A recurrent translocation, t(16;21)(q24;q22), associated with acute myelogenous leukemia: identification by fluorescence in situ hybridization

Chromosome fluorescence in situ hybridization (FISH) analyses were performed on bone marrow cells in 3 adult patients with MDS or AML with a (16;21)(q24;q22) translocation. FISH analyses with AML1 probes at 21q22 proved in all 3 patients splitting of the AML1 gene at a region spanning exons 5 and 6 and the translocation of its 5' segment to distal 16q. Chromosome painting FISH analysis in patient 1 proved the translocation of the distal 21q segment to 16q, but it failed to prove the presumed translocation of the distal 16q segment to 21q, most likely because of its small size.

[A case of intrathoracic chondrosarcoma of the rib head--comparison between MRI shadow and histopathological specimen]

A 71-year-old man was admitted our hospital because of mediastinal tumor. On chest X-ray, the mass was about 10 cm in diameter, contact with the right side of No. 3-5 vertebra and extended to the right thorax. After about 8 months, he felt anterior chest and back pain. Tumor was growing on chest X-ray and, on chest CT, linear and spotty calcification existed in it. On MRI, T1 weighted image, most part of tumor was low signal area but high area was also existed and it was parenchymatous hemorrhage. On T2 weighted image, tumor was high signal and irregular low area was calcification. Operation was performed and a hard tumor, measured 12 x 9 x 6 cm, originated from the 3rd-4th rib was resected. Histopathological diagnosis was chondrosarcoma. MRI was effective for the diagnosis of this case.

In vitro effects of sho-saiko-to on production of granulocyte colony-stimulating factor by mononuclear cells from patients with chronic hepatitis C

During the past 2 years, drug-induced interstitial pneumonia was reported in 66 Japanese patients, mainly among chronic hepatitis C patients, undergoing treatment with the Japanese herbal medicine "Sho-saiko-to" (TJ-9). As interstitial pneumonia is also induced by granulocyte colony-stimulating factor (G-CSF), we examined the effects of TJ-9 on G-CSF production in peripheral blood mononuclear cells. In patients with hepatitis B or C, G-CSF production in the absence of any stimulation was significantly lower than healthy controls (p < 0.01). G-CSF production increased along with the increase of TJ-9 levels, and this could induce excessive production of G-CSF in hepatitis C patients, and this may be a cause of interstitial pneumonia.

Expression of pS2 protein in endometrial carcinomas: correlation with clinicopathologic features and sex steroid receptor status

Using immunohistochemistry, we examined pS2 expression in 64 samples of endometrial carcinoma, 11 samples of endometrial hyperplasia and 15 samples of normal endometrium, and compared them with clinicopathological data, estrogen receptor (ER) expression and progesterone receptor (PR) expression. Of the 64 samples of endometrial carcinoma, 45 (70%) expressed the pS2 protein. The average age of the patients with pS2-positive carcinomas (54.8 +/- 8.6 years) was significantly lower than that of the patients with pS2-negative carcinomas, and all premenopausal patients were positive for the pS2 protein. Among histological types, pS2 expression was observed in 33 (92%) of the 36 G1 carcinomas, but in none of the 5 nonendometrioid carcinomas. Of the 48 ER-positive carcinomas, 43 (90%) were pS2-positive and 5 were pS2-negative. Of the 40 PR-positive carcinomas, 37 (93%) were positive for pS2. There were significant associations between pS2 expression and ER/PR expression (p < 0.001). Staining of the pS2 protein was also observed in the samples of normal endometrium. We found a progressive increase in immunoreactivity of pS2 protein from normal endometrium to endometrial hyperplasia and still more in well-differentiated carcinoma. All 11 cases of endometrial hyperplasia were strongly positive for pS2. Furthermore, patients with pS2-positive carcinomas had a better survival rate than those with pS2-negative carcinomas (p < 0.05). Our data suggest that pS2 expression is likely correlated with estrogen-related endometrial carcinoma and is possibly involved in early disease progression.

Wells' syndrome: a pathogenic role for circulating CD4+CD7- T cells expressing interleukin-5 mRNA

Wells' syndrome, or eosinophilic cellulitis, is a rare dermatosis characterized histologically by a dermal infiltrate of eosinophils, lymphocytes and histiocytes between collagen bundles and amorphous or granular eosinophilic deposits on collagen, constituting flame figures. We report a 54-year-old woman with eosinophilic cellulitis whose peripheral blood showed a marked eosinophilia and a high proportion of CD4+CD7- cells before treatment. Reverse transcriptase-polymerase chain reaction revealed that CD4+CD7- cells, but neither CD4+CD7+ nor CD4-CD8+ cells, in the circulating mononuclear cells expressed mRNA for interleukin (IL)-5, the major cytokine involved in eosinophilia. The proportion of CD4+CD7- cells decreased, and expression of mRNA for IL-5 disappeared in the peripheral blood, when the disease was treated by the administration of intravenous recombinant interferon-gamma. These findings suggest that circulating CD4+CD7- T cells play a pivotal role in the pathogenesis of eosinophilic cellulitis by producing IL-5.

A new synthetic lipid A analog, ONO-4007, stimulates the production of tumor necrosis factor-alpha in tumor tissues, resulting in the rejection of transplanted rat hepatoma cells

ONO-4007 is a new synthetic lipid A derivative with low endotoxic activities. We have examined the therapeutic effects of ONO-4007 on rat hepatocellular carcinoma KDH-8 cells, rat fibrosarcoma KMT-17 cells and rat mammary adenocarcinoma SST-2 cells in vivo. Multiple systemic i.v. administration of ONO-4007 was performed on days 7, 14 and 21 after tumor implantation of KDH-8 and SST-2 cells, and on days 5, 10 and 15 after tumor implantation of KMT-17 cells. ONO-4007 showed significant therapeutic effects on KDH-8 cells; by the administration of ONO-4007 (2.5 mg/kg) 70% of rats were cured and by the administration of ONO-4007 (5 mg/kg) 50% of rats were cured. Furthermore, the ONO-4007 treatment prolonged the mean survival time of KDH-8-bearing rats. However, ONO-4007 had no effect on KMT-17 and SST-2 cells, and it had no direct effect on the growth of KDH-8 cells in vivo. Albeit the stimulation with ONO-4007 induced mRNA expressions of interleukin (IL)-1alpha, IL-6 and tumor necrosis factor (TNF)-a, those of IL-2, IL-4, IL-10 and interferon (IFN)-gamma were not induced. Using a bioassay, we found that the production of TNF-alpha in the tumor tissues was induced by ONO-4007 in a dose-dependent manner. KDH-8 cells were sensitive to human natural TNF-alpha in vitro. However, KMT-17 and SST-2 cells were resistant against TNF-alpha in vitro. These results suggest that ONO-4007 is therapeutically useful for the treatment of TNF-alpha-sensitive tumors.

Increased expression of LH/hCG receptors in endometrial hyperplasia and carcinoma in anovulatory women

Endometrial hyperplasias and carcinomas are well documented to occur in anovulatory women with or without polycystic ovarian syndrome (PCO), which is characterized by hypersecretion of luteinizing hormone (LH). Although overexpression of LH/human chorionic gonadotropin (hCG) receptors has been demonstrated in endometrial carcinomas, whether LH/hCG receptors are also expressed in the endometrial hyperplasias is not known. In this study, the expression of LH/hCG receptors as well as that of progesterone receptors (PR) was analyzed by immunohistochemistry in 20 cases of normal endometria and 24 cases of endometrial hyperplasia and carcinoma (9 simple hyperplasias, 6 complex hyperplasias, 6 atypical hyperplasias, and 3 well-differentiated carcinomas). Fifteen of the 24 patients were 40 years old or younger, presumably anovulatory by BBT chart. Serum levels of LH, follicular stimulating hormone (FSH), prolactin, estradiol, and testosterone were measured by radioimmunoassay. Expression of LH/hCG receptors was detected in 19 of the 21 hyperplasias with a relatively stronger staining intensity in the glandular cells of complex or atypical hyperplasia as compared with normal endometrial glands or simple hyperplasia. In addition, all of the 3 carcinoma specimens showed stronger expression of LH/hCG receptors compared with normal endometria. The expression of LH/hCG receptors was well correlated with the staining for PR. Hormonal assay revealed 3 women to have the typical endocrinological profile of PCO. These findings suggest that the increased expression of LH/hCG receptors is a feature of endometrial hyperplasia and carcinoma developing in younger anovulatory women including those with PCO.

A modified stapling technique for esophagojejunostomy after total or proximal gastrectomy

BACKGROUND

Stapling devices reduce the leakage rate of digestive tract anastomoses, but they increase the risk of strictures. We investigated a newly modified technique of end-to-end anastomosis stapling in esophagojejunostomy after total or proximal gastrectomy.

STUDY DESIGN

A modified stapling technique (using a stapled anastomosis between esophageal mucosal and intact jejunal layers, with hand-sewn seromuscular sutures between the esophagus and jejunum) was used in 21 patients (modified group), while a conventionally stapled anastomosis was performed in 17 patients (conventional group). The incidence and severity of dysphagia and the size of the anastomosis as determined from x ray films were compared in the two groups.

RESULTS

The modified technique provided significantly better results for dysphagia severity than the conventional method (p = 0.0025). Most of the patients in the modified group had mild dysphagia, and most patients in the conventional group complained of moderate or severe dysphagia. In the modified group, the inner diameter of the anastomosis was 12.1 +/- 2.5 mm, significantly larger than that in the conventional group (10.0 +/- 1.8 mm; p = 0.009).

CONCLUSIONS

The use of our modified stapling technique can minimize the risk of anastomotic stricture and the feeling of dysphagia after esophagojejunostomy.

Prediction of incontinence following low anterior resection for rectal carcinoma

PURPOSE

This study was performed to predict incontinence following low anterior resection for rectal cancer.

METHODS

Preoperatively, 21 patients were evaluated via patient history and a physical examination that included anal manometric studies. Six months postoperatively, repeat manometric studies and clinical evaluations were performed to assess the level of continence. Degree of continence was graded based on severity of the dysfunction and grade of the continence score.

RESULTS

The formula used for predicted postoperative resting pressure is as follows: predicted postoperative resting pressure = 0.42 x preoperative resting pressure +1.56 x length of remaining rectum +12.37 (R2 = 0.58; P < 0.001). It was demonstrated that patients with low predicted postoperative resting pressures (< 30 mmHg) had incontinence, and those with high predicted postoperative resting pressures (> 35 mmHg) were continent. There were significant correlations between length of the remaining rectum and ratio of the decrease in maximum resting pressure (postoperative/preoperative maximum resting pressure; r = 0.63; P < 0.01).

CONCLUSIONS

Continence following low anterior resection may be influenced by maximum resting pressure function of the internal anal sphincter; if it is injured during surgery, incontinence will occur. We may be able to foretell incontinence by using the predicted postoperative resting pressure formula, which is calculated by using preoperative resting pressure measurements and then determining the length of the remaining rectum.

Increased cerebral choline-compounds in Duchenne muscular dystrophy

We investigated the hypothesis that cell membrane function is abnormal in brains of subjects with Duchenne muscular dystrophy (DMD) using proton-nuclear magnetic resonance (NMR) spectroscopy of human brain extracts. The total amount of choline-containing compounds was significantly higher (about three times) than in normal controls and patients with other myopathies, while N-acetyl-L-aspartic acid and creatine were within the normal range. These findings indicate that abnormal cell membrane function may be correlated with the abnormal dystrophin or lack of dystrophin in the brain of patients with DMD.

Ischemic damage and subsequent proliferation of oligodendrocytes in focal cerebral ischemia

In order to achieve a better understanding of the pathophysiology of ischemic white matter lesions, oligodendrocytic degeneration and subsequent proliferation were examined in the mouse model of middle cerebral artery occlusion. In situ hybridization histochemistry for proteolipid protein messenger RNA was employed as a sensitive and specific marker of oligodendrocytes, and immunohistochemistry for myelin basic protein was used as a compact myelin marker. Immunohistochemistry for microtubule-associated protein 2 and albumin was employed to monitor neuronal degeneration and the breakdown of the blood brain barrier, respectively. In the ischemic core of the caudoputamen, the immunoreactivity for microtubule-associated protein 2 disappeared and massive albumin extravasation occurred several hours after vessel occlusion, while proteolipid protein messenger RNA signals remained relatively strong at this time. The messenger RNA signals began to attenuate 12 h after ischemia and were hardly detectable 24 h after ischemia in the whole ischemic lesion. In situ end-labeling of fragmented DNA showed some cells with proteolipid protein messenger RNAs to have DNA fragmentation at this period. In contrast to proteolipid protein messenger RNA signals, the immunoreactivity for myelin basic protein was detected as long as five days after ischemia. An apparent increase in the cells possessing strong proteolipid protein messenger RNA signals was found five days after ischemia, mainly in the corpus callosum and the cortex bordering the infarcted areas. A double simultaneous procedure with in situ hybridization for proteolipid protein messenger RNA and immunohistochemistry for glial fibrillary acid protein or lectin histochemistry for macrophages/microglia showed proliferating oligodendrocytes to be co-localized with reactive astrocytes and macrophages/microglia. These findings show that oligodendrocytic damage occurred following ischemic neuronal damage and the breakdown of the blood brain barrier, but preceded the breakdown of myelin proteins in the ischemic lesion, that an apoptosis-like process was involved in ischemic oligodendrocytic death, and that surviving oligodendrocytes responded and proliferated in the outer border of the infarcted area.

C57BL/6 strain is most susceptible to cerebral ischemia following bilateral common carotid occlusion among seven mouse strains: selective neuronal death in the murine transient forebrain ischemia

Rats and gerbils have been used widely to investigate the molecular mechanism of selective neuronal death following transient global ischemia. Recently, the availability of transgenic mice has enabled us to examine the involvement of specific gene products in various pathophysiological conditions. However, there has been only limited information about the experimental model of cerebral ischemia in mice, particularly in regard to selective neuronal death. We examined whether bilateral carotid occlusion produced global forebrain ischemia in seven common mouse strains including C57BL/6, ICR, BALB/c, C3H, CBA, ddY and DBA/2, based on neurological signs, histological findings and cortical microcirculatory as well as India ink perfusion patterns. The C57BL/6 strain was found to be the most susceptible among seven strains. All C57BL/6 mice died within 6 h after permanent bilateral carotid occlusion. After transient bilateral carotid occlusion for 20 min, more than 90% of C57BL/6 mice showed typical neurological signs such as torsion of the neck and rolling fits, and developed selective neuronal death in the hippocampus and caudoputamen. Hypothermia prevented the neuronal death. Visualization of brain vasculature by India ink perfusion indicated that the susceptibility of the mice after bilateral carotid occlusion depended mainly on the degree of anastomosis between carotid and basilar arteries. Our results showed the feasibility of investigating selective neuronal death in transgenic mice with simple temporary occlusion of both common carotid arteries, when those from the C57BL/6 strain or inbred transgenic mice from other strains with the C57BL/6 strain in a back-cross manner are used.

Granulocyte-colony stimulating factor-induced proliferation of primary adult T-cell leukaemia cells

Granulocyte-colony stimulating factor (G-CSF) is known to induce proliferation and differentiation of granulocyte progenitors, and is widely used to treat neutropenia induced by intensive chemotherapy for malignant lymphoma or adult T-cell leukaemia/lymphoma (ATL). G-CSF is thought not to stimulate malignant lymphoid cells. In the present study we examined the ability of G-CSF to induce in vitro growth of primary ATL cells from 14 patients (nine acute-type, two chronic-type and three lymphoma-type), and we analysed the in vivo counts of ATL cells in patients who received G-CSF for neutropenia. FACS analysis using phycoerythrin-labelled recombinant G-CSF demonstrated that ATL cells from 11/14 patients express some G-CSF receptor (G-CSFR), with a range between 5.4% and 87.3%. Cells expressing G-CSFR also expressed CD4. Reverse polymerase chain reaction (PCR) analysis demonstrated expression of G-CSFR messenger RNA in G-CSFR expressing cells. Leukaemic cells derived from seven (four acute-type, one chronic-type and two lymphoma-type) of the 14 patients proliferated in vitro in response to G-CSF, as measured by [3H]thymidine incorporation; maximum responses were at G-CSF concentrations of 10-100 ng/ml. Nine of 14 patients receiving rG-CSF for neutropenia were analysed retrospectively for ATL cell numbers. Four patients whose primary tumour cells proliferated in response to rG-CSF in vitro showed a significant increase in ATL cell count after administration of rG-CSF (P = 0.038), whereas five patients whose leukaemic cells did not proliferate in vitro showed no significant increase in ATL cell count. G-CSF can stimulate proliferation of ATL cells which may complicate therapy for this disease.

Neuronal maturation and N-acetyl-L-aspartic acid development in human fetal and child brains

The developmental changes in N-acetyl-L-aspartic acid (NAA) were assessed in human fetal and child brains by means of high resolution proton magnetic resonance spectroscopy (MRS). NAA was detected in the cerebral cortex and white matter of fetuses of 16 weeks' gestation. NAA increased gradually from 24 weeks' gestation and remarkably from 40 weeks' gestation to 1 year of age. The developmental changes in tissue NAA in postnatal brains were found to be similar to those of NAA/Cr on clinical proton MRS. As the neuronal cell density in the cerebral cortex decreases with dendritic maturation, an increase in NAA with age may reflect the normal and abnormal development of axons, dendrites and synapses as well as neuronal soma.

Enhancement of lymphokine-activated killer cell activity by fibronectin

In this study, we demonstrated that immobilized fibronectin (FN) enhanced lymphokine-activated killer cell (LAK) activity, and that the enhanced LAK activity was completely abrogated by an anti-VLA-5 monoclonal antibody and RGD peptide. Fresh spleen cells expressed VLA-4, VLA-6, and vitronectin receptor, whereas VLA-5 was expressed only on the spleen cells activated with interleukin-2. LAK cells showed increased adhesion to immobilized FN compared with that to control bovine serum albumin, and the increased adhesion of LAK cells to immobilized FN was inhibited by anti-VLA-5 monoclonal antibody. Conjugate-formation assay showed that the LAK cells cultured on immobilized FN bound to target cells more efficiently than the control LAK cells, and that anti-LFA-1 monoclonal antibody inhibited the LAK-target cell binding. Immobilized type IV collagen and laminin, as well as FN, enhanced LAK activity. All of these results suggest that the interaction of integrins expressed on LAK cells with extracellular matrix proteins acts in a costimulatory manner for the enhancement of LAK activity, and that anchorage is necessary for full activation of LAK cells.

[Tumor reduction in advanced renal cell carcinoma with tumor thrombus by renal embolization, interferon-alpha and UFT. A case report]

A 73-year-old man with renal cell carcinoma involving the left renal vein was treated with the embolization of the left renal artery followed by interferon-alpha and UFT. Computerized tomography revealed 53% reduction of the primary lesion and 47% reduction of the tumor thrombus 40 days after treatment. The histopathological study revealed marked lymphocyte infiltration and necrosis of the tumor after nephrectomy.

Frequent expression of interleukin-9 mRNA and infrequent involvement of interleukin-9 in proliferation of primary adult T-cell leukemia cells and HTLV-I infected T-cell lines

To examine the possibility that interleukin-9 (IL-9) may be involved in oncogenesis and the proliferation of adult T-cell leukemia (ATL) cells, we examined the expression of IL-9 mRNA and growth response to IL-9 in five human T-lymphotropic virus type-I (HTLV-I) infected T-cell lines and in primary leukemia cells in peripheral blood from eight patients with ATL (four acute ATL and four chronic). Four out of five cell lines expressed IL-9 mRNA not correlated with Tax expression. Primary ATL cells from all patients also expressed IL-9 mRNA not correlated with the clinical forms. Recombinant IL-9 showed growth enhancing activity in only one out of five cell lines and one out of eight patients' primary leukemic cells. These results suggest the infrequent involvement of IL-9 in the proliferation of ATL cells, both primary tumor cells and HTLV-I infected T-cell lines.

Decrease in cerebral free magnesium concentration following closed head injury and effects of VA-045 in rats

1. We examined the alterations in cerebral free Mg2+ concentration in closed head injury (CHI) in rats and the effects of VA-045, a novel apovincaminic acid derivative, on them with in vivo 31P-NMR. 2. Free Mg2+ decreased by about 30% within 20 min after head impact and, afterward, it gradually decreased further to reach about 60% of the control level after 3 hr. VA-045 inhibited the decrease. 3. In nonimpacted rats, VA-045 did not alter the free Mg2+ level. 4. The decrease in cerebral free Mg2+ following CHI may be a critical factor in the development of irreversible tissue injury, and VA-045 may prevent it.

The fungus Gibberella fujikuroi produces copper/topaquinone-containing amine oxidase when induced by N-butylamine

Crude extract of Gibberella fujikuroi AKU 3802 mycelium induced with n-butylamine showed a single amine oxidase activity band in a non-denaturing gel that cross-reacted with the antibody against copper/topaquinone-containing amine oxidase from Aspergillus niger. The enzyme was purified by a procedure involving four chromatographic steps. Purified enzyme was pink with an absorption maximum at 490 nm. Molecular mass of 135 kDa estimated by gel chromatography and 70 kDa found by SDS-PAGE confirmed the dimeric structure of the enzyme. The enzyme readily oxidized n-hexylamine, n-butylamine, benzylamine and histamine, but not spermine or spermidine. Inactivation by carbonyl reagents and copper chelators suggested the presence of a copper/topaquinone cofactor. Spectrophotometric titration by p-nitrophenylhydrazine showed one reactive carbonyl group per subunit and redox-cyclic quinone staining confirmed the presence of a quinone cofactor. pH-dependent shift of the absorption spectrum of the enzyme p-nitrophenylhydrazone (465 nm at neutral to 580 nm at alkaline pH) supports the identity of the cofactor, with topaquinone. The N-terminal amino acid sequence of the enzyme showed high similarity to other microbial copper/topaquinone-containing amine oxidases.