[A case of embolization to a large polycystic kidney with infection].

75 year old female who was hospitalized for abdominal pain and fever up on 12th May 1998. She had been followed as a polycystic kidney patient since few years. The swelling of the right kidney and her general condition became gradually worse. On 18th May, the embolization to the right kidney using pure alcohol and gelatin sponge was performed. Within a month, CT scan showed the reduced volume of the right kidney and her blood examination data as well as her general condition became gradually well. And on 17th June, she left our hospital without any complication.

Substrate specificity of regiospecific desaturation of aliphatic compounds by a mutant Rhodococcus strain.

Substrate specificity of cis-desaturation of alipahtic compounds by resting cells of a mutant, Rhodococcus sp. strain KSM-MT66, was examined. Among substrates tested, the rhodococcal cells were able to convert n-alkanes (C13-C19), 1-chloroalkanes (C16 and C18), ethyl fatty acids (C14-C17) and alkyl (C1-C4) esters of palmitic acid to their corresponding unsaturated products of cis configuration. The products from n-alkanes and 1-chloroalkanes had a double bond mainly at the 9th carbon from their terminal methyl groups, and the products from acyl fatty acids had a double bond mainly at the 6th carbon from their carbonyl carbons.

A repeat-batch membrane bioreactor with a phase inversion for the desaturation of isopropyl palmitate by a mutant Rhodococcus strain.

A repeat-batch membrane bioreactor was constructed for the novel bioconversion of isopropyl hexadecanoate to isopropyl cis-6-hexadecenoate by a Rhodococcus mutant. The addition of glutamate, thiamine, and MgSO(4) was very effective in improving not only the rate and yield of the bioconversion but also the maintenance of desaturation activity during cell recycling. An oil-in-water (O/W) type emulsion of the reaction medium was inverted to a water-in-oil (W/O) type by discharging the water phase from the reaction mixture. The continuous oil phase containing the product could effectively be recovered through a hydrophobic hollow-fiber module. By decreasing the oil-to-water ratio upon addition of fresh medium, the medium was spontaneously inverted again to an O/W type emulsion to proceed with the next conversion. The batch reaction coupled with the phase inversion could be repeated more than 13 times for over about 300 h operation. Finally, a highly purified product was obtained with high yield by the urea adduct procedure.

Production of isopropyl cis-6-hexadecenoate by regiospecific desaturation of isopropyl palmitate by a double mutant of a Rhodococcus strain.

Resting cells of a double mutant noted as KSM-MT66, derived from Rhodococcus sp. strain KSM-B-3 by UV irradiation, were found to cis-desaturate isopropyl hexadecanoate, yielding isopropyl cis-6-hexadecenoate. Addition of sodium glutamate (1.0%), Mg SO4 (2 mM), and thiamine (2 mM) increased the productivity of the unsaturated product in phosphate buffer. Optimal temperature and pH for the reaction were around 26 degrees C and 7, respectively. Under the optimized conditions, more than 50 g/l of isopropyl cis-6-hexadecenoate was produced after a 3-day incubation by resting cells of the mutant. Thus, cis-6-hexadecenoic acid, the main component of human sebaceous lipids, can be manufactured economically by the rhodococcal bioconversion.

[Suicidal attempts in three postoperative patients with renal cancer after alpha interferon withdrawal].

We report 3 cases of suicide attempts in postoperative patients with renal cancer after alpha interferon withdrawal. In the first patient, depression occurred during interferon therapy, and remained after interferon withdrawal. A suicide attempt occurred 7 months after interferon withdrawal. In the second and third patients, depression did not occur during interferon therapy, but suicide attempts occurred 40 days and 7 months after interferon withdrawal, respectively. Depression does not always disappear after interferon is discontinued. Psychiatric supervision should be continued even more frequently after interferon withdrawal. The increased risk of psychiatric side effects due to interferon, as well as their severity, suggest that interferon should be administered with caution.

[Nephrostomy of which catheter can be introduced from the abdominal wall].

AIM OF STUDY: The aim of this study is to find out the method for the nephrostomy of which catheter can be introduced from the abdominal wall. METHODS: Subjects were the 7 patients whose agreement for this new method could be obtained. After the general nephrostomy was performed, 3 cm skin incision to the outer portion of nephrostomy, as well as 5 mm skin incision to the abdominal wall were added, and the subcutaneous tunnel between the both skin incisions was made using the special tunneler. A guide wire was introduced into the renal pelvis through the subcutaneous tunnel, and then 14 F Maleocot catheter was introduced from the abdominal skin incision to the renal pelvis. At the skin incision of the nephrostomy, catheter and subcutaneous tissue were fixed using 3-0 cutgut suture to prevent the outcomming of the catheter. RESULTS: In case 1 to case 4 showed some trouble, but case 5 to 7 showed no trouble. The operation time and the extent of invasion of our method were as well as that of the general nephrostomy, but the managements by the patients were as simple as that of the ureterocutaneostomy. CONCLUSION: The quality of our patients seem to close to that of uretero-cutaneostomy. And for the patients who have hydronephrosis after several type of urinary diversions, our method should be recommendable than the general nephrostomy.

Enzymatic properties of a novel liquefying alpha-amylase from an alkaliphilic Bacillus isolate and entire nucleotide and amino acid sequences.

A novel liquefying alpha-amylase (LAMY) was found in cultures of an alkaliphilic Bacillus isolate, KSM-1378. The specific activity of purified LAMY was approximately 5,000 U mg of protein-1, a value two- to fivefold greater between pH 5 and 10 than that of an industrial, thermostable Bacillus licheniformis enzyme. The enzyme had a pH optimum of 8.0 to 8.5 and displayed maximum activity at 55 degreesC. The molecular mass deduced from sodium dodecyl sulfate-polyacrylamide gel electrophoresis was approximately 53 kDa, and the apparent isoelectric point was around pH 9. This enzyme efficiently hydrolyzed various carbohydrates to yield maltotriose, maltopentaose, maltohexaose, and maltose as major end products after completion of the reaction. Maltooligosaccharides in the maltose-to-maltopentaose range were unhydrolyzable by the enzyme. The structural gene for LAMY contained a single open reading frame 1, 548 bp in length, corresponding to 516 amino acids that included a signal peptide of 31 amino acids. The calculated molecular mass of the extracellular mature enzyme was 55,391 Da. LAMY exhibited relatively low amino acid identity to other liquefying amylases, such as the enzymes from B. licheniformis (68.9%), Bacillus amyloliquefaciens (66.7%), and Bacillus stearothermophilus (68.6%). The four conserved regions, designated I, II, III, and IV, and the putative catalytic triad were found in the deduced amino acid sequence of LAMY. Essentially, the sequence of LAMY was consistent with the tertiary structures of reported amylolytic enzymes, which are composed of domains A, B, and C and which include the well-known (alpha/beta)8 barrel motif in domain A.

Purification and characterization of an alkaline amylopullulanase with both alpha-1,4 and alpha-1,6 hydrolytic activity from alkalophilic Bacillus sp. KSM-1378.

The novel alkaline amylopullulanase produced by alkalophilic Bacillus sp. KSM-1378 was purified to an electrophoretically homogeneous state from culture medium. The purified enzyme was a glycoprotein with an apparent molecular mass of about 210 kDa and an isoelectric point of pH 4.8. The N-terminal amino acid sequence was Glu-Thr-Gly-Asp-Lys-Arg-Ile-Glu-Phe-Ser-Tyr-Glu-Arg-Pro and showed no homology to the N-terminal regions of other amylopullulanases reported to date. The enzyme was able to attack specifically the alpha-1,6 linkages in pullulan to generate maltotriose as the major end product, as well as the alpha-1,4 linkages in amylose, amylopectin and glycogen to generate various oligosaccharides. The pH and temperature optima for the pullulanase and alpha-amylase activities were pH 9.5 and 50 degrees C and pH 8.5 and 50 degrees C respectively. Both activities were strongly inhibited by well characterized inhibitors, such as diethyl pyrocarbonate and N-bromosuccinimide. The pullulanase activity was specifically inactivated by Hg2+ ions, alpha-cyclodextrin and beta-cyclodextrin while the amylase activity was strongly inhibited by EDTA and EGTA, although inhibition could be reversed by Ca2+ ions. It is suggested that the single alkaline amylopullulanase protein has two different active sites, one for the cleavage of alpha-1,4-linked substrates and one for the cleavage of alpha-1,6-linked substrates.

[Renal artery embolism treated with a continuous selective intra-arterial urokinase infusion therapy: a case report].

A 61-year-old man with left renal artery embolus was treated with a continuous selective intra-arterial urokinase (UK) infusion therapy. UK was administered through a 5 Fr. catheter embedded into the occlusive segment of the artery selectively. Continuous low dose UK (15,000 units/hour) was infused following short-term ultra-high dose UK (480,000 units/60 min) infusion. A complete recanalization of the occluded artery was observed by day 7 and also no serious complications were noted during the treatment. Thus, a continuous selective intra-arterial UK infusion therapy seemed to be more effective than conventional methods, especially in patients with complete obstruction.

Recording the bladder electromyogram for bladder activity evaluation during post-operative urinary urgency.

When the intravesical pressure cannot be measured because of continuous drainage, bladder electromyography is an alternative means of evaluating the functional condition of the urinary bladder. However, many problems that accompany this procedure have not been solved. In the present study we tried bladder electromyography with a newly-developed carbon fiber electrode in a patient who underwent an open prostatectomy. It was helpful in recognizing the relationship between urinary urgency and the spasmic activity of the vesicular detrusor muscle.

A new technique of vesical electromyogram with cystometrogram and urethral electromyogram.

The authors improved the Nélaton catheter with a pair of carbon fiber electrodes as previously published and also improved the Foley catheter with a pair of carbon fiber electrodes which are less painful and easier to use. We also have made efforts how to record the vesical electromyogram (EMG) simultaneously with cystometry and urethral EMG which can be used easily for the evaluation of neurogenic bladder. With these specially made Foley catheters, simultaneous recordings of vesical EMG with cystometry were performed on 24 subjects (17 males and 7 females, mean age 53.6 years) who visited our clinic because of various urinary disturbances. The results of the vesical EMG recordings which show various manifestations could approximately be divided into three groups by their approximate voltage of the amplitude (normal-voltage, high-voltage and low-voltage groups), especially during the filling phase of the cystometrography.