[Drug-induced interstitial pneumonia associated with inhalation of fibrinolysin-deoxyribonuclease (ElaseR)].

A 73-year-old man was referred to our department because of sputum production and fever. He had under-gone a total laryngectomy for laryngeal cancer. His chest radiograph showed patchy ground-glass shadows in both lung fields. He was treated with antibiotics for pneumonia, but his symptoms continued, and the size of the patchy shadows in the chest radiograph increased. Inhalation therapy with ElaseR had been started from one day before fever arose. Withdrawal of ElaseR treatment resolved his symptoms. We therefore suspected drug-induced interstitial pneumonia. Transbronchial lung biopsy specimens showed infiltration of lymphocytes in the alveolar septa and thickening of those septa. A bronchoalveolar lavage revealed an increased number of lymphocytes, and the CD4/CD8 ratio was 0.3. A drug lymphocyte stimulation test (DLST) with peripheral blood lymphocytes was strongly positive (S.I. 2127%) for ElaseR. The anti-nuclear antigen (ANA) was detected (x640), and the anti-single strand DNA antibody titer was also high (123.4 IU/ml). About 10 weeks after the withdrawal of ElaseR, the infiltrative shadows and the abnormal laboratory findings improved spontaneously. On the basis of these findings, we arrived at a diagnosis of drug-induced interstitial pneumonia associated with inhalation of ElaseR.

Specific accumulation of polysaccharide-linked hydroxycinnamoyl esters in the cell walls of irregularly shaped and collapsed internode parenchyma cells of the dwarf rice mutant Fukei 71.

We examined a novel rice mutant, Fukei 71 (Oryza sativa L.), for alterations in the levels of hydroxycinnamoyl esters that are linked to cell wall polysaccharides and lignin units. In this mutant, a recessive mutation at a single locus caused the collapse of parenchyma cells in the internodes. Light microscopy revealed that the abnormal walls of internode parenchyma cells of Fukei 71 were stained by the Mäule reaction, which is specific for syringyl units in phenolic compounds. These walls were not stained by Wiesner's reagent (phloroglucinol-HCl), which reacts cinnamaldehyde in lignin. Levels of p-coumaric acid (PCA) and ferulic acid (FA) were apparently elevated in the abnormal tissue of the mutant. Western blotting analysis with antibodies specific for phenylalanine ammonia-lyase (PAL) revealed higher levels of PAL in the abnormal parenchyma tissue of Fukei 71 than in the parenchyma tissue of the parent cultivar Fujiminori. These results and the observation that PAL was produced at a greatly elevated level indicated that the phenylpropanoid pathway that leads to the biosynthesis of polysaccharide-linked FA and PCA was abnormally activated in the irregularly shaped and collapsed internode parenchyma cells, in which the biosynthesis of lignin is normally repressed.

Successful treatment of metastatic cardiac lymphoma with complete A-V block.

Although involvement of the heart is not a rare manifestation of malignant lymphoma, most cases are diagnosed by postmortem examination. In the present article, we describe a man with metastatic cardiac lymphoma with complete A-V block successfully treated by resection of the heart tumor and sequential combination chemotherapy with cyclophosphamide, doxorubicin, vincristine and predonisolone and radiation therapy. Combination modality resulted in complete disappearance of signs of heart failure and A-V block. Our experience indicated that early diagnosis and combination modality can obtain long survival in case of metastatic cardiac lymphoma.