[A case of fistula-cancer response to arterial chemoembolization]

Arterial chemoembolization was performed three times preoperatively for cancer associated with fistula-in-ano for diminishing the postoperative surgical tissue defect of the perineum. Partial response of the tumor to this treatment was confirmed by computed tomography. A sixty-two-year-old male patient recognized a mass in the perineum one and a half years ago. He had suffered from fistula-in-ano for thirty years. The mass increased its size and formed a tumor in the bilateral buttocks (12 x 9 cm and 9 x 9 cm in diameter). Biopsy specimen showed a moderately differentiated adenocarcinoma. Angiography showed a hypervascular tumor stain. The main feeders to the tumor were the superior rectal artery and bilateral internal iliac artery. Arterial chemoembolization was performed three times through the right and left internal iliac artery with Gelfoam particle. Arterial infusion chemotherapy was added through inferior mesenteric artery and bilateral internal iliac artery with a total 120 mg of adriamycin and 1,500 mg of 5-FU simultaneously. The tumor decreased in size to 44% of the preoperative size by the treatment. A radical operation was performed following the preoperative treatment. Preoperative arterial chemoembolization for cancer associated fistula-in-ano was considered to be helpful for local control.

p53 gene mutations in human prostate cancers in Japan: different mutation spectra between Japan and western countries

The involvement of p53 mutations in prostate cancers in Japan was investigated. To evaluate any possible clinicopathological significance, p53 mutations in 40 samples from 36 Japanese prostate cancers of different stages (five cases of latent tumors, three of stage A cancers, 10 of stage B, five of stage C and 13 of stage D), including four lymph node metastases of stage D cases, were examined by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis and sequencing. Mutations were detected in five of 40 samples (12.5%); four were in primary cancers and the other in a lymph node metastasis from one of them. All mutation-positive cases were in stage D, and the mutation frequency in stage D cases was 31%. This result indicates that p53 mutations may play a role in the progression of a subgroup of prostate cancers in Japanese, as observed for Americans and Europeans. However, a difference was noted between Japanese and Americans in the p53 mutational spectrum (at CpG site), presumably arising from variation in the underlying etiologic factors.

Functional analysis of the promoters of phenylalanine ammonia-lyase genes in pea

Pycnospore germination fluid of Mycosphaerella pinodes, a fungus pathogenic on pea, contains both an elicitor and a suppressor of the accumulation of pisatin, a major phytoalexin of pea. Transcription of the genes encoding key enzymes in the biosynthesis of pisatin, namely PAL (a gene encoding phenylalanine ammonia-lyase) and CHS (a gene encoding chalcone synthase), was shown to be activated upon the treatment of pea epicotyl tissues with the fungal elicitor and suppressed upon treatment with the fungal suppressor. To investigate the mechanisms underlying activation and suppression of plant defense genes by signal molecules secreted by a fungal pathogen and other stresses, such as ultraviolet (UV) light, we constructed chimeric genes composed of the 5'-flanking regions of two members of the PSPAL family (the genes encoding phenylalanine ammonia-lyase in Pisum sativum) fused to a bacterial gene for chloramphenicol acetyltransferase. Then, the cis-regulatory elements necessary for elicitor-mediated activation and suppressor-mediated suppression were examined in pea protoplasts. Functional analysis of 5' nested deletions of PSPAL1 and PSPAL2 suggested that an enhancer-like element is located in the TATA-distal region (-2,196 to -406) in PSPAL2. A cis-acting element(s) responsible for elicitor-mediated activation was found in the TATA-proximal region (-340 to -95 in PSPAL1; -406 to -158 in PSPAL2), in which the consensus sequence motifs known as box 1, box 2 and box 4 [Yamada et al. (1992) Plant Cell Physiol. 33: 715, Lois et al. (1989) EMBO J. 8: 1641] were present in close proximity. Furthermore, both promoters were activated by UV light but were partially suppressed in response to the fungal suppressor.

International comparison on ras gene mutations in latent prostate carcinoma

Latent carcinomas of the prostate, discovered at autopsy in men with no prior treatment for prostatic disease, were studied for ras proto-oncogene mutations. Subjects included 21 Japanese, 15 U.S. whites, 15 U.S. blacks, 20 Hawaiian Japanese and 10 Colombians. PCR and sequence-specific oligonucleotide hybridization identified mutations in 5 Japanese, in 1 Hawaiian Japanese, in 1 U.S. black, in 1 U.S. white and in 3 Colombians. The 5 Japanese tumor samples contained 3 point mutations in codon 12 of K-ras and 2 mutations in codon 12 of N-ras respectively. One tumor in a Hawaiian Japanese man also showed a K-ras point mutation at codon 12. Two Colombians and one U.S. black man had tumors with mutations at codon 61 of H-ras, while 1 Colombian showed an N-ras mutation at this codon. The overall frequency of ras gene mutations was low, but point mutations in codon 12 were most common in latent tumors of Japanese, who experienced the lowest incidence and mortality from this tumor. Latent tumors in men from ethnic groups with high mortality and incidence rates showed fewer ras mutations than the Japanese, and these were more likely to involve codon 61. This finding is consistent with prior studies of more aggressive clinical cancers in Japanese men that indicated a higher frequency of mutations at codon 61.

Visualization of DNA double strand breaks in the gerbil hippocampal CA1 following transient ischemia

To clarify the relationship between delayed neuronal death and apoptosis, we made an attempt to detect DNA strand breaks in the gerbil hippocampal CA1 pyramidal neurons following transient ischemia by an in situ DNA double strand breaks staining. The condensed nuclei of neurons in CA1 were occasionally seen and positively stained 3 days after ischemia. The degenerating dark neurons with condensed nuclei in CA1 markedly increased in number and were clearly stained for DNA strand breaks 5 days after ischemia, whereas normal-looking nuclei remained unstained. No neurons were stained in other hippocampal subfields and dentate gyrus. The present study strongly indicates that the CA1 pyramidal neurons die through an apoptotic process.

[Gallbladder carcinoma: expression of the c-myc and ras-p-21 oncogene products]

The expression of c-myc and p-ras-21 oncogenes was studied using an immunohistochemical method with monoclonal antibodies in 126 samples of gallbladder carcinoma (103 primary tumors and 23 metastatic lesions). Twenty five gallbladder samples without tumor evidence were used as controls. C-myc oncoprotein was positive in one control sample and p-ras-21 oncoprotein was negative in all. Among primary carcinomas c-myc was positive in 9 (9%) and p-ras-21 in 4 (4%); among metastatic carcinomas c-myc was positive in 6 (26%, p = 0.03 vs primary carcinoma) and p-ras-21 in 11 (48%, p < 0.001 vs primary carcinoma). There was a non significant association between c-myc and p-ras-21 expression and degree of histological differentiation and level of tumoral infiltration. It is concluded that c-myc and p-ras-21 oncoprotein expression is observed in less than 10% of primary gallbladder carcinomas and that this expression is significantly higher in metastatic carcinomas. This may reflect an activation or overexpression of these oncogenes in metastatic cells.

Tenascin expression and postnatal development of the human prostate

We investigated the distribution of tenascin during postnatal development of the human prostate. Monoclonal antibody specific to human tenascin was applied to paraffin sections by the avidin-biotin-complex method to examine its localization. Infantile prostates showed two distinct zones. The inner zone had sparse acini with fibromuscular bundles. The peripheral zone had similar acini and lighter stroma as compared with inner zone. Tenascin was found diffusely but weakly. The periglandular area occasionally showed immunoreactivity. The prostates from 9- to 13-year-old subjects had a morphology similar to that of the infantile gland. The difference was increased density of the acini. Immunoreactivity was low. In the prostates from 14- to 21-year-old subjects, the acini distribution was more crowded, and the epithelial lining had become taller in both zones. Tenascin distributed preferentially in the peripheral zone during this period. Simultaneously, the percent of glandular area in the peripheral zone rose abruptly. The dynamics of tenascin expression are closely associated with the development and maturation of the gland. The distribution of tenascin during the post-puberal period may suggest its participation in the preferential of prostatic carcinoma in the peripheral zone.

The frequency of latent prostatic carcinoma in young males: the Japanese experience

Prostates obtained at autopsy from five different ethnic groups were serially step-sectioned and examined microscopically using identical techniques and diagnostic criteria. The groups consisted of African-American and white males from the United States of America, Japanese immigrants in Hawaii, and Japanese men in Japan. The prostates were collected between 1965 and 1979. The fifth group consisted of newly collected prostates from indigenous Japanese between 1982 and 1986. The frequency of latent prostatic carcinoma from men under 50 years of age was compared to each other and with those from men over 50 years of age. Latent carcinoma was not found in men between 30 and 39 years old in any groups except indigenous Japanese men (6%) who died from 1982 to 1986. The frequency of latent carcinoma in the patients in fifth decade varied from 0 to 20%. Latent tumor was not found in the African-Americans in the fifth decade. There was an age-dependent increase in prostate cancer in all groups. The Japanese prostates from 1982 to 1986 had a higher rate of latent cancer than the ones from 1965 to 1979 in each decade. International comparison of the latent prostatic carcinoma from the patients under 50 years of age showed similar tendency as those from over 50 years old, Japanese men had a marked increase in the frequency of latent prostate cancer from 1965-1979 to 1982-1986. These data suggest that the prevalence of prostate cancer may be increasing worldwide.

[Routine pulmonary function tests--contributing factors of various spirogram and flow-volume parameters and their value in the diagnosis of small airway disease]

Spirogram and flow-volume analysis seems to be the most reliable and sensitive measurement in the routine pulmonary function tests. However, there remain many problems in the interpretation of the obtained values. In the present study the contributing factors for the spirogram and flow-volume parameters were elucidated through the multiple variable analysis. The analyzed parameters were VC, FEV1, FEV1%, MMF, Vp, V75, V50, V25, V50/V25-ratio, MTC75-50, MTC50-25, MTC25-RV and MTC75-50/MTC25-RV-ratio of 219 nonsmoking normal subjects. The tested predictor variables were age, height, weight, body surface area and obesity index. An F value of more than 2.0 of the predictor variables was assumed significant. The value of the obtained regression equation in the diagnosis of the small airway disease was examined in each parameter of 215 smokers. Obtained regression equations are contained different sets of predictor variables as compared with the conventional equations. There remained not a few unknown factors other than the constitutional factors especially in flow-volume parameters. Despite the presence of these unknown factors V50, V25, MTC50-25, MTC25-RV and MTC75-40/MTC25-RV-ratio were shown to be valuable parameters in the evaluation of the small airway diseases. The difficulties in the measurement and the evaluation of spirometry and flow-volume analysis in the elderly subjects, as well as the use of different criteria for the aged are discussed.

Peripheral benzodiazepine stimulates secretion of growth hormone and mitochondrial proliferation in pituitary tumour GH3 cells

High affinity receptors for peripheral benzodiazepines (PBD) are present within the pituitary gland. Whether these receptors influence cell growth, mitochondrial morphology and secretion of growth hormone was examined in pituitary tumour GH3 cells. Cells were incubated in medium with either 10% calf serum, or serum free medium, or serum free medium plus 10 nM of selective PBD ligands (PK11195 or Ro5-4864) or a central benzodiazepine ligand (clonazepam). Peripheral or central ligands had no effect on cell growth. Quantitative electron micrography, however, revealed that cells treated with PBDs had a 2.5-fold increase in the total mitochondrial area within cells, a 1.6-fold increase in the number of mitochondria, and a 2.0 to 2.7-fold increase on the number of dividing mitochondria compared to serum free controls. The activity of DNA polymerase gamma, which replicates mitochondrial DNA, was increased approximately 3 times the initial value after 6 h exposure to PBDs. The number of nucleolar organizer regions (NORs), which relate to the ultimate synthesis of cellular protein, showed a 1.4-fold increase in PBDs treated cells. Secretion of growth hormone was stimulated (240% of serum free control) by exposure to PBDs for 12 h. The central benzodiazepine ligand, clonazepam, had little effect on mitochondrial morphology or secretion of growth hormone. These findings suggest that PBD receptors may be involved in mitochondrial proliferation and may affect the secretion of pituitary hormones.

Effects of coenzyme Q10 on lung preservation: a study with an isolated rat lung reperfusion model

We studied the effect of Coenzyme Q10 (CoQ10) on lung preservation using an isolated rat lung reperfusion model. After the lung of a Wistar male rat was flushed with a solution consisting of 40 mM phosphate buffered saline, the heart-lung block was excised and immersed in the same solution at 10 degrees C for 6 hours. In experiment 1, CoQ10 was added to the flushing solution. In experiment 2, CoQ10 was injected i.v. 1 hour before the organ was harvested. After the preservation, both lungs were reperfused and ventilated for 30 minutes. No benefit was noted when CoQ10 was added to the flushing solution. However, when CoQ10 was pretreated one hour before harvesting, the lungs showed significantly better preservation in pulmonary artery pressure, airway pressure, gas exchange function and the wet/dry weight ratio than those of the control group. Thus, appropriate pretreatment of CoQ10 may have a beneficial effect on lung preservation.

Effects of pH and temperature on lung preservation: a study with an isolated rat lung reperfusion model

After the rat lung was flushed with 40 mmol/L phosphate-buffered saline solution containing 160 mEq/L of sodium and the heart-lung block was immersed in the same solution for 6 hours, the lung was reperfused with diluted autologous blood and ventilated for 30 minutes. Pulmonary artery pressure, airway pressure, difference in oxygen tension between inflow and outflow perfusate, and wet to dry weight ratio of the tissue were determined. Lungs treated at pH 7.75 showed a significantly lower pulmonary artery pressure and wet to dry weight ratio than those treated at pH 7.26 or 7.96. Organs preserved at 10 degrees C showed a significantly lower pulmonary artery pressure than those preserved at 5 degrees or 15 degrees C. When the effect of smaller temperature variations was examined, the 12 degrees C group showed a significantly lower pulmonary artery pressure than the 10 degrees C group. Thus, the isolated rat lung reperfusion model appears to provide an efficient screening system to examine the preservation solution or other conditions for lung preservation. Under the present experimental conditions, the optimal pH and temperature for rat lung preservation seem to be 7.75 and 12 degrees C, respectively.

Sarcomatoid carcinoma of the urinary tract

Sarcomatoid carcinoma is a rare variant of malignant tumor arising from the urinary tract. This tumor had been termed carcinosarcoma because of its carcinomatous and sarcomatous components. There is still some confusion in the terminology between true carcinosarcoma and sarcomatoid carcinoma; however, the latter is now regarded as primarily a malignant epithelial tumor with pseudosarcomatous transformation. Four cases of sarcomatoid carcinoma arising from the urinary tract are reported. The patients were a 77 year old female, and three males aged 62, 69 and 80 years. All but the eldest patient complained of gross hematuria. Surgical removal was performed in the younger three cases, and an autopsy was done in the remaining case. All the tumors were macroscopically polypoid. Histopathologic examination revealed fasciculated spindle-cell tumors with myxoid stroma or malignant fibrous histiocytoma-like spindle cell tumors. The epithelial nature was proven in these sarcomatous cells by immunohistochemical and/or electron-microscopic examinations. Only a small amount of squamous cell carcinoma components was also evident in the latter three cases. Although the younger three patients were alive at 44, 23 and 39 months' follow-up, respectively, constant careful monitoring is recommended.

[Treatment-resistant bacterial infection in specific bacterial species and developmental movement of new antibiotics--Mycobacterium]

Mycobacterium tuberculosis and atypical mycobacteriosis are potent diseases which had not been curable before. Progress of chemotherapy has a marked effect but not enough results. We are now waiting for the appearance of a new medicine. Other rifamycim derivatives are developed as antimycobacterial agents, which have a mainframe of 3'-hydroxy-5'-alkylpiperazinyl-benzoxazinorifamycins (KRMs). KRMs exceeds RFP in bacteriostatic function, and also have already established in vivo in chemotherapeutic efficacy. Another study will also reveal a higher of bactericidal function. We expect possibility of much more powerful and short-term initial chemotherapy.

Identification of a P-glycoprotein-related protein (mini-P-glycoprotein) which is overexpressed in multidrug resistant cells

Drug resistant variant cell lines were selected in vitro for resistance to adriamycin or vincristine, P388/ADR and P388/VCR-600, respectively, from P388 murine leukemia cells. These cells were demonstrated by immunoblot studies with P-glycoprotein specific monoclonal antibody (C219) to overexpress not only P-glycoprotein but also approximately 65 kDa protein, and the expression levels were found to correlate with the degree of resistance. Furthermore, in Northern blot analysis with an MDR1 cDNA as a probe, an overexpressed transcript with the length of about 2.4 kilobases which might encode this previously uncharacterized protein was also detected in the multidrug resistant cell line. Thus, it is suggested that this protein might be associated with multidrug resistant phenotype and be related to P-glycoprotein.

Tyrosine-specific protein kinase participates in the pathogenesis of acute immune complex alveolitis in rats

Rabbit IgG antibodies against ovalbumin (OA) was injected intravenously into Wistar rats. When the animals were challenged with OA aerosolized by ultrasonic nebulization, acute lung injury occurred as reflected by increased recovery of bronchoalveolar cells, especially polymorphonuclear leukocytes (PMN) in bronchoalveolar lavage fluid (BALF). Lung morphology demonstrated cellular infiltration in the alveolar septa and intra-alveolar hemorrhage. When the rats were administered ST-638, a novel tyrosine kinase inhibitor, intraperitoneally prior to nebulization, the number of PMN in BALF decreased in a dose-dependent manner and superoxide anion (O2-)-producing activity in peripheral leukocytes was significantly suppressed. Furthermore, the reagent inhibited migration of human peripheral blood neutrophils induced by the chemotactic peptide f-met-leu-phe in vitro. These studies strongly indicate that tyrosine kinase plays an important role in immune complex-triggered neutrophil-related lung disorders, and the novel tyrosine kinase inhibitor ST-638 attenuates lung injury by preventing superoxide production and neutrophil migration.

Increased release of platelet-derived growth factor from platelets in chronic liver disease

The concentrations of platelet-derived growth factor in serum in 7 healthy controls (61 +/- 9 years; mean +/- SD) and 10 patients (62 +/- 8 years) with chronic liver disease (chronic hepatitis and/or liver cirrhosis) were compared. The plasma concentration of platelet-derived growth factor was below the detection limit (< 0.45 microgram/l) in all the subjects studied. The peripheral blood platelet count in patients with chronic liver disease was significantly lower than that in control subjects. However, the concentration of platelet-derived growth factor in serum, which was assumed to be released from platelet, was similar in patients with chronic liver disease and control subjects. These results indicate that the mean amount of platelet-derived growth factor released from the same number (10(9)) of platelets, calculated from the serum platelet-derived growth factor concentration and the peripheral blood platelet count, in patients with chronic liver disease (33 +/- 11 ng/10(9) platelets) was significantly (p < 0.01) higher than that in control subjects (14 +/- 5 ng/10(9) platelets). Moreover, the amount of platelet-derived growth factor released from 10(9) platelets inversely correlated with the serum concentration of pseudocholinesterase activity (r = -0.65, p < 0.01), and correlated positively (r = 0.91, p < 0.01) with the percent retention of indocyanine green in serum, in all subjects studied. These findings suggest that the amount of platelet-derived growth factor releasable from platelets of patients with chronic liver disease is higher than that in normal subjects and that it correlates with the severity of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

DNA content in gallbladder carcinoma: a flow cytometric study of 96 cases

The DNA content in gallbladder carcinoma and its relation to histological and cytological features was studied in 79 primary gallbladder carcinomas and 16 metastases. Abnormal DNA content was observed in 48 (51%) of 95 cases. In primary carcinomas, 44 (55.6%) showed a diploid DNA content, and 35 (44.4%) were aneuploid. The majority of the metastatic lesions were aneuploid DNA (81.3%; P = 0.006). Marked differences in the coefficient of variation estimated by manual, Kosugi and Dean methods were detected (P = 0.005). Seventy-one per cent of early gallbladder carcinomas had a normal DNA content. In contrast 54% of the cases with subserosal or serosal infiltration had normal DNA content. In primary tumours the degree of architectural atypia had a close relationship with the degree of cellular atypia (P = 0.00001). Only two (15%) of 13 cases with mild architectural atypia, and 34 (51.5%) of 66 cases with marked architectural atypia were aneuploid. Only one (10%) of 10 cases with mild cellular atypia and 35 (51%) of 69 with high cellular atypia had abnormal DNA content (P = 0.01) The importance of DNA content as a marker in gallbladder carcinoma remains uncertain and its clinical importance requires further clinicopathological studies.

Characterization of lignoceroyl-CoA ligase activity in chicken liver microsomes

Lignoceroyl-coenzyme A (CoA) ligase activity was detected in microsomal fractions from chicken liver in the presence of alpha-cyclodextrin as a solubilizing agent of lignoceric acid. Heptakis(2,6-di-O-methyl)-beta-cyclodextrin (dimethyl-beta-cyclodextrin) and hexakis(2,6-di-O-methyl)-alpha-cyclodextrin (dimethyl-alpha-cyclodextrin), among the cyclodextrins tested, were more effective than alpha-cyclodextrin as solubilizing agents. We have characterized lignoceroyl-CoA ligase activity in comparison with palmitoyl-CoA ligase activity. Lignoceroyl-CoA and palmitoyl-CoA ligase activities showed a similar dependency on CoA concentration. However, lignoceroyl-CoA ligase activity exhibited responses to the Mg2+ ion, adenosine triphosphate (ATP), ATP analogues (adenosine monophosphate (AMP) and adenosine diphosphate (ADP)), and heat treatment, which were distinctly different from the responses of palmitoyl-CoA ligase activity. These results are consistent with the idea that lignoceroyl-CoA and palmitoyl-CoA are synthesized by two different enzymes.

Angiosarcoma of the chest wall with a gastric metastasis

A rare case of chest-wall angiosarcoma with high tendency of local recurrence and with a solitary gastric metastasis is reported. The patient was an 84-year-old man who had a left lateral thoracic mass with a colic pain. The histological diagnosis of a biopsied specimen suggested an angiosarcoma. The first resection was performed, the resected specimen consisted of the 8th, 9th and 10th ribs including the tumor. However the tumor recurred around the primary site and the second resection was undertaken eight months after the first resection. Only three months after the second resection a second chest-wall recurrence together with a solitary gastric metastasis was found. Progressive emaciation, anemia and thrombocytopenia became evident, and the patient died the 40th day after the gastrectomy. Primarily a wide resection of the chest wall beyond the pathologically negative region around the tumor is thought to be necessary.

Fatal bile pulmonary embolism following percutaneous transhepatic cholangiodrainage: case report and literature review

Bile pulmonary emboli were present at autopsy in a seventy-year-old woman who had undergone percutaneous transhepatic cholangiodrainage for pancreatic carcinoma obstructing the common bile duct. The patient also developed hemobilia following the drainage. In spite of emergency surgery, she died on the third day after the operation. Microscopic findings of the lungs at autopsy disclosed numerous bile emboli in the smaller arteries, arterioles, and capillaries. Review of the literature showed 13 cases of bile pulmonary embolism, 10 of which had an obvious history of marked jaundice and trauma to the liver, like the present case. Bile enters the systemic circulation through a fistulous communication made by trauma between the biliary tree and the hepatic vein.

Proliferating cell nuclear antigen in gallbladder carcinoma

Proliferating cell nuclear antigen (PCNA) expression was studied in 103 gallbladder carcinomas and 23 metastatic lesions as well as in 25 control non-neoplastic gallbladder specimens. Positive nuclear staining was observed in 88% of controls, in 92% of carcinomas and in 70% of metastases. The mean number of positive cells was 21.2% in controls, 44.1% in primary carcinomas and 32% in metastatic cancer cells. Differences which were significant were control v. primary tumour, P < 0.000001; control v. metastasis, P < 0.01 and primary tumour v. metastasis, P < 0.006. In 57 (60%) of the primary tumours there was positive staining in over 40% of tumour cells. We were not able to demonstrate any relationship between macroscopic or microscopic features and PCNA expression. However, tumours confined to the mucosa expressed PCNA more frequently than did more advanced tumours.