hTERT is a critical determinant of telomerase activity in renal-cell carcinoma

Telomerase is a ribonucleoprotein enzyme which stabilizes chromosomal structure, thereby inducing cellular immortality. Three major subunits composing telomerase complex have been cloned, designated hTR (human telomerase RNA), TPI (telomerase-associated protein I), and hTERT (human telomerase reverse transcriptase). In the present study, a total of 36 renal-cell carcinomas (RCC) and adjacent normal tissues, as well as cell lines derived from RCC or normal kidney, were examined for the expression of each telomerase subunit and telomerase activity. RT-PCR analyses revealed that hTR and TP I mRNA were constitutively expressed both in tumor and in normal tissues. In contrast, hTERT mRNA was expressed in most tumors, but not in normal tissues. Telomeric-repeat-amplification-protocol (TRAP) assay revealed that more than 80% of RCC tumor tissue exhibited telomerase activity, while none of the adjacent normal tissue did. There was a significant association of telomerase activity with expression of hTERT mRNA, but not with TPI mRNA or hTR expression. Two cell lines, derived from RCC and cervical cancer, expressed telomerase activity and hTERT mRNA, while normal renal cortical epithelial cells expressed neither of them. These findings suggest that hTERT plays a critical role in determining the enzymatic activity of human telomerase, and that up-regulation of hTERT probably plays a role in the progression of human cancers.

hTERT is a critical determinant of telomerase activity in renal-cell carcinoma

Telomerase is a ribonucleoprotein enzyme which stabilizes chromosomal structure, thereby inducing cellular immortality. Three major subunits composing telomerase complex have been cloned, designated hTR (human telomerase RNA), TPI (telomerase-associated protein I), and hTERT (human telomerase reverse transcriptase). In the present study, a total of 36 renal-cell carcinomas (RCC) and adjacent normal tissues, as well as cell lines derived from RCC or normal kidney, were examined for the expression of each telomerase subunit and telomerase activity. RT-PCR analyses revealed that hTR and TP I mRNA were constitutively expressed both in tumor and in normal tissues. In contrast, hTERT mRNA was expressed in most tumors, but not in normal tissues. Telomeric-repeat-amplification-protocol (TRAP) assay revealed that more than 80% of RCC tumor tissue exhibited telomerase activity, while none of the adjacent normal tissue did. There was a significant association of telomerase activity with expression of hTERT mRNA, but not with TPI mRNA or hTR expression. Two cell lines, derived from RCC and cervical cancer, expressed telomerase activity and hTERT mRNA, while normal renal cortical epithelial cells expressed neither of them. These findings suggest that hTERT plays a critical role in determining the enzymatic activity of human telomerase, and that up-regulation of hTERT probably plays a role in the progression of human cancers.

Detection of human telomerase reverse transcriptase messenger RNA in voided urine samples as a useful diagnostic tool for bladder cancer

Activation of telomerase and stabilization of telomeres are thought to be required for cellular immortality and oncogenesis. Telomerase activity is detected in >90% of various cancers, including urothelial cancers. Of the three subunits comprising telomerase complex, human telomerase reverse transcriptase (hTERT) is a rate-limiting determinant of the enzymatic activity of telomerase. In the present study, spontaneously voided urine specimens from 33 patients with bladder cancer and 26 without bladder lesions were examined for the expression of hTERT mRNA, and the usefulness of detecting hTERT mRNA in urine samples for screening of bladder cancer was evaluated. RT-PCR analysis revealed that approximately 80% of urinary sediments from patients with bladder cancer expressed hTERT mRNA, regardless of clinical stage or pathological grade, whereas only 4% of sediments from patients without urothelial lesions did. Interestingly, hTERT mRNA expression was observed, even in some urine samples from bladder cancer patients with negative urinary cytology. These findings suggest that the expression of hTERT in urine sample may be a useful diagnostic marker for bladder cancer.

[Analysis of zinc concentrations in leukocytes and its application to patients with non-insulin-dependent diabetes mellitus]

Zinc concentrations in leukocytes of healthy subjects and patients with NIDDM were determined by inductively coupled plasma mass spectrometry. Lymphocytes and granulocytes were isolated from whole blood by discontinuous gradients of mono-poly resolving medium and flow cytometry. Flow cytometry was used for isolating lymphocytes and granulocytes from mononuclear and polymorphonuclear leukocytes. The results in healthy subjects and patients with NIDDM were as follows: lymphocytes of healthy male and female subjects were 49.8 +/- 1.0 (mean +/- SE, microgram per 10(10) cells) and 50.0 +/- 1.4, respectively; granulocytes were 46.4 +/- 1.0 in male, 49.3 +/- 1.4 in female. Lymphocytes of male and female patients with NIDDM were 43.3 +/- 0.9 and 43.1 +/- 1.7, respectively; granulocytes, 41.2 +/- 1.4 in male, 43.8 +/- 1.0 in female. There was a significant difference in the zinc concentrations of lymphocytes and granulocytes between healthy subjects and patients with NIDDM. However, there was no significant difference in the zinc concentrations of lymphocytes and granulocytes between male and female. In healthy subjects, zinc concentrations of lymphocytes and granulocytes significantly lowered with aging.

Ovarian endometrioid adenocarcinoma with ectopic production of alpha-fetoprotein

alpha-Fetoprotein (AFP) is well known as a tumor marker of ovarian endodermal sinus tumor or embryonal carcinoma in gynecological malignancies. However, AFP production is extremely rare in ovarian epithelial cancers. Here we report a case of a 53-year-old woman with an AFP-producing ovarian endometrioid adenocarcinoma. The serum AFP level was elevated up to 2759 ng/ml preoperatively, with a subsequent decrease to the normal range after treatment. Histological examination of the tumor revealed a well-differentiated endometrioid adenocarcinoma with small foci of clear cell components. None of endodermal sinus tumor, hepatoid carcinoma, or embryonal carcinoma components were observed. Immunohistochemical analysis revealed that AFP was expressed in the cytoplasm of the endometrioid glandular lesions, but not in the clear cell components. This is probably the first case of a pure type of ovarian endometrioid adenocarcinoma with significant levels of AFP expression.

Expression of human telomerase subunits and correlation with telomerase activity in urothelial cancer

The activation of telomerase and stabilization of telomeres are thought to be required for cellular immortality and oncogenesis. Three major components of human telomerase--human telomerase RNA (hTERC), telomerase-associated protein (TEP1), and human telomerase catalytic subunit (hTERT)-have recently been identified. However, the roles played by these subunits in the regulation of telomerase activity are still unclear. In the present study, a total of 37 urothelial cancers, including one metastatic lesion, and adjacent normal tissues as well as cell lines derived from bladder cancers were examined for the expression of each telomerase subunit. Reverse transcription-PCR analysis revealed that more than 90% of urothelial cancers expressed hTERT mRNA, whereas less than 20% of normal adjacent tissues did. In contrast, hTERC and TEP1 mRNA were commonly expressed in both cancers and normal tissues. All of the three cell lines derived from bladder cancer expressed each of the telomerase subunits, whereas the two normal primary fibroblast cell lines expressed hTERC and TEP1 mRNA but not hTERT mRNA. Telomerase activity was examined using telomeric repeat amplification protocol assay. All of the cancers examined exhibited telomerase activity, whereas only 2 of 12 normal tissues exhibited weak activity. There was a significant association of telomerase activity with hTERT mRNA expression but not with hTERC or TEP1 mRNA expression. These findings provide strong evidence that the expression of hTERT is a rate-limiting determinant of the enzymatic activity of human telomerase and that the up-regulation of hTERT expression may play a critical role in human carcinogenesis.

Expression of human telomerase subunits and correlation with telomerase activity in cervical cancer

Activation of telomerase and stabilization of telomeres are thought to be required for both cellular immortality and oncogenesis. Three major components of human telomerase, human telomerase RNA (hTR), telomerase-associated protein (TP1/TLP1), and human telomerase catalytic subunit (hTRT/hEST2), have been identified recently. However, it remains unclear what roles these subunits play in the regulation of telomerase activity. In the present study, a total of 25 cervical cancers and 14 normal cervices as well as various cell lines derived from cervical cancer were examined for the expression of hTR, TP1 mRNA, and hTRT mRNA, and the correlations between expression of these and telomerase activity were evaluated in 23 cancers and 14 normal cervices. Reverse transcription-PCR analysis revealed that hTR and TP1 mRNA were commonly expressed in cancers and noncancerous tissues. However, hTRT mRNA was observed only in cervical cancers and cell lines, and more than 80% of cervical cancers expressed it, whereas neither normal cervical tissues nor normal primary fibroblast cells did. There was a strong correlation of telomerase activity with hTRT mRNA expression but not with TP1 or hTR expression. Cervical exfoliated cells were subjected to reverse transcription-PCR analysis for detection of hTRT mRNA, and approximately 70% of cervical cancers were positive for such expression. These findings provide strong evidence that expression of hTRT is a rate-limiting determinant of the enzymatic activity of human telomerase and that up-regulation of hTRT expression may play a critical role in human carcinogenesis. Our findings also indicate that detection of hTRT mRNA is useful for cytological screening for cervical cancer.

Telomerase activity in cervical cancer is quantitatively distinct from that in its precursor lesions

Studies using the telomeric repeat amplification protocol (TRAP) assay have demonstrated telomerase activity not only in cancers but also in non-cancerous lesions. However, quantitative differences in activity between both lesions have not been examined. In the present study, using a stretch PCR assay, telomerase activity was analyzed quantitatively in cervical cancer, its precursor squamous intra-epithelial lesions (SILs) and normal cervix. In stretch PCR assay, telomerase activity was expressed in relative units vs. control activity from C33A cells (100 units). Mean telomerase activities in cervical cancer, SIL and normal cervix were 72+/-35 units, 18+/-17 units and 7+/-4 units, respectively, suggesting that telomerase activity in cancer lesions was quantitatively distinct from that in pre-malignant lesions, which may mean a much more pronounced activation of telomerase in cancers than in SIL. Our findings also suggest that stretch PCR assay can distinguish telomerase activity in cancer from that in non-cancerous lesions and may be useful for the differential diagnosis of cancer lesions.

Telomerase activity in cervical cancer is quantitatively distinct from that in its precursor lesions

Studies using the telomeric repeat amplification protocol (TRAP) assay have demonstrated telomerase activity not only in cancers but also in non-cancerous lesions. However, quantitative differences in activity between both lesions have not been examined. In the present study, using a stretch PCR assay, telomerase activity was analyzed quantitatively in cervical cancer, its precursor squamous intra-epithelial lesions (SILs) and normal cervix. In stretch PCR assay, telomerase activity was expressed in relative units vs. control activity from C33A cells (100 units). Mean telomerase activities in cervical cancer, SIL and normal cervix were 72+/-35 units, 18+/-17 units and 7+/-4 units, respectively, suggesting that telomerase activity in cancer lesions was quantitatively distinct from that in pre-malignant lesions, which may mean a much more pronounced activation of telomerase in cancers than in SIL. Our findings also suggest that stretch PCR assay can distinguish telomerase activity in cancer from that in non-cancerous lesions and may be useful for the differential diagnosis of cancer lesions.

Quantitative differences in telomerase activity among malignant, premalignant, and benign ovarian lesions

Telomerase activation has been demonstrated in both cancers and some noncancerous lesions. However, few studies have determined levels of telomerase activity in these lesions. In the present study, using a recently developed stretch PCR assay, telomerase activity was quantitatively determined in a variety of ovarian lesions including 36 ovarian cancers, 5 ovarian low potential malignancy (LPM) lesions, 10 ovarian cysts, and 12 normal ovaries. Telomerase activity was normalized to control activity (100 units) in C33A cell line and given in relative units. Telomerase activity in ovarian cancer (51 +/- 7 units, mean +/- SE) was significantly higher than that in LPM lesions, ovarian cysts, and normal ovaries (7 +/- 3, 10 +/- 2, and 10 +/- 2 units, respectively; P < 0.001). Interestingly, all LPMs, ovarian cysts, and normal ovaries exhibited low telomerase activity less than 30 units, and no significant difference in level of telomerase activity was found among them. We also found a significant correlation between the level of telomerase activity and the clinical stage of ovarian cancer. Our quantitative telomerase assay thus clearly distinguished telomerase activity in ovarian cancers from that in LPM lesions and ovarian cysts. Significant levels of telomerase activation frequently occurred in cancer but rarely occurred in premalignant and benign lesions, suggesting that telomerase activation is a critical step in cancer development.

Expression of telomerase activity in human chorion

Telomerase activation is required for cellular immortalization and is found in most malignant tumors. Normal somatic cells are generally telomerase-negative, except for stem cells in renewing tissues. During pregnancy, human trophoblast continues to proliferate and acts as proliferating stem cells for the development of chorion and the formation of placenta. In the present study, a total of 105 chorions from placentas at various weeks of gestation were examined for telomerase activity using the telomeric repeat amplification protocol (TRAP) assay. Twenty-five of 33 (76%) normal early chorions at 5 to 9 weeks gestation were telomerase-positive. Chorions from early spontaneous abortions also exhibited telomerase activity but at a low level. In contrast, only 2 (4%) late chorions at 34 to 41 weeks gestation expressed telomerase activity. Significant telomerase activity was observed in trophoblast cell fractions of chorion, demonstrating trophoblast to be the source of the activity. Expression of human telomerase catalytic subunit (hTRT) was observed in early chorions, but not in late placenta, and there was a close correlation between telomerase activity and hTRT expression. In contrast, expression of human telomerase RNA component (hTR) was observed in both early and late chorions and was not liked to telomerase activity. These findings suggest that telomerase activity in chorion is critically regulated over the course of gestation, associated with hTRT expression. The findings of the present study also appear to support the emerging concept that normal somatic cells with stem cell-like characteristics can express telomerase activity.

Application of telomerase assay for the screening of cervical lesions

Telomerase is a ribonucleoprotein that synthesizes telomeric DNA onto chromosomal ends. The expression of telomerase is thought to be required for cellular immortality and oncogenesis. Telomerase activity has been detected not only in most cancers but also in some types of premalignant lesions, such as squamous intraepithelial lesions (SILs). In the present study, we used the telomerase assay to detect uterine cervical lesions in cervical scraping samples. A total of 82 cervical scraping samples were obtained from women with or without cervical lesions and examined by nonradioisotope telomeric repeat amplification protocol assay. Fifteen of 17 (88%) cervical cancer specimens exhibited telomerase activity, whereas 5 of 8 (63%) and 14 of 24 (58%) specimens from low-grade and high-grade SILs, respectively, also exhibited telomerase activity. In contrast, 3 of 33 (9%) specimens from normal cervices exhibited telomerase activity. Dilution telomeric repeat amplification protocol assay was performed to estimate telomerase activity; it revealed that high levels of activity were often expressed in cervical cancer. Cytological examination was also performed by Pap smear test, and 4 of 8 (50%) low-grade SILs, 21 of 24 (88%) high-grade SILs, and 16 of 17 (94%) cervical cancers were found to have cytological abnormalities. There were discordances in some cases between findings of smear abnormality and telomerase positivity. In particular, we found five cases of SILs without smear abnormality but with telomerase activity, suggesting that some lesions with false negative cytology can be detected by telomerase assay. These findings suggest that telomerase assay using cervical scrapings might be a useful screening method for cervical lesions especially when combined with a Pap smear test.

Telomerase activity in human endometrium

Human uterine endometrium undergoes a complex pattern of changes in proliferation and secretory activity during the menstrual cycle. In the present study, telomerase activity in normal endometrium was examined using a non-radioisotope PCR-based telomeric repeat amplification protocol assay. Various levels of telomerase activity were detected in the 60 normal endometrial samples examined, depending on the phase of the menstrual cycle. Of 21 proliferative-phase endometrial samples, 20 (95%) expressed telomerase activity, whereas 8 of 19 (42%) secretory-phase or menstrual endometrial samples did (P = 0.002). Five of nine (56%) samples from atrophic endometrium from postmenopausal women also expressed telomerase activity. Eleven of 21 (52%) endometrial samples in the proliferative phase expressed high telomerase activity detectable after 100-fold dilution of extracts, whereas none of the 19 endometrial samples from the secretory phase or during menstruation and none of the 9 postmenopausal endometrial samples did (P < 0.001). The highest activity was observed in the late proliferative phase, but activity dramatically decreased with the progression of the secretory phase. Surprisingly, the levels of telomerase activity detected in the late proliferative phase were comparable to those detected in the endometrial cancers examined. Immunohistochemical analysis of the expression of proliferating cell nuclear antigen revealed that telomerase activity is closely correlated with endometrial cell proliferative activity. These findings indicate that normal endometrium expresses telomerase, the activity of which changes dramatically over the course of the menstrual cycle, suggesting in turn that telomerase is a regulated enzyme linked to cellular proliferation and that hormone functions may be involved in its regulation.

[Survey on oral health of university students: examination on tooth conditions using panoramic X-ray films]

As an aid in instructions oral health care to university students, tooth conditions were examined using panoramic X-ray films. The materials were taken from 129 students of the University of Tokyo. The average age was 22 years 5 months. The results were as follows: 1. Lack of tooth was frequently found to be both maxillary and mandibular third molars. It was also occasionally found to be maxillary first premolars, mandibular lateral incisors, and mandibular second premolars. The average value for lack of tooth per individual was 0.9. 2. Root canal fillings were often found in mandibular first molars, maxillary central incisors, mandibular second molars and maxillary second premolars. The average value was 1.1. 3. Metal restorations were often made in first and second molars, especially in mandibular. The average value was 6.2. 4. As for maxillary third molar axis, the majority showed normal direction. In mandible, however, the normal direction was only found in 37.7% and the others showed troublesome axes. It seemed that careful attention should be given to the mandibular third molar conditions.

[Prevalence of depressive symptoms and its relation to demographic variables in high school students]

In order to determine the prevalence of depressive symptoms and to examine its relationship to demographic variables in late adolescents, questionnaires were administered on 3,254 high school students in Okinawa. Depressive symptoms were assessed using the Zung Self-rating Depression Scale (SDS). The results were as follows: The SDS score distribution curve was near-normal. The mean SDS scores of males and females were 40.4 and 41.7, respectively. Overall, 53.4% of males and 61.4% of females had depressive symptomatology according to an SDS cut-off point of 40 or greater. There were significant differences in mean SDS scores and prevalence by gender. Females had higher depressive symptom scores. Both indicators of depressive symptomatology were higher than those in U.S. adolescents and Japanese adults. When controlling for the effect of school type, both male and female students living in urban ureas of the main island had more depressive symptoms than students living in rural areas of remote islands. When controlling for the effect of region, female students attending vocational high schools showed more depressive symptoms than other high school students. However, there was no difference by school type among male students. The high prevalence of depressive symptoms suggests that it is necessary to modify the assessment cut-off point for high school students and to promote further school mental health care.

[A study on physique, exercise frequency and physical strength of middle-aged forestry workers]

This study was conducted to compare physical strength, physique, exercise frequency and type of work of 4,334 male and 439 female middle-aged office and outdoor forestry workers. Both male and female outdoor workers were taller and had lower Broca's indices than their office counterparts, while the body weight of outdoor male workers was lighter and that of female outdoor workers heavier than those of male and female office workers, respectively. The number of outdoor workers not engaging in frequent exercise was found to be significantly greater than that of office workers. Male outdoor workers had significantly higher maximal oxygen uptake (cardio-respiratory endurance), grip strength (muscular strength) and standing trunk flexion (static flexibility) than the male office workers whereas the opposite was true for whole body reaction time (agility), eyes-closed one-leg balancing (static balance) and sit-ups (muscular endurance). Female outdoor workers had higher maximal oxygen uptake (cardio-respiratory endurance), grip strength (muscular strength) and standing trunk flexion (static flexibility) than the female office workers, whereas the opposite was the case for whole body reaction time (agility), eyes-closed one-leg balancing (static balance) and sit-ups (muscular endurance). All of these differences among females were significant except for maximal oxygen uptake (cardio-respiratory endurance). When indoor and outdoor workers of the same sex with similar physiques and exercise frequencies were compared male outdoor workers had higher maximal oxygen uptake (cardio-respiratory endurance) and greater standing trunk flexion (static flexibility) whereas female outdoor workers had greater grip strength (muscular strength) and standing trunk flexion (static flexibility). From these results, it was suggested that maximal oxygen uptake (cardio-respiratory endurance) and standing trunk flexion (static flexibility) in the male workers and grip strength (muscular strength) and standing trunk flexion (static flexibility) in the female workers were related to their working situations. Both the physical strength of workers and personal characteristics must be carefully considered in order to preserve the health of both indoor and outdoor forestry workers.

MCI-154 activates the Ca(2+)-activated K+ channel of vascular smooth muscle cells

The aim of this study was to examine the effects of MCI-154, a new positive inotropic agent with vasodilating properties, on the Ca2+-activated K+ channel (KCa channel) of vascular smooth muscle cells. Cultured smooth muscle cells from a porcine coronary artery were studied using the patch-clamp technique. Extracellular application of 100 microM MCI-154 activated the KCa channel in intact cell-attached patch configurations. In excised inside-out patch configurations, application of 100 microM MCI-154 to the cytosolic side activated the KCa channel directly, suggesting that the Ca2+ sensitivity of the KCa channel itself is modulated. Though extracellular application of 100 microM amrinone, a phosphodiesterase inhibitor, activated the KCa channel in the cell-attached patch configurations, application of 100 microM amrinone to the cytosolic side could not activate the KCa channel in inside-out patch configurations. These results indicate that different from amrinone, MCI-154 can modulate Ca2+ sensitivity of the KCa channel in vascular smooth muscle cells.

[Factorial construct validity of a measurement scale of fatigue in junior high school students]

To investigate factorial construct validity of a measurement scale of fatigue symptoms in junior high school students, a questionnaire which consisted of Cumulative Fatigue Symptoms Index (CFSI) and Psychological Condition Test (PCT) was administered on 289 students in Okinawa. Reliability coefficients were 0.607-0.811 for CFSI scales. A principal factor analysis with varimax rotation was applied to CFSI. In boys, 4 factors were extracted; general psychological symptoms, fatigue, emotional instability, and decreased morale and vitality. In girls, 4 factors were extracted; depression and anxiety, decreased morale and vitality, fatigue, and irritability. The same procedure was applied to PCT. In boys, 4 factors were extracted; negative feeling, vigor, inferiority complex, and fatigue. In girls, 4 factors were extracted; negative feeling, anger, vigor, and fatigue. Among factors derived from CFSI and PCT, the fatigue factor of CFSI was correlated with that of PCT. The factors concerning psychological symptoms of CFSI were correlated with those of PCT. However, the vigor factor of PCT was not correlated with any other factors. These results suggest that CFSI in junior high school students had factorial construct validity.

Normotensive glucocorticoid-suppressible hyperaldosteronism in adult

A 40 year-old man was admitted to our hospital for detailed examination of hypokalemia (2.7 mEq/l). His blood pressure was normal. Metabolic alkalosis, ACTH dependent hyperaldosteronism (18 ng/dl) and over-response to synthetic ACTH were observed. Plasma renin activity, on the other hand, was within the normal range (1.7 ng/ml/hr). Serum potassium was normalized to 4.1 mEq/l and the responsiveness of the renin-angiotensin-aldosterone system was recovered after the administration of dexamethasone. These results led us to suggest that this case might be normotensive glucocorticoid-suppressible hyperaldosteronism. The etiology which was not associated with hypertension and low plasma renin activity has not been clarified but may be related to the shortness of duration of this disease. Our case was also afflicted with mild hypercortisolemia and excessive excretion of urinary 17-hydroxycorticosteroid and 17-ketosteroid which was suppressed by the administration of dexamethasone (2 mg/day). These findings may be related to hypersensitivity of the fascicular zone of the adrenal gland to ACTH.

Chronic myelomonocytic leukemia with polyneuropathy and IgA-paraprotein

A 65-year-old woman had chronic myelomonocytic leukemia with peripheral neuropathy and IgA paraprotein with kappa type light chain. Plasma cells with "flaming" cytoplasma were seen in the bone marrow specimens. The findings suggest that chronic myelomonocytic leukemia may involve B-lymphocytes in the proliferative process and that it may be a clonal disease. Moreover, this case was associated with peripheral sensori-motor polyneuropathy. The disorder was responsive to prednisolone, as oral administration of prednisolone improved not only the peripheral polyneuropathy, but also the hematological findings. Serum vitamin B12 and lysozyme in the serum and urine were decreased by the steroid therapy. The administration of prednisolone is effective not only for polyneuropathy but also chronic myelomonocytic leukemia.

A case of calcitonin-producing parathyroid adenoma with primary hyperparathyroidism

A 57-year-old female was admitted to our hospital with general lassitude, loss of appetite, nausea, upper abdominal pain, thirst, polydipsia and polyuria. On admission, she had an asymmetrical pear-shaped tumor in the right supraclavicular region and severe hypercalcemia. Plasma C-PTH was elevated to 22.72ng/ml. Plasma calcitonin was also elevated to 336 pg/ml. She died of respiratory and cardiac failure of two weeks after admission without any positive response to the treatment, including hemodialysis. Pathohistologically, the tumor was a parathyroid adenoma. The concentrations of C-PTH, intact PTH and calcitonin in the tumor tissue were markedly high: 4.56 micrograms/g wet, 13.9 ng/g wet and 50.7 ng/g wet, respectively. Immunohistologically, the tumor cells and the fibrous stroma were stained strongly positive to rabbit anti-human calcitonin antibody and rabbit anti-human N-PTH antibody by indirect immunoperoxidase staining. Calcitonin-producing tumors, except for medullary thyroid carcinoma are rarely reported. To our knowledge, this is the first report of such a calcitonin-producing parathyroid adenoma associated with primary hyperparathyroidism.

[Discrepancy in karyotypes between peripheral blood and bone marrow during blastic crisis in chronic myelocytic leukemia]

A 32-year-old female was diagnosed as having Ph1-positive chronic myelocytic leukemia (CML) on March 6, 1985. She was intermittently treated with busulfan or 6-mercaptopurine. Her regimen was changed on February 27, 1987 to interferon-alpha (HLBI, Sumitomo) because of leukocytosis (46,200/microliters) with basophilia (45%) and splenomegaly refractory to conventional therapy. She was admitted to our hospital on November 27, 1987 because of blastic crisis. Cytogenetic analysis on peripheral cells was repeated six times during the treatment with HLBI. The sixth analysis was done on bone marrow cells as well. Nineteen to 22 metaphases were analyzed by the trypsin G-banding method after short-term culture. Cytogenetic analysis of peripheral cells revealed 46, XX, Ph1 in 9% of metaphases and 47, XX, Ph1, +8, i(17q) in 91% on March 2, 1987, and 47, XX, Ph1, +8, i(17q) in 95.2% of metaphases and 48, XX, Ph1, +8, i(17q), +19 in 4.8% on December 11, 1987. Karyotypes of bone marrow cells on December 11, 1987 were 48, XX, Ph1, +8, +8, 4(17q) in 73.7% of metaphases and 47, XX, Ph1, +8, i(17q) in 26.3%. It was speculated that abnormal clones might have developed in other sites than bone marrow.