Generation of anti-tumour effector T cells from naïve T cells by stimulation with dendritic/tumour fusion cells

Tumour-draining lymph node T cells are an excellent source of effector T cells that can be used in adoptive tumour immunotherapy because they have already been sensitized to tumour-associated antigens in vivo. However, such tumour-specific immune cells are not readily obtained from the host due to poor immunogenicity of tumours and reduced host immune responses. One obstacle in implementation of adoptive immunotherapy has been insufficient sensitization and expansion of tumour-specific effector cells. In this study, we aim to improve adoptive immunotherapy by generating anti-tumour effector T cells from naïve T lymphocytes. We attempted to achieve this by harnessing the advantages of dendritic cell (DC)-based anti-cancer vaccine strategies. Electrofusion was routinely employed to produce fusion cells with 30-40% efficiency by using the poorly immunogenic murine B16/F10 cell line, D5 cells, and DC generated from bone marrow cells. CD62L-positive T cells from spleens of naïve mice and the fusion cells were cocultured with a low concentration of IL-2. After 9 days of culture, the antigen-specific T cells were identified with an upregulation of CD25 and CD69 expression and a downregulation of CD62L expression. These cells secreted IFN-gamma upon stimulation with irradiated tumour cells. Moreover, when transferred into mice with 3-day established pulmonary metastases, these cells with coadministration of IL-2 exhibited anti-tumour efficacy. In contrast, naïve T cells cocultured with a mixture of unfused DC and irradiated tumour cells did not exhibit anti-tumour efficacy. Our strategy provides the basis for a new approach in adoptive T cell immunotherapy for cancer.

Preparation of poly(vinyl alcohol)/DNA hydrogels via hydrogen bonds formed on ultra-high pressurization and controlled release of DNA from the hydrogels for gene delivery

Poly(vinyl alcohol) (PVA) hydrogels interacting with DNA mediated by hydrogen bonds (PVA/DNA hydrogel) were developed using ultra-high pressure (UHP) technology. The goal was to create a new method of gene delivery by controlled release of DNA. Mixed solutions of DNA and PVA at various concentrations were pressurized at 10,000 atmospheres at 37 degrees C for 10 min. PVA/DNA hydrogels with good formability were produced at PVA concentrations of more than 5% w/v. The presence of DNA in the obtained hydrogels was confirmed by spectroscopic analysis and nucleic acid dye staining. DNA release from the hydrogels was investigated using PVA/DNA hydrogel samples of 5% and 10% w/v formed by UHP treatment or by conventional freeze-thaw methods. The DNA release curves from both types of samples showed a rapid phase in the initial 15 h followed by a sustained release phase. However, there was a difference in the amount of DNA released. Less DNA was released by the pressurized hydrogels than by the freeze-thaw hydrogels. Also, the cumulative amount of DNA released decreased as the PVA content in the hydrogels increased. These results indicate that DNA release from the hydrogels can be modulated by changing the preparation method and the PVA content. Furthermore, it was demonstrated that DNA release could be controlled by varying the amount and duration of pressurizing used to form the hydrogels. Intact fractions of plasmid DNA released from the hydrogels were separated by agarose gel electrophoretic analysis. These results suggest that, using controlled release, DNA from PVA/DNA hydrogels formed by UHP treatment can be transfected into cells.

Phase I study of combination chemotherapy with amrubicin and paclitaxel in relapsed small cell lung cancer

18206

Background: Amrubicin (AMR) and paclitaxel (PTX) are promising agents for advanced non-small cell and small cell lung cancer (SC). However, the combination of these drugs for relapsed SC has never been reported. The aim of this study was to determine the maximum tolerated dose (MTD) of AMR and PTX, thus to investigate the recommended dose (RD) of this combination chemotherapy for relapsed SC patients. Methods: Relapsed SC patients after 1 or 2 regimens with age younger than 70 and good performance status (PS) were eligible. The treatment consisted of AMR (escalating from 30 to 40 mg/m2 by 5 mg/m2 increment) as a one- shot iv on days 1 through 3, and PTX (escalating from 70 to 90 mg/m2 by 10 mg/m2 increment) as a 60-minute infusion on days 4 and 11, repeated every 21 days. The dose-limiting toxicities (DLTs) were defined as grade 3/4 non-hematological toxicities, grade 4 thrombocytopenia, and grade 4 leukocytopenia / neutropenia for 4 days or more. Results: Nine relapsed SC patients were enrolled. All of them were sensitive-relapsed cases with mean age of 60.1 and PS of 0 - 1, and received one or more cycles of chemotherapy (mean: 2.7 cycles). Six patients were treated at level 1 (AMR 30mg/m2, PTX 70 mg/m2) with two of them on DLT of grade 4 neutropenia for 4 days or more. Three patients were treated at level 2 (AMR 35 mg/m2, PTX 70 mg/m2) with all of them on DLTs; grade 4 neutropenia for 4 days or more, grade 3 febrile neutropenia, and grade 3 pneumonia. Overall response rate was 63%. Conclusion: The MTD was identified to be level 2, and the RD for this regimen with AMR and PTX was considered to be 30 mg/m2 and 70 mg/m2, respectively. Treatment was well tolerated and the preliminary activity observed warrants further investigation. A phase II study is currently under investigation for relapsed and refractory SC patients.

No significant financial relationships to disclose.

Morphology control of polylactide microspheres enclosing irinotecan hydrochloride with polylactide based polymer surfactant for reduction of initial burst

We introduced newly biodegradable polymer surfactant to poly(D,L-lactide) microspheres for exhibiting precisely controlled release rate of antitumor agent. We newly designed biodegradable polymer surfactant, poly(ethyleneoxide monooleate)-block-poly(D,L-lactide); (MOPEO-PLA), which has a biocompatible, oil-soluble and compatible with polylactide matrices. Polylactide (PLA) microspheres with MOPEO-PLA enclosing Irinotecan hydrochloride (CPT-11) was successfully fabricated by solvent evaporation method via O/O emulsion. The surface morphology was strongly affected to MOPEO-PLA content in PLA microspheres; the wrinkles on microsphere surface were decreased with increasing MOPEO-PLA content. It was found from DSC scans that Tg of PLA drastically decreased with introducing MOPEO-PLA, indicating that MOPEO-PLA miscible with PLA. MOPEO-PLA, played as a plasticizer, made the surface smoothed. The rate of release in a short duration was minimum value at adding 20 wt.% of MOPEO-PLA. This result was due to the smaller surface area of PLA microspheres with smoothed surface.

A woman who required long-term mechanical ventilation to treat limbic encephalitis during pregnancy

We describe our experience with a woman who had severe non-herpetic acute limbic encephalitis at 20 weeks' gestation. Despite receiving mechanical ventilation for about 3 months because of impaired consciousness and frequent convulsions, she had a normal delivery and an uneventful recovery with no sequelae. The patient did not respond to treatment with antiviral agents. Anticonvulsant agents were given while monitoring plasma drug concentrations. Early treatment and the prevention of complications apparently contributed to good outcomes in the mother and child.

Imaging of cauda equina edema in lumbar canal stenosis by using gadolinium-enhanced MR imaging: experimental constriction injury

BACKGROUND AND PURPOSE

It has been reported that disturbance of blood flow arising from circumferential compression of the cauda equina by surrounding tissue plays a major role in the appearance of neurogenic intermittent claudication (NIC) associated with lumbar spinal canal stenosis (LSCS). We created a model of LSCS to clarify the mechanism of enhancement within the cauda equina on gadolinium-enhanced MR images from patients with LSCS.

METHODS

In 20 dogs, a lumbar laminectomy was performed by applying circumferential constriction to the cauda equina by using a silicon tube, to produce 30% stenosis of the circumferential diameter of the dural tube. After 1 and 3 weeks, gadolinium and Evans blue albumin were injected intravenously at the same time. The sections were used to investigate the status of the blood-nerve barrier function under a fluorescence microscope and we compared gadolinium-enhanced MR images with Evans blue albumin distribution in the nerve. The other sections were used for light and transmission electron microscopic study.

RESULTS

In this model, histologic examination showed congestion and dilation in many of the intraradicular veins, as well as inflammatory cell infiltration. The intraradicular edema caused by venous congestion and Wallerian degeneration can also occur at sites that are not subject to mechanical compression. Enhanced MR imaging showed enhancement of the cauda equina at the stenosed region, demonstrating the presence of edema.

CONCLUSION

Gadolinium-enhanced MR imaging may be a useful tool for the diagnosis of microcirculatory disorders of the cauda equina associated with LSCS.

Preparation and Interfacial Properties of a Novel Biodegradable Polymer Surfactant: Poly(ethylene oxide monooleate-block-DL-lactide)

In this paper, we report a novel synthesis of poly(ethylene oxide monooleate-block-DL-lactide) (MOPEO-PLA) in the presence of stannous 2-ethylhexanoate catalyst. By utilizing the surfactant property and the reactive double bond of the amphiphilic MOPEO-PLA, various characteristics of PLA microspheres, such as surface and internal structure, surface morphology, release property, and so on, may potentially be controlled. MOPEO-PLA was found to be hydrophobic enough to prevent loss by dissolution into aqueous solution, which is often a problem for MOPEO. Furthermore, the interfacial tension measurements of a MOPEO-PLA/toluene/water system revealed that MOPEO-PLA had a good surface activity almost equal to that of MOPEO. The MOPEO-PLA/PLA blend films were prepared by solvent casting on a water layer. Contact-angle measurements of MOPEO-PLA/PLA blend films confirmed that the hydrophilic PEO segments were selectivity accumulated at the oil/water interface. Moreover, the surface free energy on the 'water side' of the MOPEO-PLA/PLA blend films was increased because of the increase in polar components as a result of the ether bonds of the PEO segments. Schematic illustration of the adsorption property of a) MOPEO-PLA with a high-molecular-weight PLA segment and b) MOPEO-PLA with a low-molecular-weight PLA segment at an ethyl acetate/water interface.

Surface morphology control of polylactide microspheres enclosing irinotecan hydrochloride

In order to reduce the initial burst from polylactide (PLA) microspheres enclosing an antitumor agent, we prepared the microspheres with a smooth surface by varying solvent evaporation conditions such as operating temperature and pressure. PLA microspheres enclosing irinotecan hydrochloride (CPT) were prepared using the O/O emulsion system for solvent evaporation. The mean diameter and enclosing efficiency were almost constant because they were independent of solvent evaporation conditions. Scanning electron microscopic (SEM) observation verified the smooth surface of the PLA microspheres produced by varying the preparation conditions. In vitro release experiments show that the initial burst of microspheres with a smooth surface was less than that of those with a rough surface.

Observation of modulated quadrupolar structures in PrPb3

Neutron diffraction measurements have been performed on the cubic compound PrPb(3) in a [001] magnetic field to examine the quadrupolar ordering. Antiferromagnetic components with q = (1/2 +/- delta 1/2 0), (1/2 1/2 +/- delta 0) (delta approximately 1/8) are observed below the transition temperature T(Q) (0.4 K at H = 0) whose amplitudes vary linear with H and vanish at zero field, providing the first evidence for a modulated quadrupolar phase. For H < 1 T, a nonsquare modulated state persists even below 100 mK suggesting quadrupole moments associated with a Tau(3) doublet ground state to be partially quenched by hybridization with conduction electrons.

Commensurate-incommensurate crossover of charge stripe in La2-xSrxNiO4 (x approximately 1/3)

The temperature (T) dependence of the charge-stripe order in La2-xSrxNiO4 has been investigated in the vicinity of x approximately 1/3 by synchrotron radiation x-ray diffraction measurements. With decreasing T, a prominent commensurate-incommensurate (C-IC) crossover is observed in the x<1/3 region, while for the x>1/3 region the IC order is dominant over the whole T range. Such a C-IC crossover is interpreted as the entropy-driven self-doping of the charge stripes, and its x dependence indicates the clear electron-hole asymmetry with the x=1/3 compound as the Mott insulator.

Phase I/II study of daily carboplatin, 5-fluorouracil and concurrent radiation therapy for locally advanced non-small-cell lung cancer

A study was undertaken to determine the maximum tolerated dose, the dose-limiting toxicities and the response rate of carboplatin and 5-fluorouracil administered daily with concurrent thoracic radiation therapy in patients with locally advanced non-small-cell lung cancer. In a phase I/II clinical trial, patients with histologically documented, unresectable stage IIIA or IIIB non-small-cell lung cancer (NSCLC) were enrolled. Carboplatin (20-40 mg m(-2) 2-h infusion, daily) and 5-fluorouracil (200 mg m(-2) 24-h continuous infusion, daily) were administered concurrently with radiotherapy on days 1-33. Radiotherapy, with a total dose of 60 Gy, was delivered in 30 fractions on days 1-40. In the phase I portion, the daily dose of carboplatin was escalated from 20 to 40 mg m(-2). Once the maximum tolerated dose (MTD) and recommended dose (RD) of carboplatin was determined, the study entered the phase II portion. In the phase I portion, the daily MTD and RD of carboplatin were 40 and 35 mg m(-2), respectively. The dose-limiting toxicity was neutropenia. In the following phase II study, 30 patients were entered and the objective response rate was 76.7% (95% CI, 62-92%) and the local control rate was 85.7%. The median survival time was 19.8 months, with a survival rate of 70% at 1 year, 36.7% at 2 years. The major toxicities of treatment were neutropenia (>or=grade 3, 87.9%) and thrombocytopenia (>or=grade 3, 23.3%). This combined therapy for locally advanced non-small-cell lung cancer is promising and shows acceptable toxicity.

Highly degenerate canted spin structure in bilayer manganite La1.1Sr1.9Mn2O7

We have observed magnetic diffuse signals of the bilayer manganite La1.1Sr1.9Mn2O7 by neutron scattering. Even at the low temperature, 20 K, there is a diffuse signal, which is much stronger than that observed in the high temperatures, 144 and 288 K. This signal cannot be characterized by a bilayer structure as observed at 144 K nor by a monolayer structure as at 288 K, but by a high degeneracy of a canted spin structure. Thus, an observation of this diffuse signal is the direct evidence for the establishment of the canted spin structure in La1.1Sr1.9Mn2O7.

Comparison of ability of apoptosis induction by lipopolysaccharide of Porphyromonas gingivalis with Escherichia coli

We compared effects of Porphyromonas gingivalis LPS with Escherichia coli LPS to the murine peritoneal macrophage. E. coli LPS possessed a threshold dose between 100 micro g and 10 micro g, the higher dose induced apoptosis at the murine peritoneal macrophage while the lower dose did not. The ability of apoptosis induction at the murine peritoneal macrophage of P. gingivalis LPS was weaker than E. coli LPS. P. gingivalis LPS did not induce significant apoptosis in all tested dose. However, the morphology of the peritoneal macrophage treated by P. gingivalis LPS was obviously different from that of the unstimulated cells.

Successful liquid storage of peripheral blood stem cells at subzero non-freezing temperature

Although non-frozen storage of peripheral blood stem cells (PBSC) has been extensively studied and utilized clinically, the optimal storage conditions have not been determined. In order to improve the maintenance of clonogenic capacity during storage, we evaluated the feasibility of subzero non-freezing preservation of PBSC and attempted to determine the optimal conditions. Human PBSC were stored in different non-cryopreserved conditions. University of Wisconsin (UW) solution was used as the storage medium for PBSC. The stem cell integrity was optimally maintained when PBSC were preserved in a supercooled state at -2 degrees C in UW solution without any cryoprotectants, and the highest values for nucleated cell survival (91.6%), CFU-GM survival (67.3%) and trypan blue viability (92%) were achieved at 72 h. CFU-GM survival in our storage conditions was significantly better than the survival achieved with hypothermic preservation in autologous serum and ACD-A solution at 4 degrees C (67.3 +/- 9.2% vs 42.9 +/- 15.3%; P < 0.01) or cryopreservation at -80 degrees C (67.3 +/- 9.2% vs 52.7 +/- 10.7%; P < 0.01). Thus, the combination of supercooling and UW solution was the optimal non-freezing method of preserving transplantable PBSC tested here. This method is of clinical utility in peripheral blood stem cell transplantation (PBSCT) for its simplicity and storage efficiency, and has value as a short-term storage method for PBSC to support dose-intensive multicyclic chemotherapy.

Cancer immunogene therapy

The establishment of cancer in a host involves at least two major events: the escape of tumor cells from normal growth control and their escape from immunological recognition. Because of this nature of their development, cancer cells seem to be predominatly poorly immunogenic. In contrast to the previous idea that cancer cells express no recognizable antigens, recent progress in the identification and characterization of tumor antigens, as well as the expansion of knowledge on the cellular and molecular mechanisms of antigen recognition by the immune system, have raised the possibility of using immunotherapy to treat certain tumors. Information on these mechanisms has been obtained in three crucial areas: 1) the role of cytokines in the regulation of the immune response, 2) the molecular characterization of tumor antigens in both mouse and human tumors, and 3) the molecular mechanisms of T cell activation and antigen presentation. Such information has provided new insight into tumor immunology and immunotherapy. Furthermore, recombinant DNA technology allows for modification of the genome of mammalian cells for therapeutic purposes in several diseases. Several novel strategies have been developed to derive genetically modified tumor cells and use them as cellular vaccines to induce antitumor immunity in animal tumor models. This combined modality of genetically modified tumor cells and immunotherapy has been termed immunogene therapy of tumors. Crucial to this approach has been the ability to transfer into normal or neoplastic cells genes known to increase the immunogenicity of cells, which subsequently can be used to augment immune reactions in tumor-bearing mice or cancer patients. While there has been success in inducing antitumor immunity in some tumor models, there are difficulties and limitations in the application of these gene-modified tumor cells for the treatment of preexisting tumors. In this review, recent progress in cancer immunogene therapy is discussed.

Nephron structure and immunohistochemical localization of ion pumps and aquaporins in the kidney of frogs inhabiting different environments

Amphibians inhabit areas ranging from completely aqueous to terrestrial environments and move between water and land. The kidneys of all anurans are similar at the gross morphological level: the structure of their nephrons is related to habitat. According to the observation by light and electron microscopy, the cells that make up the nephron differ among species. Immunohistochemical studies using antibodies to various ATPases showed a significant species difference depending on habitat. The immunoreactivity for Na+,K(+)-ATPase was low in the proximal tubules but high in the basolateral membranes of early distal tubules to collecting ducts in all species. In the proximal tubule, apical membranes of the cells were slightly immunoreactive to H(+)-ATPase antibody in aquatic species. In the connecting tubule and the collecting duct, the apical membrane of intercalated cells was immunoreactive in all species. In aquatic species, H+,K(+)-ATPase immunoreactivity was observed in cell along the proximal, distal tubule to the collecting duct. However, H+,K(+)-ATPase was present along the intercalated cells of the distal segments from early distal to collecting tubules in terrestrial and semi-aquatic species. In the renal corpuscle, the neck segment and the intermediate segment, immunoreactivities to ion pumps were not observed in any of the species examined. Taking together our observations, we conclude that in the aquatic species, a large volume of plasma must be filtered in a large glomerulus and the ultrafiltrate components are reabsorbed along a large and long proximal segment of the nephron. Control of tubular transport may be poorly developed when a small short distal segment of the nephron is observed. On the contrary, terrestrial species have a long and well-developed distal segment and regulation mechanisms of tubular transport may have evolved in these segments. Thus, the development of the late distal segments of the nephron is one of the important factors for the terrestrial adaptation.

CD40 ligand promotes priming of fully potent antitumor CD4(+) T cells in draining lymph nodes in the presence of apoptotic tumor cells

The presence or absence of CD4(+) T cell help can determine the direction of adaptive immune responses toward either cross-priming or cross-tolerance. It has been demonstrated that interactions of CD40-CD40 ligand can replace CD4(+) T cell help and enable dendritic cells to prime cytotoxic T cells. Here, we demonstrate that antitumor reactivity induced in regional lymph nodes (LNs) by s.c. injection of CD40 ligand (CD40L)-transduced tumor (MCA205 CD40L) showed far superior therapeutic efficacy against established brain tumors of a weakly immunogenic fibrosarcoma, MCA205, when adoptively transferred. Coinjection of apoptotic, but not necrotic parental tumor cells with CD40L-expressing tumor cells caused a strong synergistic induction of antitumor reactivity in tumor-draining LNs. Freshly isolated T cells from LNs immunized with apoptotic parental tumor cells and MCA205 CD40L were capable of mediating regression of the parental tumor in vivo. In contrast, T cells derived from LNs immunized without MCA205 CD40L required ex vivo anti-CD3/IL-2 activation to elicit therapeutic activity. On anti-CD3/IL-2 activation, cells from LNs immunized with MCA205 CD40L exhibited superior per cell antitumor reactivity. An in vitro depletion study revealed that either CD4(+) or CD8(+) T cells could mediate therapeutic efficacy but that the antitumor efficacy mediated by CD4(+) T cells was far superior. Cytosolic flow cytometric analyses indicated that priming of CD4(+) cells in LNs draining CD40L-expressing tumors was polarized to the Th1 type. This is the first report that fully potent antitumor CD4(+) T cell priming was promoted by s.c. injection of CD40L-transduced tumor in the presence of apoptotic tumor cells.

The effect of heat-treated human bone morphogenetic protein on clinical implantation

For the clinical usage of human-derived bones, it is necessary to treat bones to reduce the risk of contamination by microorganisms. Bone morphogenetic protein is vulnerable to chemicals, but shows resistance to thermal heat to 70 degrees C in a short time. In this experiment, crude human bone morphogenetic protein was extracted from heat-treated bones at 60 degrees C for 10 hours and from nonheated bones. Sodium dodecyl sulfate polyacrylamide gel electrophoresis for these specimens was done. Gelatin capsules containing 5 mg of crude human bone morphogenetic protein extracted from heated and nonheated bones were implanted into thigh muscle pouches of five mice. At 20 days after implantation, the heterotopic bone formation was compared by evaluating the radiographic and histologic analyses. The sodium dodecyl sulfate polyacrylamide gel electrophoresis pattern of the human bone morphogenetic proteins showed five main bands (16, 22, 28, 35, and 67 kDa) that were almost identical. Heterotopic bone formation observed on the radiograph was induced by crude human bone morphogenetic protein from heated bones in a manner similar to that used for nonheated bones. The results from this study show that heat-treated bone preserves osteoinduction.

[Past trends in hepatitis C virus infection and route of transmission in Japan]

In Japan, it is known that the prevalence of hepatitis C virus(HCV) is high among the older people over 60 years of age in sharp contrast to the low prevalence among those under 30. The annual incidence rate of HCV carriers in general population remains quite low to be 1.8-3.4 per 100,000 person-year. On the other hand, HCV prevalence among intravenous drug users(IVDU) is still greater than 60%. Taking into account this epidemiological pattern together with the historical fact that Japan experienced an explosion of drug abuse among young generation of 15 to 25 years old in the period of post World War II turmoil together with the poor sanitary and medical conditions, it is suggested that a great wave of HCV spread in Japan occurred most likely in 1960's to 1970's. The spread then may have gradually fallen to the range today.

Characteristic features of the acetabular labrum in healthy children

Radial magnetic resonance images of the acetabular labrum were obtained on 40 hips of healthy children. There were no right-left or male-female differences. In children aged 11 years or younger, the labrum on the antero-superior weightbearing portion was triangular in shape, and there was an insular-shaped or linear high-intensity area inside; on the mid-superior portion, the labrum appeared as a regular triangular, low-intensity area; and on the postero-superior portion, it was flat. In children aged 12 and 13 years, the shape of the labrum in each portion was similar to that of the younger children, but the high signal intensity area on the antero-superior portion appeared less frequently. The size of the labrum relative to the femoral head was greater in younger children.

Genetic changes in colorectal carcinoma tumors with liver metastases analyzed by comparative genomic hybridization and DNA ploidy

BACKGROUND

Liver metastases are found in 10% of primary colorectal malignancies, and they affects the prognosis of patients with colorectal carcinoma. The authors investigated DNA copy number aberrations by using comparative genomic hybridization (CGH) and DNA ploidy alterations by using flow cytometry (FCM) in patients with primary colorectal carcinoma (primary tumors). To determine whether there are characteristic DNA copy number alterations that contribute to liver metastasis, cytogenetic aberrations were examined by CGH and FCM.

METHODS

The authors analyzed 35 primary tumors, including 16 primary tumors with liver metastasis, by using CGH and FCM.

RESULTS

Increases in DNA copy numbers were detected in 6q (5 of 16 tumors), 7q (6 of 16 tumors), 8q (7 of 16 tumors), 9p (5 of 16 tumors), 13q (8 of 16 tumors), 20p (9 of 16 tumors), and 20q (15 of 16 tumors) in primary tumors with liver metastases. Decreases in DNA copy numbers were found in 17p (5 of 16 tumors), 18p (6 of 19 tumors), 18q (8 of 16 tumors), and 22q (5 of 16 tumors). In contrast, primary tumors without liver metastasis showed gains in chromosome arms 8q (2 of 19 tumors), 13q (2 of 19 tumors), 20p (6 of 19 tumors), and 20q (5 of 19 tumors); however, they showed no gains in 6q or 7q and showed losses in chromosome arms 17p (2 of 19 tumors), 18p (4 of 19 tumors), 18q (6 of 19 tumors), and 22q (5 of 19 tumors). There was a significant difference in the frequency of DNA copy number gains and losses in 6q (P < 0.05), 7q (P < 0.01), 8q (P < 0.05), 13q (P < 0.05), and 20q (P < 0.01), respectively, between primary tumors with and without liver metastases. The differences in the DNA index were not significant between the two groups of primary tumors.

CONCLUSIONS

In liver metastases of primary tumors from patients with colorectal carcinoma, a correlation between DNA copy number aberrations and gains of chromosome arms 6q, 7q, 8q, 13q, and 20q is suggested.

Spin chirality, Berry phase, and anomalous Hall effect in a frustrated ferromagnet

An electron hopping on non-coplanar spin sites with spin chirality obtains a complex phase factor (Berry phase) in its quantum mechanical amplitude that acts as an internal magnetic field, and is predicted to manifest itself in the Hall effect when it is not cancelled. The present combined work of transport measurement, neutron scattering, and theoretical calculation provides evidence that the gigantic anomalous Hall effect observed in Nd2Mo2O7, a pyrochlore ferromagnet with geometrically frustrated lattice structure, is mostly due to the spin chirality and the associated Berry phase originating from the Mo spin tilting.

Role of autologous blood transfusion in sacral tumor resection: patient selection and recovery after surgery and blood donation

We carried out sacral en-bloc resection in six patients (three with chordoma; one with pheochromocytoma; one with malignant schwannoma; and one with giant cell tumor) using preoperatively collected autologous blood, to avoid homologous blood transfusion. An average of 3200 ml was collected preoperatively, with patients receiving recombinant human erythropoietin (r-HuEPO), at a total dose of 130 000 units on average. In four patients, we were able to accomplish the surgery without homologous blood transfusion. Postoperatively, the hemoglobin level in these four patients recovered to the pre-collective level in 4.5 weeks, on average. These clinical results indicate that en-bloc sacrectomy, which requires a large volume of blood transfusion, can be accomplished with preoperatively collected autologous blood alone.

Anorectal and bladder function after sacrifice of the sacral nerves

STUDY DESIGN

The quantitative changes in anorectal and bladder functions after sacrifice of the sacral nerves were assessed.

OBJECTIVES

To evaluate the bladder and anorectal functions before and after sacral nerve division in patients with sacral bone tumors.

SUMMARY OF BACKGROUND DATA

The quantitative changes in bladder and anorectal functions after sacrifice of the sacral nerves have not been intensively studied. The purpose of this investigation was to measure the bladder and anorectal function before and after sacral nerve division using manometry and cystometry.

METHODS

Surgical resection of a sacral tumor was performed in five patients. The sacral nerves were sacrificed bilaterally in three patients and unilaterally in two patients. Anorectal function was evaluated on the basis of symptoms and physiologic tests. Micturition function was evaluated based on symptoms, and intravesical pressures were measured by cystometry.

RESULTS

The two patients with unilateral sacral nerve loss did not experience subjective problems with defecation or micturition, although the residual volume of urine was increased after surgery. Two of the three patients with bilateral sacral nerve loss had no urge to defecate, were unable to differentiate between feces and flatus, and experienced no urgency. Fecal incontinence was uncommon because of firm feces. It was possible to control defecation using enemas on alternate days. The third patient underwent colostomy because the maximum resting pressure, which is controlled by the hypogastric nerves, was affected before surgery.

CONCLUSION

Unilateral sacrifice of sacral nerves results in little bladder or anorectal dysfunction.

Prevalence of anti-hepatitis C virus antibody and chronic liver disease among atomic bomb survivors

To investigate whether exposure to atomic bomb radiation altered the prevalence of hepatitis C virus (HCV) infection or accelerated the progress toward chronic hepatitis after HCV infection, the seropositivity of antibody to hepatitis C virus (anti-HCV) was determined for 6,121 participants in the Adult Health Study of atomic bomb survivors in Hiroshima and Nagasaki. The seropositivity of anti-HCV antibody was 2.5 times higher among those with a history of blood transfusion and 1.2 times higher among those with a family history of liver disease, whereas acupuncture showed no association with anti-HCV. Although the prevalence of anti-HCV was lower for survivors with positive dose estimates than for those with 0 dose (relative prevalence 0.84, P = 0.022), there was no evidence of a smooth dose-response relationship. However, these data suggested that the radiation dose response for chronic liver disease among HCV antibody-positive survivors may be greater than that among HCV antibody-negative survivors (slope ratio 20). In conclusion, no dose-response relationship was found between anti-HCV positivity and radiation dose; a possible increase in the radiation dose response of chronic liver disease among anti-HCV-positive individuals was found. Thus radiation exposure may accelerate the progress of chronic liver disease associated with hepatitis C virus infection.

[Obstructive sleep apnea syndrome in a patient with superior vena cava syndrome caused by lung cancer]

A 48-year-old man was treated with chemotherapy and irradiation therapy for superior vena cava syndrome (SVCS) caused by adenocarcinoma of the lung, and his symptoms subsided temporarily. However, the same symptoms recurred, and severe snoring during sleep and daytime hypersomnolence developed. Obstructive sleep apnea syndrome (OSAS) was diagnosed by respiratory inductive plethysmography. After chemotherapy, the symptoms of edema of the face and arms, snoring, and daytime somnolence tendency were alleviated, and the patient's apnea hypopnea index decreased remarkably. In addition, lateral cephalograms disclosed improved patency of the upper respiratory tract and dilation of the soft palate. These findings suggested a relationship between SVCS and OSAS. OSAS may cause a deterioration of circulatory dynamics and the quality of life when it develops secondary to SVCS. Therefore, it is necessary to determine whether OSAS is present and accordingly provide suitable treatment in patients with SVCS.