Expression and localization of urokinase-type plasminogen activator in human astrocytomas in vivo

Plasminogen activators regulate a variety of processes involved in tissue morphogenesis, as well as cell differentiation, migration, and invasion. We examined the relative amounts of mRNA and protein and localization of urokinase-type plasminogen activator (uPA) in human astrocytomas in vivo. Using fibrin zymography and densitometric quantitation, we found that uPA activity was significantly higher in malignant astrocytomas, especially in glioblastomas, than it was in normal brain tissues or low-grade gliomas. The amounts of uPA mRNA, as determined by Northern blot analysis, were higher in anaplastic astrocytomas and glioblastomas than in normal brain tissues and low-grade gliomas, consistent with the amount of uPA activity. To investigate the cellular source of uPA in various tissues, we performed immunocytochemical localization of uPA protein and in situ hybridization of uPA mRNA with astrocytomas and normal brain tissues. Immunocytochemical staining for uPA showed strong immunoreactivity in the tumor cells and vasculature of glioblastomas and anaplastic astrocytomas but undetectable or very low immunoreactivity for uPA in low-grade gliomas and normal brain tissues. uPA mRNA was located in astrocytoma and endothelial cells and was heterogeneously distributed within glioblastoma, with preferential localization near vascular proliferation and at the leading edge of the tumor. uPA expression was dramatically higher in highly malignant astrocytomas, especially glioblastomas, and was correlated with malignant progression of astrocytomas.

Prediction of recurrence after HCC resection. Faint oily deposits on preoperative Lipiodol-CT of remnant liver tissue

In trying to clarify the high recurrence rate after removal of small hepatocellular carcinoma (HCC), we assessed the postoperative evolution of minute hepatic Lipiodol deposits which had been diagnosed as artifacts on the preoperative Lipiodol-CT. Of 27 patients with solitary HCC less than 5 cm in diameter, 14 had such Lipiodol deposits in the preoperative CT and 9 of them (64%) developed recurrent tumors. On the other hand, 6 of the 13 patients without deposits (46%) suffered recurrence, but in 5 of these 6 patients the HCC was metachronous multicentric. The cumulative survival rate of the non-deposit group was better than that of the deposit group (p < 0.1). The present study suggested that, even in patients with small HCC, minute concomitant tumors invisible by conventional imaging techniques may exist at the time of surgery. Some of these lesions without sufficient tumor vasculature showing a hypervascular blush on angiography appear to retain small, vague Lipiodol deposits.

DNA interstrand crosslinking agents and human ocular fibroblasts: differential sensitivity to mitomycin-C and cis-diaminedichloroplatinum(II)

Although clinical application of mitomycin-C (MMC) as an adjunct to glaucoma filtration and pterygium ablation surgeries is based on its inhibitory effect on the local fibroblast proliferation, the extent to which fibroblasts of Tenon's capsule and adjacent tissues (ocular fibroblasts) are susceptible to MMC still remains to be investigated. In this context, we substantially compared the sensitivity of ocular fibroblasts to MMC with normal fibroblasts of other tissue origins and with Fanconi's anemia (FA) fibroblasts known to be supersensitive to MMC due to presumable genetic susceptibility. Since MMC kills cells mainly by forming DNA interstrand crosslinks, cis-diaminedichloroplatinum (CDDP), another crosslinking agent, was also used to evaluate the cytotoxic effect of crosslinks on ocular and other fibroblasts. Following the treatment with various concentrations of MMC or CDDP for 1 hr, fibroblasts were incubated for 14 days until colonies developed. Based on the colony number reflecting the cell number which survived, the regression lines of survival rates were plotted in a semilogarithmic fashion. D0 and D10, doses which reduced survival rate to 37% and 10%, respectively, were interpolated and compared among the three cell groups. Ocular fibroblasts were about 2.5 times more sensitive than other normal fibroblasts, but 4-5 times more resistant than FA fibroblasts, to MCC, since the mean D0 of ocular, other normal, and FA fibroblasts was 0.063, 0.171 and 0.015 micrograms ml-1, respectively, and the mean D10 of these was 0.154, 0.401 and 0.029 micrograms ml-1, respectively. On the other hand, ocular fibroblasts exhibited an isosensitivity to CDDP compared with other normal fibroblasts. FA fibroblasts showed a supersensitivity to CDDP as well. DNA synthesis assay analysed by immunocytochemistry using bromodeoxyuridine (BrdU) and anti-BrdU antibody showed a similar hypersensitivity to MMC but a normosensitivity to CDDP of ocular fibroblasts. These results may indicate that intracellular activation of MMC to the reactive reduced form progresses more effectively in ocular fibroblasts than in fibroblasts originating in other tissues. The hypersensitivity to MMC of ocular fibroblasts is not attributed to genetic susceptibility because of the normosensitivity to CDDP. CDDP may be a promising agent as an alternative to MMC in the ophthalmic fields.

Significance of interleukin 6 in patients with sarcoidosis

Interleukin 6 (IL-6) levels in various materials from patients with sarcoidosis were determined. The subjects of the study were 38 patients with sarcoidosis and 28 healthy controls. For detection of IL-6, an enzyme-linked immunosorbent assay method was used. Interleukin 6 activity in serum was detected in 4 of 30 patients, but not in 19 controls. In bronchoalveolar lavage (BAL) fluid, following 20-fold concentration, IL-6 activity was detected in four of ten patients (nonsmokers) and three of seven controls (two of two smokers and one of five nonsmokers). Interleukin 6 levels in the supernatants of cultured monocytes and alveolar macrophages (AMs) were significantly higher (p < 0.01 and p < 0.01, respectively) in patients with sarcoidosis than in controls. Interleukin 6 production from monocytes tended to correlate with that from AMs. A significant correlation (r = 0.70, p < 0.05) was found between IL-6 production from AMs and the ratio of CD4+/CD8+ in BAL fluid, although no correlation was observed between that from monocytes and CD4+/CD8+ ratio in BAL fluid. Taken together, IL-6 may be involved in the initiation and maintenance of alveolitis by activating and causing the proliferation of T cells.

Developmental stage- and spermatogenic cycle-specific expression of transcription factor GATA-1 in mouse Sertoli cells

GATA-1 is an essential factor for the transcriptional activation of erythroid-specific genes, and is also abundantly expressed in a discrete subset of cells bordering the seminiferous epithelium in tubules of the murine testis. In examining normal and germ-line defective mutant mice, we show here that GATA-1 is expressed only in the Sertoli cell lineage in mouse testis. GATA-1 expression in Sertoli cells is induced concomitantly with the first wave of spermatogenesis, and GATA-1-positive cells are uniformly distributed among all tubules during prepubertal testis development. However, the number of GATA-1-positive cells declines thereafter and were found only in the peripheral zone of seminiferous tubules in stages VII, VIII and IX of spermatogenesis in the adult mouse testis. In contrast, virtually every Sertoli cell in mutant W/Wv, jsd/jsd or cryptorchid mice (all of which lack significant numbers of germ cells) expresses GATA-1, thus showing that the expression of this transcription factor is negatively controlled by the maturing germ cells. These observations suggest that transcription factor GATA-1 is a developmental stage- and spermatogenic cycle-specific regulator of gene expression in Sertoli cells.

Expression and cellular localization of messenger RNA for plasminogen activator inhibitor type 1 in human astrocytomas in vivo

We investigated the expression and cellular localization of plasminogen activator inhibitor type 1 (PAI-1) in human astrocytoma in vivo. Northern blot and densitometric quantitation of PAI-1 mRNA indicated that PAI-1 transcripts were significantly higher in human malignant astrocytomas and especially in glioblastomas than in low-grade gliomas and normal brain tissues in vivo. Using in situ hybridization with paraffin-embedded surgical specimens of human gliomas and normal brain tissues, PAI-1 mRNA was abundantly expressed in glioblastomas. PAI-1 mRNA was localized mainly in tumor cells and endothelial cells. The distribution of PAI-1 mRNA expression was particularly abundant around areas of vascular proliferation and in remnant tumor cells surrounding necrotic foci. PAI-1 mRNA was also expressed in both the tumor and endothelial cells of anaplastic astrocytomas, whereas it was not expressed or only weakly expressed in low-grade astrocytomas or normal brain tissues. These results suggest that high expression of PAI-1 is associated with the malignant progression of astrocytic tumors and that excessive PAI-1 expression might be associated with intratumoral necrosis in glioblastomas.

Postoperative chemotherapy for gastric cancer in the elderly

Prolongation of the life span and improvement in technology make it more likely that the elderly will be surgically treated and chemotherapy will be prescribed, postoperatively. The relationship between postoperative chemotherapy and survival time after resection for gastric cancer in the elderly was examined in a retrospective review of data on 268 patients over the age of 70 years; all had been treated in the Department of Surgery II, between 1965 and 1987. Of these 268 patients, 161 were prescribed anticancer drugs, postoperatively. Postoperative chemotherapy was more often prescribed for those in the advanced stages of a malignancy. The survival time of those patients was shorter than for those who did not receive these drugs (p < 0.05). In a subgroup of our patients stratified to adjust for stage of the disease, there were no significant differences between the survival rates in cases of stages I, II or IV of the cancer. The survival time of patients with stage III and given chemotherapy improved compared to those not given chemotherapy (p < 0.01). Advanced chronological age is not sufficient justification to limit or withhold treatment with anticancer drugs. We propose that postoperative chemotherapy be prescribed for patients with gastric cancer, regardless of age.

[Induction of coronary artery spasm by combined cold pressor and hyperventilation test in patients with variant angina]

To examine whether or not a combination of nonpharmacologic provocative tests potentiated the occurrence of coronary spasm, the cold pressor test combined with hyperventilation was studied in 22 consecutive patients with variant angina admitted to our hospital. After a 12-lead electrocardiogram and blood pressure were recorded, the patient was asked to hyperventilate vigorously at a rate of 30 respirations per min for 6 min under continuous electrocardiographic monitoring. Immediately after hyperventilation, the cold pressor test was performed with the patient's right hand submerged in ice water for 2 min. In some patients who showed a positive response to the combined test, a hyperventilation and cold pressor test was performed on another day. Positive response (ST segment elevation > or = 0.1 mV) to the combination test was seen in 18 of 22 patients (82%). Positive response to the hyperventilation test was seen in seven of 11 patients (64%). The response to cold pressor test was all negative in seven patients. The onset of electrocardiographic changes by the combined test occurred an average of 120 sec (30-240 sec) after the end of hyperventilation, whereas the onset by hyperventilation test occurred an average of 210 sec later (60-370 sec). These results suggest the combination of the cold pressor test and hyperventilation test potentiated the occurrence of coronary spasm. The combined cold pressor and hyperventilation test is a powerful and useful nonpharmacologic provocative test for coronary artery spasm in patients with variant angina.

Human arterial smooth muscle cell strains derived from patients with moyamoya disease: changes in biological characteristics and proliferative response during cellular aging in vitro

Moyamoya disease is a progressive cerebrovascular occlusive disease that occurs frequently in children. The etiology is unknown. We examined changes in biological characteristics and responsiveness to serum mitogens during the in vitro cellular aging of arterial smooth muscle cell strains derived from patients with moyamoya disease (HMSMC) and compared them with those of cells from age-matched control patients (HCSMC). HMSMC had a normal human diploid chromosome constitution. HMSMC and HCSMC had almost the same in vitro life span and the age-related patterns of biological parameters were essentially the same. However, the doubling time at the early passages was significantly longer in moyamoya SMC than control SMC, although there was no significant difference at the late passages. Furthermore, the poor responsiveness of moyamoya SMC to platelet-derived growth factor was retained throughout the life span in vitro. These results support the hypothesis that functional alterations in vascular cells are involved in the mechanism of development of intimal thickening in moyamoya disease.

[Corneoscleral wound healing after self-sealing cataract surgery--1. Histological findings in the early postoperative period]

We investigated histologically wound adaptation and healing after self-sealing cataract surgery in rabbits in the early postoperative period. A scleral pocket (4 mm wide, 2 mm long) and an internal corneal flap (2 mm long) were made in one eye in a series of rabbits. After phacoemulsification, a balanced salt solution was injected to self-seal the wound (self-sealing group). After the same procedures were performed in the contralateral eye, a horizontal 9-0 nylon suture was placed in the wound (suture group). On the first day after operation, the adaptation of the wound was better in the suture group than in the self-sealing group. On the fourth day, the scleral wound space was filled with fibroblastic cells and fibrin-like substance, and activated keratocytes had accumulated along the corneal wound. Although inflammatory cells collected around the suture in the suture group, there was no remarkable difference between the two groups on the seventh day. These results indicated that the adaptation of the wound in the early period was different between the self-sealing group and the suture group, and that the difference might result in different peripheral corneal curvature. This might be one of the causes of the postoperative astigmatism in the early stage.

Localization of thymosin beta 4 to the neural tissues during the development of Xenopus laevis, as studied by in situ hybridization and immunohistochemistry

Thymosin beta 4, a polypeptide of 5 kDa, is known to have capacity to regulate actin polymerization by binding to an actin monomer. Distribution of Xenopus laevis thymosin beta 4 (XT beta 4) in the developing Xenopus larva was examined by means of in situ hybridization and immunohistochemistry. Analysis with in situ hybridization revealed that XT beta 4 mRNA becomes gradually localized to the neural tissues, notochord and inner epidermis during neurula stages. Intense accumulation of XT beta 4 mRNA was observed in the ganglions of cranial nerves and in the dorsal region of the spinal cord from stage 26 and onwards. XT beta 4 immunoreactivity (XTI) was observed in larvas at all developmental stages later than stage 26, tail bud embryo. Immunoreactivity was initially distributed to the ganglion of cranial nerve V and Rohon-Beard cells. As the development progressed, the XTI appeared in other neuronal groups. By late tadpole stages (stages 42-47) the XTI was found in the pineal body, oculomotor and trochlear motoneurons of the midbrain, various neurons in the rhombencephalon, ganglions of cranial nerves V, VII/VIII and IX/X. In the spinal cord the XTI was observed in Rohon-Beard cells, dorsal root ganglion cells, motoneurons and other spinal cord neurons. Immunoreactivity was seen in both cell bodies and axons of the neurons. These findings suggest that thymosin beta 4 plays a role in the development of neurons, especially of sensory neurons.

[The concept, definition and diagnostic criteria of sarcoidosis]

At the 1960 Washington International Conference on Sarcoidosis, the "Definition of Sarcoidosis" was set up by H.L. Israel. This definition was revised at 1975 New York Conference, and again as "The 1991 Descriptive Definition of Sarcoidosis" at 1991 Kyoto Conference (Sarcoidosis, 9 Suppl 1:33, 1992). As the cause (s) of sarcoidosis was still unknown, the definition of the disease will be a descriptive one. The 1991 definition consists of age-distribution, organs involved, diagnosis, immunological and laboratory findings, course and prognosis, and treatment of the disease, and is length of 230 words. This definition includes recent advances in the research of sarcoidosis, but needs numbers of improvements about the ethnical difference or efficacy of steroid-treatment. Recently, the Japanese Research Committee for Diffuse Lung Diseases of the Japan Ministry of Welfare, proposed the diagnostic criteria for sarcoidosis, and guides for the diagnosis of occular and cardiac sarcoidosis. These criteria and guides are consisted of items, and are designed to get diagnosis by applying the items. In this manuscript, these criteria and guides will be discussed.

[Phase-I clinical study of KW-2307 combined with cisplatin in non-small cell lung cancer patients]

A phase-I clinical study with coadministration of a new vinca alkaloid derivative KW-2307 with cisplatin (CDDP) at 80 mg/m2 to patients with non-small cell lung cancer was conducted by a collaborative study among 6 institutions. CDDP was given on day 1 and KW-2307 on days 1, 8 and 15, both intravenously. One 28-day course was specified to be repeated twice. The initial dose of KW-2307 was 15 mg/m2 and increased to 20 mg/m2 and then to 25 mg/m2. The numbers of enrolled subjects for each dose were 5, 8 and 12 cases, respectively, in the total 25 cases. This regimen as well as KW-2307 monotherapy induced leukocytopenia (neutropenia) as the main adverse reaction. The coadministration with CDDP tended to increase the occurrence of anorexia and nausea/vomiting. Tumor response was obtained in 5 among 24 evaluable cases (CR1, PR 4). The response rate in the cases untreated with KW-2307 and given at 20 mg/m2 or higher doses was 29.4% (5/17, 95% confidence interval of the response rate: 10.3 to 54.7%). Considering drug compliance, etc., the maximum tolerated dose in this regimen was supposed to be 25 mg/m2, and the recommended dose in phase-II study to be 20 mg/m2.

Blockade of liver macrophages by gadolinium chloride reduces lethality in endotoxemic rats--analysis of mechanisms of lethality in endotoxemia

We investigated the effects of gadolinium chloride (GdCl3.6H2O), which blocks phagocytosis by liver macrophages, on the mortality, blood tumor necrosis factor (TNF) levels, and hepatotoxicity in a lethal endotoxic shock rat model system [10 mg/kg body weight lipopolysaccharide (LPS) intravenously]. With administration of GdCl3, twice at 0.5 or 5 mg/kg, the survival rate 24 h after LPS injection was 56% and 100%, respectively, whereas the level of TNF in blood was not affected. Microscopic investigation of the liver revealed that the focal necrosis of hepatocytes under endotoxemia was completely protected by the administration of GdCl3 at 5 mg/kg. We then investigated the effects of GdCl3 on superoxide (O2-) production by isolated liver macrophages in vitro. The O2- production by liver macrophages isolated from control rats was suppressed by GdCl3 in a dose-dependent manner. GdCl3 also had a cytotoxic effect on these macrophages. The enhanced O2- production by liver macrophages isolated from sublethal endotoxemic (1 mg/kg) rats was suppressed by pretreatment with GdCl3 (5 mg/kg). It was suggested that lethality in endotoxemia cannot be explained only by the degree of increase in blood TNF levels and that the mechanism by which GdCl3 reduces mortality and hepatotoxicity in endotoxemia possibly includes suppression of superoxide production by liver macrophages.

[A case of unusual shaped pulmonary arteriovenous fistula]

Autopsy findings of pulmonary arteriovenous fistula (PAVF) was initially described by Churton in 1897. Since then, several hundreds of cases have been reported in Europe and the United States. In Japan, there has recently been an increase in case reports of PAVF. PAVF seems to be no longer a rare disorder in Japan. Several morphological classifications of PAVF have been reported. One of these classifies PAVF into 1) solitary types 2) multiple types and 3) diffuse telangiectasia. Another, for example, classifies the disorder into the following 3 types: 1) multiple telangiectasia 2) pulmonary arterial aneurysm and 3) pulmonary artery-left atrial communications. Many other classifications have been proposed. In the solitary type (PA aneurysmal type), fistulas are located at the relatively large, central vessels. Here we report a case of PAVF which presented not as a solitary aneurysm but rather as a distended and tortuous anomalous vessel.

[Sarcoidosis in identical twins]

Identical twin sisters who developed sarcoidosis at an interval of one year are reported. Case 1. (elder sister) A 22-year-old female was admitted to our hospital for examination of cervical lymph node swelling. Her chest roentgenogram showed bilateral hilar lymphadenopathy and the diagnosis was confirmed histologically by scalene node biopsy. Case 2. (younger sister) In 1987, at age 23, a routine chest roentgenogram showed bilateral hilar lymphadenopathy and the diagnosis was confirmed histologically by transbronchial lung biopsy. The occurrence of sarcoidosis in identical twins suggests that a genetic factor might be involved in the pathogenesis.

A case of hepatocellular carcinoma consisting of two solitary poorly differentiated polyclonal intrahepatic tumor nodules

Two intrahepatic solitary tumors consisting of poorly differentiated hepatocellular carcinoma (HCC) were identified as polyclonal HCC nodules by analysis of the pattern of integration of hepatitis B viral DNA into nuclear DNA. After the removal of each nodule by partial liver resection, recurrent multiple tumors appeared within 10 months postoperatively. The findings in this case suggest that the effectiveness of reduction surgery for intrahepatic multiple tumors is limited in solitary multicentric HCC that consists of poorly differentiated HCC.

In vitro study of teratogenic effects of caffeine on cultured rat embryos and embryonic cells

The teratogenic potential of caffeine was examined in vitro by a whole embryo culture system (WECS) and an embryonic cell culture system (micromas teratogen assay: MTA) in the rat. In the WECS, hyperemia of the tail, and a reduction of the placental size was induced by caffeine at concentrations higher than 50 micrograms/ml; hypoplasia of the forelimb bud was induced at concentrations higher than 100 micrograms/ml; hematoma in the yolk sac and dysmorphogenesis of the fore- and hind-limb buds, prosencephalon and tail were induced by 200 micrograms/ml caffeine. In the MTA, even with 200 micrograms/ml caffeine, the toxicological parameters obtained by proliferation and differentiation assays of the midbrain and limb bud cells were almost the same as in the control. In conclusion, caffeine induced various morphological anomalies, but did not affect proliferation or differentiation of cells in these experimental systems.

Cytokine synthesis and apoptosis by intestinal intraepithelial lymphocytes: signaling of high density alpha beta T cell receptor+ and gamma delta T cell receptor+ T cells via T cell receptor-CD3 complex results in interferon-gamma and interleukin-5 production, while low density T cells undergo DNA fragmentation

To study the biological consequences of cytokine production and apoptosis by intraepithelial lymphocytes (IEL), we have studied these characteristics in both the high and low density CD3+ IEL populations. Stimulation of low- or high-density CD3+ IEL via the T cell receptor (TCR)-CD3 complex using monoclonal anti-CD3, anti-alpha beta TCR or anti-gamma delta TCR antibodies resulted in opposing effects. In one case, a significant number of the high-density CD3+ T cells entered cell cycle from the resting stage (DNA replication was observed) and anti-TCR-CD3 treatment enhanced the numbers of interferon-gamma and interleukin-5 spot-forming cells in this cell fraction. In contrast, when the low-density alpha beta TCR+ or gamma delta TCR+ T cells were activated via the TCR-CD3 complex, DNA fragmentation was observed. These results demonstrated that the activation signals transduced via the TCR-CD3 complex resulted in their entry into the cell cycle and subsequent interferon-gamma and interleukin-5 production in the high-density IEL T cell subset. However, identical signals induced apoptosis in the majority of the low-density fraction of CD3+ IEL.

[A case of IgA nephropathy associated with psoriasis vulgaris]

Nephrotic syndrome due to IgA nephropathy was found in a 45-year-old man with psoriasis vulgaris. He was first diagnosed as psoriasis vulgaris at 20 years age and had exhibited proteinuria since 37 years of age. Recently, he developed nephrotic syndrome with unfavorable progression of psoriasis. The conditions of psoriasis and nephrotic syndrome were consistently parallel, and both diseases responded to corticosteroid therapy. The specimens from renal biopsy showed mesangial proliferative glomerulonephritis and sclerosis with mesangial deposition of IgA. Therefore, we diagnosed this case as IgA nephropathy. Twelve cases with chronic glomerulonephritis associated with psoriasis vulgaris have been published. All biopsied specimens from these cases showed mesangial deposition of IgA. Immune abnormalities have been reported in both diseases. The pathogenesis of psoriasis vulgaris and IgA nephropathy may be related through an immune mechanism.

Lipopolysaccharide-lipophorin complex formation in insect hemolymph: a common pathway of lipopolysaccharide detoxification both in insects and in mammals

The formation of the lipophorin-lipopolysaccharide (LPS) complex in Bombyx mori hemolymph and its role in LPS detoxification were explored. LPS, an antibacterial protein inducer in insects, was injected into B. mori larvae. Analytical density gradient ultracentrifugation revealed that after injection the LPS peak shifts to a zone of lower density with time. The shifted peak was identified as the lipophorin-LPS complex. This complex formation was also achieved in an in vitro mixture of cell-free hemolymph and LPS at 25 degrees C but not at 1 degree C. The lipophorin-LPS complex had a significantly lower capacity to elicit the mRNA of cecropin B, an antibacterial protein. The biological activity of reextracted LPS from the complex was slightly reduced in the Limulus test and no structural modification was observed in sodium dodecylsulfate-polyacrylamide gel electrophoresis (SDS-PAGE). These results suggested that the formation of lipophorin-LPS strikingly reduces the cecropin inducibility of LPS without any structural change in LPS. Similar serum lipoprotein-LPS complex formation and reduction of biological activities of LPS were also observed in mammals. We, therefore, suggest that the formation of the serum lipoprotein-LPS complex is a common pathway to inactivate LPS both in insects and in mammals.