[Rational extent of lymph node dissection for carcinoma of the lower third of the thoracic ESOP-hagus of T2 or T3 stage with abdominal lymph node metastasis]

We discussed the rational extent of the lymph node dissection for carcinoma of the lower third of the esophagus of T2 or T3 stage with abdominal lymph node metastasis. Lymph node metastasis developed in 89.5% of patients. Cervical lymph node metastasis was seen in 35.8%. In the cases with positive abdominal lymph node, 40.9% of the patients had cervical node metastasis. The most frequent site of the positive node in the neck is the area along the right recurrent laryngeal nerve. On the stand point of removal of metastatic lymph node, neck dissection should be required. Three-field dissection yielded better survival rate than two-field dissection but statistical significance was not obtained. When the patients have cervical lymph node metastasis, they have greater possibility of developing blood borne metastasis. However, this observation does not deny the validity of the three-field dissection. Because this dissection may help reducing nodal spread and nodal recurrence. We have to wait for accumulation of the patients to analyze the definite extent of node dissection for T2 or T3 stage of carcinoma of the lower third of the esophagus with positive abdominal lymph node.

Characterization of molecularly cloned human 5-aminoimidazole-4-carboxamide ribonucleotide transformylase

The cDNA encoding human 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR) transformylase has been cloned from a placenta cDNA library, utilizing a PCR-derived probe. It encodes a peptide of 592 amino acids. The amino (N)-terminal sequence of this enzyme, purified from HeLa cells and CCRF-CEM cells, was found to be APGQLALF-. Both sequencing results revealed a difference of six N-terminal residues when compared to the reported sequence of cloned cDNA from a hepatoma cDNA library. Northern-blot analysis of human AICAR transformylase mRNA showed the expression of a single 2.0 kb mRNA in all tissues examined. With the cloned cDNA fragment, we constructed expression vectors for mature and GST-fused AICAR transformylase. Both recombinant molecules possessing AICAR transformylase activity were overproduced in Escherichia coli. GST-AICAR transformylase can be purified to homogeneity by a single-step affinity procedure with glutathione Sepharose. Mutational analysis, utilizing this expression system, showed that His213 and His267 were essential for AICAR transformylase activity.

[Application of arbitrarily primed polymerase chain reaction analysis to epidemiological study of Salmonella enterica serovar enteritidis]

An arbitrarily primed polymerase chain reaction (AP-PCR) DNA profile was applied to epidemiological analysis of Salmonella enterica subsp. enterica serovar Enteritidis. A total 21 strains of S. Enteritidis isolated from 21 cases (10 cases of healthy persons, 7 cases of food poisoning outbreaks and 4 sporadic diarrhea cases), during the period between December 1991 and August 1996 in Wakayama City, were used. A total of 60 arbitrary primers (DNA oligomer (12) set, Wako) were screened with 4 S. Enteritidis strains of different cases. A-11, B-32, C-42 and C-45 primers were chosen. Plasmid DNA profiles, antimicrobial susceptibility patterns and phage types were also examined. The combination of these three methods resolved the collection into five groups (A to E). And type C strains were found in 17 cases (81%) out of 21 cases. However, according to AP-PCR DNA profile, all 21 strains were classified into six groups (I to VI), and 17 type C strains were classified into three groups (III, IV and V). Type IV was predominant in Wakayama City, and type C.IV was found in 15 cases (71%). In conclusion, we considered that AP-PCR DNA profile using appropriate primers was an effective epidemiological marker.

[Mantle cell lymphoma with multiple extranodal involvement]

A 79-year-old male was admitted to our hospital because of general fatigue and night sweat. Physical examination showed generalized superficial lymphadenopathy, marked splenomegaly, and tumors in the conjunctiva and the abdomen. Chest X-ray and computed tomography (CT) revealed pleural effusion and intrathoracic lymphadenopathy. Abdominal ultrasonography and CT showed hepatosplenomegaly and intraperitoneal tumors. Upper gastrointestinal fiberscopy revealed multiple polypoid lesions and ulcers in the duodenum and the stomach. Involvement of relatively small-sized lymphocytes with cleaved nuclei was identified in each biopsied specimen from a cervical lymph node, a tumor in the conjunctiva, gastrointestinal polypoid lesions, and the bone marrow. Surface marker analysis of abnormal lymphocytes in the bone marrow revealed that CD5, CD19, and CD20 were strongly positive, but CD23 was weakly positive. Although (11:14)(q13:q32) translocation was not identified by chromosome analysis of bone marrow cells, Northern blot analysis of bone marrow cells revealed overexpression of the PRAD1 oncogene. Diagnosis of mantle cell lymphoma (MCL) was made. Combination chemotherapy by cyclophosphamide and vincristine was not effective, but etoposide perorally given at a dose of 50 mg per day was effective. In MCL, extranodal involvement of a digestive tract and bone marrow is well known. This case suggests that involvement of multiple organs including lacrimal glands and pleura could be characteristic of MCL cells.

The novel anti-rheumatic drug TA-383 has a macrophage migration enhancing activity

We have investigated the effect of a novel anti-rheumatic drug, cis-2-(4-chlorophenyl)-4,5-diphenyl-2-imidazoline hydrochloride (TA-383), on macrophages. TA-383 (> or = 10(-9) M) significantly stimulated rabbit alveolar macrophage (AM) migration, and its migration-stimulatory activity was more potent than those of L-fucose (5 x 10(-3) M), lobenzarit disodium, bucillamine (SA-96) and salazosulfapyridine. In addition, TA-383 enhanced the production and/or release of macrophage migration enhancement factor by rabbit spleen cells. In vivo, TA-383 (0.4 mg/kg, p.o.) has suppressive effects on picryl chloride-induced delayed type hypersensitivity and type II collagen-induced arthritis in mice. These results suggest that the anti-rheumatic activity of TA-383 may be exerted through the dispersion of macrophages from inflammatory sites.

Development of a membrane fusible drug carrier from erythrocytes by the spontaneous transfer of viral fusion protein from influenza virus-infected cells

In order to develop a membrane fusible drug carrier from human erythrocytes, we attempted the reconstitution of influenza virus fusion protein hemagglutinin (HA) to an erythrocyte membrane. In this study, we succeeded in the preparation of HA-reconstituted erythrocytes (HA-erythrocytes) by the incubation of erythrocytes with influenza virus-infected CV-1 cells, and confirmed the ability of HA-erythrocytes to fuse with the cell membrane. Furthermore, by using an HA-reconstituted ghost (HA-ghost), which entrapped fluorescent-labeled ovalbumin, 25% of the protein was incorporated into cells through the fusion of the HA-ghost with the cell membrane.

Prognostic factors in adenocarcinoma of the gastric cardia: pathologic stage analysis and multivariate regression analysis

PURPOSE

To clarify the pathologic stages of adenocarcinoma of the gastric cardia in which the prognosis is worse than in adenocarcinoma of the middle or distal part of the stomach, and to determine prognostic factors in these stages by multivariate analysis.

PATIENTS AND METHODS

We analyzed 2,536 cases of surgically resected gastric adenocarcinoma of all pathologic stages. Four hundred seventy-two cases of gastric carcinoma, in which cumulative survival of gastric cardia was poor, were subjected to Cox regression analysis for prognostic factors, and to logistic regression analysis for factors influencing venous or lymphatic invasion.

RESULTS

The prognosis of adenocarcinoma of the gastric cardia was inferior when compared with similarly staged carcinomas of the middle or lower part of the stomach when there was invasion of proper muscle layer or subserosal layer, with no lymph node metastasis or with only adjacent (group 1) lymph nodes metastases (T2N0 or T2N1, according to the Japanese classification). In these stages, the prognostic factors were age, histologic type, venous invasion, and location of the tumor in the upper part of the stomach. Tumor location in the upper stomach was also a predictor for the presence of venous invasion.

CONCLUSION

The prognosis of adenocarcinoma of the gastric cardia is poor in patients with T2 tumors with no or few lymph node metastases. Additional treatment after surgery may be necessary to improve the survival of this population.

Hyaluronic acid inhibits interleukin-1-induced superoxide anion in bovine chondrocytes

OBJECTIVE

To examine the effect of hyaluronic acid (HA) on the induction of superoxide anion by IL-1 in chondrocytes.

MATERIALS AND METHODS

Bovine articular chondrocytes were treated with different concentrations of IL-1. A chemiluminescent probe (L-012) was added to the medium and chemiluminescence detection was used to measure super oxide anion.

RESULTS

IL-1 caused induction of superoxide anions in a dose-dependent manner. HA (10-100 micrograms/ml) countered superoxide induction caused by 20 ng/ml of IL-1.

CONCLUSIONS

HA can afford protection against cartilage degradation, probably acting as a free-radical scavenger.

Isolation and partial characterization of cytoplasmic granules of LAK cells from mice showing side effects of recombinant human IL-2

The side effects of recombinant human interleukin-2 (rhIL-2) in mice are considered to be mediated by lymphokine-activated killer (LAK) cells that have cytoplasmic granules and infiltrate into target organs. In cloned cytotoxic lymphocytes (CLs) including LAK cells in vitro, granule exocytosis is one of the mechanisms in target cell lysis, and hemolytic and BLT-serine esterase (BLT-SE) activities detected in the granules are important to the cytotoxicity of the CLs in vitro. However, no information is available on these activities of LAK granules in vivo in mice showing the side effects of rhIL-2. Therefore, the present study was designed to isolate the LAK granules from the homogenate of LAK cell-rich subcutaneous tissue in mice treated with continuous infusion of a dose of rhIL-2 that induces known toxicity. High activities in hemolysis and BLT-SE were detected in Percoll fractions from the tissue homogenate. Electron microscopic observation of these fractions revealed almost only LAK granules. These results indicate that hemolytic and BLT-SE activities are detectable in the LAK granules in vivo, suggesting that the cells have potency for cytotoxicity via their granules and are involved in the toxicity of rhIL-2 in mice. In addition, perforin, which has been identified as a hemolytic protein in CL granules in vitro, was not detected by immunoblotting in the granule fraction of the LAK cells in vivo, indicating that the hemolytic activity of the LAK granules in vivo is not due to perforin.

Age-related changes in the brain transfer of blood-borne horseradish peroxidase in the hippocampus of senescence-accelerated mouse

Age-related changes in the brain transfer of blood-borne horseradish peroxidase (HRP) were examined by light microscopy in senescence-accelerated prone mice (SAMP8) and senescence-accelerated resistant mice (SAMR1). The intracerebral HRP transferred from the blood stream was reacted with tetramethyl benzidine (TMB) and the area showing the presence of HRP-TMB reaction products was morphometrically evaluated. Areas containing HRP reaction products in the medial CA1 region and medial dentate gyrus of the hippocampus were observed in 3- and 13-month-old SAMP8 and SAMR1. The mean percentage of the positive area for the HRP to the area of interest was significantly higher in the rostral portion of the hippocampus in 13-month-old than in 3-month-old SAMP8. On the other hand, age-related changes in the area positive for HRP-TMB reaction products in the cortices and the caudal portion of the hippocampus in SAMP8 were not observed. In addition, positive staining reaction for HRP was also observed in the dorsal portion of the thalamus of 13-month-old SAMP8. There were no significant age-related changes in the area positive for HRP-TMB reaction products in rostral and caudal portions of the cortices and the hippocampus of SAMR1. These findings suggest that blood-borne macromolecules have access to the medial and rostral portion of the hippocampus, that this phenomenon becomes more pronounced during the process of senescence in the SAMP8 brain and, moreover, that intravascular macromolecules have access to the dorsal portion (periventricular area) of the thalamus of 13-month-old SAMP8.

Hexagonal structures at lens capsule zonular attachments

Two years after uneventful phacoemulsification with posterior intraocular lens implant in an 84-year-old female patient, the capsular bag and enclosed intraocular lens luxated into the vitreous cavity. A vitrectomy was done to extract the lens and capsule for electron-microscopic examination. We found very few zonular attachments to the capsule, but did note hexagonal structures of unknown significance that our study indicates may be related to the lens epithelium.

A novel function of transferrin as a constituent of macromolecular activators of phagocytosis from platelets and their precursors

Macromolecular activators of phagocytosis from platelets (MAPP:s-MAPP, 1500kDa and 1-MAPP, 300kDa) are glycoproteins released from human platelets and activate leukocyte phagocytosis via the Fc gamma receptors. Their production can be shown in CPD-stored platelets which have lost MAPP releasing activity by incubation with plasma-derived precursos of MAPP (pre-MAPP : pre-s-MAPP, 150kDa and pre-l-MAPP, 300kDa) in the presence of Ca++. Partial amino acid sequence analysis of s-MAPP revealed that it had homogeneity with transferrin (TF). Affinity chromatography using anti TF immunosorbent column showed that all of pre-MAPP and MAPP had immunoreactivity with anti TF antibodies. S-MAPP and 1-MAPP rich preparations from platelet release products lost their activity after treatment with ATP at acidic pH, in which condition iron atoms could be removed from holo-transferrin molecules. In the experiment using polymerized TF and stored platelets, it was shown that platelets incubated with dimer and tetramer TF could produce MAPP function. These results suggest that dimer and tetramer transferrin are precursors of s-MAPP and 1-MAPP, respectively and that iron atoms are necessary for their phagocytosis activating function.

Abscesses caused by "dropped" stones after laparoscopic cholecystectomy for cholelithiasis: a report of three cases

While laparoscopic cholecystectomy is a standard therapeutic option for gallbladder stones, it is associated with a significant risk of injury to the gallbladder wall, which may result in the dispersion of free stones within the peritoneal cavity. However, the incidence and consequences of these dropped stones remains unclear. We report herein the cases of three patients in whom abdominal abscesses developed as a result of dropped stones during this procedure. Of particular interest was the relatively long interval from the procedure to the onset of symptoms and the unusual progression of the inflammation. These case reports strongly reinforce the risk of dropped stones during laparoscopic cholecystectomy.

Primary solitary amyloidoma of the lung: findings on CT and MRI

Pulmonary amyloidoma is a rare disease which is usually found incidentally on chest radiographs in asymptomatic, elderly people. Amyloid nodules may be solitary or much more commonly multiple. There have been many reports of radiological findings of pulmonary amyloidosis; however, those have not been characteristic. We report the findings on CT and MRI of a proven primary pulmonary amyloidoma in an asymptomatic 76-year-old woman. The low intensity of the lesion on T2-weighted images may be useful in the differential diagnosis from bronchogenic carcinoma.

Neuropathological studies on strains of senescence-accelerated mice (SAM) with age-related deficits in learning and memory

In a series of inbred Senescence-Accelerated mice (SAM) strains, accelerated-senescence prone SAMP substrains show early onset and rapid advancement of senescence. SAMP8 and SAMP10, in particular, exhibit a significant age-related deterioration in memory and learning for passive and active avoidance tasks with, respectively, a low and high incidence of systemic senile amyloidosis. In the brains of both SAMP8 and SAMP10 strains, we have found numerous morphological alterations. Here we review the changes seen in both neuronal or glial components in SAMP8/P10 brains. They may serve as markers of the neuronal degeneration leading to the deficits in learning and memory.

Histological localization of advanced glycosylation end products in the progression of diabetic nephropathy

We studied the immunohistochemical localization of advanced glycosylation end products (AGEs) in the progression of diabetic nephropathy. Fourteen NIDDM patients with diabetic nephropathy were evaluated: 2 patients with normoalbuminuria, 4 with microalbuminuria (MA) and 8 with overt proteinuria (OP). Three patients with minor glomerular abnormalities were used as nondiabetic controls. Immunoreactivity to a monoclonal anti-AGE antibody (6D12) was recognized on the internal elastic membranes of arterial walls in every diabetic group. Hyaline lesions of arterioles of the MA and OP groups demonstrated strong reactions with 6D12. A portion of the nodular and exudative lesions in glomeruli of OP group patients also revealed immunoreactivity to 6D12. No immunoreactivity to 6D12 was observed in nondiabetic control specimens. We confirm that the accumulation of AGEs began in arterial walls of the early stage and presented in glomerular lesions of the late stage of the progression of diabetic nephropathy.

Facilitation of ipsilateral motor pathways during recovery from hemiplegia in two adolescent patients

In two hemiplegic patients with acquired cerebral lesions, transcranial magnetic stimulation (TMS) was carried out to examine the contribution of the ipsilateral motor pathways to recovery from hemiplegia. A 13-year-old girl (patient 1) had acute hemiplegia due to a rupture of an arteriovenous malformation, and a 13-year-old boy (patient 2) had subacute hemiplegia due to a brain tumour. They showed complete upper limb palsy but recovered after therapy; patient 1 had slightly disabled motor function of the arm, and patient 2 recovered completely. Motor evoked potentials (MEPs) were recorded from the biceps brachii muscles on both sides. The MEPs of the paretic biceps were only elicited by TMS of the intact hemisphere at the beginning of recovery from hemiplegia, but not by TMS of the affected hemisphere. The MEP amplitudes increased and cortical representation areas for the paretic biceps by TMS were enlarged temporarily during recovery. They regressed in patient 1 and MEPs were not evoked at all in patient 2 after recovery. Conversely, MEPs were obtained by TMS of the affected hemisphere after recovery in both patients. These data indicate that ipsilateral motor pathways play a role in recovery from hemiplegia, especially at the beginning, and become inactivated when the contralateral motor pathways recover.