Glutathione derivatives enhance adriamycin cytotoxicity in a human lung adenocarcinoma cell line

We evaluated the effects of a panel of glutathione derivative (S-butyl, S-decyl, S-ethyl, S-heptyl, S-hexyl; S-methyl, S-nonyl, S-octyl, S-propyl and S-pentyl glutathiones) on glutathione-S-transferase activity in the cell lysates of a human lung cancer, PC-9. Glutathione derivatives inhibited glutathione-S-transferase activity in PC-9 cell lysates by up to 67%. When PC-9 cells were incubated with the IC50 concentration of adriamycin (200 nM) and with nontoxic concentrations (1 microM) of the glutathione derivatives, cytotoxicity ranged from -20% to +55% of the control levels. Enhancement of adriamycin toxicity by glutathione derivatives was significantly correlated with the inhibition of glutathione-S-transferase activity. S-decyl-glutathione, which was one of the most potent inhibitors of glutathione-S-transferase activity, significantly enhanced the adriamycin-induced antitumor effect in vivo. Findings suggest that some glutathione derivatives, including the S-decyl, S-octyl, and S-hexyl glutathiones, enhance adriamycin-induced cytotoxicity in part by inhibiting glutathione-S-transferase and that these agents may be useful as chemosensitizers for adriamycin therapy. In conclusion, the present results showed that some glutathione derivatives enhanced sensitivity of tumor cells to ADR by inhibiting GST activity. The use of BSO and EA as sensitizers to chemotherapy is currently being evaluated in clinical trials. The present data suggest that the use of GSH derivatives to modulate GST activity may improve the response to ADR.

Structure of the monophosphoryl lipid A moiety obtained from the lipopolysaccharide of Chlamydia trachomatis

Monophosphoryl lipid A was prepared from the lipopolysaccharide of Chlamydia trachomatis, converted to the methyl ester, and fractionated by reverse-phase high-performance liquid chromatography. The peak fractions were collected and analyzed by mass spectrometry. Matrix-assisted laser desorption/ionization and liquid secondary ion mass spectrometry of the first of two major high-performance liquid chromatographic fractions showed multiple quasi-molecular ions of MNa+ at m/z 1780, 1794, 1808, 1822, and 1836. The positive-ion liquid secondary ion mass spectrometry spectrum also showed a minor series of peaks at m/z 1916, 1930, 1944, 1958, and 1971, consistent with the formation of matrix adducts with 3-nitrobenzyl alcohol. Oxonium ions representing the distal subunit were observed at m/z 1057, 1071, 1085, 1099, and 1113. The second fraction was similarly analyzed and found to contain structural homologs of the first fraction. Based on this study, the major lipid A component of chlamydial lipopolysaccharide is a glucosamine disaccharide that contains five fatty acids and a phosphate in the distal segment. Three fatty acyl groups are in the distal segment, and two are in the reducing end segment. The acyloxyacyl group is located in the distal segment in amide linkage. Two structural series, differing by 14 atomic mass units in the reducing subunit, were observed. Chlamydial lipid A is complex and consists of at least 20 homologous structural components. The relatively low potency of Chlamydia trachomatis lipopolysaccharide in activating lipopolysaccharide-responsive cells might be related to the unusual fatty acid composition of the lipid A moiety.

Endocrine disorders associated with inappropriately high aromatase expression

Aromatase P450 (P450arom) is responsible for conversion of C19 steroids to estrogens in a number of human tissues, such as the placenta, gonads, adipose tissue, skin and the brain. Aromatase expression in human tissues is regulated by use of alternative promoters in the placenta (promoter I.1), adipose tissue (promoters I.4, I.3 and II) and gonads (promoter II). Aromatase expression is absent in the disease-free adult liver, adrenal and uterine tissues. Excessive or inappropriate aromatase expression in adipose fibroblasts and endometriosis-derived stromal cells, as well as in testicular, hepatic, adrenal and uterine tumors, is associated with abnormally high circulating estrogen levels and/or with increased local estrogen concentrations in these tissues. Whether systemically delivered or locally produced, elevated estrogen levels will in turn promote the growth of hormone-responsive tissues. We recently studied aromatase expression in testicular tumor and adipose tissue samples from prepubertal boys with gynecomastia, in hepatocellular cancer and adrenocortical tumor samples from adult men with gynecomastia, in breast adipose tissue samples proximal to breast tumors, and in endometrial cancer, leiomyoma and endometriosis tissues. Excessive aromatase activity and P450arom transcript levels were found in these tissue samples or in cultured cells derived from these tissues. In these neoplastic or non-neoplastic tissues or cells, the regulation of aromatase expression was studied in terms of alternative promoter use, both in vivo and in response to various hormonal stimuli. Our results were suggestive of a common metabolic abnormality associated with activation of a cyclic AMP-dependent signalling pathway that gives rise to transcriptional transactivation of aromatase expression via promoters I.3 and II in all of the above tissues. This article describes the common pathophysiological and molecular features of excessive aromatase expression in these disease states.

Effect of CPT-11 in combination with other anticancer agents in lung cancer cells

To determine the optimal combination of commonly used anticancer agents with 7-ethyl-10-hydroxy-camptothecin (SN-38), an active metabolite of 7-ethyl-10-[4(1-piperidino)-1-piperidino] carbonyloxy camptothecin (CPT-11), for chemotherapy of lung cancer, we studied the effects of SN-38 in combination with six representative anticancer agents on the human small cell lung cancer (SCLC) cell line, NCl N417, and the non-small cell lung cancer (NSCLC) cell line, PC-9. The anticancer activity was evaluated by MTT assay and the effects of drug combinations on ID50 were analyzed by an improved isobologram method. In the SCLC cell line, supra-additive effect was observed for SN-38 in combination with cisplatin, etoposide (VP-16) and paclitaxel (Taxol). An additive effect was observed for its combination with bleomycin. Sub-additive and protective effects were found in combination with adriamycin (ADR) and 5-fluorouracil (5-FU). In the NSCLC cell line, supra-additive and marginal supra-additive effects were found for SN-38 in combination with VP-16, ADR, 5-FU and bleomycin. The others showed additive effects with SN-38. No drug showed sub-additive and protective effects with SN-38. These results suggest that all the drugs we selected can be used with SN-38 simultaneously for NSCLC, while for SCLC, cisplatin, VP-16 and Taxol are the most suitable for combination with SN-38.

Prostaglandin E2 stimulates aromatase expression in endometriosis-derived stromal cells

C19 steroids are converted to estrogens by aromatase P450 (P450arom). Aromatase expression in humans is regulated by use of tissue-specific promoters in the placenta (promoter I.1), adipose tissue (promoters I.4, I.3, and II), and gonads (promoter II). The use of each promoter gives rise to a population of P450arom messenger ribonucleic acid (mRNA) species with a unique untranslated 5'-terminus. Aromatase is not expressed in the endometrium of disease-free women. We demonstrated, however, the presence of P450arom mRNA in pelvic endometriotic implants and eutopic endometrial curettings of women with endometriosis. In the current report, aromatase activity and P450arom gene expression were investigated in cultured stromal cells derived from eutopic endometrium and ovarian endometriomas of women with pelvic endometriosis. We also investigated the hormonal regulation of aromatase expression and alternative promoter use in these cells. The effects of interleukin-1 beta (IL-1 beta), IL-2, IL-6, IL-11, oncostatin M, IL-15, tumor necrosis factor-alpha, PGE2, estradiol, R5020, dexamethasone, and dibutyryl cAMP (Bt2cAMP) on aromatase activity in endometriosis-derived stromal cells were assessed. We chose treatments with PGs and ILs because of the inflammatory nature of endometriosis. PGE2 stimulated aromatase activity in endometriosis-derived stromal cells by 19- to 44-fold (37-221 pmol/mg protein-4 h), whereas Bt2cAMP induction was 26- to 60-fold the baseline level. No stimulation was observed by estradiol or R5020 or by IL-1 beta, IL-2, IL-6, IL-11, IL-15, or TNF alpha in the presence or absence of glucocorticoids. A modest induction of aromatase activity (2-fold) was observed in dexamethasone- plus oncostatin M-treated cells. These changes in aromatase activity were accompanied by comparable changes in the levels of P450arom mRNA levels, determined by a quantitative reverse transcription-PCR method. Promoter-specific 5'-ends of P450arom transcripts in total RNA from endometriosis-derived stromal cells treated with PGE2 and Bt2cAMP were amplified employing a novel modified rapid amplification of cDNA5'-ends/Southern hybridization method using exon-specific oligonucleotide probes. The majority of P450arom transcripts in these cells contained the gonadal-type promoter II-specific sequences, whereas very few transcripts contained adipose-type promoter I.3- and I.4-specific sequences. PGE2 appears to be the most potent known stimulator of aromatase in endometriosis. Aromatase expression in PGE2-stimulated stromal cells of endometriosis is regulated primarily by the classically located promoter II, which, in turn, is regulated by cAMP. As PGE2 is known to increase intracellular cAMP levels, estrogen biosynthesis in endometriosis may be primarily regulated by PGE2 that is locally produced. Consequent local estrogen production may promote the growth of endometriotic implants.

[Delayed traumatic hernia diagnosed with magnetic resonance imaging]

A 30-year-old man was admitted to the hospital 7 years after an automobile accident during which a lumbar vertebra was fractured. Immediately after the accident he had neither thoracic nor abdominal symptoms. An X-ray film obtained 4 years after the accident showed elevation of the left side of the diaphragm. That elevation progressed over the next 3 years, although the patient had no symptoms. On admission, a chest X-ray film showed blunting of the left costo-phrenic angle and mobility of the shadow, which simulated a pleural effusion. A chest CT scan and barium studies showed that portions of the small intestine, transverse colon and descending colon were in the left side of the thorax, but the diaphragm was not seen. The patient was given a diagnosis of delayed traumatic diaphragmatic hernia after T1-weighted sagittsal magentic resonance images revealed the whole diaphragm and the hernial orifice. Magnetic resonance imaging can be very useful in the evaluation of diaphragmatic hernia.

Distribution and projection of the medullary cardiovascular control neurons containing glutamate, glutamic acid decarboxylase, tyrosine hydroxylase and phenylethanolamine N-methyltransferase in rats

This study was aimed at showing the distribution and projection of the medullary cardiovascular control neurons that contain a standard neurotransmitter or a related enzyme in the rat. A small amount of HRP was injected into either the depressor area of the caudal ventrolateral medulla (D-CVLM) or the pressor area of the rostral ventrolateral medulla (P-RVLM). Using an immunohistochemical method, we identified HRP-labelled neurons which were stained with antiserum to glutamate (Glu), glutamic acid decarboxylase (GAD), tyrosine hydroxylase (TH) or phenylethanolamine N-methyltransferase (PNMT). Our findings are summarized as follows. (1) The Glu-containing neurons in the nucleus tractus solitararii (NTS) project to the D-CVLM (n = 279, 100% assumed as a standard value) and P-RVLM (n = 225, 81% against the standard), indicating divergent excitatory projection. (2) The GAD-containing neurons in the NTS (n = 74, 27% against the standard) project to the P-RVLM, indicating the convergent inhibitory projection. (3) The projections of the TH-containing neurons from the NTS (n = 19, 7% against the standard) and CVLM (n = 4, 1% against the standard) to the P-RVLM are weaker than those of the GAD-containing neurons, suggesting that the catecholaminergic neurons play a minor role in inhibition of the sympathetic activity of the P-RVLM neurons. These results suggest that the glutamatergic NTS neurons excite both the P-RVLM and D-CVLM neurons, and the gamma-aminobutyric acid (GABA)ergic NTS and CVLM neurons inhibit the sympathetic activity of the P-RVLM neurons.

[Correlation between MR imaging and histopathological findings of cystic metastatic brain tumors]

To clarify the correlation between the histopathological findings and MR signal intensity of the cyst wall, fifteen cystic metastatic brain tumors of eleven patients were imaged using a 0.5T MR unit just before surgery, and the MRI findings were correlated with the histopathological findings of resected lesions. On T2-weighted images, all cyst walls showed hypointensity. On T1-weighted images, the intensity of the cyst wall could be classified into three groups, compared with the cerebral cortex. Walls with hyperintensity on T1WI(group H; n = 6) consisted of ample tumor cells, blood vessels and connective tissues, suggesting viable tumor cells. Iso-intense walls on T1W1(group I; n = 3)had abundant reactive glial tissues. Hypointense walls on T1W1 (group L; n = 5)revealed hemorrhage and/or hemosicerin in the wall, suggesting hemorrhagic necrosis. Thus a good correlation was demonstrated between the MR signal intensities and histopathological findings of cyst walls of cystic metastatic brain tumors. This may contribute not only to more precise diagnosis on MRI but also to more planning for treatment of cystic brain metastases.

[Interstitial pneumonia treated with intermittent cyclophosphamide pulse therapy]

A 52-year-old woman was admitted to the hospital because of polyarthralgia and dry coughing. A chest X-ray film showed bilateral diffuse reticulo-nodular shadows. A specimen obtained by transbronchial lung biopsy revealed alveolar septal thickening and infiltration by mononuclear cells. Interstitial pneumonia associated with rheumatoid arthritis was diagnosed. Interstitial pneumonia relapsed soon after the first pulse of corticosteroid therapy. Cyclophosphamide pulse therapy was given in addition to a second pulse of corticosteroid therapy; 700 mg of cyclophosphamide (500 mg/m2) was administered intravenously every month and the dose of steroids was gradually reduced. Cyclophosphamide pulse therapy was repeated three times and the dose of oral corticosteroids was reduced from 60 mg to 35 mg. There was no bone marrow suppression or hemorrhagic cystitis after the cyclophosphamide pulses. Eventually, corticosteroid therapy was stopped with no clinical deterioration. This case suggests that intermittent cyclophosphamide pulse therapy can be effective for treatment of interstitial pneumonia unresponsive to corticosteroids.

Barosensitive and chemosensitive neurons in the rat medulla: a double labeling study with c-Fos/glutamate, GAD, PNMT and calbindin

The purpose of this study was to survey distribution and density of the barosensitive and chemosensitive neurons in the medulla of rats anesthetized with fentanyl/midazolam, using immunohistochemical methods. After stimulation of the arterial baroreceptor or the chemoreceptor, we identified c-Fos-labeled neurons with immunoreactions to antisera of glutamate. PNMT, GAD and calbindin in the nucleus tractus solitarii (NTS) and the ventrolateral medulla (VLM). The double labeled neurons were located in the medical part of the NTS, and in the lateral part of the paragigantocellular reticular nucleus and the ventral division of the ambiguus nucleus. Main findings were as follows: (1) No significant difference was found in distribution and density of glutamatergic, adrenergic and calbindin-containing neurons between the barosensitive and chemosensitivie types; (2) a few GABAergic neurons were distributed almost evenly in the NTS and VLM, and in these neurons the barosensitive type outnumbered the chemosensitive one; (3) glutamatergic and calbindin-containing neurons were dominant in the NTS; adrenergic neurons in the VLM. (4) as for the adrenergic neurons in the NTS, the chemosensitive type significantly outnumbered the barosensitive one. This study showed that distribution and density of the barosensitive neurons, either glutamatergic, adrenergic, or calbindin-containing neurons, overlapped with those of the chemosensitive corresponding neurons, suggesting presence of the neural matrix of the cardiopulmonary interaction. Exceptionally, the number of the barosensitive GABAergic neurons was significantly larger than that of the chemosensitive GABAergic ones.

Granulocyte-colony stimulating factor promotes invasion by human lung cancer cell lines in vitro

The effects of exogenous and endogenous granulocyte colony-stimulating factor (G-CSF) on invasion by cancer cells were studied, using lung cancer cell lines that produce G-CSF (NCI-H157) and lines that do not (PC-9 and NCI-H23). The invasive capacity of NCI-H157 cells was 26- to 27-fold higher than that of PC-9 and NCI-H23 cells. The invasiveness of PC-9 cells was stimulated by exogenous G-CSF, while that of NCI-H157 cells was not. Antibodies against G-CSF blocked the stimulation of PC-9 cell invasiveness by exogenous G-CSF. Anti G-CSF antibodies also inhibited invasion by NCI-H157 cells in the absence of exogenous G-CSF. These results suggest that endogenous and exogenous G-CSF both stimulate invasion by lung cancer cells.

Immunohistochemical expression of glutathione S-transferase-Pi can predict chemotherapy response in patients with nonsmall cell lung carcinoma

BACKGROUND

Resistance to chemotherapy agents is a major problem in the treatment of patients with nonsmall cell lung carcinoma (NSCLC). Recent studies have indicated that glutathione S-transferase-Pi (GST-Pi) may play an important role in the resistance of cancer cells to alkylating agents, including cisplatin compounds.

METHODS

The expression of GST-Pi in tissues obtained by bronchoscopic biopsy from 38 NSCLC patients was investigated immunohistochemically. These patients were treated with a combination of cisplatin-based chemotherapy and were evaluated to determine the relationship between GST-Pi expression and chemotherapy response.

RESULTS

Of the 38 patients, 25 (66%) were GST-Pi-positive and 13 (34%) were negative. There was no significant correlation between GST-Pi expression and the clinicopathologic factors examined (age, sex, performance status, histology, differentiation grade, and stage). Of the 38 patients treated with cisplatin-based chemotherapy, 12 patients responded to chemotherapy (overall response rate, 32%). For the patients with negative GST-Pi expression, the response rate was 69% (9 of 13 patients). In the patients with positive GST-Pi expression, the response rate was 12% (3 of 25 patients). This difference was statistically significant (P=0.0012).

CONCLUSIONS

The expression of GST-Pi in NSCLC patients was significantly related to response to cisplatin-based chemotherapy, and may be a useful predictor of chemotherapy response.

Empyema following the percutaneous instillation of antifungal agents in patients with aspergillosis

We report two cases of empyema as a complication of the percutaneous instillation of antifungal drugs for pulmonary and pleural aspergillosis. Case 1 underwent percutaneous administration of amphotericin B and fluconazole for 2 months. Six months later, the patient was found to have an Aspergillus empyema with a bronchopleural fistula. Case 2 with pulmonary and pleural aspergillosis underwent percutaneous administration of amphotericin B for one month. Four months later, the patient underwent pleural drainage due to empyema. Pleural biopsy revealed pleural aspergillosis. In both cases, it was suggested that the preceding Aspergillus infection and percutaneous instillation of antifungals resulted in the development of empyema.

Immunohistochemical study of steroidogenesis and cell proliferation in polycystic ovarian syndrome

We evaluated the immunolocalization of the steroidogenic enzymes involved in the production of ovarian steroids, including the cholesterol side-chain cleavage enzyme (P450scc), 3beta-hydroxysteroid dehydrogenase (HSD), 17alpha-hydroxylase (P450c17) and aromatase (P450arom), oestrogen receptor (ER) and androgen receptor (AR), a steroidogenic transcription factor. Ad4-binding protein (Ad4BP) and a cell cycle-related nuclear antigen, Ki67, in five patients with polycystic ovarian syndrome (PCOS). Results were compared with those from normal cycling human ovaries to study in situ ovarian steroidogenesis and cell proliferation in polycystic ovaries (PCO). We classifed the follicles morphologically according to the development of granulosa types: type A, more than four layers (n = 7); type B, one to three layers (n = 11); and type C, theca interna cells only (n = 21). ER and P450arom were not observed in any of the follicles examined. In type A follicles, P450scc, 3beta-HSD, P450c17, AR and Ad4BP were observed in theca cells in all seven follicles examined, but the granulosa cells were positive only for Ad4BP (4/7) and AR (7/7). These immunohistolocalization patterns resembled those in non-selected antral follicles of normally cycling human ovaries. In theca cells from types B and C follicles, follicles positive for the steroidogenic enzymes, AR and Ad4BP were decreased in number. There were no significant differences between types A and B PCO follicles in the Ki67 labelling index of granulosa or theca cells, and between PCO and antral follicles from normally cycling human ovaries. Data demonstrate that the follicles of PCO are by no means atretic and are actively involved in both steroidogenesis and cell proliferation. The absence of ER and aromatase expression in the granulosa cells of PCO may be important in abnormal follicular development in patients with PCOS.

Bcl-2 expression as a predictor of chemosensitivities and survival in small cell lung cancer

PURPOSE

The bcl-2 gene belongs to a new category of oncogene that inhibits programmed cell death (apoptosis). No data are available on the frequency or clinical importance of its expression in patients with small cell lung cancer (SCLC), although its expression is reported in SCLC cell lines. We investigated the correlation between bcl-2 expression and prognosis, including response to chemotherapy, in SCLC patients and report our findings here.

MATERIALS AND METHODS

Tumor specimens biopsied bronchoscopically in 38 SCLC patients were used for immunohistochemical study. Bcl-2 oncoprotein was detected by obtaining an immunostain using a specific monoclonal antibody, DAKO-bcl-2, 124. All patients received more than two courses of chemotherapy with 3- to 4-week intervals.

RESULTS

We detected bcl-2 expression in 21 of the 38 SCLC patients (55%). In 17 patients with bcl-2-negative tumors, the objective response to chemotherapy was 76% with 12% complete response and in 21 patients with bcl-2-positive tumors it was 62% with 8% complete response. The difference in response rate was not significant. In patients with bcl-2-positive tumors, survival time tended to be shorter than in those with bcl-2-negative tumors. There was no significant correlation between bcl-2 expression and clinical factors (gender, age, smoking, performance score, staging).

CONCLUSIONS

In 21 of the 38 SCLC patients bcl-2 oncoprotein was abnormally expressed and its expression may be associated with shorter survival times and poor response to chemotherapy.

Characterization of dipalmitoylphosphatidylcholine liposomes containing a soybean-derived sterylglucoside mixture by differential scanning calorimetry, Fourier transform infrared spectroscopy, and enzymatic assay

Previously, we reported that dipalmitoylphosphatidylcholine liposomes (DPPC-liposomes) containing soybean-derived steryl glucoside mixtures (SG) (DPPC/SG-liposomes) accumulated in the liver, especially in parenchymal cells. DPPC/SG-liposomes and a mixture of DPPC and SG (DPPC/SG mixture) were compared by means of differential scanning calorimetry, Fourier transform infrared (FT-IR), and enzymatic assays. The results suggested that the maximum molar mixing ratios of DPPC and SG in a powder was DPPC:SG = 7:2.2. Enzymatic assays indicated that the glucose group of SG projected outward from the liposomal surface and that the amount of SG on the liposomal surface was limited, the maximum mole fraction of SG in DPPC/SG-liposomes being 0.27 (DPPC: SG = 7:2.6). FT-IR spectra indicated that the glucose group of SG interacts with the phosphate group of DPPC on the surface of liposomes, since the phosphate symmetric and asymmetric stretching bands of DPPC/ SG-liposomes were shifted to lower frequencies with increasing SG. These results suggested that the glucose group of SG projecting outward from the liposomal membrane contributes to the hepatic cellular distribution of DPPC/SG-liposomes.

P53 immunostaining predicts chemosensitivity in non-small cell lung cancer: A preliminary report

PURPOSE

Although resistance to chemotherapy is a major problem in cancer treatment, there is no predictor of treatment response. Recent reports suggest that p53 status may provide a genetic basis for drug resistance.

METHODS

Transbronchial biopsy specimens from 18 patients with non-small cell lung cancer were evaluated for p53 expression using anti-p53 antibody (DO-1). After biopsy, these patients received more than two courses of identical chemotherapy including cisplatin, carboplatin, and vindesine.

RESULTS

Ten of 18 (56%) patients responded to chemotherapy. The accumulation of p53 protein was detected in 10 of 18 (56%) patients. Positive staining for p53 was significantly correlated with unresponsiveness to chemotherapy. Other factors, including gender, performance status, body weight loss, serum albumin, and serum LDH, did not correlate with the immunohistochemical expression of p53.

CONCLUSIONS

These results suggest that immunostaining with p53 can be a predictor of the response to chemotherapy in non-small cell lung cancer. Further studies are needed to confirm the relationship between p53 expression and chemosensitivity.

[Pulmonary arterio-venous fistula treated by embolization with steel coils]

A 63-year-old man was referred to our hospital for evaluation and treatment of severe dyspnea on exertion which had persisted for a few years. He presented with cyanosis and markedly clubbed fingers, and laboratory data disclosed hypoxemia, polycythemia, and liver dysfunction. A chest X-ray film showed increased vascular markings in both lower lung fields. Arterial blood gas analysis showed severe hypoxemia, with a PaO2 of 46 Torr and a PaCO2 of 31 Torr while the patient was breathing room air. The PaO2 increased only slightly with inhalation of 100% oxygen, which suggested the presence of a large R-L shunt. The hepatopulmonary syndrome was diagnosed. Angiography of the pulmonary artery revealed a large pulmonary arterio-venous fistula with markedly dilated arteries in both lower lobes. Transarterial embolization was done three times with a total of 62 metal coils. There were no complications. Embolization reduced the shunt from 56% to 31%, increased the PaO2, and relieved the dyspnea. Pulmonary artery embolization can be useful in treating pulmonary arterio-venous fistulas associated with the hepatopulmonary syndrome.

Determination of timiperone in rat plasma by high-performance liquid chromatography with electrochemical detection

We report a sensitive new method for the determination of timiperone in rat plasma by using high-performance liquid chromatography with electrochemical detection. The method involves extraction of plasma samples with heptane-isoamyl alcohol at pH > 8, followed by back-extraction into dilute acetic acid. Separation was accomplished by reversed-phase high-performance liquid chromatography on an ODS column with the mobile phase consisting of 0.1 M phosphate buffer (pH 3.5)-acetonitrile-methanol (65:20:15, v/v). Recovery was greater than 80%. Calibration curve was linear over the concentration range 0.5-50.0 ng/ml. The limit of quantitation of timiperone was 0.5 ng/ml plasma.

A pivotal role of IL-12 in Th1-dependent mouse liver injury

Intravenous injection of Propionibacterium acnes and lipopolysaccharide (LPS) with a 7 day interval caused CD4+ T cell-dependent severe liver injury in the C57BL/6 (H-2b) mouse strain. In contrast, BALB/c (H-2d) mice were resistant to P. acnes and LPS-induced liver injury. The different susceptibilities of the two mouse strains to liver injury appeared to be closely correlated with their different abilities to produce IFN-gamma after P. acnes priming. Namely, the sensitive C57BL/6 mouse strain produced a significant level of IFN-gamma 7-10 days after P. acnes injection, whereas no significant amount of serum IFN-gamma was detected in the resistant BALB/c mouse strain. The important role of IFN-gamma in liver injury was demonstrated from the finding that in vivo administration of anti-IFN-gamma mAb abrogated P. acnes and LPS-induced liver injury in C57BL/6 mice. Moreover, it was demonstrated that in vivo administration of recombinant IL-12, a key cytokine for the induction of IFN-gamma, into mice induced P. acnes and LPS-induced liver injury in the resistant BALB/c mouse strain. Conversely, in vivo administration of anti-IL-12 mAb blocked the development of liver injury in the sensitive C57BL/6 mouse strain. Moreover, it was demonstrated that the failure of the induction of liver injury in BALB/c mice appeared to be derived from the lack of expression of IL-12 at the local site of liver in P. acnes-primed mice. These results strongly indicated that endogenous IL-12, which stimulates Th1-dominant cellular immunity and IFN-gamma production, may be an essential cytokine on the course of T cell-dependent liver injury.

Defects in the DNA repair and transcription gene ERCC2(XPD) in trichothiodystrophy

Trichothiodystrophy (TTD) is a rare autosomal recessive disorder characterized by brittle hair with reduced sulfur content, ichthyosis, peculiar face, and mental and growth retardation. Clinical photosensitivity is present in approximately 50% of TTD patients but is not associated with an elevated frequency of cancers. Previous complementation studies show that the photosensitivity in nearly all of the studied patients is due to a defect in the same genetic locus that underlies the cancer-prone genetic disorder xeroderma pigmentosum group D (XP-D). Nucleotide-sequence analysis of the ERCC2 cDNA from three TTD cell strains (TTD1V1, TTD3VI, and TTD1RO) revealed mutations within the region from amino acid 713-730 and within previously identified helicase functional domains. The various clinical presentations and DNA repair characteristics of the cell strains can be correlated with the particular mutations found in the ERCC2 locus. Mutations of Arg658 to either His or Cys correlate with TTD cell strains with intermediate UV-sensitivity, mutation of Arg722 to Trp correlates with highly UV-sensitive TTD cell strains, and mutation of Arg683 to Trp correlates with XP-D. Alleles with mutation of Arg616 to Pro or with the combined mutation of Leu461 to Val and deletion of 716-730 are found in both XP-D and TTD cell strains.

[Small cell lung cancer associated with ectopic ACTH syndrome]

A 70-year-old woman was referred to our hospital for diagnosis and treatment of a pulmonary mass detected on a chest X-ray film. Small cell lung cancer was diagnosed from pathological examination of a specimen of the tumor obtained by transbronchial biopsy. Paraneoplastic Cushing's syndrome was diagnosed on the basis of an elevated serum ACTH level (2000 pg/ml), the serum cortisol level (171.9 micrograms/dl), elevated excretion of urinary 17-OHCS (67 mg/day), persistent hypokalemia, metabolic alkalosis, hyperglycemia, central obesity, hypertension, systemic pigmentation, and the lack of a history of diabetes mellitus. Immunohistochemical staining with a polyclonal anti-ACTH antibody of a biopsy specimen from a lymph node with metastasis showed that tumor cells were weakly positive. The patient responded well to intensive chemotherapy with VP-16 (100 mg/m2 day 103), CBDCA (100 mg/m2 day 1-3), and CDDP (80 mg/m2 day 1). Complete response was obtained after 6 courses of chemotherapy. The serum ACTH level decreased rapidly as the tumor shrank. The primary tumor, however, relapsed after 3 months and the patient died of progressive disease, 11 months after diagnosis.

Parapyramidal rostroventromedial medulla as a respiratory rhythm modulator

After inhalation of 15% CO2, immunoreactions to glutamate and glutamic acid decarboxylase were found in some c-Fos or c-Jun-labeled neurons distributed in the reticular region just dorsal to the pyramidal tract in the rostroventromedial medulla (parapyramidal RVMM). This region forms vertically the narrow strip between the nucleus raphe pallidus and nucleus parapyramidalis superficialis, and extends rostrocaudally from the level just ahead of the inferior olivary complex to the level just behind the nucleus of the trapezoid body. When we placed lesions with kainate in the parapyramidal RVMM, hyperpneic and tachypneic responses to brief inhalation of 15% CO2 were completely abolished, and the eupneic rhythm changed into the gasping rhythm. This study suggests that the parapyramidal RVMM consists of neuronal substrates that subserve as the respiratory rhythm modulator.

A nested case-control study on alcohol drinking, tobacco smoking, and cancer

A nested case-control study was conducted to investigate the effect of alcohol consumption and tobacco smoking on cancers of various sites. The study population was based on 887 cases and 1774 controls, selected from a cohort of 17,200 male participants of a gastric mass survey in 1984, who were followed up for 9 years by the Chiba Cancer Registry, Japan. The odds ratio (OR) of colon cancer was significantly elevated in alcohol drinkers of one cup of sake-equivalent (27 ml ethanol) per day (OR = 3.5), and three cups of sake-equivalents per day (OR = 3.2) compared with nondrinkers, but its dose-response was not clear since two cups of sake-equivalents per day had an OR of 1.9, which was nonsignificant. Cancer risk elevation was especially predominant in the proximal colon, again showing no dose-response: OR = 30.7 for one cup of sake-equivalent per day, OR = 12.4 for two or more cups per day. Lung cancer showed a dose-response relationship with alcohol consumption, independent of tobacco smoking. A synergistic effect of alcohol intake and tobacco smoking was observed for upper aerodigestive tract and bladder cancer. Both alcohol drinking and tobacco smoking were found not to be associated with stomach cancer.