[Survival in patients with clear cell carcinoma of the ovary]

Thirty-one patients with clear cell ovarian carcinoma who underwent primary surgery and postoperative therapy were retrospectively evaluated. Eighteen patients (58%) had International Federation of Gynecology and Obstetrics (FIGO) stage I disease, 3 patients (9.7%) stage II disease, and 10 patients (32.3%) stage III and IV disease. Patients with stage III and IV disease demonstrated a significantly poor prognosis compared with patients who had stage I or II disease (p < 0.01). No patients with stage III and IV disease survived 5 years. p53 protein expression and proliferative activity (PA) were studied by immunohistochemical methods using p53 molecule and antibodies to PCNA (proliferative cell nuclear antigen). Intranuclear accumulations of p53 product were observed in 15 of 31 (48.4%). On the other hand, 15 of 31 (48.4%) patients stained positively for PCNA (> or = 60% of cancer cells stained positively). Positive p53 staining and highly PA were associated with poor survival. Two patients with stage I a relapsed were positive p53 and highly PA. Accordingly, consolidation chemotherapy is necessary for patients with stage I a who are positive p53 and highly PA. Platinum-based chemotherapy for patients who had minimal residual tumor was effective, but 5 patients who had > or = 2 cm tumor burden were not effective at all. The response rate for platinum-based chemotherapy was 20% (1/5) among p53 positive, in contrast to 66.7% (4/6) among p53 negative patients. So it seems that p53 positive patients are chemoresistant.

[A randomized study on intravesical pirarubicin (THP) chemoprophylaxis of recurrence after transurethral resection of superficial bladder cancer]

A prospective randomized study was conducted to evaluate the efficacy of prophylactic intravesical instillation of tetrahydropyranyladriamycin (THP) following complete transurethral resection (TUR) of superficial bladder cancer. A total of 80 patients were randomized into "THP" or "control" group. In the THP group, 20 mg of THP dissolved in 40 ml saline (or 5% dextrose) was administered intravesically once a week for 10 weeks, starting from about 7 days after TUR. In the control group, 40 ml saline was given with the same schedule. The patients were followed up by cystoscopy and urinary cytology every 3 months. The number of evaluable patients was 36 for the THP group and 37 for the control group. The non-recurrence rates in the THP group and control group were 79.4% versus 63.2% at 1 year and 69.8% versus 47.4% at 3 to 5 years, respectively. These figures were not statistically significant. However, THP instillation significantly reduced tumor recurrence rates for multiple tumors, and also tended to decrease recurrence rates for primary and pT1 tumors. Adverse effects were observed in 53.6% of the patients in the THP group, but they were tolerable. Our results suggest that intravesical THP instillation would not be effective for all patients with superficial bladder cancer. Further study is warranted in a selected group of patients.

Hepatic injury localized to the field of total lymphoid irradiation

A 37-year-old woman with severe aplastic anemia underwent allogeneic bone marrow transplantation following cyclophosphamide (CY) and total lymphoid irradiation (TLI). On day +30, a CT scan was carried out because of a mild elevation in liver enzymes, and it revealed a low density area with a sharp border in the left lobe corresponding to the irradiated area. MRI showed a hypersignal intensity on both T1 and T2-weighted images and suggested that hepatic damage was mainly severe fatty change. These abnormalities resolved with no treatment. CY with TLI for adult patients with severe aplastic anemia may induce hepatic injury.

Transurethral visual laser ablation of the prostate for benign prostatic hyperplasia using a KTP/YAG laser

BACKGROUND

Transurethral visual laser ablation of the prostate (VLAP) has been established as an alternative method for the treatment of benign prostatic hyperplasia (BPH). However, most VLAP procedures utilize only a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. Since a potassium-titenyl-phosphate (KTP) laser offers limited tissue penetration, KTP can be safely utilized to excise part of the obstructing prostatic tissue. This study assessed the interaction between KTP vaporization and YAG coagulative ablation to determine the safety and efficacy of VLAP utilizing a combined KTP/YAG treatment.

METHODS

Forty patients with bladder outlet obstruction secondary to BPH were treated with VLAP using a KTP/YAG laser. The laser light was delivered by an angle delivery device.

RESULTS

Most cases demonstrated a significant improvement in routine subjective and objective parameters (AUA symptom score, peak flow rate, average flow rate, and amount of residual urine). No significant complications relating to this procedure were reported, however, 4 patients experienced postoperative acute urinary retention.

CONCLUSION

KTP/YAG laser ablation of the prostate is safe and effective for the treatment of BPH.

[A case of lung carcinoid]

A 78-year-old female was pointed out an abnormal shadow in left lung field. For 4 years this shadow was followed up as benign tumor. Chest CT scan revealed growing tumor and new tumor in right lung. Tumor resection was performed. Until operation time carcinoid syndrome was not found. This case was diagnosed histopathologically typical carcinoid of peripheral lung.

A beta-glucosidase gene downstream of the cellulose synthase operon in cellulose-producing Acetobacter

An open reading frame was found 214 bp downstream of the cellulose synthase operon of Acetobacter. The encoded amino acid sequence was found to be similar to some beta-glucosidases (G3ases). We detected G3ase activity in the culture medium and analysis of the N-terminal amino acid sequence showed that this gene encodes the enzyme. Therefore, it is possible that this region is a gene cluster for cellulose synthesis.

[Radiation therapy for adrenal metastases]

PURPOSE

To evaluate the role of radiation therapy for adrenal metastases.

MATERIALS AND METHODS

Fourteen patients, 13 with primary lung carcinoma and one with primary unknown carcinoma, received radiation therapy for adrenal metastases from 1984 to 1995 at the Hyogo Medical Center for Adults. Total dose ranged from 16 Gy to 60 Gy, and fractional dose from 1.6 Gy/ Fr to 3 Gy/Fr.

RESULTS

Partial response of the local tumor was recognized in 2 of 7 patients by CT imaging. Pain relief was obtained in 7 of 8 patients. Median survival was 3 months, and 6-month survival was 28.6% in all patients. Among patients in the symptomatic group, who had complaints of pain due to adrenal mass, survival was even worse (12.5% at 6 months). There were no severe complications, but 4 patients (29%) had gastrointestinal symptoms.

CONCLUSION

Radiation therapy is useful for the purpose of pain relief in adrenal metastases.

[Effect on 5'-deoxy-5-fluorouridine (5'-DFUR) of pyrimidine nucleoside phosphorylase (PyNPase), matrix metalloprotease and serum IAP values. Hokuriku Colorectal Cancer Chemotherapy Study Group]

PyNPase activity, MMPs activity and serum IAP values were measured in tumor tissues from colorectal cancer patients who had been divided into two groups, one given preoperative 5'-DFUR and the controls. PyNPase activity of the preoperative administration group was approximately equivalent to that of the controls. In the control group, correlations were assessed between PyNPase activity and activities of MMP1 and MMP3. To assess the effect of 5'-DFUR on the activity of MMPs, we divided patients into two groups, a high and a low PyNPase activity group. Although there was no correlation with MMPs activity of the preoperative administration group and the control group in the low PyNPase activity group, the activities of MMP1 and MMP9 of the control group were significantly higher in the high PyNPase activity group. Moreover, the serum IAP value of the administration group was significantly lower than that of the control group. These results indicated that PyNPase activity was thus suggested to be somehow related to MMPs activity and serum IAP values.

Trends of survival in neuroblastoma and independent risk factors for survival at a single institution

To assess the progress of survival in neuroblastoma which varies with many risk factors and to evaluate the influence of these factors on survival as independent risk factors. The study subjects were 159 neuroblastoma patients seen from 1965-1994 at the oldest and largest children's hospital in Japan. Trends of survival in three treatment eras-1965-81, 1982-86, 1987-94-were assessed by the Kaplan-Meier method for different sex, age at diagnosis, the clinical stage, the site of onset, and the histological type. Then the influence on survival of these factors as independent prognostic variables was evaluated by the Cox proportional hazards regression analysis. Age at diagnosis, the clinical stage, the site of onset, the histological type, and the treatment era were independent risk factors in the order of their influence on survival. Unfavorable survival outcomes were obtained for patients with age at diagnosis above 1 year, the clinical stage of VI by the Evans classification, adrenal onset, and neuroblastoma rather than ganglioneuroblastoma. Survival improved from the first to the second and from the second to the third treatment era. Improvement of survival in neuroblastoma took place during the past 3 decades. Age at diagnosis, the clinical stage, and the histological type have still remained overwhelming prognostic factors over the progress in treatment.

Cessation of spermatogenesis in juvenile spermatogonial depletion (jsd/jsd) mice

BACKGROUND

Mice homozygous for the jsd (juvenile spermatogonial depletion) allele are sterile because they become azoospermic. The onset of such azoospermia was investigated by histologic analysis of sections of testes from jsd/jsd mice.

METHOD

The testes removed from C57BL/6-jsd/jsd mice aged 3 to 10 weeks were examined microscopically.

RESULTS

At 3 weeks of age, spermatocytes were seen in most of the seminiferous tubules of jsd/jsd mice. However, the number of tubules that contained spermatids was significantly smaller than that counted in the wild-type mice. Since degenerative figures were not abundant in the jsd/jsd testes, the decreased number of spermatids found in the tubules suggested a longer duration of development from spermatocyte to spermatid in jsd/jsd mice. The abnormality extended to the development of type B spermatogonia, and a decrease in their number became apparent after 6 weeks of age in most of the jsd/jsd tubules. However, as early as 3 weeks of age, a few seminiferous tubules in jsd/jsd mice already contained only Sertoli cells and type A spermatogonia.

CONCLUSION

It is assumed that the decrease in type B spermatogonia occurred at various ages and locations. The defect of spermatogenesis in jsd/jsd mice was attributable to aberrations in multiple steps of spermatogenesis.

Pharmacokinetic analysis of benzodiazepine receptor binding of [123I]iomazenil in human brain

PURPOSE

The purpose of this study is to evaluate the central benzodiazepine (BZP) receptor binding of iomazenil (IMZ) by pharmacokinetic analysis and to establish a methodology for the diagnosis of CNS disorders with abnormalities in BZP receptor binding.

METHODS

BZP receptor binding of IMZ was analyzed kinetically using plasma concentration-time profiles and dynamic single photon emission computed tomography (SPECT) data obtained after the intravenous administration of IMZ to patients with neuropsychiatric disease. The analysis was based on a 3-compartmental model including the processes of both blood-brain barrier (BBB) transport and BZP receptor binding.

RESULTS

Hydrolized metabolite of IMZ was detected in plasma, indicating the need for separation by HPLC. The BBB influx clearance and the receptor binding potential of IMZ in the medial temporal region was reduced in the epileptic patient.

CONCLUSIONS

Our findings suggest the possibility of detecting the epileptic focus by using our method.

Loss of imprinting of the insulin-like growth factor II gene in renal cell carcinoma

Loss of imprinting (LOI) has been implicated in the pathogenesis of embryonal malignancies as well as adult cancers. Insulin-like growth factor II (IGF2) gene is an imprinted gene, normally transcribed only from the paternal allele. We investigated allele-specific expression of the IGF2 gene in 22 cases of renal cell carcinoma (RCC), a common adult-onset renal tumor. Sixteen cases (72%) were informative for IGF2 gene expression, and 9 (56%) of these cases showed biallelic expression of the IGF2 gene. Additionally, in four cases with biallelic expression from which uninvolved kidney tissue was available, LOI of the IGF2 gene was also demonstrated in the normal tissue. All cases with LOI of IGF2 were low-grade and low-stage tumors. LOI of the IGF2 gene in RCC was not associated with overexpression of IGF2 mRNA, whereas IGF2 overexpression was frequently observed in high-stage tumors. These results suggest that LOI of IGF2 predisposes to low-grade and low-stage tumors, whereas IGF2 overexpression may have a role in RCC tumor progression.

Adenosine 3',5'-cyclic monophosphate-stimulated Ca++ efflux and acetylcholine release in ileal myenteric plexus are mediated by N-type Ca++ channels: inhibition by the kappa opioid receptor agonist

Adenosine 3',5'-cyclic monophosphate (cAMP) is an important second messenger involved in cholinergic transmission. The aims of this study were to characterize the calcium channels associated with cyclic AMP-mediated acetylcholine release and Ca++ efflux in ileal myenteric plexus. We also examined if this process can be inhibited by agents such as opioids that inhibit N-type calcium channels via a pertussis toxin-sensitive G protein. Application of a cell permeant analogue, 8-bromoadenosine cyclic AMP (8Br-cAMP) (1 mM), and an activator of the adenylyl cyclase system, forskolin (0.1 mM), in a superfusion system resulted in both Ca++ efflux and 3H-acetylcholine (ACh) release from the dispersed myenteric ganglia. A preferential N-type Ca++ channel blocker, omega-Conotoxin GVIA (omega-CgTx, 10-100 nM), significantly inhibited 3H-ACh release stimulated by 8Br-cAMP. 10 nM omega-CgTx also totally inhibited 8Br-cAMP-induced Ca++ efflux, whereas the L-type Ca++ channel blocker, nifedipine (1 microM), and the T-type Ca++ channel blocker, nickel (100 microM), both had no effects on the action of 8Br-cAMP. 3H-ACh release during 0.1 mM forskolin stimulation was inhibited by pretreatment with a kappa receptor agonist, U50488H at 1 to 100 nM. In addition, U50488H significantly inhibited 3H-Ach release and Ca++ efflux elicited by 8Br-cAMP. Inhibition of 3H-ACh release by U50488H was reversed by 3 hr pretreatment with 300 ng/ml pertussis toxin. These results suggest that, in the myenteric plexus, cyclic AMP-stimulated Ca++ efflux and Ach release were mediated by N-type calcium channels. This process may be inhibited by activation of the kappa opioid receptor through pertussis toxin-sensitive G protein(s).

[Transurethral incision for ureterocele in children]

Transurethral incision (TUI) was performed as the initial treatment in 10 children with ureteroceles. Three patients had ureteroceles associated with a single ureter. TUI relieved hydronephrosis and preserved renal function in all 3 cases. Urinary tract infection developed in no patients. However, all the patients required an antireflux operation because of postoperative vesicoureteral reflux (VUR). Seven children had a total of 8 ureteroceles associated with a duplex system. TUI resulted in preservation of the upper pole function in 6 of the 8 ureteroceles. Urinary tract infections and VUR developed in 3 and 7 patients, respectively. Common sheath reimplantation was performed in 2 ureteroceles. TUI relieves obstruction before the onset of devastating infections although it carries the risk of postoperative VUR. We recommend TUI as the initial treatment for ureteroceles associated with both single and duplex systems.

Restriction of cadmium transfer to eggs from laying hens exposed to cadmium

The transfer of Cd to eggs of white Leghorn laying hens has been shown to be restricted. After Cd was injected ip into laying hens, the Cd concentrations in the blood, livers, ovaries, and eggs were measured. Although the Cd concentrations in the maternal blood and livers increased remarkably at certain levels of administrations, the Cd concentration in the yolks of eggs was not significantly increased, and was less than 0.04 microgram/g wet weight. After egg production stopped in the highest injected group (7.5 mg Cd/kg), Cd in the yolks of eggs had an accumulated range of 0.02-0.03 microgram/g wet weight. This was despite the high Cd accumulation in the liver. Furthermore, the Cd concentration in the follicle walls of the ovary increased and was 13- to 52-fold higher than in the follicle yolks. An additional experiment was conducted in order to estimate whether hatching success is affected by the Cd in the laid eggs of Cd-injected laying hens. The ratio of hatching success in the 0.3 or 1.2 micrograms Cd/egg-injected groups was similar to that in the saline-injected group, indicating that a small amount of Cd in the eggs might exert no marked influence on the hatching success. In conclusion, Cd transfer from laying hen to eggs was restricted after the maternal bird was exposed to Cd. Furthermore, Cd accumulates in the follicle walls of ovary. These results suggest that the follicle walls might play a role in protecting the follicle yolks against Cd toxicity.

Altered imprinting of the H19 and insulin-like growth factor II genes in testicular tumors

PURPOSE

H19 and insulin-like growth factor II (IGF2) genes are imprinted in normal human tissues. Recent reports have described loss of imprinting (LOI) for these genes in some malignancies. We therefore examined the allele-specific expression of the H19 and IGF2 genes in testicular tumors.

MATERIALS AND METHODS

Restriction fragment length polymorphisms were examined in 17 testicular germ cell tumors and 2 testicular malignant lymphomas.

RESULTS

All 4 informative testicular germ cell tumors showed LOI for the H19 gene. Five of 9 informative germ cell tumors showed LOI for the IGF2 gene, while testicular lymphomas did not show biallelic expression of the H19 or IGF2 gene.

CONCLUSION

Loss of imprinting for the H19 and IGF2 genes in testicular seminomatous germ cell tumors may be involved in oncogenesis.

Effects of amino acid replacements on cadmium binding of metallothionein alpha-fragment

To evaluate whether only 20 cysteine residues at invariant positions are needed to bind and coordinate the metals in metallothioneins (MTs), and whether changing the positions of cysteine residues in the sequence affects the metal-binding capacity and the coordination of MTs, we examined the cadmium-binding affinities of seven mutant MT alpha s using an Escherichia coli expression system. Five mutant MT alpha s in which the constitutive amino acid residues other than cysteines of the alpha-fragment were replaced with glycine residues, and the remaining two mutant MT alpha s in which the invariant positions of the cysteine residues of the alpha-fragment were shifted, were analysed for their ability to be expressed as cadmium-binding forms and for their biochemical properties. The results showed that extreme alteration of the constitutive amino acid residues other than cysteines in the MT alpha-fragment leads to disruption of their cadmium-binding abilities and of their structure. However, mutant MT alpha s containing changes of the invariant positions of the cysteine residues were expressed in a cadmium-binding form in Escherichia coli, although the invariant positions of 20 cysteine residues in the MTs are thought to be important for their metal-binding abilities. These results suggest that the position of cysteine residues and the chemical nature of the other amino acids in the amino acid sequence of MTs are less critical than expected.

Significance of alpha-fragment of metallothionein in cadmium binding

In order to evaluate the significance of alpha- and beta-fragments of metallothionein with regard to Cd binding in biosynthetic processes, the Cd-binding ability of four mutant metallothioneins was examined using the Escherichia coli expression system. The features of the mutant metallothioneins were proteins in which cysteine residues in the alpha- or beta-fragment were replaced with alanine residues, or that the sequential order of the fragments was altered. The expressed mutant metallothioneins having an intact alpha-fragment showed the constructive abilities of the Cd-thiolate cluster. On the other hand, mutant metallothionein having an alpha-fragment lacking metal-binding sites exhibited no Cd-binding ability. The condition for maintaining the Cd-binding capability of metallothionein was that the alpha-fragment remains intact irrespective of the sequential order of the two fragments. The alpha-fragment is an indispensable component in metal-binding processes of Cd-metallothionein.

[The correlation between interleukin-10 and interferon-gamma produced by peripheral blood mononuclear cells stimulated by house dust mite antigen in atopic dermatitis]

The production of interleukin (IL)-10 and interferon (IFN)-gamma by peripheral blood mononuclear cells (PBMC) stimulated by house dust mite (HDM)antigen and concanavaln A (Con A) was measured in patients with atopic dermatitis (AD). The HDM-stimulated PBMC from AD patients revealed to produce significantly higher levels of IL-10 (12 h: 918.4 +/- 206.5, 24 h: 1252.5 +/- 145.8, 72 h: 1332.7 +/- 123.9 pg/ml) than those from normal control subjects (12 h: 231.1 +/- 139.0, 24 h: 585.7 +/- 196.2, 72 h: 813.5 +/- 181.8 pg/ml). Con A-stimulated AD-PBMC also showed significantly higher levels of IL-10 production than those from normal controls, although they were lower than the productions induced by HDM antigen. By contrast, the levels of IFN-gamma from AD PBMC stimulated with HDM or Con A, were significantly lower than those from normal controls. IFN-gamm production might be down-regulated by IL-10 in AD-PBMC. The overproduction of IL-10 seems to show that helper T type 2 (Th2) cells are rather dominantly activated than Th1 cells and Th2 cells might contribute to produce the cytokines in response to HDM antigen in AD patients.

Differential role of metallothionein on Zn, Cd and Cu accumulation in hepatic cytosol of rats

To examine the role of metallothionein (MT) on heavy metal accumulation in hepatic cytosol of rats, this study was carried out to determine the relative Zn, Cd and Cu-binding capacities of MT in hepatic cytosol of Zn, Cd and Cu-injected rats, respectively. The heavy metal contents were detected in the liver and cytosol in the following proportions: 65.2-74.8% of the Zn content, 61.9-65.6% of the Cu content, and approx. 65% of the Cd content. Each rat was given a single intraperitoneal injection of saline, ZnSO4 (1, 5, 10 and 20 mg Zn/kg b.w.), CuSO4 (2, 4 and 6 mg Cu/kg b.w.) or CdCl2 (1, 2 and 3 mg Cd/kg b.w.). The amounts of the increased Zn and Cu were attributable to MT and high molecular weight proteins, while most of the increased Cd was attributable to MT. There was a close relationship between heavy metal content of the cytosol and MT in all heavy metal-injected rats. Our data demonstrated that approx. 60% of the increased Zn or Cu in the hepatic cytosol of Zn or Cu-injected rats was bound to MT, while 83% of the increased Cd in hepatic cytosol of Cd-injected rats was bound to MT. Therefore the order of relative binding capacity in vivo of MT determined for several metals (Cd > Zn > Cu) did not correlate with the published in vitro order of affinity to MT, Cu > Cd > Zn. These results suggested that the role of MT in Zn or Cu accumulation in the liver of Zn or Cu-injected rats was different from that of MT in Cd accumulation in the liver of Cd-injected rats.

A mutant metallothionein which has inverse fragment composition exhibits high cadmium-binding ability

In order to investigate the role of the alpha-fragment of metallothionein (MT) in metal-binding, two mutant MTs, beta Ala alpha Cys- and alpha Cys beta Cys-mutant MTs, expressed in Escherichia coli were analyzed for their metal-binding ability. A mutant MT where all of the cysteine residues in the beta-fragment of MT were substituted by alanine residues and another mutant MT that had the inverse fragment composition (alpha-beta, i.e., beta-alpha in wild-type MT) were designated as the beta Ala alpha Cys and the alpha Cys beta Cys-mutant MT's, respectively. Both expressed Cd-binding mutant MTs were identified by amino acid analyses. From their metal-binding capacities, the two mutant MTs exhibited higher Cd-binding abilities than wild-type MT. The results suggested that the alpha-fragment plays a key role in the Cd-binding of MT, and that the metal-binding tightness of MT is dependent on the metal-binding ability of a prior fragment in MT.