Overexpression of IL-6 by gene transfer stimulates IL-8-mediated invasiveness of KYSE170 esophageal carcinoma cells

Interleukin-6 (IL-6) has been associated with disease progression and poor prognosis in esophageal carcinoma. The aim of this study was to investigate the possible influence of IL-6 on the biological activities of esophageal carcinoma cells in terms of invasiveness. The human esophageal carcinoma cell line, KYSE170, was transfected with a plasmid vector expressing IL-6, and a stable transfectant overexpressing IL-6 was established. Invasiveness was evaluated by an invasion assay and compared between IL-6 and control transfectants. The invasiveness of the IL-6 transfectant was significantly higher than that of the control transfectant, and was significantly reduced by IL-6-specific siRNA. In reverse transcriptase-polymerase chain reaction (RT-PCR) analysis, IL-8 expression was significantly higher in the IL-6 transfectant than in the control transfectant, whereas the expression of Hepatocyte growth factor (HGF) and Vascular endothelial growth factor (VEGF) was not different. IL-8 expression in the IL-6 transfectant was significantly inhibited by IL-8-specific siRNA, whereas IL-6 expression was not. In addition, the invasiveness of the IL-6 transfectant was significantly reduced by IL-8-specific siRNA. These results indicate that the overexpression of IL-6 increases the invasiveness of KYSE170 esophageal carcinoma cells and IL-6-induced IL-8 plays a predominant role in increasing invasiveness.

Time course of serum C-reactive protein levels during induction chemoradiotherapy and its correlation with treatment response and survival in patients with advanced esophageal squamous cell carcinoma

Preoperative serum C-reactive protein (CRP) levels have been shown to be of prognostic significance in patients with advanced esophageal carcinoma. However, the clinical significance of serum CRP levels in patients with unresectable or marginally resectable tumors in the absence of induction therapy has not been fully elucidated in relation to treatment response and prognosis. Thirty-four patients with clinical T3-T4 esophageal squamous cell carcinoma who underwent induction chemoradiotherapy (CRT) followed by esophagectomy were enrolled in this retrospective study. Serum CRP levels were measured during the course of CRT, i.e., prior to, during (1, 2, 3 and 4 weeks following initiation) and after CRT (prior to surgery). The association between CRP levels, CRT response and survival was analyzed. Elevated serum CRP levels exhibited a favorable decrease 2-3 weeks following CRT initiation in pathological responders and CRP ≤0.3 mg/dl at 2 and 3 weeks following CRT initiation, as well as prior to surgery, was significantly correlated with responders. In patients with pretreatment CRP >0.3 mg/dl (67.6% of patients in this study), CRP ≤0.3 mg/dl at 2 and 3 weeks following CRT initiation predicted responders with accuracies of 87.0 and 73.9%, respectively. In the univariate survival analysis, CRP levels 3 weeks following CRT initiation, as well as CRP levels prior to surgery and pathological stage, were significant prognostic factors, although CRP levels prior to surgery was the only independent prognostic factor in the multivariate analysis. Serum CRP levels during the course of CRT may be of prognostic and predictive significance for the CRT response in patients with unresectable or marginally resectable esophageal squamous cell carcinoma who undergo induction CRT.

COX-2 overexpression Induced by gene transfer reduces sensitivity of TE13 esophageal carcinoma cells to 5-fluorouracil and cisplatin

Previous clinicopathological studies demonstrated that overexpression of cyclooxygenase-2 (COX-2) is associated with a poor treatment response of esophageal carcinoma. The aim of this study was to elucidate the role of COX-2 overexpression in the chemosensitivity of esophageal carcinoma cells. TE13 human esophageal squamous cell carcinoma cells were transfected with a COX-2 constitutive expression vector, and stable transfectants overexpressing COX-2 were established. COX-2 overexpression in COX-2 transfectants was confirmed with western blotting and prostaglandin-E(2) (PGE(2)) assay. Chemosensitivity testing revealed that sensitivity of COX-2 transfectants to 5-fluorouracil and cisplatin was significantly lower than in control vector-only transfectants, and that sensitivity of COX-2 transfectants was restored by the transfection of COX-2-specific siRNA. In addition, expression of antiapoptotic B-cell lymphoma-extra large (BCL-xL) and myeloid cell leukaemia-1 (MCL-1) was increased in COX-2 transfectants. These results indicate that COX-2 overexpression may reduce the chemosensitivity of esophageal carcinoma cells through up-regulation of the expression of antiapoptotic BCL-2 family proteins.

PSK induces apoptosis through the inhibition of activated STAT3 in human esophageal carcinoma cells

PSK, a protein-bound polysaccharide, is widely used in Japan as an immunopotentiating biological response modifier for cancer patients. PSK exerts antitumor activities through stimulation of the host's immune response; however, few studies have addressed the direct actions of PSK on tumor cells. Recently, it has been found that STAT3 is aberrantly activated in various types of malignancies, and plays a crucial role in tumor cell proliferation and survival. In the present study, STAT3 was constitutively activated in KYSE170 and TE13 esophageal carcinoma cells, and PSK inhibited proliferation and induced apoptosis in these cells in a dose-dependent manner. Based on these findings, the relationship between STAT3 and apoptosis in these cells was investigated. Results showed that PSK inhibited the expression of activated STAT3 and stimulated the expression of pro-apoptotic Bax in a dose-dependent manner, without affecting the expression of anti-apoptotic Bcl-xL and Mcl-1. These results indicate that PSK may induce apoptosis in esophageal carcinoma cells by inhibiting the expression of activated STAT3.

Overexpression of Interleukin-6 suppresses cisplatin-induced cytotoxicity in esophageal squamous cell carcinoma cells

Interleukin-6 (IL-6) expression at local tumor sites or in systemic circulation is associated with disease progression and poor prognosis of esophageal cancer. The aim of this study was to investigate the possible influence of IL-6 on biological activities of esophageal cancer cells in terms of chemosensitivity. Human esophageal cancer cell lines TE13 and KYSE170 were transfected with a plasmid vector expressing IL-6 and stable transfectants overexpressing IL-6 were thus established. The sensitivity of IL-6 transfectants to cisplatin was evaluated using a WST-8 assay and cell-cycle analysis. In addition, the inhibitory effects of IL-6-specific siRNAs were investigated. IL-6 transfectants showed significantly reduced sensitivity to cisplatin compared to control transfectants. In addition, the reduced cisplatin sensitivity of IL-6 transfectants was restored by pretreatment with IL-6-specific siRNA. These results suggest that intracellular IL-6 expression in tumor cells may acts as a resistance factor against cisplatin-based treatments for esophageal cancer.

[Early prediction of treatment response by serum CRP levels in patients with advanced esophageal cancer who underwent definitive chemoradiotherapy]

Serum CRP has been shown to be associated with the progression of esophageal cancer. The purpose of this study was to examine the relationship between treatment response and serum CRP levels in time course during definitive chemoradiotherapy (CRT) in terms of early prediction of CRT response by serum CRP. The subjects of this study were 36 patients with cT3/cT4 esophageal squamous cell carcinoma who underwent definitive CRT in our hospital. Serum CRP levels during definitive CRT (pretreatment, 1W, 2W and 3W after CRT initiation) were compared between CR and non-CR group. In addition, partition model was constructed to discriminate CR with non-CR and the prediction accuracy was evaluated. The patients were consisted of 28 males and 8 females. At pretreatment diagnosis, tumors were categorized as T3 (n=21) and T4 (n=15). Thirty four patients received FP-based chemotherapy and 2 patients received docetaxel-based chemotherapy. Treatment responses were categorized as CR (n=8), PR (n=14), NC (n=2) and PD (n=12). Serum CRP levels at the time of 2W after CRT initiation (CRT2W) in CR group were low compared to those in non-CR group (p=0.071). The partition model was constructed based on CRP levels at CRT2W. The prediction accuracies to discriminate CR from non-CR by CRP≤0.1 were 50%, 82%, and 75% in sensitivity, specificity and accuracy, respectively. Serum CRP is a useful biomarker for an early prediction of CRT response.

[Case of laparoscopic cholecystectomy for a double gallbladder]

A case of a double gallbladder, a congenital anomaly of biliary system is reported in a 71-year-old woman presenting with right hypochondrial pain. After a confirmed diagnosis of double gallbladder with gallstones was made by MRCP or ERCP, both gallbladders were removed laparoscopically. Double gallbladder is rare anatomic malformation of the biliary tract with only 88 cases, including ours, reported in the Japanese literature. Detailed preoperative investigations are required for an accurate preoperative diagnosis especially when considering laparoscopic removal to avoid inadvertent damage to biliary ductal system.

HMG-CoA reductase inhibitors reduce matrix metalloproteinase-9 activity in human varicose veins

Matrix metalloproteinases (MMPs) have been implicated in tissue degradation in varicose veins. The aim of this study was to investigate the effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) on the activity of MMPs in varicose veins. MMP-9 was present at significantly higher levels in varicose veins than in controls and was localized mainly in smooth muscle cells at the tunica media, where marked degradation of the extracellular matrix was observed. Both simvastatin and pravastatin strikingly suppressed MMP-9 activity in ex vivo culture of varicose veins. Simvastatin suppressed MMP-9 at both the mRNA and protein levels as well as at the urokinase-type plasminogen activator protein level, resulting in the dramatic suppression of MMP-9 activity induced by tumor necrosis factor-alpha. Therefore, statins suppress MMP-9 activity by multiple mechanisms in varicose veins, suggesting they may have clinical potential for the treatment of this disease.

Identification of a H+/glucose and galactose symporter gene glt from Xanthomonas oryzae pv. oryzae

We identified a glucose and galactose transporter gene from the plant-pathogenic bacterium Xanthomonas oryzae pv. oryzae. Sequence analysis indicated that the gene, named glt, encoded a polypeptide of 592 amino acid residues and the product was significantly homologous with members of the Na+/glucose cotransporter (SGLT) family from mammalian and bacterial origin, especially with vSGLT from Vibrio parahaemolyticus (50% identity). GLT functioned as a glucose and galactose transporter in an Escherichia coli mutant deficient in glucose and galactose transport activity. A protonophore inhibited the transport activity, suggesting that GLT is a H+-coupled glucose/galactose symporter.

Comparison of heavy metal concentrations in human umbilical cord in 1980 and 1990

The well-known Minamata disease was caused by mercury; the Itai-Itai disease by cadmium; and lead poisoning by gasoline additives. Following our previous investigation on heavy metal concentrations in the umbilical cords in 1980, total mercury, cadmium and lead concentrations in the umbilical cords (from 20 males and 20 females) have been measured in 1990 for comparison in the present study. The changes in metal concentrations in 1980 and 1990 were: from 0.007 +/- 0.005 microgram/g to 0.011 +/- 0.008 microgram/g for total mercury; from 0.019 +/- 0.016 microgram/g to 0.006 +/- 0.005 microgram/g, from 0.151 +/- 0.123 microgram/g to 0.046 +/- 0.038 microgram/g for lead. Total mercury accumulated in the umbilical cords increased to approximately 1.6-fold, while cadmium and lead decreased to approximately 1/3-fold during these 10 years.

Successful management of a giant spinal arteriovenous malformation with multiple communications between primitive arterial and venous structures by embolization: report of a case

A 47-year-old woman was admitted to our hospital with a giant spinal arteriovenous malformation (AVM) causing heart failure and thoracic myelopathy. Angiography revealed that the spinal AVM had multiple feeding vessels branching from the 5th through 12th intercostal arteries. The drainage vein flowed to the azygos vein and superior vena cava. The AVM destroyed the 7th thoracic vertebra. The cardiac output was 16.7l/min and the shunt ratio was 64% before treatment. Embolization with cyanoacrylate was performed because the operation was considered to be associated with a significant risk of paraplegia and organ ischemia. The cardiac output decreased to 11.6l/min and the shunt ratio was reduced to 32%. After embolization the patient demonstrated no symptoms of either heart failure or sensory deficits. During embolization, provocative tests using sodium amytal and lidocaine with magnetic stimulation were also performed. The above findings suggest that provocative tests and magnetic stimulation are useful to predict paraplegia, which could result from embolization while, in addition, embolization is considered to be a useful treatment for multiple shunt and nidus in this region.

Effect of E5510 on anastomotic intimal hyperplasia and platelet aggregation in dogs

We examined the effect of an antiplatelet agent, E5510, which inhibits both platelet aggregation and release of platelet-derived growth factor (PDGF), on anastomotic intimal hyperplasia and platelet aggregation. Twenty Beagle dogs underwent infrarenal aortic reconstruction with an expanded polytetrafluoroethylene (ePTFE) graft 5 mm in diameter and 3 cm long. The dogs were divided into three groups: placebo (control group, 7 dogs), E5510 1 mg/day (1-mg group, 6 dogs), and E5510 4 mg/day (4-mg group, 7 dogs). E5510 was administered orally 2 h before operation and once daily for 3 months after operation. Grafts were harvested 3 months after operation. All 13 grafts in the treated groups remained patent without evidence of intimal hyperplasia, whereas only 4 of 7 grafts (57%) remained patent in the control group, including 1 graft with > 50% stenosis. Three occluded grafts showed severe intimal hyperplasia at the anastomoses. The platelet aggregation ratio (PAR) with collagen (100 micrograms/ml) before drug administration at 3 months in the 4-mg group was significantly lower than that in the control and 1-mg groups. PAR after drug administration at 3 months in the 1- and 4-mg groups was significantly lower than that in the control group. Intimal thickness at the distal anastomosis was 817 +/- 190 microns in the control group, 240 +/- 80 microns in the 1-mg group, and 197 +/- 28 microns in the 4-mg group. Intimal thickness in the control group was significantly greater than that in the 1- and 4-mg groups. Smooth muscle cell (SMC) values in the intima at the distal anastomosis were 65.6 +/- 4.4% extinction (%E) in the control group, 47.6 +/- 3.4%E in the 1-mg group, and 51.3 +/- 3.5%E in the 4-mg group. SMC value in the control group was significantly greater than that in the 1- and 4-mg groups. E5510 inhibited PAR and reduced the degree of anastomotic intimal hyperplasia.

Changes in angiographic features and the ankle/brachial pressure index of femorodistal arterial bypass grafts during knee flexion

Systolic ankle pressure was measured in limbs in the extended and 90 degrees-flexed positions in three groups of patients who had undergone below-knee femorodistal arterial bypass. Group 1 consisted of eight limbs in seven patients who had received an autologous saphenous vein (ASV) graft; group 2 consisted of seven limbs in seven patients who had received a ringed expanded polytetrafluorethylene (ePTFE) graft; and group 3 consisted of five limbs in five patients who had received a reinforced biosynthetic borine collagen vascular (Omniflow) graft. Intravenous digital subtraction angiography was performed within 3 months of implantation. The ankle/brachial index (ABI) was significantly lower when the knee was flexed than when it was extended in group 1 and 3, but not in group 2. The ABI flexion in group 1 was similar to that in group 2. Morphologic changes such as kinking were demonstrated angiographically in groups 1 and 3. Given that the ABIs in groups 1 and 2 were similar with the knee flexed, despite the morphologic changes in group 1, we concluded that saphenous vein and ringed ePTFE grafts are more durable when subjected to acute knee flexion than Omniflow grafts. Thus, as graft failure is unlikely to result from kinking as a result of knee flexion alone, further clinical studies are required to elucidate the precise causes of graft failure.

Secular changes of PCB concentration accumulated in organs and tissues of Japanese from 1974 to 1989

The concentration and component types of PCB in adult human liver and fat tissue (64 samples) from forensic autopsy cases of Osaka Prefecture in 1989 were measured for comparison with the data for the same organ and tissue during the period from 1974 to 1984. The mean values of PCB levels in 1989 were 0.06 microgram/g (whole base) in the liver and 2.20 micrograms/g (fat base) in the fat tissue. These concentrations both were the same as those observed for the 15-year period. The percentages of the 5,6-chlorinated compound of PCB in the liver and fat tissue were lower but those of the 7-chlorinated compound were 15-20% higher.

Estimation of age from soft X-ray findings of Japanese pubic symphysis based on a image processing

A method for estimating the age at death through the image processing of soft X-ray pictures of pubic symphysis is reported. The collected 533 materials were sliced at the thickness of 5 mm. Prior to the image processing, subjective assessment was made on the five indices of gross morphological findings. The pictures showed roughening and darkening tendencies with age and two indices for image processing were introduced. Applying the natural logarithm to data obtained by the image processing and making regression analysis. two kinds of age estimation equations were derived in the form of; Y = -39.91 lnX + 189.63 and the estimated age Y was proportional to natural logarithm of measured indices X. The age estimation equations showed accuracies of 70% or more for the age range of +/- 5 years and 100% for +/- 8 years. The accuracy was satisfactory for age estimation in the field of person appraisal in legal medicine.

Estimation of age from image processing of soft X-ray findings in Japanese male thyroid cartilages

A method was developed for estimating the age at death based on image processing of soft X-ray pictures of thyroid cartilage from Japanese males. Data for 501 individuals were used to derive equations for this determination. Prior to image processing, gross morphological findings were used for estimation. Soft X-ray pictures indicated ossification with age and one index for image processing was introduced. The exponential function was applied to age estimation.

Estimation of age from soft X-ray findings of Japanese females thyroid cartilages

A method for estimating the age at death using the image processing of soft X-ray pictures of the thyroid cartilages of Japanese females was examined. The soft X-ray pictures showed increasing ossification with age. One index for image processing was introduced. It is ossification rate (OSFR). Corresponding to this index, one age estimation equation was obtained. This age estimation equation showed accuracies of 60% or more for the age range of +/- 5 years and about 80% for the age range of +/- 8 years.

Autopsy cases of giant heart during the past ten years in Osaka (1985-1994)

We collected data from 30 autopsied cases, in which the heart weight were 800 g or more (maximum 1,300 g), at the Osaka Medical Examiner's office, for past 10 years. Among these cases, the cause of death was cardiac failure in 17 cases (56.7%), followed by pulmonary diseases (3 cases, 10.0%), cerebral infarction (3 cases, 10.0%), and aortic rupture (2 cases, 6.6%). The mean weight of the giant hearts was 880 g (about 77% of the cases) and 4 cases (13%) had 1,000 g or more. The mean height of the giant heart victims was close to the standard level, and thus the mean level of the ratio of heart weight to height were about 2.5 times higher than the standard levels. The liver weights were also greater by 500-1,000 g than the standard levels.

Ringed grafting for an abdominal aortic aneurysm in a 92-year-old patient: report of a case

We report herein the case of a 92-year-old man with an abdominal aortic aneurysm who underwent successful surgical resection using a ringed graft. His postoperative course was uneventful, and he was discharged after 42 days, following which he attended the outpatient department twice a month for regular check-ups. He finally died of pneumonia which developed from an upper respiratory tract infection 6 months after his operation. Thus, surgical treatment should always be considered when an aneurysm is detected, even in very aged patients for whom the activities of daily living are possible.

[Study on secular changes of cadmium concentration accumulated in main organs of Japanese]

With the development of the mining and manufacturing industries and the petrochemical industry, cadmium (Cd) has been used not only for metal products but also petroleum products. Recently, environmental pollution due to waste fluids and gases from factories using cadmium and also domestic waste materials has become a cause for concern. In this connection, studies on the accumulated levels of Cd in the human body, its age-distribution in the general population and its secular changes during the last decade would be useful for clarifying the degree of contamination in the human body and providing an index which could be used as a basis for preventive measures against environmental pollution. For this purpose, the levels of Cd accumulated in main organs of the human body were determined using forensic data 3 times at 5-year intervals starting in 1976. The age intervals starting in 1976. The age group having the highest Cd level was 50-59 years, old and the mean weights of Cd per wet weight of heart, liver and kidney were 0.421, 2,984 and 56.43 micrograms/g, respectively. Each of these organs in babies less than a year old exhibited lower Cd levels, but teenagers had levels close to those in adult. However, the level in each organ was lower in individuals over 60 years old. 4 distinct age-related increase in the level of Cd was found only in the kidney. The levels of accumulated Cd in the liver and kidney showed a rise during the last 10 years from 2.358 to 5.568 micrograms/g and from 43.95 to 73.47 micrograms/g, respectively, whereas the Cd level in the heart has remained about the same, i.e. from 0.207 to 0.181 micrograms/g.

Studies on secular changes in the concentration of lead accumulated in organs and rib of Japanese

As environmental pollution due to waste fluids and gases from factories using lead (Pb), as well as domestic waste materials, has become a matter for public concern, studies on the accumulated levels of Pb in man have become necessary for defining the degree of contamination in the ordinary population. For this purpose, Pb levels in tissues of 76 forensic cadavers were determined in order to investigate the age distribution of accumulated Pb, and 120 samples were used to clarify secular changes in Pb accumulation during the last decade in the general population. The age group showing the highest Pb level was 50-59 years, with mean Pb contents per unit wet weight of 0.262, 0.520, 0.427 and 4.479 micrograms/g for heart, liver, kidney and rib, respectively. Each of these organs in all age groups exhibited almost the same Pb levels, but babies less than one year old had levels close to those in adults. However, ribs in babies exhibited much lower Pb levels. The levels in each organ were lower in individuals over 60 years old. A distinct age-related increase in Pb levels was found only in ribs from age 0 year to 50-59 years. The Pb levels in the heart, liver, kidney and rib showed a decrease during the last 10 years from 0.188 +/- 0.073 to 0.006 +/- 0.003 micrograms/g, from 0.307 +/- 0.169 to 0.076 +/- 0.057 micrograms/g, from 0.287 +/- 0.145 to 0.021 +/- 0.011 micrograms/g and from 3.203 +/- 1.477 to 2.366 +/- 1.469 micrograms/g, respectively.

[The fate of patients with intermittent claudication-comparison of surgical and non-surgical treatment]

The purpose of this study was to determine the operative indication for patients with intermittent claudication because of arteriosclerosis obliterans, and to compare the late result of the surgical treatment group (182 cases, 250 limbs) with that of the non-surgical treatment group (35 cases, 43 limbs). There were 3 operative deaths and 34 late deaths in the surgical group, and 14 late deaths in the non-surgical group. The number one cause of death was heart failure, including ischemic heart disease, in both groups. The 4-year cumulative patency rates were 91% in the aorto-iliac, 71% in the femoro-distal and 79% in the aorto-femoro-distal arterial reconstructions. Long term symptom free rates of the surgical group and the non-surgical group, except fatal case, were 83% and 44% in the aorto-iliac, 79% and 27% in the femoro-distal, 87% and 33% in the aorto-femoro-distal arterial regions, respectively. Late result of intermittent claudication in the surgical group was better than that in the non-surgical group. We concluded that intermittent claudication should be considered to be the indication for surgery, except for the cases with high risk diseases or malignant diseases.