Influence of esculetin on incidence, proliferation, and cell kinetics of mammary carcinomas induced by 7,12-dimethylbenz[a]anthracene in rats on high- and low-fat diets

The effects of a high-fat diet and esculetin were investigated on 7,12-dimethylbenz[a]anthracene (DMBA)-induced mammary carcinogenesis in female Sprague-Dawley rats. Rats were given a 5-mg dose of DMBA. Seven days later, they were fed either a high-fat (20% soybean oil) or low-fat (0.5% soybean oil) diet. A half of the rats received diets containing 0.03% esculetin. Esculetin significantly inhibited tumor incidence, growth and cell kinetics of the tumor in the rats fed the high-fat and the low-fat diets. Our findings indicate that DMBA-induced mammary tumorigenesis is affected by lipoxygenase products.

Effects of milbemycin D on microfilarial number and reproduction of Dirofilaria immitis in dogs

A single dose (1 mg/kg) of milbemycin D was administered orally to 24 dogs with microfilaremia of Dirofilaria immitis, and the number of circulating microfilariae was counted weekly. The number was decreased by 3 to 8% of the pretreatment levels 1 week after the drug administration. The number remained relatively stable for the first 8 weeks and was gradually increased thereafter without returning to the pretreatment levels by 20 weeks. Three or 4 dogs each were euthanatized on day 1, and 1, 4, 8, 12, 16 and 20 weeks after the drug administration to examine the effects of the drug on intrauterine microfilariae and embryos of the worms. Although no intrauterine microfilariae were destroyed directly by the drug, degeneration and collapse of morular embryos and decrease in the number of intrauterine microfilariae were observed 12 after weeks the drug administration. These findings became more remarkable with time, and no intrauterine microfilariae developed in any worms by 20 weeks. The electron-microscopic findings revealed that the nucleoli of oocytes had a high density in the worms of 1, 4 and 8 week groups. Unequal size of cleavage cells and decrease of polysome number were noticed in the early-stage embryos after 8 weeks. It was assumed that the drug might have some effect on the chromosomes or genes in the germinal stem-cell of the heartworm and interfere with protein syntheses, resulting in inhibition of embryonic development. Twelve dogs were given milbemycin D (1 mg/kg) a total of 4 or 6 times monthly according to a prophylactic program.(ABSTRACT TRUNCATED AT 250 WORDS)

[The surgical management of breast cancer, especially breast conserving treatment]

The management of breast cancer is highly controversial. Various operations have been performed at different hospitals. Herein, we reviewed the results of randomized clinical trials regarding breast conserving treatment, and axillary and internal mammary lymph node dissections. Variations in local-regional therapy may not substantially affect survival, but the incidence of local-regional failure is inversely related to the extent of operation and/or radiotherapy. At present, surgeons are highly recommended to perform adequate surgery which provides the ultimate local control, does not compromise the chance for cure and gives the best cosmetic and aesthetic results. Therefore, quadrantectomy with or without immediate reconstruction, axillary dissection and internal mammary biopsy and breast irradiation are more preferably recommended for ensuring local control and for providing a better cosmetic and psychological impact.

Prognostic significance of Helix pomatia lectin and c-erbB-2 oncoprotein in human breast cancer

We investigated the prognostic significance of Helix pomatia lectin (HPA) staining on disease-free and overall survival in 120 primary breast carcinomas. HPA staining was present in 58 (48%) of these carcinomas. It was significantly associated with axillary lymph node metastases (P < 0.001) and c-erbB-2 expression (P < 0.01). A univariate study revealed that disease-free and overall survival were significantly correlated with clinical stage, tumour size, axillary lymph node metastases. HPA staining and c-erbB-2 expression. In a multivariate study, all previous prognostic indicators except HPA staining and c-erbB-2 expression were independent factors. However, stratifying the patients on the basis of HPA and c-erbB-2 status suggested that HPA +/c-erbB-2+ status was predictive of a higher incidence of axillary lymph node metastases (P = 0.000001) and a poorer overall (P < 0.0002) and a shorter disease-free (P < 0.000006) survival when compared with the other subgroups, although this combination did not provide any additional prognostic information for overall (P = 0.3544) or disease-free (P = 0.7152) survival by a multivariate analysis. For patients in whom axillary lymph node dissection has not been performed, therefore, HPA and c-erbB-2 status seems to be a powerful tool to discriminate subpopulations with a high recurrence risk and shorter survival who should undergo more aggressive therapy.

[A new leak test of anesthetic machine]

A case of the inspired PCO2 increase secondary to the malfunction of expiratory valve due to a defected edge of creator is presented. In this case, we could not detect the malfunction of expiratory valve using the preanesthetic routine leak test but found it by observing the expiratory phase of the capnometric curve. Therefore, we devised a new leak test for checking the malfunction of inspiratory and expiratory valves. This test is simple and effective. The test consists of the following procedures.: 1. Connecting yokes to the oxygen piping system. 2. Connecting the breathing bag. 3. Occluding the inspiratory terminal. Closing the semiclosed valve completely. 4. Flushing the O2 gas and increasing the pressure of breathing circuit to 30 cmH2O. 5. Monitoring the pressure gauge of the anesthesia system. If the function of valves is normal, the system pressure decreases slowly. If either of the valves works wrong, it decreases rapidly. We checked anesthesia machines in our facilities using the new leak test, and found some cases of the expiratory valve malfunctions.

Mastectomy with and without immediate breast reconstruction using a musculocutaneous flap

We compared surgical cosmetic results in 83 patients who underwent mastectomy with immediate breast reconstruction (MIBR) using a myocutaneous flap with those of 153 patients with breast cancer who underwent mastectomy without breast reconstruction. Cosmetic results were significantly better in patients who underwent MIBR than radical mastectomy or extended MIBR, although no intergroup difference existed in the reconstructive technique. Neither did any difference exist in the incidence of complications between patients undergoing MIBR and mastectomy without breast reconstruction, or between patients undergoing modified mastectomy and radical or extended mastectomy. Finally, MIBR did not appear to adversely effect recurrence or overall survival. We conclude that MIBR using a myocutaneous flap is an acceptable treatment option for patients with breast cancer.

Immunoreactive fucosylceramide as a B-cell differentiation marker

The reactivity of PC47H, a monoclonal antibody (mAb) directed against fucosylceramide, with cells of lymphoid lineage was examined. Immunoreactive fucosylceramide (FC) was recognized only in pokeweed mitogen (PWM)-stimulated B blasts, plasma cells and germinal center cells. mAb PC47H did not react with T cells at different stages or with peripheral blood B cells. Furthermore, FC was expressed abundantly in blastic cells of B-cell lymphoma, multiple lymphoma and myeloma cell lines KMS-12-BM and KMS-12-PE. In other words, FC was expressed more strongly in mature than in immature B cells. Immunoelectron microscopy showed that FC was located in the plasma membrane and rough endoplasmic reticulum. mAb PC47H can therefore be used as a unique B-cell differentiation marker for study of B-cell activation and differentiation and clonal analysis of lymphoid malignancies.

Cloning and expression of human Gal beta 1,3(4)GlcNAc alpha 2,3-sialyltransferase

Here we report the cDNA sequence of human Gal beta 1,3(4)GlcNAc alpha 2,3-sialyltransferase. The cDNA was isolated from a human placental cDNA library by screening with a 150bp probe generated by PCR using degenerate primers based on the sequences found in the sialyl motif. Comparative analysis of this cDNA with the rat liver alpha 2,3-sialyltransferase sequence indicates 91% nucleotide similarity between the two sequence in the predicted coding region. On the amino acid level, the degree of conservation is 97%. Surprisingly, Northern analysis indicated that the gene is expressed at low levels in human placenta but is abundantly expressed in skeletal muscle and fetal tissues.

Differential role in lipid peroxidation between rat P450 1A1 and P450 1A2

The role of cytochrome P450 (P450) in lipid peroxidation induced by NADPH or peroxide was investigated in a reconstituted system. When cumene hydroperoxide, t-butyl hydroperoxide and hydrogen peroxide were used as initiators, the rates of malondialdehyde (MDA) formation were much higher in a reconstituted system containing P450 1A1 than those observed in a reconstituted system containing P450 1A2. In contrast to peroxide-induced lipid peroxidation, P450 1A2 catalysed NADPH-induced lipid peroxidation more effectively than did P450 1A1 regardless of the presence of ADP-Fe(NO3)3. Carbon monoxide inhibited NADPH-induced formation of MDA in a reconstituted system containing P450 1A2, but not P450 1A1. In addition, superoxide dismutase (SOD) was an effective inhibitor in a NADPH-induced lipid peroxidation system catalysed by P450 1A2 but not by P450 1A1. These results suggest that a peroxide-induced reaction might proceed readily with P450 1A1, whereas P450 1A2 mainly functions in NADPH-induced lipid peroxidation via generation of an active oxygen species. It is furthermore indicated that the difference in the effect of SOD in NADPH-induced lipid peroxidation depends on the P450 used.

The psychological and cosmetic aspects of breast conserving therapy compared with radical mastectomy

An evaluation of the psychological and cosmetic morbidity of 31 patients who had undergone breast conserving treatment (BCT group) and 71 patients who had undergone radical mastectomy (RM group) revealed that 85% and 73%, respectively, were satisfied with their operative results. BCT appeared superior to RM in relation to body image, with 93% of the BCT group indicating BCT as a future choice of treatment, whereas only 35% of the RM group indicated RM as a future choice of treatment. For 59% of the BCT patients, the results were considered excellent or good by a physician, but fear of recurrence was frequently expressed by both groups even though an early stage of breast cancer had been significantly more common in the BCT group than the RM group. Sexual adjustment was the same in both groups. Body image was thus concluded to have been improved by BCT rather than RM, but psychological morbidity was essentially the same in both groups.

A retrospective study on the clinical and biological prediction of axillary lymph node metastasis in breast cancer

If axillary lymph node metastases were able to be accurately predicted, dissection could be avoided in some patients with breast cancer whose axillary nodes are clinically negative. In this study, we assessed the relationships between histological axillary lymph node metastases and clinical axillary nodal status, tumor size, DNA-ploidy, c-erbB-2 expression, and the score of the argyrophilic nucleolar organizer region. We then attempted to evaluate their predictive values for axillary lymph node metastasis in 173 patients with invasive breast cancer, retrospectively. The clinical and biological variables were significantly correlated with the presence and degree of axillary lymph node metastases. A metastatic index, calculated from the clinical and biological variables, proved especially useful for predicting axillary lymph node metastases in patients whose axillary nodes were clinically negative. However, the predictive abilities were still limited and thus it was concluded that as yet, only axillary dissection can provide accurate information on axillary lymph node metastases.

Poor prognostic value of proliferating cell nuclear antigen labelling index in breast carcinoma

AIM

To investigate the association between proliferating cell nuclear antigen immunostaining and various clinicopathological variables, and its prognostic value in breast carcinoma.

METHODS

A monoclonal antibody PC10 was applied to formalin fixed, paraffin wax embedded tissue in 144 cases of primary breast cancer. PCNA immunostaining was scored by counting 1000 cells; the percentage of positive stained cells was recorded as the PCNA labelling index (PCNA-LI).

RESULTS

The PCNA-LI varied from 0-77% with a mean of 18%. When tumours were separated on the basis of the mean value, 93 had a low PCNA-LI of less or equal than 18% and 47 a high PCNA-LI of more than 18%. There was no significant correlation between PCNA-LI and all prognostic factors included in this study. Moreover, PCNA-LI failed to show any prognostic value for overall and disease free survival.

CONCLUSION

PCNA immunostaining is not correlated with clinicopathological variables and patient survival in breast cancer.

Parkinson-like symptoms as a manifestation of systemic lupus erythematosus

A 42-year-old Japanese woman with systemic lupus erythematosus (SLE) developed Parkinsonian-like movements. Steroid pulse therapy was most effective and additional anti-Parkinsonian drugs were not required. Although psychosis, seizures and meningitis are common central nervous system (CNS) manifestations in SLE patients, Parkinsonian-like symptoms are extremely rare. The putative genesis and treatment of CNS lupus are discussed.

Further analysis of predictive value of Helix pomatia lectin binding to primary breast cancer for axillary and internal mammary lymph node metastases

We investigated the relation between Helix pomatia (HPA) staining of primary breast cancer and the presence of axillary (AX) or internal mammary (IM) metastases, and evaluated its predictive value for AX or IM metastases in comparison with the use of clinical variables. There was a significant association between the HPA staining and AX or IM metastases. When HPA staining was regarded as an indicator of AX metastases, a diagnostic accuracy of 72%, a sensitivity of 69% and a specificity of 75% were achieved. As an indicator of IM metastases, these values were 64%, 76% and 62%, respectively. In predicting the presence of AX metastases using a discriminant function with clinical AX status, location of tumour and tumour size, diagnostic accuracy, sensitivity and specificity were 79%, 69% and 87%, respectively. In predicting the presence of IM metastases using the discriminant function with clinical AX status and tumour size, these values were 74%, 71% and 75%, respectively. Therefore, it was concluded that the HPA staining may be useful, but it was equivalent with the discriminant function with clinical variables in prediction of AX or IM metastases.

The prognostic-significance of proliferating cell nuclear antigen in breast-cancer - correlation with DNA ploidy, C-erbb-2 expression, histopathology, lymph-node metastases and patient survival

We have investigated the relationship of PCNA expression with established clinicopathologic and biologic prognostic variables and determined its prognostic value in 91 patients with operable invasive breast cancer. The PCNA index varied within a range of 0-74% with the average in all specimens equal to 17%. When the tumors were separated on the basis of the mean value of the PCNA index, PCNA expression did not correlate with clinical stage, histologic type or grade, tumor size, axillary or internal mammary lymph node metastases, DNA ploidy, or c-erbB-2 expression. Moreover, PCNA expression did not appear to be a significant prognostic factor by univariate or multivariate analyses. Therefore, we conclude that PCNA expression does not correlate with established clinicopathologic and biologic prognostic factors and may not be useful in clinical practice to identify a poor prognostic group of patients with breast cancer.

Analyses of origin of synovial cells and repairing mechanisms of arthritis by allogeneic bone marrow transplantation

MRL/lpr mice spontaneously develop rheumatoid arthritis (RA)-like disease. Recently we have observed that bone marrow transplantation (BMT) with bone graft to recruit donor stromal cells can be used to treat autoimmune diseases (including RA-like lesions) in MRL/lpr mice. In this paper, we characterize the origin of synovial cells with the use of radiation chimeras and elucidate the repairing mechanism of RA by BMT. Type A synoviocytes have been thought to play an important role in the initiation of inflamed synovia, since a large number of Type A synoviocytes have been seen in inflamed synovia of both RA patients and MRL/lpr mice. Using [C57BL/6JJic-bg-->MRL/lpr] chimeric mice, we found Type A synoviocytes to be derived from donor bone marrow cells. They appeared in the inflamed synovia 4 weeks after BMT. However, at this time, the repairing process was not prominent. Serial biopsy studies revealed that newly developed T cells with normal functions play a more crucial role in the treatment of RA in MRL/lpr mice than do Type A synoviocytes.

Expressions of N-myc and ras oncogene products in neuroblastoma and their correlations with prognosis

Thirty-six neuroblastomas were studied to determine the clinical significance of the N-myc gene product, N-myc, and the ras gene product, p21. The expressions of both gene products were analyzed immunohistochemically using formalin-fixed paraffin sections. Neuroblastoma cells were positive for N-myc expression in 13 cases and for p21 expression in 19 cases. N-myc expressions showed no significant relation to any clinical prognostic factor, whereas p21 expression was well correlated with clinical staging and Shimada's classification. There was a tendency for p21 expression to be low in N-myc(+) tumors, whereas p21 expression was frequently detected when N-myc expression was absent. The survival rate for N-myc(-) patients was significantly higher than for N-myc(+) patients (P < 0.01). The survival rate for p21(+) patients was significantly higher than for p21(-) patients (P < 0.001). In addition, N-myc(+) and p21(-) patients showed a strong tendency towards a poor prognosis, whereas a combination of p21(+) and N-myc(-) indicated a good prognosis (P < 0.01). The results suggest that expressions of N-myc and p21 detected by immunohistochemical staining could be among the most reliable prognostic indicators in neuroblastoma patients.

A clomiphene citrate and tamoxifen citrate combination therapy: a novel therapy for ovulation induction

OBJECTIVE

To assess the efficacy of a clomiphene citrate (CC) and tamoxifen citrate (CC/tamoxifen) combination therapy in ovulation induction by comparing with a CC alone therapy.

DESIGN

A randomized cross-over study with CC alone and CC/tamoxifen combination therapies for 20 normoprolactinemic anovulatory women. Randomly selected 10 of the 20 women (group A) underwent a CC alone therapy (100 mg CC during cycle days 5 to 9) for the initial three consecutive treatment cycles and a CC/tamoxifen combination therapy (50 mg CC and 20 mg tamoxifen during cycle days 5 to 9) for the subsequent three consecutive treatment cycles. The remaining 10 (group B) were treated similarly but with the inverse sequence. Ovulation was documented when a high BBT phase persisted for 11 days or more, when midluteal serum P levels exceeded 7 ng/mL (22.3 nmol/L), or when pregnancy ensued.

RESULTS

The rates of ovulatory/treated, pregnant/treated, and pregnant/ovulatory cycles were 42 of 56 (75.0%), 3 of 47 (6.4%), and 3 of 35 (8.6%) for CC/tamoxifen, respectively. Those were 25 of 57 (43.9%), 1 of 48 (2.1%), and 1 of 21 (4.8%) for CC, respectively. Clomiphene citrate/tamoxifen was more effective in ovulation induction than CC. All the pregnancies were normal and single. None of the treatments was accompanied by any remarkable side effects.

CONCLUSION

Clomiphene citrate/tamoxifen is a novel treatment modality of ovulation induction with high efficacy.

Clinical and laboratory changes after administration of milbemycin oxime in heartworm-free and heartworm-infected dogs

Adverse reactions to oral administration of milbemycin oxime were investigated in heartworm (HW)-free and HW-infected dogs given either the minimal HW prophylactic dose (0.25 mg/kg of body weight) or the hookworm anthelmintic dose (0.5 mg/kg). In 12 HW-free control dogs treated with lactose excipient (100 mg/kg), abnormal signs were not observed. There were no differences between the 2 doses in prevalence of clinical signs of disease and laboratory test results. In 60 HW-free dogs (50 dogs administered the low dose, and 10 dogs given the high dose) and 46 nonmicrofilaremic HW-infected dogs (35 dogs administered the low dose, and 11 dogs given the high dose), only a transient and slight paleness of the visible mucous membranes, intestinal hyperperistalsis, or both were observed in some dogs. In 77 microfilaremic (MF) dogs (41 dogs administered the low dose, and 36 dogs given the high dose), weakness or loss of appetite was observed in 13 dogs (16.9%). Paleness of the visible mucous membranes was observed in 16 dogs (20.8%), intestinal hyperperistalsis was observed in 27 dogs (35.1%), and respiratory signs, such as mild labored respiration, were observed in 13 dogs (16.9%). Dullness of heart sounds was noticed in 4 dogs (5.2%). In 12 (9 dogs administered the low dose, and 3 dogs given the high dose) of 89 MF dogs (13.5%), adult heartworms migrated from the pulmonary arteries to the right atrium, causing signs of caval syndrome, including heart murmurs, jugular pulsations, and weakness. In HW-free dogs, rectal temperature tended to decrease gradually, and heart and respiratory rates were transiently decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood gas analysis in dogs with pulmonary heartworm disease

Blood gases were analyzed in dogs with pulmonary heartworm (HW) disease. The arterial oxygen tension (PaO2) in dogs with mild signs of dirofilariasis (mildly affected group, n = 48, 85.7 +/- 8.2 mmHg) and in dogs with signs of right heart failure (severely affected group, n = 13, 76.4 +/- 11.6 mmHg) was lower (p < 0.01) than in dogs without HW infection (HW-free group, n = 19, 91.5 +/- 7.3 mmHg). Only 2 dogs in the severely affected group had a PaO2 less than 60 mmHg. The arterial carbon dioxide tension (PaCO2, p < 0.01) and mixed venous O2 (p < 0.01) and CO2 (p < 0.01) tensions were lower, and alveolar-arterial oxygen difference (AaDO2, p < 0.01) was greater in the severely affected group than in the HW-free and mildly affected groups. Arterial pH and bicarbonate (HCO3-) concentrations were lower (p < 0.01) in both affected groups than in the HW-free groups. The anion gap level was not different among the 3 groups. Serum lactic acid level in the severely affected group was higher (p < 0.01) than in the HW-free and mildly affected groups. However, a slightly higher serum lactic acid concentration was found only in 2 dogs of the severely affected group (3.84 mmol/l and 3.82 mmol/l). The PaO2 (r = -0.62) and AaDO2 (r = 0.66) correlated significantly (p < 0.01) with mean pulmonary arterial pressure. One week after HW removal, blood gases, pH and HCO3- concentration remained unchanged in the mildly affected group. In the severely affected group, blood gas values were the same, but pH and HCO3- concentration improved slightly.

Risk of bilateral cervical lymph node metastases in papillary thyroid cancer

We evaluated the risk of bilateral or contralateral cervical lymph node metastases in 135 patients with papillary thyroid cancer who underwent bilateral neck dissection. We confirmed that bilateral jugular lymph node metastases were frequent in patients with obvious carcinoma in both lobes of the gland, in those with cancers arising in the isthmus, in those with clinically detectable bilateral lymphadenopathy, and in those with recurrent thyroid cancer. However, only 24% of the patients who had cancer clinically confined to one lobe with no bilateral or contralateral lymphadenopathy had histologically detected bilateral or contralateral jugular lymph node metastases. But the occurrence of contralateral jugular lymph node metastases was significantly correlated with both clinical lymphadenopathy in the ipsilateral neck and contralateral paratracheal lymph node metastases. Bilateral lymph dissection might be beneficial for these patients.

Influence of hormones on tumor growth, cell kinetics, estrogen receptor and insulin-like growth factor-I-related protein of human breast cancer (MCF-7) cells transplanted in nude mice

The influence of estrogens and tamoxifen on estrogen receptor (ER)-positive human breast cancer (MCF-7) cells transplanted into athymic nude mice was investigated. The mice were divided into the following three groups: (1) an E2 group with mice receiving 17 beta-estradiol dipropionate; (2) a TAM group with mice receiving tamoxifen; (3) a control group with mice given no hormone. (1) Tumor growth was significantly increased in the E2 group, but significantly decreased in the TAM group compared to control; (2) the tumor contents of insulin-like growth factor-I (IGF-I) and the rate of IGF-I-positive cells were significantly lower in the E2 group, but significantly higher in the TAM groups compared to control; (3) the IGF-I-positive cell rates were in significant inverse correlation with the [3H]thymidine-labeled cell rates in the E2, TAM and control groups. Thus, the tumor contents of IGF-I and the rate of IGF-I-positive cells were inversely correlated to the tumor growth and the [3H]thymidine-labeled cell rate in this in vivo study, although IGF-I is known to be a mitogen for breast cancer cells in vitro. Further studies are necessary to answer the questions as to the in vivo roles of immunoreactive IGF-I in ER-positive breast cancer.

Hemangioma of the upper arm associated with massive hemorrhage in a neonate

A rare case of an ulcerated hemangioma of the upper arm in a neonate is described herein. Resection of the huge hemangioma, which occupied the axilla and extended down the entire length of the upper arm, was necessary due to massive hemorrhage from the ulcer and progressive heart failure caused by the arteriovenous fistula in the hemangioma. After complete resection of the hemangioma, extensive defects of the skin and subcutaneous tissue were replaced by a skin flap closure technique which involved considerable difficulty. However, the arm gradually recovered its size and function with good wound healing. The present case illustrates that rapid surgical intervention may be required to prevent clinical deterioration in such cases.