[Efficacy and safety analysis of surgical bypass and endovascular management in the treatment of 116 Takayasu arteritis]

OBJECTIVE

To analyze the efficacy and safety of surgery and endovascular management in treating Takayasu arteritis.

METHODS

The data of 116 patients (24 males and 92 females; mean age (32±12) years) with Takayasu arteritis and underwent surgery or endovascular therapy was retrospective analyzed. According to the two different surgical procedures, the patients were divided into two groups: open repair group and endovascular repair group. One hundred and fifty-four surgical procedures were done including 69 cases of open repair and 85 cases of endovascular repair. A total of 211 arterial lesions were revascularized (open repair 114; endovascular repair 97).

RESULTS

Among the 154 surgical procedures, 11(7.1%) presented a complication during perioperative period including 6(8.7%) of open repair and 5(5.9%) of endovascular repair. After a median follow-up of 38.5(0.5-142.0) months, three(4.3%) cases of stroke and death were observed in open repair group, two(2.3%) cases of stroke and 4(4.7%) cases of death were observed in endovascular repair group. At 1, 3, 5 and 10 years of follow-up, primary patency rate of open repair and endovascular repair were 95.0% and 89.3%, 84.3% and 69.8%, 73.3% and 56.3%, 53.4% and 48.1%, respectively; Primary assisted patency rate were 100% and 97.5%, 90.4% and 78.2%, 79.1% and 72.8%, 60.7% and 54.0%, respectively; Secondary patency rate were 100% and 98.8%, 95.6% and 92.7%, 85.8% and 78.1%, 74.8% and 58.0%, respectively. Cumulative survival rate were 97.0% and 100%, 97.0% and 97.6%, 97.0% and 90.6%, 91.3% and 84.5%, respectively (χ(2)=0.182, P=0.669).

CONCLUSIONS

Both of the surgical revascularization and endovascular management are safe and effective in the treatment of Takayasu arteritis. Although long-term patency of endovascular therapy is low, it can be performed repeatedly and can be used as a preferred approach in treating a short stenosis. Surgical repair shows excellent long-term durability, it seems to be more suitable for complex lesions and failure cases of endovascular management.

The Cardioprotective Effects of Late-Phase Remote Preconditioning of Trauma Depends on Neurogenic Pathways and the Activation of PKC and NF-κB (But Not iNOS) in Mice

BACKGROUND

A superficial abdominal surgical incision elicits cardioprotection against cardiac ischemia-reperfusion (I/R) injury in mice. This process, called remote preconditioning of trauma (RPCT), has both an early and a late phase. Previous investigations have demonstrated that early RPCT reduces cardiac infarct size by 80% to 85%. We evaluated the cardioprotective and molecular mechanisms of late-phase RPCT in a murine I/R injury model.

METHODS

Wild-type mice, bradykinin (BK) 2 receptor knockout mice, 3M transgenic mice (nuclear factor κB [NF-κb] repressor inhibitor of nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor alpha [IκBα((S32A, S36A, Y42F))]), and inducible nitric oxide synthase (iNOS) knockout mice were analyzed using a previously established I/R injury model. A noninvasive abdominal surgical incision was made 24 hours prior to I/R injury and the infarct size was determined at 24 hours post-I/R injury.

RESULTS

The results indicated that a strong cardioprotective effect occurred during late-phase RPCT (58.42% ± 1.89% sham vs 29.41% ± 4.00% late RPCT, mean area of the infarct divided by the mean area of the risk region; P ≤ .05; n = 10). Furthermore, pharmacological intervention revealed the involvement of neurogenic signaling in the beneficial effects of late RPCT via sensory and sympathetic thoracic nerves. Pharmacological experiments in transgenic mice-implicated BK receptors, β-adrenergic receptors, protein kinase C, and NF-κB but not iNOS signaling in the cardioprotective effects of late RPCT.

CONCLUSION

Late RPCT significantly decreased myocardial infarct size via neurogenic transmission and various other signaling pathways. This protective mechanism differentiates late and early RPCT. This study describes a new cardiac I/R injury prevention method and refines the concept of RPCT.

Anti-inflammatory effects of hinokitiol on human corneal epithelial cells: an in vitro study

PURPOSE

This study assessed the anti-inflammatory effect and mechanism of action of hinokitiol in human corneal epithelial (HCE) cells.

METHODS

HCE cells were incubated with different concentrations of hinokitiol or dimethylsulfoxide (DMSO), which served as a vehicle control. Cell viability was evaluated using Cell Counting Kit-8 (CCK-8) assay. After polyriboinosinic:polyribocytidylic acid (poly(I:C)) stimulus, cells with or without hinokitiol were evaluated for the mRNA and protein levels of interleukin-8 (IL-8), interleukin-6 (IL-6), and interleukin-1β (IL-1β) using real-time PCR analysis and an enzyme-linked immunosorbent assay (ELISA), respectively. Nuclear and cytoplasmic levels of nuclear factor kappa B (NF-κB) p65 protein and an inhibitor of NF-κB α (IκBα) were evaluated using western blotting.

RESULTS

There were no significant differences among the treatment concentrations of hinokitiol compared with cells incubated in medium only. Incubating with 100 μM hinokitiol significantly decreased the mRNA levels of IL-8 to 58.77±10.41% (P<0.01), IL-6 to 64.64±12.71% (P<0.01), and IL-1β to 54.19±8.10% (P<0.01) compared with cells stimulated with poly(I:C) alone. The protein levels of IL-8, IL-6, and IL-1β had similar trend. Further analysis revealed that hinokitiol maintained the levels of IκBα and significantly reduced NF-κB p65 subunit translocation to the nucleus which significantly inhibiting the activation of the NF-κB signal pathway.

CONCLUSION

Hinokitiol showed a significant protective effect against ocular surface inflammation through inhibiting the NF-κB pathway, which may indicate the possibility to relieve the ocular surface inflammation of dry eye syndrome (DES).

INHIBITORY EFFECT OF TETRAMETHYLPYRAZINE ON HEPATOCELLULAR CARCINOMA: POSSIBLE ROLE OF APOPTOSIS AND CELL CYCLE ARREST

Hepatocellular carcinoma (HCC) is the fifth most common cancer. An important approach to control HCC is chemoprevention. This study aims at investigating the antitumor effect of Tetramethylpyrazine (TMP). Rats were injected with N-Nitrosodiethylamine (DEN) to establish HCC. Tumor development was observed. Liver function was evaluated. Apoptosis and cell cycle arrest-related makers and signaling cascades were determined by Western blot, RT-PCR and flow cytometric analysis. The administration of TMP could significantly inhibit tumor development in DEN-induced HCC rats, shown by reduced incidence of tumor, decreased number of tumor nodules and reduced maximal size of tumor. DEN-induced increase of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase and alkaline phosphatase activities were significantly inhibited by TMP. TMP exhibited inhibitory effect on HCC through induction of apoptosis and cell cycle arrest in rats. TMP induced apoptosis through increasing Bax, decreasing Bcl-2, increasing the release of cytochrome c, and activating caspase, which consisted of the mitochondrial apoptotic pathway. TMP induced G2/M cell cycle arrest through down-regulation of cyclin B1/cdc2. In addition, inhibition of Akt and ERK signaling and the antioxidant activities of TMP may also contribute to its antitumor effect. These data provide new insight into the mechanisms underlying the antitumor effect of TMP.

Picosecond ultrasonic measurements using an optical mask

In this paper we describe results obtained using a variation of the picosecond ultrasonics technique. We place a transparent optical mask very close to the surface of the sample. The lower surface of the mask has a series of grooves to produce a variation of the intensity of the pump and probe light pulses across the surface of the sample. Because the light intensity varies with position, the application of the pump light pulse can generate surface acoustic waves with a wavelength equal to the period of the mask. We report results obtained in this way and discuss the possible practical applications of this new approach.

First Report of Rice stripe virus in Vietnam

Rice stripe virus (RSV) is the type member of the genus Tenuivirus, and one of the prevalent viruses infecting rice. The disease was first recorded in central Japan in 1903, and is currently present in many Asian countries, including South Korea and China in the Far East (1,2). In May of 2012, a disease outbreak in Indica rice (Oryza satira L.) caused losses in a field in Huaifu, Hungyen, Vietnam (20°53'N, 106°02'E). Infected plants showed yellowing stripe symptoms on leaves. A survey indicated that disease incidence was about 10%. Six leaf samples were randomly collected and four were found positive in dot-ELISA using RSV-specific monoclonal antibodies (provided by Dr. X. Zhou, Institute of Biotechnology, Zhejiang University) (3). To confirm RSV infection, total RNA was extracted from dot-ELISA positive and asymptomatic control samples. RT-PCR was performed using RSV-specific primers (CP(+): 5'-GAGGATCCATGGGTACCAACAAGCCAG-3', CP(-): 5'-TCGTCGACCTAGTCATCTGCACCTTCTG-3'; SP(+): 5'-TGGGATCCATGCAAGACGTACAAAGGAC-3', SP(-): 5'-CTGTCGACCTATGTTTTATGAAGAAGAGGT-3'; NS2(+): 5'-GAGGATCCATGGGTACCAACAAGCCAG-3', NS2(-): 5'-CCGTCGACTCATACATCTGAATTTG-3'; NS3(+): 5'-ACCGGATCCATGACTATCAAATACAAC-3', NS3(-): 5'-CCGTCGACTCATACATTAGCTATTGTC-3') that amplify the coat protein, disease-specific protein, and NS2 and NS3 genes of RSV, respectively. Amplicons of the expected size were obtained from the four symptomatic but not the asymptomatic plants. Amplicons obtained from one of the positive samples were cloned into the vector pMD18-T (TaKaRa, Dalian, China) and sequenced (GenBank Accession Nos. KC197055 to KC197058). Sequence comparisons indicated that the complete sequences of the CP, SP, NS2, and NS3 of the Vietnamese isolate shared 97.1%, 97.5%, 96.8%, and 97.3% sequence identity at the nucleotide level with the corresponding genes of RSV isolate T (NC_003776, NC_003753, and NC_003754, respectively). These results indicate that the virus associated with yellowing stripe disease of rice in Vietnam is an isolate of RSV. To our knowledge, this is the first report of RSV in Vietnam. This finding redefined the distribution of RSV in the world. Research on whole-genome sequencing of the Vietnamese isolate is continuing and is being expanded to compare the genetic diversity of the virus, assisting in the study of the evolution of the virus. References: (1) S. Toriyama. Microbiol. Sci. 3:347, 1986. (2) Q. Y. Lin et al. J. Fujian. Agric. Univ. 20:24, 1991. (3) G. Z. Wang et al. Acta Phytopathol. Sinica 34:302, 2004.

Interference between resonant and nonresonant inelastic x-ray scattering

A detailed study of inelastic x-ray scattering from the ground state to the 3Σg(3σ(g)(-1)3s(g)1) state of the O2 molecule is presented. The observed angular anisotropy shows that the vibrational excitations within this final state are strongly dependent on the polarization of the incident radiation. The analysis demonstrates that this is a manifestation of interference between resonant and direct nonresonant inelastic x-ray scattering. This interference provides a new tool to monitor nuclear dynamics by relative rotation of the polarization vectors of the incident and scattered photons.

Dissociative x-ray lasing

X-ray lasing is predicted to ensue when molecules are pumped into dissociative core-excited states by a free-electron-laser pulse. The lasing is due to the population inversion created in the neutral dissociation product, and the process features self-trapping of the x-ray pulse at the gain ridge. Simulations performed for the HCl molecule pumped at the 2p(1/2)→6σ resonance demonstrate that the scheme can be used to create ultrashort coherent x-ray pulses.

CCL2−2518 (A/G) polymorphisms and tuberculosis susceptibility: a meta-analysis

BACKGROUND

It has been found that the -2518 C-C motif ligand (CCL)-2 promoter variant increases the risk of developing active tuberculosis (TB).

OBJECTIVE

To study the association between -2518 variants and susceptibility to TB.

DESIGN

We searched Medline, PubMed and the Wan Fang databases for human genetic studies on whether the -2518 CCL2 polymorphism influences the expression of active TB. Articles published from January 1998 to November 2010 were included. A random effects model was conducted in the meta-analysis.

RESULTS

The CCL2-2518G allele (OR 1.51, 95%CI 1.11-2.04, P = 0.008) showed significant association with susceptibility to TB. In genotype analysis, the recessive model (CCL2 genotype GG, OR 1.66, 95%CI 1.19-2.33, P = 0.003) was slightly superior to the dominant model (G carrier genotypes OR 1.53, 95%CI 1.07-2.17, P = 0.018). These observations were prominent among Asians and Latin-Americans of Hispanic ancestry, but not in Africans from Ghana and South Africa. The presence of epistatic genes in one population but not in the other, environmental differences and pathogen virulence may account for this.

CONCLUSION

The CCL2-2518G allele increases the risk of developing TB in Asians and Hispanics.

Stability in brain glucose metabolism following brown adipose tissue inactivation in chinese adults

BACKGROUND AND PURPOSE

The thermogenesis of BAT is believed to be controlled through some pathways initiated in the brain, though the changes in brain activity among different states of BAT-positive subjects are still unclear. We hypothesized that some significant differences of regional cerebral metabolism between various groups were related to the BAT activities regardless of temperature changes.

MATERIALS AND METHODS

Relative regional cerebral glucose metabolism was compared between 15 healthy subjects with activated BAT and 30 healthy controls without activated BAT by using a brain FDG-PET scan. A follow-up PET scan was performed to assess metabolic changes of the brain when BAT activity was eliminated by heat exposure.

RESULTS

Compared with controls, BAT-positive subjects exhibited lower activity in the inferior parietal lobule, limbic system, and frontal lobe and higher activity in the precuneus before heat exposure. Compared with the BAT elimination status, subjects with activated BAT showed a decreased metabolism in the parietal lobe, frontal lobe, culmen, cingulate gyrus, and sublobar region. Compared with controls, BAT-positive subjects after BAT inactivation had significant hypometabolic areas in the temporal lobe and limbic lobe and hypermetabolic areas in the parietal lobe.

CONCLUSIONS

Our findings illustrate that changes of regional cerebral metabolism are related to BAT activities regardless of temperature changes. This before-after controlled study supports the finding that the brain responses appear to be active in modulating the metabolic function of BAT activity.

Reversible changes in brain glucose metabolism following thyroid function normalization in hyperthyroidism

BACKGROUND AND PURPOSE

Patients with hyperthyroidism frequently present with regional cerebral metabolic changes, but the consequences of endocrine-induced brain changes after thyroid function normalization are unclear. We hypothesized that the changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroid, and some of these changes can be reversed with antithyroid therapy.

MATERIALS AND METHODS

Relative regional cerebral glucose metabolism was compared between 10 new-onset untreated patients with hyperthyroidism and 20 healthy control participants by using brain FDG-PET scans. Levels of emotional distress were evaluated by using the SAS and SDS. Patients were treated with methimazole. A follow-up PET scan was performed to assess metabolic changes of the brain when thyroid functions normalized.

RESULTS

Compared with controls, patients exhibited lower activity in the limbic system, frontal lobes, and temporal lobes before antithyroid treatment. There were positive correlations between scores of depression and regional metabolism in the cingulate and paracentral lobule. The severity of depression and anxiety covaried negatively with pretreatment activity in the inferior temporal and inferior parietal gyri respectively. Compared with the hyperthyroid status, patients with normalized thyroid functions showed an increased metabolism in the left parahippocampal, fusiform, and right superior frontal gyri. The decrease in both FT3 and FT4 was associated with increased activity in the left parahippocampal and right superior frontal gyri.

CONCLUSIONS

The changes of regional cerebral glucose metabolism are related to thyroid hormone levels in patients with hyperthyroidism, and some cerebral hypometabolism can be improved after antithyroid therapy.

Histone deacetylase inhibitor trichostatin A modulates cell cycles in A2780 human ovarian cancer cell lines

PURPOSE OF INVESTIGATION

To analyze the effect and mechanism of TSA on cell cycles in human ovarian cancer cells.

METHODS

cells were cultured in RPMI 1640 supplemented. Flow cytometry analysis and RT-PCR were used to examine the distribution of cell cycles and the level of P21(WAF/CIPI) mRNA.

RESULTS

TSA induced increase of the G2/M phase accompanied by decrease of the S phase and enhanced level of P21(WAF/CIPI) mRNA in a concentration and time-dependent manner in A2780 cells.

CONCLUSION

Trichostatin A affects the activity of cyclin-dependent kinase through increased expression of P21(WAF/CIPI) mRNA. TSA causes A2780 cell blockage in the G2/M phase and inhibits cell proliferation of A2780 cells. The minimum level of active TSA is 100 nM and the minimum time is 12 hours. The effect relies on time and concentration.

Defining the Need for Breast Cancer Radiotherapy in the General Population: a Criterion-based Benchmarking Approach

AIMS

Determining the appropriate rate of radiotherapy is important for ensuring optimal radiotherapy utilisation and accessibility. A criterion-based benchmark (CBB) was developed for estimating the need for radiotherapy in incident breast cancer cases. Our primary objective was to compare an evidence-based estimate (Ebest) of need against the CBB. These estimates were then compared with radiotherapy rates in Ontario, Canada and the USA. Surgical rates were also examined.

MATERIALS AND METHODS

Benchmarks were defined in Ontario as communities in proximity to cancer centres and without long waiting lists. Patient data from 1997 to 2001 were prospectively collected from radiotherapy cancer centres. Surgical data were obtained from the Canadian Institute for Health Information database. The public use file of Surveillance, Epidemiology and End Results (SEER) described treatment in the USA.

RESULTS

In total, 4241 cases of breast cancer were diagnosed in benchmark communities. The overall radiotherapy rate by Ebest was 64.0% (95% confidence interval: 58.1-69.8%) compared with the CBB of 60.7% (59.3-62.1%). In comparison, Ontario's overall radiotherapy rate was 55.6% (55.0-56.1%) and in SEER it was 49.3% (48.9-49.6%). Adjuvant radiotherapy rates after lumpectomy were 100% in Ebest and 83.6% (82.0-85.1%) by the CBB. The Ebest and CBB post-mastectomy rates were 21.9% (20.6-23.3%) and 34.6% (32.5-36.7%), respectively. Observed post-lumpectomy radiotherapy rates were 75.1% in Ontario and 65.3% in SEER. Post-mastectomy radiotherapy rates were 29.5% in Ontario and 17.0% in SEER.

CONCLUSIONS

CBB provides a reasonable estimate of the overall need for radiotherapy in breast cancer. Observed radiotherapy rates in Ontario and the USA suggest an age-related decrease in the use of radiotherapy. The benchmark estimate suggests a shortfall of adjuvant breast radiotherapy utilisation in Ontario.

Biological effects of protons targeted to different ranges in Arabidopsis seeds

PURPOSE

To investigate the biological effects of radiation damage induced at different depths of a plant seed and to investigate the difference in radiation response between dry seeds and water-imbibed seeds to the same type of radiation.

MATERIALS AND METHODS

Arabidopsis seeds of the wild-type Columbia ecotype were used in our experiments. Dry or water-imbibed Arabidopsis seeds were irradiated with 1.1 MeV, 2.6 MeV or 6.5 MeV protons (H+). For comparison, 30 keV nitrogen ions (N+) were also used to irradiate dry Arabidopsis seeds. The germination and survival rates of the seeds were measured after each irradiation.

RESULTS

After irradiation with 2.6 MeV H+ and 6.5 MeV H+, the fluence-response curves for germination and survival had distinct shoulders and then survival was reduced rapidly with increasing fluence. 2.6 MeV H+ was more effective than 6.5 MeV H+ in inhibiting germination and survival and water-imbibed seeds were more sensitive to the 6.5 MeV H+ irradiation than dry seeds. For 1.1 MeV H+ the germination and survival rates were reduced gradually and an intermediate plateau emerged for germination, which was similar to that observed for survival following 30 keV N+ irradiation. One of the key morphologic malformations, the multi-SAM (shoot apical meristem), was observed both for dry and water-imbibed seeds after all proton irradiations and for the dry seeds after 30 keV N+ irradiation.

CONCLUSIONS

Radiation-induced damage produced at different ranges in Arabidopsis seeds results in different fluence-response curves with water-imbibed seeds being more sensitive to proton irradiation than dry seeds. As well as the shoot apical meristem (SAM) being the primary target for irradiation, there exists a secondary target around the SAM that also contributes to the radiation response.

Roles of an extracellular matrix (ECM) receptor and ECM processing enzymes in demyelinating canine distemper encephalitis

Canine distemper virus (CDV) belongs to the genus Morbillivirus of the Paramyxoviridae family. Due to the central nervous system (CNS) tropism of the virus and associated neuropathological changes, demyelinating canine distemper encephalitis (CDE) represents a relevant model for human demyelinating diseases like multiple sclerosis. The present review decribes the role of CD44 antigen (CD44), the principle cell surface receptor for hyaluronate and extracellular matrix (ECM) processing enzymes (matrix metalloproteinases [MMPs]) and their inhibitors (TIMPs) in the pathogenesis of demyelination. In acute and subacute CDE, a plaque-associated CD44 up-regulation is found that parallels astrocyte activation. Likewise, MMPs and TIMPs are prominently up-regulated in these lesions and are expressed mostly by astrocytes and microglia. In chronic lesions, CD44 expression declines together with the number of glial fibrillary acidic protein (GFAP) positive astrocytes. In addition, in this plaque type, CD44 is expressed on the cell membrane of perivascular mononuclear cells. In this phase, a decrease of MMP and TIMP expressions apart from MMP-11, -12, and -13 is obvious. In summary, CD44 and MMPs might be associated with the onset of demyelination and may interact to initiate ECM disturbances. Ligation of CD44 in the early phase may induce chemokines and cytokines and hence initiate and perpetuate the inflammatory process. In the chronic phase, it is conceivable that a MMP-TIMP imbalance may be the motor for lesion progression with a simultaneous influx of CD44-positive activated immune cells.

Phosphatidic acid-phosphatidylethanolamine interaction and apocytochrome c translocation across model membranes

The translocation of apocytochrome c (apocyt.c) across large unilamellar vesicles (LUVs) constructed from mixtures of anionic and zwitterionic phospholipids, phosphatidylethanolamine (PE) and phosphatidylcholine (PC), has been studied. It was shown that the import ratio of horse heart apocyt.c in LUVs composed of phosphatidic acid (PA) combined with PE and PC (62+/-10%) was much higher than that in LUVs made of PE and PC plus any other acidic phospholipid species (20+/-5%). This feature was shared by tuna heart and chicken heart apocyt.c. In addition, the greater efficiency of the PA/PE/PC system versus others in facilitating apocyt.c translocation was maintained using synthetic anionic phospholipids with the same acyl chains. Besides, apocyt.c induces more leakage of entrapped fluorescein sulphonate (FS) from the interior of PA/PC/PE vesicles compared with phosphatidylglycerol (PG)/PC/PE ones. By measuring the intrinsic fluorescence emission spectrum and the accessibility of the preprotein to the fluorescence quencher, acrylamide, differences could be detected in the conformational changes of apocyt.c as a consequence of its interaction with PA/PE/PC and PG/PE/PC vesicles, respectively. Particularly notable is that PE is indispensable for the PA/PE/PC system to most efficiently facilitate apocyt.c translocation across the model membranes. With the fraction of PE increasing from 0 to 30 mol%, the translocation efficiency of apocyt.c as well as its ability to induce FS efflux was significantly enhanced in PA-containing LUVs, whereas this was not observed in the case of replacement of PA by PG or phosphatidylserine. It is also interesting to note that in LUVs containing PA, dioleoyl-PE, but not dielaidoyl-PE, can exert such influences, indicative of the role of non-bilayer formation propensity. On the basis of these results it is postulated that PA might increase the bilayer-destabilizing effects of PE, and hence increase the translocation efficiency of apocyt.c and its leakage-induction ability.

Leakage and aggregation of phospholipid vesicles induced by the BH3-only Bcl-2 family member, BID

BID is a BH3 domain-only member of the Bcl-2 family that acts as an apoptotic agonist in programmed cell death. After cleavage by caspase-8, the N-terminal of BID (N-BID) stays in the cytosol while the C-terminal of BID (C-BID) translocates to mitochondria, leading to cytochrome c release in vivo and in vitro. We have previously reported that BID or truncated BID (tBID) can induce the release of entrapped trypsin and cytochrome c from large unilamellar vesicles (LUVs). Further studies have been performed and are presented here; the results demonstrate that C-BID, like BID and tBID, induces vesicle leakage, whereas N-BID or the BID mutants BID (D59A) and BID (G94E) fail to have any significant effects. The affinity of the above-mentioned proteins for soybean phospholipid LUVs (SLUVs) decreased in an order similar to their leakage-inducing capability: tBID > BID > BID (D59A), while N-BID and BID (G94E) were unable to bind to the vesicles at all. BID-induced leakage was dependent on the lipid composition of vesicles. Acidic phospholipid (e.g. phosphatidic acid or phosphatidylglycerol) was necessary for BID-induced leakage while the presence of phosphatidylethanolamine or cholesterol reduced the leakage. It was also found C-BID is better able to penetrate the soybean phospholipid monolayer than BID or tBID. A further finding was that tBID, but not full-length BID, could stimulate the aggregation of SLUVs. Finally, Bcl-x(L), an apoptotic antagonist in programmed cell death, can prevent the aggregation of LUVs induced by tBID, but not the release of entrapped trypsin. It is postulated that two separate domains of tBID are responsible for inducing leakage and aggregation of phospholipid vesicles.

Adenosquamous lung carcinoma: clinical characteristics, surgical treament and prognosis

OBJECTIVE

The effectiveness of surgical resection of adenosquamous carcinoma of the lung remains poorly defined because of the histology's relatively low frequency, the failure in most published series to separate adenosquamous carcinoma from the other variants of non-small cell lung carcinoma. To define the effectiveness of treatment of adenosquamous carcinoma, we have retrospectively reviewed our hospital experience over a 12-year period.

METHODS

Retrospectively reviewed 22 cases of adenosquamous carcinoma who were surgically treated, except one patient, in the PUMCH from Jan. 1985 to Aug. 1997. This series constitutes the 1.9% of a total of 1 245 patients with all types of surgical treatment for the primary lung cancer during the same time.

RESULTS

The adenosquanous carcinoma was mostly presented in the old patients with a mean age of 60 years and mostly located in the peripheral of lung (n = 20). The overall 5-year survival was 23%. Those with stage I tumors survival was only 18% (n = 13), stage II 5%. The survival in stage III tumos was not longer than 25 months and in stage IV survival was not longer than 12 months.

CONCLUSION

Our results suggest that adenosquamous carcinoma of lung was a virulent tumor, which exhibited highly aggressive biological behavior with early lymph nodes metastasis (46%) and its prognosis was worse than that of both squamous cell carcinoma and adenocarcinoma.

A distinct mutational spectrum of p53 and K-ras genes in lung cancer of workers with silicosis

Crystalline silica was recently classified as a human carcinogen by the International Agency for Research on Cancer (IARC). However, the direct genotoxic effect of silica in humans remains unclear. We examined the p53 and K-ras gene mutations in lung cancer in workers with silicosis (LCWS). DNA was extracted from paraffin-embedded tissues and examined by PCR-RFLP, PCR-SSCP, and DNA sequencing. The mutation frequencies of p53 gene were high, but the mutation distributions in exons and among the histological types of LCWS differed from those of common (i.e., not silicosis-related) lung cancer. Furthermore, no mutations in codon 12 of K-ras gene (predominant in common lung cancer) were found in LCWS. These findings in the mutational spectrum support a carcinogenic effect of silica dust at the DNA molecular level.

[Evidence on the carcinogenicity of silica at DNA level in human]

The alteration of p53 and K-ras gene in 36 lung cancers of workers occupationally exposed to silica (LCWS) was studied. DNA was extracted from paraffin\|embedded tissues and amplified by PCR. PCR-SS-CP analysis on exons 5, 7 and 8 of p53 gene revealed that 43.8% of mutations were clustered in exon 8 of p53 gene. In ordinary lung cancer, the mutation rate of exon 8 was fluctuated around 20%. The prevalence of mutations was the highest (70%) in small cell lung cancer (SCLC) and the lowest in adenocarcinoma(33%). In our study the mutation rate was high in adenocarcinoma(53.9%) and low in SCLC (30.8%). The K-ras gene of LCWS also revealed a different mutation pattern. Unexpectedly, no mutation was found at codon 12 in 36 LCWS by PCR-RFLP, which is the predominant mutation in K-ras gene in ordinary lung cancer. The point mutation study by DNA sequencing confirmed the absence of codon 12 mutation in K-ras gene in LCWS. The mutations observed in this study were frequently distributed in codons 13 and 15, principally a G-C transversion, instead of G-T transversion in ordinary lung cancer.

[Management of thoracic esophageal perforation]

OBJECTIVE

To compare surgical management of esophageal perforation on thoracic portion with nonoperative management.

METHODS

Seventeen patients were treated for thoracic esophageal perforation at our department between 1962 and 1996. Among them, seven patients underwent nonoperative management. The remaining 10 had operative procedures (primary repair in 5, esophagostomy in 3, and drainage alone in 2 cases).

RESULTS

Postoperative leakage occurred in 2 patients; among the two leakages, 1 required cervical esophagostomy, and 1 became a controlled fistula needed pleural drainage and feeding jejunostomy. One patient had anastomotic narrowing after esophagostomy. Of patients with nonoperative management, five survived (with 28% in-hospital mortality rate), Whereas only one patient, who was treated by surgical procedure, died (with 10% inhospital mortality rate). The mean hospital stay in nonoperative and operative group were (28.3 +/- 12.9) days and (57.6 +/- 52.7) days respectively.

CONCLUSIONS

The clinical observation suggested that rapid diagnosis of thoracic esophageal perforations is essential and once the diagnosis of esophageal perforation is established, a appropriate management must be selected promptly.

p53 gene mutations in asbestos associated cancers

The accumulation of mutant p53 protein in cancer cells was observed by immunohistochemistry analysis. DNA was extracted from paraffin-embedded tissue. Exons 5, 7 and 8 were amplified and studied by PCR-SSCP and sequencing analysis. Ten cases of asbestos associated cancer tissue were studied, of which five cases had adenocarcinoma, and the other five had mesothelioma, squamous carcinoma, small cell lung cancer, adenosquamous carcinoma and malignant lymphoma respectively. Employing monoclonal antibody PAb1801, five cases were found to be mutant p53 protein positive. Seven cases were found to have mutations by PCR-SSCP. A total of 7 cases (8 mutations) were found to be positive and 4 cases were found to be positive by both of these analyses. Of the 8 mutations found by SSCP analysis, 4(50%, 4/8) were clustered in exon 8. A high mutation frequency was noticed in adenocarcinoma (80%, 4/5). Sequencing analysis on two specimens revealed two hotspot mutations. In codon 234, TAC for tyrosin was mutated to AAC for asparagine by a T to A transversion of the first letter. In codon 273, CGT for arginine was mutated to AGT for serine by a C to A transversion of the first letter. In conclusion, the mutation of p53 gene is common in asbestos associated cancers. However, the mutational spectrum of asbestos associated cancers might be different from that of non-asbestos associated cancers.