Case report: hippocratic digital and Crohn's disease

A case of Hippocratic digital associated with secondary hypertrophic osteoarthropathy complicating Crohn's disease in a 29 year old Japanese male is reported. Hippocratic digital, or finger clubbing, complicating inflammatory bowel disease has been frequently reported in the Western hemisphere. However, its association with secondary hypertrophic osteoarthropathy has been very rarely found in that disease. In Japan, Hippocratic digital has not been described previously. With regard to the pathogenesis of Hippocratic digital and secondary hypertrophic osteoarthropathy, the theory that both entities belong to the same pathological spectrum and that megakaryocytes or platelet clumps may play the most important role, is discussed.

[Diagnosis of superficial-type early carcinoma of the gallbladder by endoscopic ultrasonography--comparison with ultrasonography]

The detectability of superficial-type carcinoma of the gallbladder by ultrasonography (US) and endoscopic ultrasonography (EUS) were investigated. Eight patients with such carcinoma of the gallbladder were reviewed. They had undergone both US and EUS previous to surgery. The tumor was detected in 3 patients by US, 2 patients with IIa + IIb-type carcinoma and 1 patient with IIa-type carcinoma. Those lesions were visualized as localized thickening of the gallbladder wall or as broad-based tumor. In 2 patients, lesions were not initially detected by US, but were shown by US after the examination by EUS. The tumor was detected by EUS also in 1 case of IIb + IIa-type carcinoma besides those 3 patients mentioned above. All four of these lesions were visualized as broad-based tumor by EUS. It was difficult to detect pure IIb-type or small IIa-type carcinoma even by EUS. In patients with concomitant acute cholecystitis or gallbladder stone, it was difficult to evaluate the abnormal findings of the gallbladder wall.

Comparison of horizontal nystagmus in different head positions: a study by damped pendular rotation test

Damped pendular rotation was given with the initial maximum speed of 180 degrees/s. The subject's head was tilted forward at an angle of 30 degrees from the upright position, or kept in the upright position, or tilted backward at 30 degrees from the upright position. Electronystagmography was used to evaluate the maximal slow-phase eye velocity (mx SPEV) of the horizontal nystagmus. Differences existed in mx SPEVs of the horizontal nystagmus for the head-tilted positions at 30 degrees forward or backward and that obtained in the upright position. The mx SPEV of the horizontal nystagmus in the upright position was higher than those acquired in the head-tilted positions.

Drug sensitivity testing for clinical samples from oesophageal cancer using adhesive tumour cell culture system

A total of 83 specimens of surgically resected tumours from 78 patients with oesophageal cancer were assayed for drug sensitivity using an adhesive tumour cell culture system (LifeTrac CSA assay). Seventyone of 83 specimens had a sufficient number of cells to permit growth in culture and 57 of 71 (80%) were evaluable for drug response. Cells (3 x 10(3) ml-1 well-1) were cultured for 14 days and exposed to drugs on days 3-8. Growing cells were confirmed as cancer cells by immunohistochemical staining. IC90 values against several anti-cancer drugs were determined and population distributions of IC90 for each drug served as the basis for judging sensitivity. The 10th percentiles of IC90 (microgram ml-1) for CDDP, 5-FU, DOX, CPM, MTX, VP16, IFOS, VDS, BLM and CDDP + 5-FU were 0.3, 0.16, 0.005, 0.9, 0.006, 0.09, 0.8, 0.006, 0.04 and 0.15 + 0.09 respectively. The population distribution of IC90 against each drug showed a specific pattern that was very similar among histopathological gradings and stages of the disease. This system appeared to be a clinically applicable drug sensitivity test for human oesophageal cancer.

Incoherent pattern detection using a liquid-crystal active lens

Incoherent pattern detection by a simple imaging system using a liquid-crystal active lens is proposed. The imaging system works as a spatial filtering system with a rewritable phase-only filter. We found that, in the incoherent matched filtering system, a conventional phase-only filter has a higher optical efficiency but a lower pattern discrimination than a complex filter. To improve the pattern discrimination ability, we optimized the phase-only filter by using simulated annealing and a genetic algorithm. We designed phase-only filters that have discrimination ability comparable with that in a complex filter. The performance of optimized phase-only filters is experimentally demonstrated.

Contrasting effects of SM-9018, a potential atypical antipsychotic, and haloperidol on c-fos mRNA expression in the rat striatum

SM-9018 (cis-2-(4-(4-(1,2-benzisothiazol-3-yl)-1-piperazinyl)butyl) hexahydro-1 H-isoindole-1,3(2H)-dione HCl) is a potential atypical antipsychotic with high affinity for 5-HT2, dopamine D2 and 5-HT1A receptors. Northern blot analysis was performed to compare the effects of SM-9018 and of haloperidol on the striatal c-fos mRNA expression in rats. Haloperidol (0.3-30 mg/kg, p.o.) markedly increased the striatal c-fos mRNA levels (about eight-fold at 30 mg/kg), the increase being abolished by lesioning of dopamine neurons with 6-hydroxydopamine. In contrast, SM-9018 produced only a slight increase (about two-fold) in c-fos mRNA expression at doses up to 30 mg/kg (p.o.). The 5-HT2 receptor antagonist, ritanserin (0.1-3 mg/kg, i.p.), dose-dependently attenuated the haloperiodol-induced c-fos expression, but the putative 5-HT1A receptor antagonist, NAN-190 (1-(2-methoxyphenyl)-4-(4-(2-phethalimmido)butyl)piperazine HBr; 1-10 mg/kg, i.p.), did not. These findings suggest that SM-9018 is weaker than haloperidol for induction of striatal c-fos mRNA expression, to which the 5-HT2 receptor blocking activity of SM-9018 seems to contribute.

Phenotype-linked amino acid alteration in leptin receptor cDNA from Zucker fatty (fa/fa) rat

The mouse obese (ob) gene product (leptin), expressed specifically in adipose cells, regulates energy balance in mice. Both mouse diabetes (db) and rat fatty (fa) gene products are thought to play major roles in leptin signaling pathways in the hypothalamic area. Mutations of these genes in murines result in marked obesity and type II diabetes as part of a syndrome that resembles morbid obesity in humans. Reported herein are the cloning and sequencing of one of spliced variant forms of rat leptin receptor (OB-R) cDNA with a short intracellular domain. In the Zucker (fa/fa) rat, no changes in either the gene structure or the expression levels were observed. However phenotype-linked nucleotide alteration exists in the cDNA from Zucker (fa/fa) rat, which results in an amino acid substitution.

Loss of heterozygosity at the DCC gene locus is not crucial for the acquisition of metastatic potential in oesophageal squamous cell carcinoma

Tumour specimens from 111 patients with oesophageal squamous cell carcinoma were screened for loss of heterozygosity (LOH) at the deleted colorectal carcinoma (DCC) gene locus. DCC-LOH occurred in 10 of 61 informative cases (16%). No statistically significant correlation was observed between DCC-LOH and lymph node metastasis, histopathological grade or tumour stage. The survival of patients exhibiting DCC-LOH was not statistically different from that of patients without LOH. These results suggest that LOH at the DCC locus is not related to the acquisition of metastatic potential or the state of tumour cell differentiation in oesophageal squamous cell carcinoma.

Allograft stapes surgery for conductive hearing loss in patients with ossicular chain anomalies

An allograft stapes was used during surgical intervention for conductive hearing loss due to ossicular malformations in 11 ears of seven patients. The external auditory canal and tympanic membrane were normal in all ears. The surgical findings for the ossicles were stapes fixation (7 ears), stapes fixation with discontinuity of the incudostapedial joint (in both ears of one patient), a deformed incus and stapes crura compressed by the facial nerve (one ear in which the stapes was not fixed) and an anomaly of the incus and stapes combined with a dermoid cyst (in one ear in which the stapes was also not fixed). In all ears, the following procedures were performed: stapedectomy followed by sealing the oval window with a vein graft and placing an allograft stapes between the oval window and the lenticular process of the incus or the handle of the malleus. The allograft stapes was placed with its capitulum on the oval window in all cases, and fibrin glue was used for stabilizing the seal and the allograft stapes. The indications for stapedectomy for conductive hearing loss due to ossicular chain anomalies and the utility of allograft stapes are discussed.

Quantification of genistein and genistin in soybeans and soybean products

It has been suggested that the isoflavone, genistein,, may have some role as a chemopreventive agent against cancer in humans. Levels of genistein and its beta-glucoside conjugate, genistin, ingested in soybeans and related bean products by the Japanese were quantified by HPLC, to estimate daily intake of these compounds. Amounts of genistein and genistin in soybeans, soy nuts and soy powder were in the range of 4.6 to 18.2 and 200.6 to 968.1 micrograms/g food, respectively. The values for soy milk and tofu (bean curd) were 1.9 to 13.9 and 94.8 to 137.7 micrograms/g food, respectively. Levels of isoflavones in fermented soybean products, miso (bean paste) and natto (fermented soybeans), were 38.5 to 229.1 micrograms/g food for genistein and 71.7 to 492.8 micrograms/g food for genistin. Thus, the level of genistein in the fermented soybean products was higher than in soy beans and soybean products such as soy milk and tofu. From these observations, it is suggested that the beta-glycosyl bond of genistin is cleaved to produce genistein by microbes during fermentation to yield miso and natto. Soy sauce was also found to contain both isoflavones, but at levels lower than in miso and natto. On the basis of these data for average annual consumption of soybeans and related products, daily intake of genistein and genistin by the Japanese is calculated to be 1.5-4.1 and 6.3-8.3 mg/person, respectively. These levels are much higher than those for Americans or Western Europeans, whose mortality rates for breast, colon and prostate cancers are greater than the Japanese.

Exercise training has a long-lasting effect on prevention of non-insulin-dependent diabetes mellitus in Otsuka-Long-Evans-Tokushima Fatty rats

Exercise training has been shown to be effective in preventing the development of non-insulin-dependent diabetes mellitus (NIDDM) in a model rat (Otsuka-Long-Evans-Tokushima Fatty [OLETF]). For determination of how long a preventive effect of exercise training against the development of NIDDM lasts in this model, six male OLETF rats each were assigned to training (1) for a whole experimental period, from 7 to 28 weeks of age (E-E); (2) for the first half of the period, from 7 to 15 weeks of age (E-S); and (3) for the second half of the period, from 16 to 28 weeks of age (S-E). In addition, eight male OLETF rats were given no exercise during the experimental period (S-S). At 28 weeks of age, E-E, E-S, S-E, and S-S rats, weighed averages of 514, 542, 557, and 669 g and had abdominal fat deposits of 13.9, 21.3, 38.2, and 76.0 g, respectively. At 28 weeks of age, the cumulative incidence of NIDDM in S-S was 100%, while none of the trained rats were diabetic. The glucose infusion rate (GIR) during a hyperinsulinemic euglycemic clamp test, an index of insulin sensitivity, in the E-E group was significantly greater than that in the S-S group. The values in the E-S and S-E groups were slightly, but not significantly, less than that in the E-E group. Morphologic studies on the pancreas of E-E rats and S-E rats showed minimal changes of islets, whereas sections of islets from E-S rats appeared slightly enlarged and fibrotic, although significantly less than those of islets of S-S rats. These results demonstrate that the preventive effect of excercise training against the development of NIDDM lasts for at least 3 months after the cessation of exercise in this model.

Effects of transfection with the Cu, Zn-superoxide dismutase gene on xanthine/xanthine oxidase-induced cytotoxicity in fibroblasts from rat skin

PURPOSE

The effects of transfection with the human Cu, Zn-superoxide dismutase (hSOD)4 gene on active oxygen-induced cytotoxicity in rat skin fibroblasts (FR) were studied for the purpose of developing the novel delivery system of hSOD using hSOD gene.

METHODS

An expression plasmid for hSOD, pRc/RSV-SOD, was constructed and used to transfect FR cells. Xanthine (X)/xanthine oxidase (XO) system were used to generate active oxygen species. The effects of transfection with the hSOD gene on active oxygen-induced cytotoxicity were assessed by comparing the number of surviving cells and the level of lipid peroxidation in host and transformants after exposure to X/XO system.

RESULTS

The cellular SOD activity in RSV-SOD cells transfected with pRc/RSV-SOD was significantly increased in comparison with host or RSV cells transfected with the pRc/RSV plasmid containing no hSOD gene as a control. Furthermore, Western blot analysis using an anti-hSOD antibody indicated the production of hSOD in RSV-SOD cells. On the other hand, although the numbers of surviving cells in both host and RSV-SOD cultures after exposure to X/XO system decreased in a time-dependent manner, the decrease in number of surviving RSV-SOD cells was less than that in host cells. In the presence of catalase, the decreases in number of surviving cells in both host and RSV-SOD cultures after exposure to the X/XO system were also less than those in the absence of catalase. However, the decreases in cell survival in RSV-SOD cultures were significantly less than those in host cells in the presence of catalase. Furthermore, the levels of lipid peroxidation in RSV-SOD cells exposed to the X/XO system in the presence or absence of catalase were lower than those in host cells. These results indicated that the increase in cellular SOD activity by transfection with the hSOD gene protects cells from oxidative stress.

CONCLUSIONS

Human SOD gene therapy may be useful for treatment of diseases in which oxidative tissue damage is produced.

Suppression of azoxymethane-induced aberrant crypt foci in rat colon by nimesulide, a selective inhibitor of cyclooxygenase 2

Non-steroidal anti-inflammatory drugs, such as piroxicam and sulindac, are known to inhibit development of aberrant crypt foci (ACF) and cancer in the colon. However, these agents cause gastrointestinal side-effects. Nimesulide is a selective inhibitor of cyclooxygenase 2 and has been shown to have a more potent anti-inflammatory action than piroxicam, but be less ulcerogenic and, therefore, a potentially more useful chemopreventive agent. To assess this possibility the inhibitory effects of nimesulide on the formation of ACF induced by azoxymethane in rat colon were investigated, and compared with those of piroxicam and sulindac. Male F344 rats were treated s.c. with 15 mg/kg body weight azoxymethane once a week for 2 weeks and given 50, 100 or 200 ppm nimesulide, 200 ppm piroxicam, or 200 ppm sulindac in their diet from the day before the first carcinogen treatment until the end of the experiment at week 4. At this time, nimesulide at doses of 50, 100 and 200 ppm had reduced the numbers of azoxymethane-induced ACF to 75%, 71% and 65% respectively compared to the control. The number of azoxymethane-induced ACF per colon in the group given 200 ppm nimesulide was almost the same as in those given 200 piroxicam, and lower than that in the group given 200 ppm sulindac. These results suggest that nimesulide, a selective cyclooxygenase 2 inhibitor, warrants attention as a candidate for chemopreventive agent with low toxicity, active against colon carcinogenesis.

Serum soluble interleukin-2 receptor and immunohistochemical staining of IL-2R/Tac antigen in gastric cancer

In the present study, we investigated the significance of serum soluble IL-2R as a tumor marker, and examined the existence and localization of positive cells for IL-2R/Tac antigen in gastric cancer tissues and its regional lymph nodes. Eighty-two patients with gastric cancer were included. Levels of serum soluble-IL-2R were measured by an enzyme-linked immunosorbent assay. In the tissues obtained from 19 cases, immunohistochemical staining was performed with the use of avidin-biotin-peroxidase complex technique, in which mouse anti-human interleukin-2 receptor antibody was used. The preoperative levels of serum soluble IL-2R in patients-with gastric cancer were significantly higher than those of normal controls (p<0.001). The levels of serum soluble IL-2R in cases with metastatic lymph nodes were also significantly higher than those without metastatic lymph nodes (p<0.05). Concerning the tumor markers, there were significant differences of serum soluble IL-2R levels between those who were positive and those negative for CA19-9, CEA, alpha-FTP, and IAP. In the immunohistochemical staining of IL-2R, 13 of 19 cases (68.4%) showed IL-2R positive cells in the gastric cancer tissues. In regard to the metastatic lymph nodes, 3 of 5 cases (60.0%) showed IL-2R positive cells. On the other hand, IL-2R positive cells were not recognized in normal gastric tissues and non-metastatic lymph nodes. These results may suggest that activated T-lymphocytes infiltrating into the cancer tissues play an antitumor role and release a large amount of alpha-chain of IL-2R, resulting in the high levels of serum soluble IL-2R in patients with gastric cancer.

Common deleted region on the long arm of chromosome 5 in esophageal carcinoma

BACKGROUND & AIMS

The existence of an unknown tumor-suppressor gene on 5q for esophageal carcinoma other than the APC gene has been suggested. The location of the putative tumor-suppressor gene on 5q, distinct from the APC gene, was examined.

METHODS

Sixty-one primary esophageal carcinomas were examined for nine microsatellite loci by the polymerase chain reaction followed by polyacrylamide gel electorophoresis. Loss of heterozygosity at the APC gene locus also was examined by the polymerase chain reaction-restriction fragment length polymorphisms.

RESULTS

Thirty-five of 61 esophageal carcinomas (57%) showed loss of heterozygosity at single or multiple loci on 5q, and the smallest common deleted region was identified at 5q31.1, the location of the IRF-1 gene locus. All tumors showing loss of heterozygosity at the APC gene locus showed complete or large interstitial deletions on 5q.

CONCLUSIONS

Deletion at the APC gene locus may just be the result of large deletions on 5q and may not be important in esophageal carcinogenesis, and the IRF-1 gene or other gene(s) on 5q31.1 may be the true target of frequent deletions on 5q that may play an important role in the pathogenesis of the majority of esophageal carcinomas.

[A case of so-called carcinosarcoma of the esophagus]

So-called carcinosarcoma of the esophagus is rare malignant tumors composed of carcinoma and sarcomataous components. We described a case of so-called carcinosarcoma and reviewed some literature. A 67-year-old man visited our hospital because of difficulty in swallowing, general fatigue, and sore throat. Barium swallow esophagogram showed a large polypoid lesion in the middle, lower thoracic esophagus. Endoscopy also demonstrated a pedunculated polypoid tumor. Histological examination of the biopsy specimen revealed malignant findings. Thoracic esophagectomy with cervical, thoracic, abdominal dissection was performed. A polypoid tumor, 10.5 x 5.2 x 3.5 cm in size, was removed. In the polypoid lesion, spindle-shaped cells made interlacing bundles similar to sarcoma and surrounded nests of squamous cell carcinoma. Near the pedicle, squamous cell carcinoma invaded muscularis mocosae. And lymph node metastasis was detected. Epitherial membrane antigen (EMA) was detected in some parts of the polypoid lesion. So according to Guide Lines for Clinical and Pathological Studies on Carcinoma of the Esophagus, this case was diagnosed as so called carcinosarcoma.

Effects of fructose-induced hypertriglyceridemia on hepatorenal toxicity of acetaminophen in rats

The mode of hepatorenal toxicity of acetaminophen (AAP) was compared between fructose-induced hyper-triglyceridemic and normal rats. The hypertriglyceridemic and normal rats received a single dose of AAP (0, 750 and 900 mg/kg ip) at week 5 of fructose-treatment. At 24 hrs after AAP-dosing, they were sacrificed and examined blood biochemically and histopathologically. Hepatotoxicity as indicated by an increase in plasma ALT and AST activities and centrilobular necrosis of hepatocytes was more severe in the normal rats than in the hypertriglyceridemic ones. In contrast, nephrotoxicity as indicated by an increase in plasma urea nitrogen content and necrosis of epithelial cells in the proximal straight tubules was more severe in the hypertriglyceridemic rats than in normal ones. Thus, in the fructose-induced hypertriglyceridemic rats, as compared with normal ones, hepatotoxicity of AAP became apparently less severe, whereas nephrotoxicity of AAP became significantly more severe.

IL-4 upregulates Fc epsilon RI alpha-chain messenger RNA in eosinophils

By using the reverse transcription polymerase chain reaction and Southern blot hybridization, we demonstrated that Fc epsilon RI alpha-chain (Fc epsilon RI alpha) messenger RNA was expressed in eosinophils purified from the peripheral blood of patients with allergic rhinitis and that this expression was enhanced by IL-4. However, studies in which flow cytometry or immunostaining was used did not reveal the expression of Fc epsilon RI alpha protein on eosinophils from peripheral blood. Neither IL-4 alone nor the combination of IL-4 and other cytokines could induce detectable Fc epsilon RI alpha protein; nevertheless, they do express Fc epsilon RI alpha mRNA. Double-labeling immunostaining on cryostat sections of nasal mucosa clearly demonstrated that some Fc epsilon RI alpha-positive cells were eosinophil cationic protein-positive, which confirms their eosinophilic nature. Not all the eosinophil cationic protein-positive cells express on Fc epsilon RI alpha signal. Considering that Fc epsilon RI alpha mRNA was detectable in four of five samples of eosinophils from those patients with nasal allergy and that only one of five eosinophil samples from normal subjects expressed Fc epsilon RI alpha mRNA, the level of Fc epsilon RI expression may be correlated with the activation of eosinophils. It seems very likely that some other unidentified factors are required for the process from the expression of Fc epsilon RI alpha mRNA to that of Fc epsilon RI as a protein.

Characterization of DBT cell clones derived from cells persistently infected with the JHM strain of mouse hepatitis virus

Twelve clones derived from the cells persistently infected with the JHM strain (JHMV) of mouse hepatitis virus (MHV) were established from mouse astrocytoma-derived DBT cells and characterized. All the cell clones were resistant to superinfection with MHV. Only one of the persistently infected cell clone synthesized viral RNA and proteins and produced virus particles. Viral RNA was detectable in some other cell clones without production of viral protein nor the virus. No cell clones exhibited contact fusion activity. The results suggested that such variety of cell clones might have resulted from persistent infection with JHMV.