Preoperative factors of prognostic significance in gastric cancer

This study was undertaken to investigate the ability of local anatomical and primary histological features of gastric cancers, as well as DNA analysis, to predict prognosis. Using multivariate analysis, results indicate that location of a tumor in the gastric cardia, poor differentiation, involvement of adjacent organs, and aneuploidy are all independent predictors of survival. All of the factors studied can be determined by endoscopic procedures preoperatively on patients with gastric cancers and could be helpful in selecting some patients for perioperative adjunctive therapies.

O6-methylguanine-DNA methyltransferase in normal and malignant tissue of the breast

An important component of high-dose chemotherapy/autologous bone marrow support regimens for adjuvant treatment of breast cancer is carmustine. Preclinical studies have shown that the level of the DNA repair protein O6-methylguanine-DNA methyltransferase is correlated with the resistance of cultured human tumor cells to this drug, but little is known about transferase levels of breast tissue in vivo. We measured the DNA repair activity in 80 tissue samples from 65 patients, including normal, abnormal, benign, and malignant specimens. Wide interindividual variations was observed and average transferase levels were similar in normal and benign tissue. However, transferase levels were significantly elevated in stage I-IV disease. In addition, the frequency of samples with no detectable transferase was greatly reduced in this malignant group, and transferase was positively correlated with the presence of positive nodes, a marker for disease progression. In contrast, transferase levels were not correlated with age or estrogen receptor status, and the levels in normal tissue did not vary between patients with benign or malignant disease. These results suggest that this DNA repair activity may be increased in breast cancer relative to normal tissue and encourage further study of the predictive value of transferase measurements in high-dose chemotherapy/autologous bone marrow transplant for breast cancer.

Let us now revisit prepaid group practice

American medicine will soon enter health care reform. The Clinton Administration's Task Force on Health Care Reform is likely to introduce change that relies heavily on managed care, a field now dominated by the health insurance industry. Physicians can manage health care themselves by forming Prepaid Group Practices (PGPs). PGPs combine health insurance functions with physician managed health care. They can negotiate directly with health care purchasers, thereby abrogating the commercial health insurance industry.

The value of flow cytometric analysis in patients with gastric cancer

Tumors in the gastric cardia and the body/antrum were studied to determine the effect of ploidy and S-phase fractions on patient survival. Forty-two percent of tumors were located in the cardia and 58% in the body/antrum. Nodal metastases occurred more often with cardia tumors than with body/antrum tumors (86% vs 65%). Aneuploidy occurred more frequently in patients with cardia tumors than in patients with body/antrum tumors (39% vs 20%). Metastasis to lymph nodes was more common in patients with aneuploidy than in patients with diploidy (31% vs 7%). S-phase fractions were not different between aneuploid and diploid tumors. More patients with diploid cancer were alive at 5 years than were patients with aneuploid tumors (90% vs 10%). We conclude that primary cellular differences in gastric tumors of the cardia or body/antrum determine patient survival.

Prognostic Factors in Node-Negative Breast Cancer

One hundred patients with node-negative breast cancer were examined to analyze the influence of tumor size, nuclear grade, and DNA content determined by flow cytometry on overall survival. Patients with diploid cancers lived significantly longer than those with aneuploid cancers (126 +/- 8 vs 80 +/- 11 months). Patients with an S-phase fraction less than 10% lived significantly longer than those with S-phase fractions 10% or greater (122 +/- 8 vs 85 +/- 10 months). Tumor size had the major impact on survival, and multivariate analysis of variance by the Cox proportional hazards model showed the greatest effect on prognosis. Tumor grade did not significantly influence overall survival.

Expression of the amiloride-blockable Na+ channel by RNA from control versus aldosterone-stimulated tissue

The amiloride-blockable Na+ channel was expressed in Xenopus oocytes injected with total RNA isolated from the toad urinary bladder. This system was used to investigate mechanisms that mediate the natriferic action of aldosterone. Incubation of the epithelium with aldosterone for 3 h doubled its channel activity but did not increase the ability of isolated RNA to express functional channels in oocytes. A 20-h incubation with the hormone produced an additional increase of Na+ transport across the intact epithelium and also augmented the channel activity expressed in oocytes by nearly 10-fold. The data are in agreement with our model that aldosterone enhances the apical Na+ permeability of tight epithelia by a short term activation of pre-existing channels, followed by chronic induction of new channel protein. Blocking methyl transfer reactions, previously shown to inhibit the natriferic action of aldosterone in tight epithelia, did not alter the basal or aldosterone-induced response in oocytes.

Prefrontal sonic treatment: MR findings

The authors describe the use of MR in a patient who underwent prefrontal sonic treatment for relief of intractable headaches. MR demonstrated well-demarcated regions of encephalomalacia within the white matter of the frontal lobe (with relative sparing of cortex) in a characteristic conical volume that corresponded to the insonified regions.

Pathogenesis of acute pulmonary inflammation in strain 2 and strain 13 guinea pigs

An acute inflammatory response was elicited in the lungs of strain 2 and 13 guinea pigs following immunization and aerosol challenge with ovalbumin. The pulmonary inflammatory response, characterized by hemorrhage and influx of inflammatory cells, progressed from initiation at 12-hours postchallenge through resolution at 96-hours postchallenge. Inflammatory and immunoregulatory cells, recovered by bronchoalveolar lavage, showed quantitative changes in their relative contribution to the bronchoalveolar cell infiltrate over the course of inflammation. Changes in concentrations of macrophages and T cells, in particular, are discussed in terms of their possible contributions to initiation and resolution of acute pulmonary inflammation.

Effect of an inhibitor of DNA methylation on T cells. I. 5-Azacytidine induces T4 expression on T8+ T cells

Maturing thymocytes express a series of cell surface glycoproteins which can be identified by monoclonal antibodies. The stage II or common thymocyte expresses the phenotype T4+T8+T6+T3-. In response to unknown signals, but presumably involving interactions with products of the major histocompatibility complex, the thymocyte suppresses either the T8 or T4 gene, becoming committed to the T4+T8- or T4-T8+ phenotype. With maturation, the thymocyte also becomes T6-T3+. To study whether DNA methylation may be involved in regulating expression of these determinants in mature T cells, we treated cloned interleukin 2-dependent T8- and T4-bearing T cells with 5-azacytidine (5-azaC), a nucleoside analog which inhibits methylation of newly synthesized DNA. In this report, we show that T8+ T cells treated with 5-azaC express the phenotype T8+T4+T6-T3+. Treatment of the same cells with hydroxyurea, an inhibitor of DNA synthesis, failed to induce T4 on T8+ cells. These results suggest that expression of the T4 gene may be suppressed by DNA methylation in mature T8+ cells.

Effect of an inhibitor of DNA methylation on T cells. I. 5-Azacytidine induces T4 expression on T8+ T cells

Maturing thymocytes express a series of cell surface glycoproteins which can be identified by monoclonal antibodies. The stage II or common thymocyte expresses the phenotype T4+T8+T6+T3-. In response to unknown signals, but presumably involving interactions with products of the major histocompatibility complex, the thymocyte suppresses either the T8 or T4 gene, becoming committed to the T4+T8- or T4-T8+ phenotype. With maturation, the thymocyte also becomes T6-T3+. To study whether DNA methylation may be involved in regulating expression of these determinants in mature T cells, we treated cloned interleukin 2-dependent T8- and T4-bearing T cells with 5-azacytidine (5-azaC), a nucleoside analog which inhibits methylation of newly synthesized DNA. In this report, we show that T8+ T cells treated with 5-azaC express the phenotype T8+T4+T6-T3+. Treatment of the same cells with hydroxyurea, an inhibitor of DNA synthesis, failed to induce T4 on T8+ cells. These results suggest that expression of the T4 gene may be suppressed by DNA methylation in mature T8+ cells.