, four cell lines expressed caveolin-1alpha, -1beta and -2, but not -3, which was consistent with the protein levels. The expression profiles in most cell lines are caveolin-1alpha > caveolin-1beta > caveolin-2. Two cell lines did not express either of the caveolin mRNAs. Methylation analyses for the CpG sites in the promoter region of a positive and a negative cell line did not show a clear correlation with the expression status, suggesting that mechanisms other than CpG methylation are involved in the regulation of caveolin-1alpha expression in human T cell leukemia cell lines.

Caveolin-1, an essential structural component of caveolae, functions as a negative regulator for signal transduction and has been suggested to be a candidate tumor suppressor. Lack of caveolin-1 expression has been implicated in the pathogenesis of oncogenic cell transformation and tumorigenesis in many cancers. On the other hand, over-expression has also been associated with tumor progression and metastasis in prostate cancers. Hence, alteration of caveolin-1 expression has been proposed as a clinical marker for diagnosis and prognosis in various cancers. For precise analyses of the caveolin expression in human T cell leukemia cell lines, we measured the mRNA levels of caveolin isoforms, caveolin-1alpha, -1beta, -2, and -3 with real-time RT-PCR using external standards for each isoform. In the panel of human T cell leukemia cell lines tested, four cell lines expressed caveolin-1alpha, -1beta and -2, but not -3, which was consistent with the protein levels. The expression profiles in most cell lines are caveolin-1alphacaveolin-1betacaveolin-2. Two cell lines did not express either of the caveolin mRNAs. Methylation analyses for the CpG sites in the promoter region of a positive and a negative cell line did not show a clear correlation with the expression status, suggesting that mechanisms other than CpG methylation are involved in the regulation of caveolin-1alpha expression in human T cell leukemia cell lines.

Survivin, a novel member of the inhibitor of apoptosis protein (IAP) family, has been markedly overexpressed in most types of human carcinoma, and recognized as a potential target in anticancer therapy. In addition, two splice variants of survivin, survivin-2B and survivin-deltaEx3, have recently been identified. However, expression analysis on its splice variants has not been reported in colorectal carcinomas. Therefore, we investigated the transcription levels of survivin and its splice variants in human colorectal carcinomas, and the correlation between transcript expression levels and pathological findings was analyzed. Tumor tissue samples were provided from 52 cases with colorectal adenocarcinoma resected at the Osaka Medical College from 1995 to 1996. Transcription levels were measured by performing quantitative reverse transcription-polymerase chain reaction (RT-PCR) using primer pairs specific for survivin and either of its splice variants, then normalized by the glyceraldehyde 6-phosphate dehydrogenase. The transcription levels of survivin and its splice variants were significantly higher in the tumor tissue samples, and significantly lower in the normal tissue samples. In addition, approximately 40% of the normal tissue samples did not have any survivin expression. The relative expression level of survivin-2B to survivin (survivin-2B/survivin) was significantly higher in the tumor tissue samples than in the normal ones. In contrast, survivin-deltaEx3/survivin revealed no difference between tumor and normal samples. When Comparing the histological disease stages (stage I and II vs. stage III and IV), there were no significant differences in the expression levels of survivin and its splice variants. The expression level of survivin-2B/survivin for stage III and IV was lower than the one for stage I and II. In addition, a higher level of survivin-2B/survivin significantly correlated with a better prognosis in the present series. The present study demonstrates high expression level of survivin and its splice variants, which is relatively specific in tumor tissue and suggests that they have important roles in the progression of human colorectal carcinomas.

Object: During the surgical resection of malignant gliomas, it is important to make clear the border zone between the tumor tissue and normal brain tissue. For this purpose, we conjugated fluorescein and human serum albumin (FLS-HSA) and compared its effectiveness against that of fluorescein-sodium (FLS-Na) alone in detecting human glioma xenografts in SCID mice through a fluorescence microscope. Methods: We made FLS-HSA conjugate using carbodiimide as a linking reagent. SCID mice, with U251MG cells transplanted subcutaneously, were prepared as tumor models. The animals were sacrificed 15, 30, 60, 180, 360, or 720 min after the intravenous administration of either the FLS-HSA conjugate or FLS-Na alone (n = 3). Fluorescence images were taken with a digital camera, and the brightness of the tumor and that of the peripheral tissue in each image were quantified. In the group of tumor-bearing mice that received FLS-Na, the fluorescence of tumor tissue disappeared 60 min after the reagent was administered, and there was no significant difference in brightness between the tumor and peripheral tissue at any time point. On the other hand, injection of FLS-HSA revealed relative tumor-selective brightness and sufficient contrast between the tumor and surrounding tissue 60 and 360 min after administration. Conclusion: FLS-HSA has the advantages of specificity and persistence of fluorescence over FLS-Na for the purpose of identifying glioma nodules in xenogenic subcutaneous tumor transplantation models.

Alpha-tocopherol (a form of vitamin E) is a fat-soluble vitamin that can prevent lipid peroxidation of cell membranes. This antioxidant activity of alpha-tocopherol can help to prevent cardiovascular disease, atherosclerosis and cancer. We investigated the alpha-tocopherol level and the expression of alpha-tocopherol transfer protein (alpha-TTP) in the leukocytes of children with leukemia. The plasma and erythrocyte alpha-tocopherol levels did not differ between children with leukemia and the control group. However, lymphocytes from children with leukemia had significantly lower alpha-tocopherol levels than lymphocytes from the controls (58.4 +/- 39.0 ng/mg protein versus 188.9 +/- 133.6, respectively; p0.05), despite the higher plasma alpha-tocopherol/cholesterol ratio in the leukemia group (5.83 +/- 1.64 micromol/mmol versus 4.34 +/- 0.96, respectively; p0.05). No significant differences in the plasma and leukocyte levels of isoprostanes (the oxidative metabolites of arachidonic acid) were seen between the leukemia patients and controls. The plasma level of acrolein, a marker of oxidative stress, was also similar in the two groups. Investigation of alpha-TTP expression by leukocytes using real-time PCR showed no difference between the two groups. These findings suggest that there may be comparable levels of lipid peroxidation in children with untreated leukemia and controls, despite the reduced alpha-tocopherol level in leukemic leukocytes.

Object. Survivin, one of the apoptosis inhibitor proteins, has been detected in most cancers in humans. In addition, two splice variants (survivin-2B and survivin-ΔEx3) have been identified. The authors investigated the transcription levels of survivin messenger (m)RNA and its splice variants in nine tumor cell lines, including gliomas, and in 25 brain tumor samples, by performing quantitative reverse transcription-polymerase chain reaction. The correlation between transcript expression levels and pathological findings were also analyzed. Methods. Transcription levels were measured using primer pairs specific for survivin and either of its splice variants and were normalized to the glyceraldehyde 6-phosphate dehydrogenase. Among the tumor cell lines tested, glioblastoma cell lines showed the highest levels of survivin expression. Among brain tumor samples studied, survivin was preferentially expressed in malignant brain tumors and gliomas. The relative expression level of survivin-ΔEx3/survivin was significantly higher in malignant than in benign brain tumor samples. Expression patterns were dominant for survivin-ΔEx3 in malignant brain tumors and dominant for survivin-2B in benign ones. A significant linear correlation between survivin mRNA expression and MIB-1 labeling index was demonstrated in all brain tumor samples. Conclusions. The authors' results indicate that quantifying the levels of survivin and its splice variants is useful for the prediction of the cell biological malignancy of gliomas, independent of their pathological features.

To study the neutralizing epitopes of influenza B virus Yamagata group strains, two monoclonal antibodies (mAbs) were used to select escape mutants of the virus. mAbs 5H4 and 3A12 were found to react with B/Yamagata group strains in haemagglutination inhibition and neutralization tests; no reactivity with B/Victoria group strains was observed. Most of the mutants reacted poorly to polyclonal ferret antibody against the 1998 isolate. Analysis of the deduced amino acid sequences identified a single amino acid substitution at residue 141 (Gly--Arg) or 149 (Arg--Gly) in 5H4-escape mutants and 141 (Gly--Arg), 147 (Thr--Ile) or 148 (Ser--Gly) in 3A12-escape mutants. These residues are situated in close proximity in the 'loop' of the haemagglutinin molecule. These epitopes have been conserved in B/Yamagata group strains for almost 10 years in Japan but amino acid substitutions in the loop have been observed in clinical isolates only since 1999.

Influenza B virus Yamagata group strains, isolated in the 2000 to 2001 influenza epidemic season, reacted poorly to the polyclonal ferret sera prepared against strains isolated earlier. The results of genetic analysis clarified that a point mutation of the nucleotide at position 126 in the HA1 region and the corresponding one-amino-acid substitution altered viral antigenicity.

Hereditary eosinophil peroxidase (EPO; EC 1.11.1.7) deficiency is a rare abnormality without clinical symptoms characterized by decreased or absent peroxidase activity and decreased volume of the granule matrix in eosinophils. Nearly 100 cases have been reported, but a specific mutation has been reported in only one case. We report the genetic analysis of an EPO-deficient subject and his family. The case was found by automated blood analyzer. Sequencing of the entire coding region of the EPO gene disclosed a novel mutation, a 2060 G-A transition (g. 2060G>A) causing an amino acid change from aspartic acid to asparagine (D648N). Both the son and daughter of the propositus inherited the G-A transition, and in vitro expression experiments suggest this transition is responsible for the deficiency. We then analyzed the location of the affected amino acid within this molecule using a structural model of EPO based on myeloperoxidase (MPO). Asn648 is on the inside of the molecule; changing D to N would cause loss of the electrostatic interaction with Arg146 which is crucial for disulfide bonds of the light chain in the N terminus. Hum Mutat 17:235–236, 2001. © 2001 Wiley-Liss, Inc.

Seventy-three B/Victoria group strains isolated in the 1996–1997 influenza season were divided into three groups according to the degree of reactivity to monoclonal antibody 8E6. Analysis of nucleotide sequences of the HA1 region clarified that single amino acid substitutions were responsible for the difference in reactivity to 8E6.

Herpes simplex virus (HSV) myelitis has previously been reported to be a form of acute ascending necrotizing myelitis caused by HSV type 2 (HSV-2). We studied neurological symptoms, clinical course, magnetic resonance imaging (MRI) findings, and diagnosis by polymerase chain reaction (PCR) methods in 9 patients with HSV myelitis. In 6 cases, disease onset was marked by sensorimotor disturbances of lower extremities and urinary disturbances, with the transverse myelopathy gradually ascending to the cervicothoracic spinal cord level. The other 3 cases showed transverse myelopathy without an ascending pattern. Six cases showed acute progression, while 3 cases showed a subacute course. There were 2 cases with recurrent episodes. Three patients recovered, however, in the remaining 6 patients severe sequelae such as paraplegia persisted despite antiviral therapy. MRI showed a hyperintense lesion on T2-weighted images. Gadolinium enhancement was observed in 2 cases, and 1 case showed a hyperintense lesion both on T1- and on T2-weighted images, suggesting hemorrhagic necrosis. HSV-2 was detected by PCR techniques in all 6 cases with an ascending pattern. HSV-1 DNA was detected in 2 and HSV-2 DNA in 1 of the 3 cases with a nonascending pattern. Our findings demonstrate diverse clinical manifestations of HSV myelitis.

The expression of interferon-gamma (IFN-gamma) receptors on normal human B cells and four B cell lines was studied. Recombinant human IFN-gamma was labeled with [gamma-32P]ATP using the catalytic subunit of a cAMP-dependent protein kinase. All four B cell lines, although differing in their responsiveness to IFN-gamma, were found to express high-affinity receptors (1,000-11,000 receptors/cell). Normal unactivated B lymphocytes were also found to express constitutively high-affinity receptors, approximately 1,400 receptors per cell with an estimated affinity of 295 pM. Activation of the normal B cells in vitro with the polyclonal B cell activator, Staphylococcus aureus Cowan strain I (SAC), resulted in a slight decline in receptor number and a more pronounced fall in receptor density. One of the B cell lines and unactivated normal B cells were shown to internalize labeled IFN-gamma rapidly. Chemical cross-linking of 32P-IFN-gamma to the CB B cell line and to freshly isolated B lymphocytes revealed one major cross-linked receptor-ligand complex which had an estimated molecular weight of approximately 110 kilodaltons. This complex corresponded to a 93 kD receptor cross-linked to recombinant IFN-gamma. Our data indicate that normal B lymphocytes constitutively express an approximately 93 kD IFN-gamma receptor which is similar to the receptor present on Epstein-Barr virus-transformed B cell lines.

Participation of angiotensin II in the myointimal proliferation following a vascular injury was postulated. This study assessed the potential involvement of the local angiotensin II-forming enzymes in injured arteries of dogs. The potential angiotensin II-forming enzymes are angiotensin-converting enzyme (ACE) and chymostatin-sensitive angiotensin II-generating enzyme (CAGE) which is highly homologous to or could be identical to the mast cell chymase. Both ACE and CAGE catalyze the conversion of angiotensin I to angiotensin II. We found that the enzymatic activities of ACE and CAGE, and the mRNA levels of ACE and chymase were increased in the injury-induced hypertrophied vessels. The results suggest that ACE and CAGE participate in the hypertrophy through the production of angiotensin II which is a growth promoter for vascular smooth muscle cells.

Ig production was induced in human leukemic B cells or a transformed B cell line (CESS) by anti-Ig or T cell-derived helper factor(s). It was shown that three signals, i.e., crosslinkage of Ig receptors by anti-Ig, B cell growth factor (BCGF) and T cell replacing factor (TRF), were required for the activation of leukemic B cells into Ig-producing cells. Establishment of human T hybridomas secreting monoclonal immunoregulatory molecules showed that BCGF or TRF was different from the factor required for the proliferation of T cells (IL-2). Injection of the cytoplasm from TRF-stimulated CESS cells into non-stimulated cells induced IgG production, suggesting TRF-induced generation of the cytoplasmic sub-stnace responsible for the signal transmission. The binding of TRF with TRF acceptors induced methylation of membrane phospholipids followed by the activation of serine esterase. TRF-activated serine esterase was shown to be involved in the generation of the cytoplasmic factor(s) which were responsible for the signal transmission from membrane to nuclei.

Efforts to evaluate normal human B cell physiology have resulted in the development of a model in which a resting B cell must progress through stages of activation, proliferation, and differentiation before becoming an immunoglobulin (Ig)-producing cell (1–4). Presumably each of these stages has specific signals, positive as well as negative, which control the nature as well as the intensity of the response. To evaluate the validity of this model, researchers have looked for reagents which act selectively at each of these stages. These include antigens, mitogens, soluble factors produced by various cell types, and various pharmacologic agents. In this review we will emphasize some of the studies performed in our laboratory on the various stages of B cell function in humans.

B lymphocytes originate from pluripotent hematopoietic stem cells and differentiate into antibody producing cells through several distinct differentiation stages. Commitment of the antigen specificity in each B cell clone occurs at the stage of pre B cells by two step DNA rearrangements including V, D and J segments, i.e. from DJ joining to the functional VDJ formation (1). Following the rearrangement of heavy chain genes, light chain gene rearrangements occur (2) and 7S IgM molecules are expressed as antigen receptors on the surface of mature B cells. A given antigen selects a B cell clone with a matched receptor and activates this clone into antibody producing cells under the influence of helper T cells.